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Article of Interest - Mental Health

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Bridges4Kids LogoLack 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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