Monday, November 26, 2007

Expanding mental healthcare in schools would reduce crime

Though this blog focuses on the Texas justice system, the reality is the justice system is the dumping ground for failures of state and local government in other arenas, particularly education and mental health treatment. When the education system fails, when mental health problems or childhood traumas go unaddressed, those systems' funnel all their failures into Texas jails and prisons.

So I'm thrilled to see the Fort Worth Star-Telegram's Steve Jacob present an excellent and informative article yesterday ("Mental health: Class dismissed?," Nov. 25) focusing on the need to improve front-line mental healthcare in schools, raising the profile of an issue that underlies quite a bit of criminal conduct. (I don't know comparable figures on the juvie side, but thirty percent of adult Texas prison inmates are former clients of the state's indigent mental health system.)

Here are some of the highlights of Jacob's article, but really you should go read the whole thing:

A 1995 study called schools the de facto mental health system for children and adolescents. Between 70 and 80 percent of children with mental health problems were seen by school personnel -- usually guidance counselors and school psychologists -- and for most of them, school was the sole source of care.

Yet that raises the question of whether school personnel with limited mental health expertise can adequately meet the clinical demands of treating emotionally and mentally disturbed children.

And funding? The Texas attitude seems to be: "Don't even try to go there."

An estimated 75 percent of children in the Texas juvenile system have behavioral health issues, and 30 percent of those in the juvenile system will end up in the adult system. An increase in the number of U.S. juvenile delinquents has been blamed in part on diagnosed and undiagnosed mental illness. Since 1991, there has been a 33 percent increase of children 7 to 12 years old appearing in juvenile court.

The relentless imperatives of the federal 2001 No Child Left Behind Act -- and the associated state standards such as those of the Texas Assessment of Knowledge and Skills -- have school administrators focusing on little else. They cannot afford to acknowledge -- let alone address -- the fact that a significant percentage of the nation's schoolchildren have often-undiagnosed mental disorders or are mentally scarred by their inability to deal with life's insults: broken homes, hopeless living conditions, abuse by adults and peer intimidation. A 1999 U.S. surgeon general's report said that the rate of suicide by those 10 to 14 years of age increased 100 percent from 1980 to 1996. During the same period, the rate increased 14 percent for ages 15 to 19.

About 20 percent of children have a diagnosable disorder at any given time, and 5 percent have serious, ongoing disorders.

School is considered a natural setting for mental health services. School is a familiar setting for students, easing the stigma and intimidation often felt in more traditional mental health settings. Cost of care has been found to be less in schools, compared with private or community-based services.

Convenience is also crucially important. Less than one-third of children who need mental health services are receiving them. But researchers discovered that when mental health services were introduced in a school setting, 98 percent of referrals obtained service, compared with 17 percent of students referred to traditional clinic-based programs

A 2004 Texas Education Agency survey of school-based mental health and substance abuse programs statewide showed just how outgunned school counselors are in dealing with these problems. The survey of 8,000 public schools showed that elementary school counselors spent about 33 percent of their time on mental health issues, declining to 18 percent in middle school and 12 percent in high school.

A 2003 study that found 71 percent of Texas public schools had guidance counselors, but only 28 percent employed licensed mental health professionals.
Jacob declares the state is "crippled by a shortage of mental healthcare providers," particular in the Rio Grande Valley and areas outside the I-35 population corridor.

In the story's final paragraph, Jacob puts his finger on the main reason Texas fails to focus resources on this problem: Though he doesn't use the words, basically stupidity and ignorance on the part of the general public:
There are myriad reasons for such paltry mental health spending. The chief reason likely lies in a survey that showed 71 percent of Texans believed mental illness was the result of emotional weakness; 43 percent said victims of mental illness bring it on themselves.
If we were truly engaged in a "War on Crime," this underlying fallacy would be the equivalent of the period before the Iraq War when the majority of the public believed Saddam Hussein helped plan 9/11. It's not just a misguided conception, but a starkly dangerous one.

For a "tuff" state whose leaders frequently adopt the mantle of "victims rights," this is an especially disturbing phenomena, since in more than a few cases the system punishes victims after the fact. All evidence shows victims themselves easily become predators when they cannot find justice or relieve their emotional pain, and that's even more true of juveniles. Practically speaking (i.e., setting aside for the moment what "should be" and focusing on what "is"), societal norms cannot reasonably be enforced on people with either an organic mental imbalance (like schizophrenia or bipolar disorder) or an extreme situational one (like post-traumatic stress disorder from physical or sexual abuse), at least not without honestly considering the situation as it faces each individual. To adopt such a callous attitude invites increased crime and recidivism.

