Wednesday, May 14, 2008

Frequency of mentally ill youth in juvie detention twice as high as previously believed

America has reached the point, sadly, where we treat prisons, jails and youth detention as substitutes for mental health treatment or else the only place where indigent people can access mental health care.

For adults the issues can be more complex, but for kids they're pretty simple: Criminalizing mental health problems only makes sense from a bureaucratic perspective (to get the person access to treatment), not from any viable theory of justice anyone could possibly describe.

Last week the Houston Chronicle's Sarah Viren published some astonishing data ("Survey of youth in custody find half have mental health problems," May 8):

Nearly half of the youths locked up in the Harris County Juvenile Detention Center suffer from mental health problems — far more than the estimated 20 percent with mental disorders in the general youth population — figures released Thursday show.

These youngsters, mostly teenagers, have been diagnosed with maladies including bipolar and attention deficit disorders, according to data compiled by a group of organizations studying the issue. Nearly 20 percent have severe emotional problems, the data show, and a quarter had never been diagnosed previously. ...

Researchers and juvenile justice workers have long noted a correlation between mental health issues and delinquency. In Harris County, however, juvenile offenders held in the detention center were not routinely psychologically evaluated until last year.

"When I go out and speak or just have conversations with the general public, they just don't realize that there are that many kids," said Harvey Hetzel, head of the probation department. "It's high and people need to realize that."

With the help of private foundation grants and public dollars, Operation Redirect spent the past year testing close to 3,500 juveniles in detention, or about 90 percent of those in lock-up awaiting a court hearing. That's up from 10 percent to 15 percent tested the previous year.

Identified problems ranged from mood to psychotic disorders for kids arrested for crimes such as theft, drug possession and violence against a family member.

Judge Mike Schneider, the newest member of the juvenile courts, said his cases frequently involve kids hampered by their mental issues.

"One of the things we see is either kids who commit offenses or violate their probation when they make the decision on their own to stop taking the medication that they are supposed to take," he said.

Of the youths with severe emotional disorders in juvenile detention, 22 percent had been physically abused and 12 percent were abused sexually, the new data show. More than half have experienced some form of traumatic loss.

Schneider said the county has options for those with severe problems, but could use more. Operation Redirect members voted Thursday to fund a pilot program, used successfully in other cities including Dallas, which works with mentally ill kids and their families.

These are pretty astonishing data, and a lot higher than already disturbing earlier estimates. As Scott Hickey from the Harris County MHMR authority reported in a presentation last year, when "Harris County matched mental health records with the juvenile probation rolls, they found 24.8% of kids matched." So a more thorough vetting of kids for mental illness, attempting to diagnose those who weren't already plugged into the system, nearly doubled that figure!

I asked my friends over at the Texas Criminal Justice Coalition - Leah Pinney and Isela Gutierrez - what resources they knew of that might help make sense of this figure, and they turned me onto a lengthy report on the identification and treatment of youth with mental health needs in the juvenile justice system (pdf), and pointed out this short YouTube video by one of the report's authors.


Thanks to Leah and Isela for sending along the extra info. I've not had a chance to read the report they mentioned, but wanted to make it available for those working on these issues. Perhaps I'll have more to say about this topic after looking over it more carefully.

23 comments:

Anonymous said...

There are "mental disorders" and there are "mental disorders." Over the years, kids referred to juvenile detention have shown increased numbers of mental issues and it keeps getting worse. Of course, the number of diagnoses increase yearly as well. Some are serious and some are flat ass amusing. I'll bet a large number of readers and posters here sufer from some kind of a "mental disorder" if not a half dozen. But, the problem is very serious. Depending where one lives, services are avaiable through MHMR. In other areas, MHMR plain ol' sucks. I live in one of those suckie jurisdictions. I have said for some time that the juvenile justice system in Texas, every year, becomes more and more a mental health oriented system than anything else and it worsens by the year.

One positive thing in Texas, though. TJPC employes a wonderful lady named Erin Espinoza and she's a mental health issue handler. Knows where all the bodies are buried in MHMR/Austin and is a hell of an advocate for local probation departments whos local MHMR agency is in the thumb sucking business. She'll bring fire down on the MHMR bureaucrats asses and make them do what they are lawfully charged to do. Erin! - Erin! - Erin!

Plato (of the Plains)

kbp said...

Grits, you touch on many interesting topics, always resourceful.

I just imagine young minds screaming "help me", only to meet the response of "after you serve your time..."

lawschoolinmate said...

