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U.S. detention centers becoming warehouses for mentally ill youth

Sunday, July 15, 2001

By Steve Twedt, Post-Gazette Staff Writer

Juvenile detention centers are supposed to be a temporary stop for troubled youths before they go someplace else: jail, foster care, a treatment facility, or home.

But they become warehouses for many mentally troubled teens.

Directors at detention centers throughout the nation underscored that point in their responses to a Pittsburgh Post-Gazette survey done for this project. More than 40 percent -- 72 of the 172 centers responding to the survey -- said children with mental health problems stay in detention longer than others because placements can't be found for them.

Among the 12 Pennsylvania detention centers responding, 11 cited a shortage of placement options as the reason that juveniles with mental health problems stay in detention longer.

Alex Wilson, director of Allegheny County's Shuman Juvenile Detention Center, started tracking emotionally ill children at his facility after a noticeable jump in their numbers four years ago -- shortly after state officials closed Mayview State Hospital's adolescent unit.

On average, juveniles stay at Shuman for 11 days before placement or release, Wilson said. Among those with mental health problems, though, the average is 35 to 40 days.

"When they closed those big facilities and put them in the community, more and more children wound up in the juvenile justice system. A lot of times, it might not be that serious a charge, but they still end up in detention."

And they stay there.

When officials at the Grand Rapids, Mich., detention center checked the records of children who stayed longer than 30 days, for example, they found that 60 percent had significant mental health problems.

Susan Dufreche, director of programs at Florida Parishes Juvenile Detention Center in Covington, La., said the average stay is 40 days. But they've had children with mental health problems stay six months, nine months and a year, respectively.

The Post-Gazette sent the survey to more than 650 juvenile detention centers across the United States, and officials at 172, or about 25 percent, responded. Because the survey was voluntary, the results may not be representative of all centers.

But one theme came up consistently -- detention centers have more children with serious mental health problems than they used to, and have more trouble finding help for them.

At the 14-bed Stevens Point, Wis., center, mental health children stay longer because "not as many facilities want to deal with serious behavior problems or persistent mental health issues," wrote administrator Ross Dick.

In Texas, several mental health treatment centers have closed in recent years with the emergence of managed care, wrote Thomas Faschingbauer, chief psychologist at the Fort Bend County Juvenile Probation Department in Richmond, Tex. "One almost has to go to jail to get treated for mental illness now."

Other findings from the Post-Gazette survey:

*Overall, 1 of every 10 centers reported that 80 percent or more of their residents had a diagnosable psychiatric problem. The range among all centers went from one small center in New Mexico that said none of its 21 residents had psychiatric diagnoses, to centers in Arkansas and Ohio that said 90 percent of their residents were on psychotropic medications for mental health problems.

*Several centers said they had no idea how many psychologically impaired children they have because they only screen those considered suicide risks.

*Centers in Canton, Ohio, and Newark, N.J., reported more than 40 suicide attempts each year. Shuman Center in Allegheny County has about one each week, although it has had only one completed suicide, in 1988. The Post-Gazette also found 12 newspaper reports of other detention centers where suicides had occurred since 1995, but only three of those centers responded to the survey, and only two of the three answered the question about suicides.

*The 172 centers average slightly more than five emergency psychiatric hospitalizations each year, but some centers report nearly one each week. Santa Maria Juvenile Hall in Santa Maria, Calif., now experiences one emergency hospitalization a month at its 52-bed facility -- triple the number five years ago.

These hospitalizations also can be expensive. On June 21, Santa Maria Director Wayne Nichols said he had to hospitalize two suicidal teen boys. But because the state had closed two local mental hospitals for juveniles four years ago, he had to send them to private hospitals -- at a cost of $2,000 a day.

A few places said they have no hospitalizations, but only because their local hospital now refuses to treat the children, forcing detention officials to try to stabilize the youths themselves.

"We send children to the hospital, they're labeled 'conduct disorder,' and then they're sent back because they say they can't control them," said Brent Norris of the Galveston County, Tex., detention center.

And even when centers can find placements, they often end up getting the teens back later on.

In May, Shuman had such a return visitor, a young man who is now 19 and was brought back to Shuman for an unspecified probation violation.

During his previous stay, from October 1998 to mid-March 1999, he fought constantly with staff and other residents. In his disturbed mental state, he sometimes smeared his feces on walls. Wilson said probation officers "scoured the state" for mental health programs that would accept him.

"They just would not take him because of the mental health issues." Ultimately he was sent to a special program in Texas.

Now he's back and "we're starting all over again," Wilson said grimly. "Unfortunately, I don't see a real bright ray of hope for this particular kid. He will be in the juvenile justice system until he's 21," when he will be set free.

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