It's not "soft" or "liberal" to think that failure to finance juvenile mental health care contributes to crime. You just have to read past Grits posts on the Texas Youth Commission to see how frequently mental health services, or their lack, crop up in juvenile justice discussions. In many cases, those unmet mental health needs are big contributors to criminal behavior. It's not the only factor, but it's a major one, especially for the most chronic and difficult offenders.


Anonymous said...

TYC was the main dumping ground for children with mental disorders. There was little real help for the children at TYC from UTMB. The lack of real mental health care for children in TYC is abuse of the highest order.

Anonymous said...


What is your opinion on vouchers?

I think that competition would produce schools that specialized in the needs of the children.

Instead of trying to make each local public school system fit all children- mentally ill, gifted, spanish speaking- vouchers would produce a variety of choices.

The mentally ill would not be trapped in a particular district, but could pursue the school that fit their needs.


Anonymous said...

I think this would cost alot of funding but I guess reducing crime might decrease funding for the schools. If you think i basicaly have no clue what im saying i dont :)

Help Out

Anonymous said...

To 11:43


Anonymous said...

I have always believed that the two biggest governmental failures that contributed to TYC's population are (1)a poor education system and (2) inadequate mental health treatment in that order.

Howard A. Hickman

Anonymous said...

"Expanding Mental Health Care in Schools Would Reduce Crime."

There's just no answer......

Well, there is but we can't say that. Nor that! Nor that! and we certainly cannot recommend that either. Nope that won't work. Did that! Hell no! It would never happen! I'll be thrown out of office if I did that! Call....he will know what to do! Shiiieeettt Man, just shoot the M.....F.....'. Did that caused a civil war. Someone else tried that and distroyed half the world. Make parents accountable! AHHH hell that won't work either, both my kids are parents.....!

Anonymous said...

Excuse me, but isn't the public EDUCATION system supposed to be EDUCATING children? Remember Reading...writing...math? But nowadays, due to a total systemic breakdown, the public schools are expected to provide everything else from parenting skills to family therapy. We try and then everyone cries about how Johnny can't read. And now ya'll are blaming the public schools for the woes of a lame ass agency like TYC (that can't even agree on a Use of Force policy). When's the last time any of you set foot in a public school? How about a special ed class like mine with 4 emotionally disturbed kids, an autistic kid, 2 MR kids and a couple of average IQ thugs?
And what do you think school "counselors" are trained for anyway? Academic counseling Einstein, NOT MH treatment. By the way, on my campus
we have a grand total of 2 social workers for almost 2,600 hormone charged, drama king & queen do the math.

Let's tell it like it is: Until folks put the tax money where their loud mouths are and adequately fund education, mental health, corrections, etc. so that good people can do their jobs right, then there really is no answer to this problem. Face it, we live in a society that doesn't blink when a steroid abusing idiot gets 20 Million a year for swinging a bat, but just try asking for a few million to fund after school tutoring or medication for mental illness or life skills training.

So yes, many children go through a lot of systems and countless of them ultimately end up in places like TYC and adult prisons. Well, it just goes to prove the saying that you always get what you pay for.

Anonymous said...

At one time, I worked for CPS - I found that agency to be failing kids, so I went to work for TYC. At least there, the majority of the people in management as well as in direct service, seemed to be intent on helping kids. Most of the kids I have seen in TYC over the past 17 years are what I would call CPS failures. Sure, there are some true criminals among them, some of whom come from good homes, but the vast majority come from backgrounds of neglect; neglect from their parents, neglect from the school systems and neglect from the very agencies, such as CPS and MHMR that are supposed to help them.

From whence does all the institutional neglect stem? From our state's refusal to spend the money necessary to provide the services they need. That is the same reason TYC has been failing - it has not failed for lack of effort on the part of most TYC employees (including those poor souls who used to inhabit central office).

What do our political leaders provide us with? Biannual cuts in funding, followed by flashy "reforms". It happened at CPS, it happened at MHMR, and now it is happening at TYC. When will it end? Old Salty

Anonymous said...

This would only happen when combined with stigmatization for those treated. Is this a good thing? I can just see the teasing and the false identification. Anyone who disagrees with the political agenda of schools will see the psychiatric counselor for "re education". Just like in the ole USSR.

Anonymous said...

One reason children are not receiving adequate mental health treatment is because the funding for such services is fundamentally broken. I am a counselor in private practice and I do not take children clients unless I have to because the demands on my time are different.

An adult client comes to my office for a 50-minute session, pays his bill and comes back next week for his next appointment.

A child client, however, comes to my office for a 50-minute session but then I'm expected to show up in court, at the school's IEP meetings and work with the parents. I still get paid for one hour but actually put 5-10 hours into the child's treatment that week.

I love working with children, but I'd got bankrupt if I tried to provide services to very many children.