Well, I'm not sure if it's surprising, given that adult mental health statistics are actually equivalent or higher. If you look at the Bureau of Justice Statistics' mental health report from 2006, 56% of state prisoners and 64% of jail inmates were deemed to have a mental health problem of some kind. For women, the number is astronomically high: 73% of women state prisoners. So it would make sense that the kids would have high numbers.

And while I am fully sympathetic to kids' mental health problems, I have to concur with the above poster that there are many kinds of mental disorders. If I came from an abusive home, had few role models, and engaged in crime, I bet I would display symptoms that could be classified as a "mental health problem." Heck, it wasn't that long ago that just being a criminal was classified as a mental illness. Perhaps we should be more surprised that there are any kids who _aren't_ exhibiting mental health problems.

The reality is that mental illness and incarceration go hand-in-hand and need to be addressed concurrently. I'm glad to see that the juveniles' needs are being addressed (or at least, I hope that they will be).

Anonymous said...

The correlation between mental illness and delinquency has been well known since the earliest years of the American juvenile court.

The nation's first juvenile court opened in 1899; within a decade, the National Committee for Mental Hygiene was formed to push alternatives to institutionalization for people with mental illness.

The juvenile court and mental health movements overlapped considerably in the early 20th century, most notably in the opening of the first child guidance clinics in the 1920s. These clinics often evaluated kids for juvenile courts.

However, this historical connection has not produced the desired results. As I see it, this story reflects two long standing problems:

1. Inadequate mental health services in the community, including in the public schools, which causes juvenile justice to become a de facto provider of last resort (kids are dumped into the system b/c its the only place they can receive needed services); and,

2. Inadequate mental health services in the juvenile justice system, and physical and social environments that often exacerbate mental illness.

Remedying each problem will cost money and demands a serious rethinking of current practices, at both the state and local levels.

Unfortunately I don't have time to read the linked report or I would comment more specifically.

Bill Bush

Anonymous said...

The Ombudsman made the claim in a legislative hearing that TYC has not adequately kept pace with the growth of the MH population at TYC. I heard him state that the "manifestation" of this is kids with MH needs populating suicide alert cells. I'll bet that is accurate.

dirty harry said...

Well, the ombudsman has finally taken notice of a major lack of services to special ed at Al Price, record falsification, and some lawbreaking in the process. In doing so, they have also discovered that it being done by two freeloading peices of dead wood on the payroll, who also don't show up for work half the time. Other employees in the education dept have been pointing this out to administration without results, and the IG has also turned a blind eye to it. I'm anxious to see if the ombudsman is actually going to prove they are worth their paycheck.

Gritsforbreakfast said...

Try to stay on topic, dirty harry. There's nothing in this post about special ed, TYC or Al Price. This isn't the place to complain about your co-workers.

dirty harry said...

Grits said:
"Try to stay on topic, dirty harry. There's nothing in this post about special ed, TYC or Al Price. This isn't the place to complain about your co-workers."

1) I don't work for TYC. I couldn't take the pay cut.

2) I thought we were talking about the high rate of incarceratd mentally ill youth. The fact that a high rate of mentally ill youth end up incarcerated is no big secret. Their problems usually don't get recognized or dealt with until they do something that gets them incarcerated in places like TYC. The problem is, (as others have already mentioned) that once they get into TYC, they don't recieve the services they need, and are just eventually released back out into society, no better off than they were. Special ed personnel are usually the front-line people who are first to determine that youth may have a specific problem, and then refer them to one of the other agencies through a shared service arrangement. However, that seems to be where the buck stops. However, the problem occurs up and down the food chain, and the IG and ombudsman know this, and they know full well where some of the specific "problems" are. But, unless you deal with some of the specific problems and personnel that cause them, all the lip service in the world isn't going to reduce the amount of mentally ill youth in TYC.

I merely used the opportunity, since the ombudsman was mentioned in the previous message, to state that they know where the problems exist. I'm waiting to see if they actually do something constructive about it.

Gritsforbreakfast said...

That's fine, dirty harry, but please express your opinions about fellow employees, Al Price, etc., in another venue. Enough's enough already.

Anonymous said...

The youth locked up are not the only ones who are suffering from mental illness. More than 2/3 of the adults locked up are also suffereing from mental illness.

The lock'em up mentality has to go away. Treat people who need help and don't just lock them up; this only tends to make their conditions worse and then they are released and the illness is worse due to the treatment they received locked up than when they were free, help, those who need help and stop locking everyone up!!!

dirty harry said...

Grits said:
"That's fine, dirty harry, but please express your opinions about fellow employees, Al Price, etc., in another venue. Enough's enough already."

