October 18, 2005
Few Mentally Ill Juvenile Detainees Get Treatment
CHICAGO—More than 130,000 juveniles are held in juvenile facilities on a given day. More than one in six of them have a major mental disorder. Most do not receive treatment, a Northwestern University study has found.
The study of nearly 2,000 juvenile detainees aged 10 to 18 years, published in the October issue of the American Journal of Public Health, showed that only 16 percent of detained youths who needed mental health treatment received it—either at the correctional facility where they were being held or in the community.
“Interestingly, the detention center did a better job than the community services,” said Linda A. Teplin, PhD, lead author on the study.
About 15 percent of detained youths received mental health treatment in the detention center, compared with about 8 percent who received treatment in the community.
Dr. Teplin is Owen L. Coon Professor of Psychiatry and Behavioral Sciences and director of the Psycho-Legal Studies Program at Northwestern University’s Feinberg School of Medicine.
Dr. Teplin and colleagues assessed the need for mental health services among male and female youths randomly selected at admission to the Cook County Juvenile Temporary Detention Center in Chicago. To determine who received services, they examined records from juvenile justice and public health agencies. The Cook County facility was selected because it is typical of other urban detention centers nationwide.
“This is a national problem,” Teplin said. “The U.S. Department of Justice estimates that 1.1 million youths are referred to juvenile courts each year.”
This is the first large-scale prospective study to examine whether detained youths who need mental health treatment receive it (in either the detention center or the community) before disposition of their cases.
A participant was considered “treated” if any mental health treatment was provided—including psychotropic medications or contact with a mental health professional—within six months after the juvenile’s intake to the detention center.
Significantly more girls than boys received needed mental health treatment either in the community or in the detention center (41 percent versus 13 percent, respectively). The demographic group least likely to receive treatment was African American males, aged 14 to 18 years (7 percent).
Dr. Teplin and co-researchers suggest that future studies examine the increasing number of youths transferred to adult courts or housed in adult facilities.
“We also need to know what happens to these kids when they become adults and transition from the systems that serve youth—primary care, mental health, education, child welfare, and juvenile justice—to the systems that serve adults,” Dr.Teplin commented.
“Collaboration is key. Mental health and juvenile justice systems must work together to improve services for underserved demographic groups, especially racial/ethnic minorities,” Dr. Teplin said.
Although juvenile crime is relatively similar across race/ethnicity, the U.S. Department of Justice finds that, nationwide, racial/ethnic minorities constitute 29 percent of arrestees, 62 percent of detainees, and 60 percent of juveniles who are serving sentences.
Findings from the Northwestern study suggest that these disparities carry over to the provision of mental health services. “If adequate mental health services are not provided in the community, these kids may fall through the cracks into the juvenile justice net,” Dr. Teplin noted.
“The challenge to public health is to provide accessible, innovative, and effective treatments to a population that is often beyond the reach of traditional services,” the authors stated.
Collaborating with Dr. Teplin on this study were Karen M. Abram, PhD, assistant professor of psychiatry and behavioral sciences; Gary M. McClelland, PhD, research assistant professor of psychiatry and behavioral sciences; Jason J. Washburn; and Ann K. Pikus.
This work was supported by grants from the National Institute of Mental Health (RO1MH54197 and RO1MH5946), Division of Services and Intervention Research and Center for Mental Health on AIDS, and Office of Juvenile Justice and Delinquency Prevention (1999-JE-FX-1001). Other major funding was provided by a consortium of other federal agencies and private foundations.