Blog: Adolescent Mental Health

One aspect of the Obama Administration’s Affordable Care Act that’s often overlooked in the media is its attention to mental health and substance abuse treatment.
Overall the landmark legislation hopes to bring near universal health insurance to the United States when the last round of its major provisions goes into effect on Jan. 1, 2014. These provisions include the controversial individual and employer insurance mandates.
But the law goes further though than just getting people insured, it aims to improve the American health care system, especially in the areas of mental health and substance abuse.
Mental health and mental health policy have been favorite topics in the news these last few years with the tragedies in Tucson, Aurora, and Newtown. Pundits from all sides have found a new pastime in discussing and arguing over how the system should be changed.
Opinions aside mental health and substance abuse are serious issues in America. About one in every four adults can be expected to experience a mental illness during the course of a given year, according to stats from the National Alliance on Mental Health (NAMI). That’s nearly 55.7 million people, no small number for a nation of 315 million.
That number of adults rises to one in 17 when talking about more serious mental illnesses like schizophrenia, major depression, or bipolar disorder. For younger Americans the rate continues to climb with one in 10 children living with a serious mental or emotional disorder, according to NAMI numbers.

Substance abuse is estimated to cost the United States over $600 billion annually. A 2012 survey conducted by the National Institute on Drug Abuse found that among teenagers alcohol and cigarette use has declined in recent years but the use of illicit drugs is on the rise.
So it’s no wonder that the Care Act looks to extend coverage and improve treatment of mental health and substance abuse. Let’s take a look at some of the ways it aims to do that.

Juvenile Justice Reform

• Efforts Sought to Rehabilitate Troubled Youth (Tribune-Democrat.com)
  While there have been drastic changes in the juvenile justice system in the wake of the “Kids for Cash” scandal, some advocates believe Pennsylvania has so far failed to widely embrace efforts to fully focus on rehabilitating troubled young people. One of the more innovative efforts in Pennsylvania involves the use of youth courts, in which young people themselves mete out justice for their peers.
• Bad Food, a Bible, and a Blanket: 24 Hours in Juvenile Solitary Confinement (Wired.com)
  As a photographer, how far would you go to get in the heads of your subjects? For Richard Ross, it meant 24 hours in solitary confinement at a juvenile detention center. Over six years, Ross has photographed hundreds of detention centers and interviewed more than a 1,000 children for a project called Juvenile-in-Justice that aims to educate people about the juvenile justice system. He’s as familiar as any outsider with the subject, but he decided it wasn’t enough.
• Past Traumatic Experiences Common Among Detained Juveniles (JJIE.org)
  Most young people placed in detention have experienced at least one traumatic event in their lifetime, according to a new report from the federal Office of Juvenile Justice and Delinquency Prevention (OJJDP). “PTSD, Trauma and Comorbid Psychiatric Disorders in Detained Youth,” released Tuesday, included findings culled from the Northwestern Juvenile Project, which assessed more than 1,800 young detainees in Chicago between 1995 and 1998.
• Nebraska Gov. Heineman Signs Juvenile Justice Reform Bill, Focusing on Youth Rehabilitation (TheRepublic.com)
  Nebraska Gov. Dave Heineman has signed a juvenile justice reform bill into law. The measure by Sen. Brad Ashford, of Omaha, is designed to shift the state's focus toward rehabilitation for youths who break the law. Heineman approved the legislation on Wednesday during a news conference.
• Gov. Heineman Signs Juvenile Justice Reform into Law (Omaha.com)
  The state embarked on a new approach in dealing with troubled juveniles Wednesday. Gov. Dave Heineman signed into law a major reform bill that shifts the focus from incarceration to treatment for youthful offenders and puts state probation officers in charge of that rehabilitation work instead of state social workers.