You don't seem to get it. I don't work for TYC. Look at the time and date stamps on my posts. If you think I am a TYC employee sitting at my desk posting on this blog, then you haven't spent any quality time in those units.

As far as mentally ill youth ending up in incarceration, just what about the problem do you want to address? Mentally ill youth often don't come to the attention of professionals until they:

1) get referred for special ed testing by a public school teacher who notices something isn't quite right. Of course, this is no guarrantee that the public school system is going to properly follow up. Any time that an ARD comittee recommends off-campus special ed services, the district has to foot the bill. School administrators usually have the attitude that money would be better spent on new computers or buses for the football team.

2) End up breaking the law and get themselves incarcerated in places like TYC. (And, we already know what the chances of them getting the help they need are there.)

You might wonder why parents don't readily recognize when one of their kids are a little weird, and deal with it early. Some parents do. But, try being a special ed advocate in your spare time. You will learn quickly that the last thing many parents want to deal with is the fact that their kid is different from all the others. It can be emotionally devastating to parents. It's much easier for them to be in denial, and hope that the kid will just "grow out of it."

Anonymous said...

Hell this is Texas! If you are mentally Ill then we put you in prison cause we don’t want you all hanging around us normal folks cause they might commit some bad crime. Aint no use wasting money on crazy people. Damn crazy people are liable to kill some good folks. We need to keep tham locked up in prison and knocked out on cheap dope of some kind. You know a generic knock you out dope so they aint no problem to the prison guards. I damn sure don’t want them livin in my trailer park! I don’t want them crazy people bring down the property value on my double wide. Hell one of em might rape the little wife or molest my pit bull dog. It don’t make no difference if they are grown folks or kids if they are nuts lockem upand dopeem up! Most of you all must be Yankees cause that’s how you all sound. You all go on and on about stuff when there are easy answers to all this stuff. Either you putem in prison or putem down.

Roy D Mercer

Gritsforbreakfast said...

Dirty, I really don't care who you work for, though if you don't work for TYC I don't understand why you spend so much time talking trash about mid-level employees few others would care about. You're welcome here as long as your comments relate to the topic at hand. But I'm tired of seeing garbage spewed about individuals at specific TYC facilities in unrelated posts, and you're one of the offenders. Stop it.

Anonymous said...

I hate to say it but the majority of the reasons that these kids don’t get treatment for mental health issues in the incarceration setting is that there is not enough man power to do so. I don't currently know about institutions other than TYC, but I know in the past (and some currently) several JDC's in larger communities have had or currently have only 2 positions for full-time, master level or licensed professionals to provide therapy for these kids. In regards to TYC there is less than 1 master level therapist/LPC (Licensed Professional Counselor) per 100 youth. These are the qualifications for an Associate Psychologist. Previous reports indicated 1 per 10 youth. Hate to say it but this is incorrect. This is supposed to be true for the mental health facilities (there is only 2 of them) and they are not fully staffed. All other facilities are fully staffed if the ratio is 1 associate psychologist or a PhD level psychologist to 100 youth. I know it has been said before, but it must be said again; in order to recruit qualified and licensed professionals the state must offer more of an incentive. Yes, I mean paycheck. I, personally believe it is all about helping the kids, but TYC and the State of Texas can’t expect one individual who already works more than 50 hours a week (and doesn’t get paid overtime) to do the job of 10 people.

dirty harry said...

Grits said:
"Dirty, I really don't care who you work for, though if you don't work for TYC I don't understand why you spend so much time talking trash about mid-level employees few others would care about."

Have you ever given much thought that perhaps, that is why the agency is having such trouble? You can give all the lip service you want to what should be done, and who should be put in the drivers seat. But, unless people are doing their job and/or obeying the law at the unit level, it won't matter who is in charge in Austin. And, this particular topic falls right in line with what is wrong with that particular agency. Specific services aren't being delivered to those that need them. No matter what the rate of incarceration is for the mentally ill, unless you deal with their problems when they are finally incarcerated, then you will achieve nothing, other than releasing them back out into society with the same mental problems that got them incarcerated to begin with. And, when these individuals mature and have their own families, they often have an uncanny ability to pass their behaviors on to their offspring.

Grits then said:
"You're welcome here as long as your comments relate to the topic at hand. But I'm tired of seeing garbage spewed about individuals at specific TYC facilities in unrelated posts, and you're one of the offenders. Stop it."

My post does relate to the topic at hand. If you are one of those people that would rather talk abstractly about something rather than take specific action, I can understand why it may offend you, because it gets right to the root of the problem. But, just because you don't want to acknowledge it or deal with it, doesn't mean it isn't valid.

