Mental Health in the Juvenile Justice System

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I had to cut out a lot of info to meet the constraints but I hope you get my point.


Introduction

   The purpose of this report is to identify and describe the trend of inadequate mental health policies and factors related to substandard screening processes and treatment provided to at-risk juvenile offenders who are serving time in a juvenile correctional facility.  Since mental illness affects approximately 66% of incarcerated youth, with 40% having more than one disorder, the need for treatment is obvious but difficult to attain (Haegerich, and Tolan 123). 

   This paper will explore the similarities between the juvenile courts of the mid-1800’s and present day juvenile court.  The deinstitutionalization movement has created serious problems throughout the United States justice systems that we are still adjusting to today. Changes to national programs and policies that were designed to provide psychiatric treatment to both children and adults unintentionally created a massive mental health crisis.  The complexity of circumstances that surround the issue of treating juvenile offenders who suffer from mental illness are both enlightening and disturbing.  The reader will be able to compare the possible long term therapeutic benefits of treatment and weigh them against the enormous costs associated with these programs. An oscillating pattern will become obvious by the conclusion of this paper.



The Development of the Juvenile Justice System

   The first juvenile court was established in Illinois in the year 1899.  Society’s belief system regarding children had changed dramatically during this period.  In the early nineteenth century, children as young as seven would be charged with a crime and sentenced as an adult.  The child would serve his time alongside adult criminals in dangerous and deplorable conditions. 

Movement of Change

During the mid-1800’s a movement called the “child savers”, made up of men and women who believed that children needed to be nurtured and reformed through prayer, caused society to shift its belief to a more humane philosophy.   Usually middle to upper-middle class women sought out delinquent children and would take them to reformatories where they would be cared for and taught a trade in order to become productive members of society.  Institutions referred to as “Houses of Refuge” were being built in large cities such as New York, Boston, and Philadelphia.  These homes housed older children that were known to have behavior problems directly related to living in severe poverty. Crimes such as prostitution, gambling, vagrancy and public drunkenness were common.  Many children lived in deplorable conditions similar to the jails they once shared with hardened criminals and violent psychopaths.  Because of the “child-saver” movement, society’s perception of children shifted to reflect the reform and nurture philosophy (Shoemaker, and Wolfe 14-28).

The Deinstitutionalization Movement

Miracle Medication

   An unprecedented movement designed to change mental health program policies was prompted in part by the extraordinary results produced by a new and effective psychotropic medication.  Thorazine, the first effective anti-psychotic drug, helped patients experience relief from hallucinations, paranoia, delusions and increased their ability to function at higher cognitive levels allowing them to qualify for discharge  (“Deinstitutionalization: A Psychiatric Titanic”).  Patients who were diagnosed with disorders such as schizophrenia prior to the introduction of Thorazine would most likely live most of their lives in psychiatric institutions.

Money as a Motivator

      Politicians celebrated and supported the deinstitutionalization movement mostly due to economic opportunities to redistribute funds originally designated to support psychiatric hospitals.  Finance committees decided how funds would be redistributed back into community cultural programs that would benefit taxpayers in hope of generating political support in future elections. 

Ralph Slovenko, author of Psychiatry in Law/Law in Psychiatry explains that the government’s lack of planning to ensure there was adequate community based mental health support services available to the increasing number of patients upon discharge was directly responsible for the crisis associated with the deinstitutionalization movement in the following statement:

Given that economics was the primary motivation in the deinstitutionalization of the mentally ill, the tax dollars not spent on hospitalization did not follow the patient into the community.  During these changes, no one seemed to ask about the community in mid-twentieth-century America. …The sprawl of the suburbs has encroached upon and enhanced the value of the land of the historic asylums resulting in their demolition.  The new domicile of mental patients is the jail or the abandoned inner cities. (568-9)

The sudden discharge of such a large number of patients swamped every community based mental health clinic and created a mental illness crisis of epic proportion.  Patients who were in need of medication were unable to acquire a prescription.  Many patients attempted to admit themselves back in to any hospital that would take them (“Deinstitutionalization: A Psychiatric Titanic”). The movement created an unintentional mental health crisis that ultimately entered into detention centers nationwide.   Juvenile correction facilities were becoming holding centers for many displaced mentally ill juveniles, just as orphans and social misfits were housed in jails prior to 1899. 

In an interview with Frontline, a witness who observed the sudden surge of offenders suffering from severe mental illness during the years following the beginning stage of the deinstitutionalization process.  He stated “The [jail] system seemed to have inherited responsibility for these persons by default rather than preference.”  It is obvious that the number of people who were unintentionally displaced had very little or no support from family and friends and had nowhere else to go (“Deinstitutionalization: Psychiatric Titanic”). Figure 1 shows the drastic decline in the number of patients that had received in-patient psychiatric treatment between 1955 and 1995. 

Figure 1. Drastic Decline of Hospitalizations from 1955 to 1995.

