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State and local groups reach out to troubled juveniles

Sunday, August 19, 2001

By Steve Twedt, Post-Gazette Staff Writer

Mentally disturbed teens in Pennsylvania lockups are about to get more help.

First, the state's maximum security juvenile facilities will soon implement uniform mental health screening of their residents, and second, the Mental Health Association of Allegheny County has volunteered to assist troubled youth at Shuman Juvenile Detention Center.


A four-part series by Steve Twedt on mentally ill teens trapped in juvenile lockups.



In another development, the incoming deputy secretary for the state Office of Mental Health and Substance Abuse Services has asked county administrators for proposals to enhance mental health services for youths in the juvenile justice system.

Last month, a four-part Pittsburgh Post-Gazette series, "It's a Crime," detailed how mentally ill teens nationwide were trapped in lockups because privately run mental health group homes would not accept them and couldn't be forced to do so. The stories documented how youths with bipolar disorder, schizophrenia and other serious mental illnesses often spent months in detention centers while awaiting placement.

In the four weeks since the series appeared, these developments have taken place:

*Jim Johns, head of the Department of Welfare's Bureau of State Children and Youth Programs, has directed all 13 Youth Development Centers -- the juvenile system's maximum security lockups -- to start using the same mental health screening already under way in several Pennsylvania juvenile detention centers by Oct. 1.

*Beginning this week, child advocate Bonnie McConnell of the nonprofit Mental Health Association of Allegheny County is scheduled to participate in Shuman's weekly mental health meetings, in which officials discuss how to help their mentally troubled teens. With parental consent, she will coordinate an array of possible support services for teens and their families, both during their stays at Shuman and after they leave.

*The state Office of Mental Health and Substance Abuse Services is offering two $125,000 grants to county mental health/mental retardation offices to "increase the availability, accessibility, scope and effectiveness" of services to mentally ill and emotionally disturbed youths in the juvenile justice system. The goal will be to set up pilot programs to better coordinate services and improve the continuity of treatment between mental health and juvenile justice agencies. The application deadline is Oct. 1.

Detecting problems quickly

The new statewide mental health screening at Youth Development Centers "has promise to benefit the system," the Welfare Department's Johns said. "It will be a consistent way to do a quick assessment, so we can align our resources in a particular direction."

The screening, called the Massachusetts Youth Screening Instrument, or MAYSI, has been used in the state's major county detention centers, including Shuman, as part of a research project run by the Juvenile Detention Centers Association of Pennsylvania and funded by the Pennsylvania Commission on Crime and Delinquency.

The MAYSI test asks the teens such questions as whether they hear voices or if they've felt like killing themselves. MAYSI screening is not designed to diagnose mental health or psychiatric problems, but is meant to give caregivers a quick idea of how troubled a youth is.

Lead consultant Elizabeth Cauffman, an assistant professor at UPMC's Western Psychiatric Institute and Clinic, has been analyzing MAYSI data collected at 10 detention centers in the past year and has found startling results. Cauffman discovered that 34 percent of teen girls in detention say they've thought of suicide and more than 40 percent of boys report delusional thoughts that may suggest a psychotic disorder. More than 30 percent of all detained adolescents say they've witnessed or been victims of violence, rape or other trauma.

Including data from maximum-security youth development centers, Cauffman said, will help determine if a commonly held impression is true -- that mentally disturbed teens tend to get driven further and further into the corrections system.

"We really do need a better understanding of who these kids are in the system, and at all points of the system. It will allow the system to better understand who their kids are and how to service them. And maybe we can divert them to better programs."

The 800 or so adolescents in the maximum security lockups already undergo varying levels of mental health testing. But each center may use a different approach or methodology, which makes comparisons unreliable.

After observing what the detention centers have done, Johns decided he wanted the youth development centers to use the MAYSI screening to get "more solid, concrete information on the needs of the kids, where they go in the system and what resources are needed."

Extra layer of help

As for the new Mental Health Association program at Shuman, McConnell said, the group has been developing programs for schools, but that the Post-Gazette stories prompted them to look at Shuman and reconsider their approach.

"Normally, we wait for the parents to contact us. In this case, we have a plan to say, 'Hey, here we are.' " Shuman officials say the association's presence will be a welcome addition to its services.

"Anything that can be done to follow up and advise families will be good, because that's kind of a weak area," said Alex Wilson, director at Shuman. "Parents may be unaware of some things, and the mental health association may be able to give them a little bit more direction."

After one meeting, McConnell has identified a teen whom she thinks she can help.

The 17-year-old was judged delinquent for marijuana possession but had no history of violence or other serious crime. He has been diagnosed with attention deficit and hyperactivity disorder, and McConnell said his behavior had worn his parents down. With the parents unwilling to take him back, the teen is about to be sent to a group home in Erie County after spending more than two months at Shuman.

"Right now, he's very depressed" because he wants to continue at the same North Hills school he has been attending, McConnell said. She's trying to find a local group home or foster family that will allow him to do that.

In coming months, the mental health association also plans to offer training for Shuman staff and its residents, said Terri DeFazio, who manages health services at Shuman.

"If you look at traditional delinquent kids, their behavior is inappropriate because of choices they're making. They're in control and making those choices, for whatever reason. So, to an untrained mind, it's hard to understand that these mentally ill kids don't have the full capacity to control themselves. They're not actually managing their own behavior."

She also believes that talking to other Shuman residents will help sensitize them to mentally ill teens whom they might otherwise pick on. "One problem with kids who develop anti-social behaviors is that they tend not to be able to connect with anyone else's emotions," DeFazio said. "This may teach them to empathize with others."

At the same time, she added, more services and training are a poor substitute for placement outside detention where the teens can get the therapy they need. "This isn't the best milieu for the kids, but we've got them."

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