Hey, this is your sandbox, Grits. If you don't like the way I play in it, I'll gladly save you the trouble of having to lock me out of it. Believe me, I have just as little patience for "talkers" as you seem to have for "doers." I only offered what input I had because I thought there were some that were truly interested in why the mentally ill population in juvenile detention was high. There's nothing to talk about regarding the fact, because it's no secret. Those of us who have been working with special needs youth have known it for years. However, there is plenty that can be done about it, and I gave you big hint where to start.

Just remember though, talk is cheap. It takes specific action directed at specific shortcomings to solve a problem such as this topic adresses. Sitting around waxing abstractly in broad terms won't get it done. And, don't think for a minute that the lege in Austin wants to deal with it out of the kindness of their hearts. I've had more than one politician tell me in so many words, that the only reason they deal with special needs youth is because they have to.


PS - Your platform proposal for TYC will be carried by my county delegates to the state republican convention. It is a worthwhile proposal. Maybe some good will become of it.

Anonymous said...

Forrest Novy used to tell us, when he was director of Special Education, that 40% of TYC's population received Special Education services. On the two campuses I worked we had 78% Special Education and 62% Special Education respectively.

What this means is that these students had significant mental and psychological problems that impacted their ability to learn in school.

Two of TYC's top Psychologists presented a presentation to the TYC Board in 2003 that the entire population of TYC was under estimated on the amount of mental disorders among TYC students, and presented a needs assessment for providing more beds for these students. I was present for the presentation, I was impressed by the data and the degree os research that was put into the presentation. Nothing ever came of it.

Anonymous said...

BTW that presentation was by Lynda Reyes and Don Brantley.

Gritsforbreakfast said...

Dirty, if you're a doer, go do it and stop talking about others and topics unrelated to Grits posts. I don't see you doing much re: Al Price but complaining, over and over, about the same couple of people for many months. If you've got a problem with specific TYC employees, tell Richard Nedelkoff, but stop the anonymous, off-topic blog sniping.

I appreciate the news about the resolution passing, and I don't want to seem like I'm telling you to go away. But I'm going to put a stop to what I see as a destructive use of Grits comments. If you had the courage to put your name on the statements, and document them (and the courtesy to comment under related topics), that'd be different. But anonymous backstabbing does nothing but destroy the culture of th agency, and that's all I can tell you're "doing" here.

Gritsforbreakfast said...

BTW, dirty, by that last comment "all you're doing here", I was referring to your original, 8:37 offering. You wound your way back to the point of the post on the other ones. :)

dirty harry said...

Oh, I have a problem with more than just two TYC employees. And, I have the documentation to prove what I say. The reason I don't make it public here, is to protect certain employees throughout the units. But, hey, I'll be glad to show it to anyone who wants to see it in person. And, I have a box full. Certain people in Austin have already seen it. I'm waiting to see if anything happens.

But, as a previous poster above stated: "..that 40% of TYC's population received Special Education services. On the two campuses I worked we had 78% Special Education and 62% Special Education respectively. What this means is that these students had significant mental and psychological problems that impacted their ability to learn in school."

It has long been common knowledge by those working with the TYC youth that the special ed/special needs population at TYC was about 50 percent. Only at the last round of hearings did it actually slip out that the current official count was 46 percent. Yeah, we were guessing. But, we didn't miss it by much.

In a nutshell, you have this:

1) A certain percentage of the youth population has, or develops mental illness which, can lead to learning disabilities.

2) These learning disabilities show up in the childs' educational process, and may or may not be diagnosed, or addressed (as required by law) by the public school system.

3) This failure by the student to achieve in public school evolves into a failure to adapt well into society, and leads to criminal activity.

4) These juvenile offenders end up in places like TYC.

5) When they get to TYC, their problems are still not properly dealt with (as required by law) and they end up back out on the street, no better off than they were.

Ignoring this is just ignoring a major root of the problem that this thread addresses. Unfortunately, "ignorance is bliss" seems to be the most popular method used by those in charge to deal with it. When you recieve federal/state money to deal with special needs, you are expected to address their problems according specific laws that define you act within specific time frames in delivering services. Yes, laws do exist that state you have to deal with special ed/MHMR issues within specific timeframes. This still isn't happening in TYC, no matter what the people in Austin think.

Now, I didn't specifically address any TYC employees per say. Is this vagueness more in line with your posting requirements?

Anonymous said...

funding for MHMR was cut drastically years ago by the legislature.... there's the biggest problem... MHMR won't see anyone unless they qualify financially...otherwise it's left to parents to figure it our by themselves

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