“Deinstitutionalization: A Psychiatric Titanic.” Frontline. 2005. Public Broadcasting Station. Web. 24 Apr. 2013.

Juvenile Justice System

Initial Juvenile Screening and Assessment Process

The juvenile justice system operates with the offender’s best interest as the primary issue contrast to adult criminal court that is solely interested in the guilt or innocence of the accused.  Both systems work toward the same goal which is to ensure that justice is served in a fair and swift manner with the exception of terminology which differs.  The juvenile courts were established and expected to act as an equivalent to the parent and provide for the best interest of the juvenile that address the issues of punishment and rehabilitation.

   Intake officers, known as juvenile court counselors in North Carolina, and attorneys are responsible for screening referrals from law enforcement and parents, in states that grant parents petition privileges.  Intake officers have the responsibility of making critical decisions as to how a referral is processed. 

After a referral is deemed valid, an intake officer will begin the screening process.  The process should take place within two to three hours of the juvenile’s arrival.  Only screening tools identified as “evidenced based” have been proven to be valid and reliable and known to produce accurate results should be used.  Screening staff should have accurate training that relates directly to the tool’s procedure manual (United States. National Center for Mental Health and Juvenile Justice).

The accuracy of results measured by evidenced based screening instruments ensures that the recommendations compiled from information that is reliable and preserves the integrity of the pretrial assessment that will be used by the court to determine how to handle each specific case. 

The Reality of Dysfunction within the Juvenile System

   The intended purpose of the juvenile system is to provide an offender with support services that would decrease his chance of recidivism.  The reality is that the criminal justice system as a whole does not have the ability to function as intended due to lack of funding.  As the number of identified mentally ill juveniles increases, the criminal justice budget continues to decrease (MacReady). 

   Lack of funding cripples the system’s ability to function.  Since the majority of offenders are from low socioeconomic backgrounds, many rehabilitation programs that are required for an offender to complete actually become problematic due to expense.  Offenders and their families cannot afford to pay for these programs which then cause the offender to return to court to be fined for noncompliance of the initial court order.  This adds additional financial burden onto the offender and his family starting a cycle of recidivism, the polar opposite of the court’s intended results (McGarrel 563).

   The deinstitutionalization movement allowed for politicians to justify the redistribution of funds intended to support the mentally ill which continues to occur today.  The movement also changed society’s views on mental illness when hundreds of thousands of mentally ill patients were displaced among society causing social chaos.  The negative effects deinstitutionalization caused over the last six decades produces a negative outlook on the effectiveness of social programming, reducing public support of funding programs for mentally ill offenders.

Conclusion

   The juvenile justice system was created with the intention of stepping into the role of a parent in order to provide an individualized program of rehabilitative services in order to correct delinquent behavior and for the juvenile to function properly within society.  Lack of proactive political support for funding the juvenile system, and the continuing cuts to an already insufficient budget has caused the system to become ineffective and an unintended causation of juvenile recidivism. 

   Juveniles are not able to follow through with mandatory programming due to their family’s socioeconomic situation.  The increase of incarcerated juveniles produces overcrowding in outdated facilities that somewhat parallels the conditions that juveniles experienced in the nineteenth century. 

   Until proper funding of the system is a priority, the system will continue to malfunction.  The juvenile justice system is creating an unintended crisis and is increasingly incarcerating juveniles living in poverty who were identified as mentally ill. The juvenile corrections system, due to lack of funding is unable to provide effective long term treatment ultimately producing a holding center for misfits and the socially unacceptable.  This system has come full circle and has presently become an ineffective entity in need of change.

   

      




   


Works Cited

“Deinstitutionalization: A Psychiatric Titanic.” Frontline. 2005. Public Broadcasting Station. Web. 24 Apr. 2013.

Haegerich, Tamara M., and Tolan, Patrick H. “Delinquency and Co Morbid Conditions.” The Oxford Handbook of Juvenile Crime and Juvenile Justice. 2012 ed. New York: Oxford UP, 2012. Print.

MacReady, Norra. “US Faces Crisis in Mental Health Care For Juvenile Offenders.” Lancet 374. 9690 (2009): 601 Academic Search Complete. NC LIVE. Web. 22. Apr. 2013.

McGarrell, Edmund, F. “Policing Juveniles.” The Oxford Handbook of Juvenile Crime and Juvenile Justice. 2012 ed. New York: Oxford UP, 2012. Print.

Shoemaker, Donald J. and Timothy W. Wolfe. Juvenile Justice. Santa Barbara: ABC-CLIO, Inc., 2005. Print.

Slovenko, Ralph. Psychiatry in law/law in psychiatry. Eds. Taylor & Francis. New York: Brunner-Routledge, 2002. Books.Google.com. Web. 22 Apr. 2013

United States. National Center for Mental Health and Juvenile Justice. Blueprint for Change: A Comprehensive Model for the Identification and Treatment of Youth with Mental Health Needs in Contact with the Juvenile Justice System. January 2006. Web. 22 Apr. 2013.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders