At the first-ever congressional hearing on the subject of solitary confinement, Sen. Dick Durbin of Illinois recently observed that it’s not always “the worst of the worst” who are subjected to the practice. Mentally-ill inmates, immigrants and juvenile offenders are put in solitary as well. And perhaps, said a series of witnesses at the hearing, the time has come to rethink the issue. Many states are now doing just that. But the debate is not devoid of its own unique politics.
The Substance Abuse and Mental Health Services Administration (SAMHSA) and the John D. and Catherine T. MacArthur Foundation have teamed up for a new $1 million project to divert youth with behavioral health conditions away from the juvenile justice system and into community-based programs and services. According to SAMHSA, 60-70 percent of youth in the juvenile justice system have a mental disorder and more than 60 percent suffer from a substance abuse disorder. Many of these youth, SAMHSA says, wind up in the juvenile justice system rather than receiving treatment for their underlying disorders. Up to eight states will be selected competitively to participate in the new collaborative initiative. If selected, states would receive support to develop and initiate policies and programs to divert youth away from the juvenile justice system early.
The Rhode Island Youth Suicide Prevention Project (RIYSPP) will receive $480,000 to implement suicide prevention programs in select community organizations and public schools throughout the state, U.S. Sen. Jack Reed (D-Rhode Island) announced on Thursday. Suicide is believed to be the second leading cause of death among college students and third leading cause among youth age 10 to 24, according to the American Foundation for Suicide Prevention and the Centers for Disease Control's 2009 Youth Risk Behavior Survey. “Many young people who commit suicide have a treatable mental illness, but they don't get the help they need,” Reed said in a press release. “This grant will provide critical resources for prevention and outreach efforts in Rhode Island to help reach at-risk youth before it is too late.”
The grant will provide the RIYSPP with necessary resources to screen, identify and refer at-risk youth, and launch a media campaign to help educate adults about warning signs and how best to respond. Currently RIYSPP operates in six communities throughout the state, but will soon provide technical assistance to the Rhode Island National Guard and state's Veterans ' Administration in an effort to reach military personal and their families.
If you care about adolescent substance abuse treatment (and mental health treatment) this is really important. As I posted last week, SAMHSA is proposing big changes to its mental health and alcohol and drug treatment block grants. They want your comments by this Friday, June 3, 2011. Ho-hum, right? Far from it.
Gail Wasserman and her colleagues from the Center for the Promotion of Mental Health in Juvenile Justice at Columbia University published an important new study that was released mid-February in Criminal Justice and Behavior: "Psychiatric Disorder, Comorbidity, and Suicidal Behavior in Juvenile Justice Youth." It may be the best source of information yet on the prevalence of substance abuse and mental health disorders among youth in the juvenile justice system. We need accurate information. I've heard many practitioners around the country make the same mistake, claiming that "70 percent" of the youth in "the system" have diagnosable disorders. As I've said before elsewhere, this common mistake usually starts with a misreading of the 2002 study by Linda Teplin at Northwestern University.
85% of children treated for substance abuse also have mental health problems. The Child Welfare League of America reports this is a growing problem across the country. In addition, 23.1 million people age 12 or older needed treatment for drugs or alcohol in 2008. But only 9.9% of them got help at a specialty facility.
A growing number of states are looking for ways to assess and treat the mental health problems of children in the juvenile justice system. The newest report comes from the Berkeley Center for Criminal Justice at the Berkeley School of Law in California. An estimated 40 to 70 percent of teens in California’s juvenile justice system have mental health disorders and the numbers are rising. Researchers recommend some practical strategies:
Better definitions of mental health problems linking diagnosis with treatment options across the system
Proven screening and assessment tools
Outcome-based treatment programs
A four-year study of the juvenile justice system in California unveils alarming mental health problems:
An estimated 50% of teens arrested in California have a suspected mental illness. 75% have a substance abuse problem
The Healthy Returns Initiative is searching for ways to improve treatment options and outcomes for young offenders. The study reports on conditions in California’s Juvenile Justice System which sound a lot like conditions in Georgia: State and local budget cuts, insufficient staff to handle kids with mental health problems, shortage of placement options for children with severe mental illness and substance abuse. The Initiative worked with 5 counties, both urban and rural, to identify teens with problems. They found the key is routine, standardized mental health screening at the earliest point of contact with the system. They conclude ignoring mental health issues leads to longer and more costly stays in detention. Read more in the Sacramento Bee