December 13, 2002
Psychiatric Disorders Prevalent Among Juvenile Detainees
CHICAGO— Mental health professionals have speculated for years that many adolescents with serious psychiatric disorders are arrested instead of treated. Yet, there have been few studies.
Now, a Northwestern University study has found that the majority of boys and girls currently detained in a juvenile facility in the United States have one or more psychiatric disorders.
This study, led by Linda A. Teplin, PhD, professor of psychiatry and behavioral sciences and director of the Psycholegal Studies Program atNorthwestern University’sFeinberg School of Medicine, appears in the Dec. 17 issue of Archives of General Psychiatry.
“The large number of detained youth with psychiatric disorders places a great burden on detention facilities. Detention centers were never intended to be mental health centers,” Dr. Teplin said.
The study, funded by a unique consortium of federal agencies and private foundations, is the first comprehensive investigation of psychiatric disorders and outcomes among delinquent youth.
More than 106,000 teens are in custody on an average day in U.S. juvenile facilities, and, of these, over 60 percent are racial or ethnic minorities and from low-income families.
Thus, psychiatric disorders in detained adolescents are a significant health disparities issue, Dr. Teplin said.
Dr. Teplin and colleagues assessed psychiatric disorders in 1,829 African American, non-Hispanic white and Hispanic teens who were 10 to 18 years old and randomly selected at admission to the Cook County Juvenile Temporary Detention Center. About 8,500 juveniles enter the facility each year for pre-trial detention and brief sentences. The Cook County facility was selected because it is typical of other urban detention centers nationwide.
Results of the study showed that, excluding conduct disorder, which is common among jailed youth, nearly two thirds of the boys and about three fourths of the girls had one or more psychiatric disorders.
About half of the detained teens had substance abuse or dependence. Overall, disorders were more prevalent among older youth and among girls.
“We are especially concerned about the high rates of depressive disorders among detained adolescents—more than17 percent of boys and 26 percent of girls,” Dr. Teplin noted.
Results of the group’s study show that teens with psychiatric disorders pose a challenge for the juvenile justice system and, after their release, for the larger mental health system.
Moreover, as welfare reform, managed care and a shrinking public health care system limit access to services, many poor and minority youth with psychiatric disorders may “increasingly fall through the cracks into the juvenile justice system,” said Dr. Teplin.
Co-authors on this study, from the department of psychiatry and behavioral sciences at the Feinberg School, were Karen Abram, PhD, assistant professor; Gary McClelland, PhD, researchassistant professor, and Mina K.Dulcan, MD,professor. Amy Mericle, School of Social Service Administration, University of Chicago, also was a co-author.
This study was funded by grants from the National Institutes of Health,Substance Abuse and Mental Health Services Administration,Centers for Disease Control and Prevention,U.S. Department of Justice,William T. Grant Foundation,Robert Wood Johnson Foundation and a consortium of other agencies.