Mentally ill youth go straight to jail

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July 2004

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Mentally ill youth go straight to jail
A new congressional study reports that thousands of mentally ill youths are being "warehoused" in criminal detention facilities across the country because there is nowhere else for them to go.

According to the study, a survey of more than 500 juvenile detention centers in 49 states, "the inappropriate incarceration of youth who are waiting for community mental health services to become available" is "a serious consequence of the health system’s failure to ensure effective mental health care."

More than 160 of the 524 centers surveyed reported suicide attempts by youths held unnecessarily.

"The last place some of these kids need to be is in detention," the study quoted a Tennessee juvenile center administrator as saying. "Those with depression are locked up alone to contemplate suicide. I guess you get the picture."

One Louisiana administrator told investigators, “The availability of mental health services in this area is slim to none. . . . We appear to be warehousing youths with mental illnesses due to lack of mental health services.”

The U.S. Surgeon General has found that debilitating mental disorders affect one in five U.S. youth, but access to effective treatment is often limited. The study, prepared at the request of California Rep. Henry Waxman, the House Government Reform Committee's top Democrat, and Sen. Susan Collins, R-Maine, chairwoman of the Senate Governmental Affairs Committee, notes that "without access to treatment, some youth with serious mental disorders are placed in detention without any criminal charges pending against them. In other cases, such youth who have been charged with crimes but are able to be released must remain incarcerated for extended periods because no inpatient bed, residential placement, or outpatient appointment is available."

According to the report, "This misuse of detention centers as holding areas for mental health treatment is unfair to youth, undermines their health, disrupts the function of detention centers, and is costly to society.

The report argues that "the use of juvenile detention facilities to house youth waiting for community mental health services is widespread and a serious national problem."

The report found:

• Two-thirds of juvenile detention facilities hold youth who are waiting for community mental health treatment. These facilities are located in 47 states. In 33 states, youth with mental illness are held in detention centers without any charges against them. Youth incarcerated unnecessarily while waiting for treatment are as young as seven years old.

• Over a six -month period, nearly 15,000 incarcerated youth waited for community mental health services. Each night, nearly 2,000 youth wait in detention for community mental health services, representing 7 percent of all youth held in juvenile detention.

• Two-thirds of juvenile detention facilities that hold youth waiting for community mental health services report that some of these youth have attempted suicide or attacked others. Yet one-quarter of these facilities provide no or poor quality mental health services, and over half report inadequate levels of training.

A Missouri administrator stated, “Youth who are banging their head or fist or feet into walls or who are otherwise harming themselves must be restrained creating a crisis situation. . . . [C]onsequently detention staff have to divert all resources to that one youth for an extended period of time.”

• Juvenile detention facilities spend an estimated $100 million each year to house youth who are waiting for community mental health services. This estimate does not include any of the additional expense in service provision and staff time associated with holding youth in urgent need of mental health services.

A Washington administrator wrote, “We are receiving juveniles that 5 years ago would have been in an inpatient mental health facility. . . . [W]e have had a number of juveniles who should no more be in our institution than I should be able to fly.”

While this survey was not designed to assess why so many youth are incarcerated to wait for community mental health services, juvenile detention administrators cite difficulties accessing community residential treatment, inpatient psychiatric care, outpatient mental health care, and foster care services. As an Ohio administrator stated, “Most youth with mental health concerns are housed here whether appropriate or not as there are minimal mental health resources provided . . . for them.” According to experts in mental health and juvenile detention, the survey results likely underestimate the full scope of the problem.

The report concludes: "Major improvements in community mental health services are urgently needed to prevent the unnecessary and inappropriate incarceration of children and youth in the United States."

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