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.