Juvenile Justice Reform

• Juvenile Justice Shows Progress (Illinois Times)
  When the Illinois Department of Juvenile Justice was created in 2006, the state’s youth prisons held 1,500 juvenile offenders. Today, there are fewer than 900 kids behind bars in Illinois juvenile justice system. It’s one sign of progress for the relatively new department, which was previously part of the adult-oriented Illinois Department of Corrections.
• Forsyth County Clerk of Court Wants to Turn Old School into a Juvenile Court (MyFox8.com)
  Forsyth County, N.C., Clerk of Court Susan Frye wants to see the now closed Hill Middle School in Winston-Salem turned into a one-stop shop for the more than 1,300 offenders who come through juvenile court each year. Frye says the courthouse is out of space and can not house the services the young offenders are often sentenced too. Hill closed last year after consolidating with Philo Middle School.
• Pennsylvania Finds 20 Percent of Juveniles Re-offend Within Two Years (JJIE.org)
  A new report issued by the Pennsylvania Juvenile Court Judges’ Commission finds that among juveniles whose cases were closed in 2007, one-in-five recidivated within two years. The Pennsylvania Juvenile Justice Recidivism Report found juvenile recidivism rates to be as high as 45 percent in some counties, with the average length between case closure and recidivism to be 11.5 months.

Al Jazeera English recently released an Inside Story 30-minute video examining the state of solitary confinement, including teens, in United States prisons. The discussion includes the following:  

Amongst those in solitary confinement today are juveniles as young as age 16, with one study suggesting that in 2012, 14 percent of adolescents in the New York City prison system had been held in isolation at least once. So, why does the United States put more people into solitary confinement than any other country in the democratic world?

We've reported in the past about the particularly harsh negative affects that solitary confinement has on teens, and while this video offers a broader look at solitary confinement, its themes are still relevant to our work in the juvenile justice system. Watch the full program below:
 

Juvenile Justice Reform

• Advocates for Juvenile Justice Reform Rally at Hearing for Bel Air Teenager Accused of Killing Father (DaggerPress.com)
  Friday’s demonstration came ahead of a motions hearing in Robert Richardson’s case, and was the latest organized by a group which seeks to have his case—and Richardson himself—moved back into the juvenile criminal justice system.
• The Crucial Role of Prosecutors in Juvenile Justice (JJIE.org)
  The role and responsibilities of the juvenile prosecutor are plentiful and extend well beyond the courtroom. In fact, in cases involving juveniles, much of the work can and should be done outside the courtroom. Working collaboratively with other youth-serving agencies in their communities, prosecutors often play a leadership role in these efforts.
• Senate Committee Approves Changes in Juvenile Justice System (AJC.com)
  The Senate Judiciary Committee approved proposed changes to the juvenile justice system Wednesday after making some adjustments to address concerns of judges. House Bill 242, which has passed the House, is designed to send fewer juveniles to state facilities for committing felonies and to divert kids who are not dangerous — especially so-called status offenders such as truants, runaways and the unruly — into less expensive community-based programs.

While we need to hold teens accountable for their actions, simply locking them up isn’t effective. Young people in the juvenile justice system need more treatment, better treatment, and support beyond treatment.
I encourage you to watch this brief interview with Wansley Walters, secretary of the Florida Department of Juvenile Justice. In the video, Secretary Walters shares her views on the importance of early assessments and prescriptive measures in juvenile justice reform. We need to continue this investment to stay on track and reduce crime. "As the resources pull away, the problem starts to creep back in," Walters says.  

Models for Change recently published an innovation brief, “Juvenile Justice and Mental Health: A Collaborative Approach,” [PDF download] that reports the benefits of a collaborative model for juvenile justice and mental health. Although teens with mental health problems used to be handled outside of the juvenile justice system, a shift in the 1990s placed “rehabilitation” responsibility to the juvenile justice system. From the report (emphasis mine):
High crime rates [in the 1990s] led to get-tough measures, including zero-tolerance policies in schools and criminalization of normal adolescent behaviors, that put more youths in the system. The closing of psychiatric hospitals, a trend that began in the 1970s, continued apace, while the community mental health system, initiated with such optimism in the 1960s, was being downsized. As a result, youths with mental health problems frequently ended up in the juvenile justice system, which could not refuse to serve them.
To better serve teens with mental health troubles, Models for Change recommends a framework for multi-system change, including (via the report):

