Find a better way than lockup for mentally ill youth

I was about through interviewing Metro Juvenile Court Referee Carlton Lewis on Tuesday when he said, “'I never had any idea until I started working here that so many children who come through this court are diagnosed with a mental illness.

“I couldn't believe it. I'm talking about everything from attention deficit disorder to kids with severe emotional disturbance.”

I was talking to Lewis, who is my brother, about such youngsters following a recent congressional report that said 15,000 children with psychiatric disorders were improperly incarcerated last year because no mental health services were available. A story in The New York Times said the figures were compiled by the Democratic staff of the House Committee on Government Reform in the first such nationwide survey of juvenile detention centers.

“The use of juvenile detention facilities to warehouse children with mental disorders is a serious national problem,” Sen. Susan Collins, R-Maine, was quoted as saying.

The study found that children as young as 7 were incarcerated because of a lack of access to mental-health care. It said more than 340 detention centers, two-thirds of those that had responded to the survey, said youths with mental disorders were being locked up because there was no place else for them to go while awaiting treatment. It added that 71 centers in 33 states said they were holding mentally ill youngsters with no charges.

“Since coming to work here in 1998, I have observed that well over half of the youngsters who come into juvenile court have some form of mental illness,” Lewis said. “Starting with (Juvenile Court) Judge Betty Adams Green, we've made an effort not to let any child with a mental illness sit in here without getting the proper evaluation and treatment.”

And no child anywhere with a mental illness should be made to sit or be warehoused, even if he or she is in trouble with the law. This issue of children with psychiatric disorders is bigger than most of us probably want to believe. In Tennessee last year, a survey measured mental illness, substance abuse and developmental disabilities among youth in state juvenile justice facilities. The survey was conducted by a Juvenile Justice/Mental Health work group of 40 facilities across the state. On the day the survey was conducted, 1,215 youths were being held in custody. The work group, comprising of people who work specifically with children and youth, found that one quarter (27%) were being held prior to court decision and three quarters (73%) were post-adjudication.

The survey showed that:

Half (53%) of the youth in juvenile justice facilities were experiencing mental health problems.
One of every seven young people (15%) was on some type of psychiatric medicine while in the juvenile justice facility.
Two of every five young persons (42%) were known to have substance abuse problems.
Over one quarter (30%) of all the youth in juvenile justice facilities had co-occurring mental health and substance use problems.
The most frequent psychiatric diagnoses reported for youth in juvenile justice facilities were conduct disorder and depression.

So what happens to these youngsters? Do they get the treatment they need to be successful when they return to society, or are they just hidden away?

“In Tennessee, we don't have the resources that we need,” said Linda O'Neal, executive director of the Tennessee Commission on Children and Youth, and a member of the Juvenile Justice/Mental Health work group.

“And the reason we need to pay more attention to this issue and intervene in these problems is that if we don't we are limiting their opportunity to be successful and increasing the likelihood that we will have to support them later in mental health facilities or jails and prisons.”

Surely, that's not what we want.

And like O'Neal, Lewis says more observation and assessment centers are needed to enable more youngsters in trouble with the law and believed to have a mental illness to be assessed and get needed care. O'Neal and Lewis agree that more community-based service providers are needed, especially in rural areas of the state.

“Mental-health problems are brain-based diseases, and they need treatment just as diabetes and cancer when those diseases are detected,” O'Neal said. “We have to help these youngsters become successful, whether it is staying on their medication or getting a job or retraining for a job.

“It's the same as an adult with a mental- health problem.”

She's right. And while Tennessee may not be warehousing children with mental disorders, we still have a long way to go to say we're doing what we should be when it comes to this important issue. And, as is often said: Most of us know someone with a mental illness, and we know the good things that can come about when treatment is provided. These youngsters deserve just that.

Dwight Lewis
16 July 2004

http://www.tennessean.com/opinion/columnists/lewis/archives/04/07/54414332.shtml?Element_ID=54414332

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