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 From 1997 to 2011, researchers found, 63 percent of detained youth
who were hospitalized had a primary diagnosis of mental health
disorder, compared to 20 percent of their counterparts in the
community. The detained youth were also hospitalized a day or two
longer than their peers outside the justice system.
Previous studies have found that up to two-thirds of detained youth
have psychiatric disorders, lead author Dr. Arash Anoshiravani and
his team point out in the Journal of Adolescent Health.
“From my clinical experience, I would say the vast majority of those
who have mental health problems are coming in with them . . . it’s
not something that occurs within the juvenile justice system,” said
Anoshiravani, an assistant professor of adolescent medicine at
Stanford University Medical School and medical director of Santa
Clara County Juvenile Custody Institutions.
Health care and social services should be banding together to find
ways to help these youth before detention, he told Reuters Health.
Mental health disorders included in the study included anxiety and
stress, depression, and disruptive or psychotic behavior.
Accompanying problems included trauma, pregnancy and other medical
conditions.
Breaking the law often stemmed from psychological stress that hadn’t
been addressed, Anoshiravani noted.
“Whether it’s the child who was physically abused and has PTSD
(posttraumatic stress disorder) and ends up using drugs . . . or the
one that started selling drugs to buy food and clothes for himself
and his siblings after his ‘gang-banging’ father was deported . . .
these kids have experienced a lot of loss and a lot of adversity,”
he said by email.
“I think the issue for the kids who end up in our juvenile justice
system is, why haven’t we been able to meet their needs in the
community they’re coming from,” he said.
The study used a large California patient discharge dataset,
comparing mental health and accompanying physical and behavioral
problems in 11,367 detained youth and 1.9 million youth in the
community.
The detained youth tended to be older - 16 years old, on average,
versus 15 in the community comparison group. The detained youth also
tended to be on public insurance and from larger metropolitan areas
in California.
Compared to their nondetained peers, more of the detained black and
Hispanic youth were hospitalized for each of the problems included
in the study except pregnancy.
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Upon discharge, many more detained youth had substance abuse
problems than non-detained counterparts. More of the detained youth
also had anxiety and stress, depression, disruptive disorders and
psychosis than those in the community.
More girls tended to suffer from mental illness (74 percent) than
boys (58 percent), although more boys had trauma-related problems.
Detained youth overall suffered much more from trauma-related
injuries that involved assault or suicide attempts.
Janet Warren of the Institute of Law, Psychiatry and Public Policy
at the University of Virginia said the study underscores the high
rates of psychiatric diagnoses in detained youth and that community
mental health centers are not receiving enough funding to help such
youth.
“I think what has happened and part of the concern I certainly see
nationally is that kids are really put into the juvenile justice
system so they can get mental health services,” said Warren, who is
also a clinical social worker and adult psychoanalyst. “Often we are
unable to provide any type of mental health intervention in the
community, so that placement in detention becomes a way of accessing
these services for youth.”
If troubled youth haven't received psychological aid through mental
health centers or schools, they should ideally receive help in
detention centers, Warren told Reuters Health. But, she said, they
were often sent from detention to state facilities, which should be
reserved for more complex or confusing psychiatric conditions.
SOURCE: http://bit.ly/1gvM3qq Journal of Adolescent Health, online
July 21, 2015.
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