|
 Lack
of Mental Help Keeps Kids Locked Up
Stays in detention cost millions, survey finds.
by Jack Kresnak, Detroit Free Press, July 7, 2004
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Thousands of
children sit needlessly in the nation's juvenile-detention
facilities because they need mental health services, costing
those facilities more than $100 million a year, according to a
survey commissioned by two lawmakers to be released today in
Washington.
Juvenile-detention facilities have become, by default, a
last-resort placement for many mentally ill or emotionally
disturbed children, said Leonard Dixon, director of the Wayne
County Juvenile Detention Facility in Detroit.
"Kids are coming into detention who really should not be in
detention; they should be served in the community," said Dixon,
who is among six experts scheduled to testify before the Senate
Governmental Affairs Committee today in Washington.
Such youths "are more difficult to manage, more explosive, more
easily agitated, require more intensive supervision and create
more strain on direct-care staff than other youths within a
juvenile-detention facility," said Dixon, who is president of
the National Juvenile Detention Association.
The survey, commissioned by Rep. Henry Waxman, D-Calif., and
Sen. Susan Collins, R-Maine, found that during a 6-month period
of 2003, nearly 15,000 youths -- about 8 percent of all children
in more than 500 centers surveyed from 49 states -- were in
detention because there were no suitable mental health services
available for them. The survey was conducted after years of
complaints by advocates for mentally ill people and incarcerated
youths. The average length of stay for most juveniles at the
Wayne County facility is about 18 days, Dixon said, but kids
with serious mental health needs stay more than twice as long
because there are not enough suitable mental health programs for
them.
Between May 1, 2003, and May 31, 2004, 4,152 youths ages 10-17
were admitted to the Wayne County facility , and 2,331 of them
-- 56 percent -- were identified as needing mental health
services, Dixon said. Those children were treated in the mental
health clinic at the detention facility.
But juvenile detention is expensive -- $350 a day per child at
the Wayne County center. Dixon said many community-based mental
health programs are less expensive.
So why isn't the less expensive option used more often? Under
federal spending restrictions, children from poor families who
are eligible for Medicaid are cut off from federal funding if
they are placed in a public juvenile detention facility. But
families often face difficulty in accessing care or they lack
insurance, according to the survey. Also, there are often
waiting lists for community mental health programs.
The survey found that staff members at the nation's
juvenile-detention facilities are overwhelmed by youths who
often cannot be easily segregated from other delinquents. The
youths have mental health problems that include depression,
substance abuse, retardation, learning disabilities such as
attention-deficit/hyperactivity disorder and schizophrenia, the
survey found.
In his testimony today, Dixon will give three examples of youths
with mental problems in his facility. One, a 16-year-old boy,
stabbed a classmate in the neck with a pencil without warning.
When placed at the Wayne County facility, the youth was
psychotic and depressed. He was declared incompetent to stand
trial and placed in a mental health facility in another state
because his parent could not get him into a Michigan facility,
Dixon said.
Another youth, an 11-year-old girl, was placed in the center
after assaulting her mother. Her family had a history of bipolar
disorder, and she had previously been treated in a psychiatric
hospital.
Dixon said the girl's mother, who suffered from depression,
decided to let her daughter stay in detention for three months
to "teach her a lesson."
"The family should have been engaged in outpatient therapy, and
the detention system should not have been used to separate the
child from her mother," Dixon said.
The third youth was a 15-year-old boy who had been in foster
care for several years because of abuse and neglect. Dixon said
the youth preferred the juvenile-detention facility and called
it "home." The boy, diagnosed with depression, is still at the
facility because there is a lack of a suitable alternatives,
Dixon said.
Ninety youth-advocacy organizations have signed a letter to the
Senate Government Affairs Committee on which Waxman and Collins
serve, asking that the various systems involved with children --
such as the juvenile justice and mental health departments -- be
allowed to collaborate more effectively with flexible federal
funding. Then the dollars will follow the children who need
mental health care.
Along with Dixon, others set to testify are Waxman; Carol
Carothers, executive director of the National Alliance for the
Mentally Ill of Maine; Tammy Seltzer, senior staff attorney of
the Bazelon Center for Mental Health Law; Chief Judge Ernestine
Gray of Orleans Parish Juvenile Court in New Orleans, and
Kenneth Martinez, director of children's behavioral health of
New Mexico's Department of Children, Youth and Families.
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