Juvenile Justice Reform

• Department of Juvenile Justice Strengthens Oversight (PNJ.com)
  In the wake of allegations of abuse by staffers at a girls’ lockup in Milton, the Florida Department of Juvenile Justice is tightening its oversight of private residential facilities — adding interviews with youths and a partnership with the nonprofit Annie E. Casey Foundation to its monitoring procedures.
• Nebraska Chief Justice: Guardianship, Juvenile Probation Initiatives Show Success (Omaha.com)
  Tighter court oversight of guardians and conservators in recent months has exposed cases of theft and misuse of funds, Nebraska's top judge said Thursday. Chief Justice Michael Heavican said changes to state law made in 2011 are providing more protection for vulnerable adults in Nebraska.
• Georgia Governor: $5 Million for New Juvenile Diversions (JJIE.org)
  Georgia Gov. Nathan Deal is asking the state legislature to spend $5 million dollars to set up community diversion programs for low-risk youth offenders, on the model of other states. The appropriation would “create an incentive funding program” to encourage communities to treat appropriate youth at home, Deal told lawmakers at his annual State of the State address on Jan. 17.
• Florida Tightening Juvenile Justice Monitoring (WCTV.tv)
  Florida is tightening monitoring and improving the quality of juvenile justice residential and detention facilities. Department of Juvenile Justice Secretary Wansley Walters announced the new efforts on Friday. They come nearly a month after a privately owned facility for girls in the Florida Panhandle agreed to end its contract following the arrest of a staff member who was accused of battering a 15-year-old inmate.
• Study: Minority Youth in Wash. Arrested, Referred to Juvenile Court More Often than Whites (TheRepublic.com)
  Minority youth are arrested and in the Washington state's court system more often than their white counterparts, a recent study commissioned by the state Supreme Court shows. But researchers said counties aren't keeping complete data on ethnicity and the gap between minority and while youth is larger.
• Palm Beach County School, Justice Officials Warn Students Juvenile Crimes can Follow, Hinder Them as Adults (The Palm Beach Post)
  Sometimes, Sonya Saucedo gets mad. It happens: She’s 13 years old. But Saucedo said she worries sometimes about where that anger and frustration will lead her. “I’ve gotten in trouble at school a few times,” the Pahokee Middle School student said. “I once screamed at everyone in class and threw books.” So on Thursday morning, Saucedo tentatively approached the microphone at a school assembly to ask one question: How hard is it to get your life back after you’ve committed a crime?

Juvenile Justice Reform

• DJJ Study: Fewer kids Getting Booked at School (The Orlando Sentinel)
  A new Florida study says the number of students arrested at schools was cut in half over the last eight years, which ”correlates” with a decline in juvenile delinquency. The Department of Juvenile Justice report says school arrests fell from from more than 24,189 in the 2004-05 school year to 12,520 last year, a drop of 48 percent. School delinquency arrests fell 36 percent during the same period.
• Juvenile Defendants can Meet Victims, Settle Charges Outside Court (Courier-Journal.com)
  The suspect was caught on camera and admitted he caused about $1,800 worth of damage vandalizing a Louisville business. Instead of handling the 16-year-old defendant’s case in juvenile court, local officials asked the business owner, Keith Bush, if he would take part in a “restorative justice” pilot program designed to repair the harm caused by a crime and find ways to keep offenders from re-offending — instead of seeking only retribution.
• Juvenile-Justice Corrections Program Trains Dogs, Youths (Statesman.com)
  “This is a program where the girls can learn life skills through training these dogs,” said Mike Griffiths, executive director of the Texas Juvenile Justice Department. “It’s a small program that pays big dividends — for the girls and the dogs.” The dividends include allowing the dogs to be trained to erase their bad habits, or to at least teach them how to manage their problems and keep their actions in check, so they might be adopted into new homes, he said.
• Putting a Developmental Approach Into Practice (JJIE.org)
  Having developmental competence means understanding that children and adolescents’ perceptions and behaviors are influenced by biological and psychological factors related to their developmental stage. For adults working with young people, taking a developmental approach could lead to better outcomes for kids.
• Can Forgiveness Play a Role in Criminal Justice? (The New York Times)
  At 2:15 in the afternoon on March 28, 2010, Conor McBride, a tall, sandy-haired 19-year-old wearing jeans, a T-shirt and New Balance sneakers, walked into the Tallahassee Police Department and approached the desk in the main lobby. Gina Maddox, the officer on duty, noticed that he looked upset and asked him how she could help. “You need to arrest me,” McBride answered. “I just shot my fiancée in the head.” When Maddox, taken aback, didn’t respond right away, McBride added, “This is not a joke.”
• Looking Back and Casting Forward: An Emerging Shift for Juvenile Justice in America (Chicago-Bureau.org)
  The close of 2012 focused so narrowly on terrible events and startling numbers – the Newtown massacre, for example, or Chicago’s sharp rise in homicides – some major criminal justice developments were nearly squeezed out of the national conversation.