Incarcerated Youth Needing Mental Health Care

Excerpts from the following report:

INCARCERATION OF YOUTH WHO ARE WAITING FOR
COMMUNITY MENTAL HEALTH SERVICES IN THE UNITED STATES

UNITED STATES HOUSE OF REPRESENTATIVES
COMMITTEE ON GOVERNMENT REFORM — MINORITY STAFF
SPECIAL INVESTIGATIONS DIVISION
JULY 2004

PREPARED FOR
REP. HENRY A. WAXMAN AND SEN. SUSAN COLLINS

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.

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. 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 finds 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 finds:

• 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.
  • A Louisiana administrator commented, “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.”

• 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% of all youth
  held in juvenile detention.
  • A Montana administrator wrote, “a majority of the youth held here are
    warehoused awaiting placement.”
• 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.”

Conclusion:

The unnecessary detention of youth who are waiting for mental health treatment
is a serious national problem. Detention facility administrators across the country
report that thousands of youth with mental health problems are being held
unnecessarily in the juvenile justice system. Inappropriate detention is dangerous
for youth and the staff of detention centers and is costly to society. Major
improvements in community mental health services are urgently needed.

A related report may be found at:

Juvenile Justice: By the Numbers
http://www.house.gov/reform/min/pdfs_108_2/pdfs_inves/pdf_health_mental_health_youth_incarceration_july_2004_rep.pdf