Psy problems in Juvenile centers

 By Charnicia E. Huggins 

NEW YORK (Reuters Health) - Psychiatric problems, such as substance use disorders and depression, appear to be common among youth serving time in juvenile detention centers, according to new study findings. 

  Mental health professionals have long speculated that many adolescents with mental health problems are being arrested instead of being treated, lead study author Dr. Linda A. Teplin of Northwestern University in Chicago, Illinois told Reuters Health. These findings do not prove that to be true, she said, but they do show the "tremendous burden that is placed on the juvenile justice system." 

Teplin and her colleagues investigated the prevalence of psychiatric disorders in a study of 1,829 randomly selected African-American, white and Hispanic adolescents aged 10 to 18 who were being held in Illinois juvenile detention centers. 

According to previous studies, nearly 60% of the more than 106,000 youth that are detained in juvenile facilities on an average day are African-American or Hispanic. 

Almost two out of every three male detainees and three out of every four females met the criteria for a diagnosis of one or more psychiatric disorders, the investigators report in the December issue of Archives of General Psychiatry. 

This prevalence of psychiatric disorders remained high even when conduct disorders, which are common among detained youth, were taken into consideration, the researchers note. Excluding those disorders, nearly 6 in 10 males and more than two out every three females still met the criteria for a diagnosis of one or more psychiatric disorders. 

Half of the adolescent males and nearly as many of their female peers had a substance use disorder, characterized by substance abuse or dependence, and more than 4 in 10 youth had symptoms strongly suggestive of a disruptive behavior disorder, the report indicates. Many of the youth also had affective disorders, such as depression, which was identified among more than 20% of the females. 

Despite these findings, it is not known whether the disorders caused the delinquency, made the youth more likely to be arrested and detained, or were just something common among the youth, the researchers note. Further, they add, the adolescents may have exhibited some of the symptoms in reaction to their detention. 

Adolescents are served by a web of public health services including the educational system, childcare system and the primary care health system, Teplin said. "I'm concerned that when these systems fail, kids fall through the crack into the juvenile justice net." 

But the juvenile justice system does not have the resources to provide adequate care for the many detained youth with mental health problems, the report indicates. And even if it did, most youth are detained for only about two weeks or so, Teplin said. Thus, the implications of the study findings stretch far beyond the justice system. 

"We have to spend the money" to provide the resources that will enable community mental health centers to provide "continuity of care when these kids are released," she said. "If we don't, these kids could be on a lifetime cycle of dysfunction as they age." 

The study was primarily supported by grants from the National Institute of Mental Health and the Office of Juvenile Justice and Delinquency. Additional funding was provided by the National Centers for Disease Control and Prevention (news - web sites), the Center for Substance Abuse Prevention, The Robert Wood Johnson Foundation and various other federal agencies and foundations. 

SOURCE: Archives of General Psychiatry 2002;59:1133-1143.