Two-thirds of boys and three-fourths of girls in juvenile detention have one or more psychiatric disorders, according to research by Linda A. Teplin, PhD, of Northwestern University, and colleagues, published in the Archives of General Psychiatry (Vol. 59, No. 12).
"For years, people have speculated that juvenile justice is a dumping ground for kids who could be better treated in the mental health system," Teplin says. Moreover, she says that her study--funded by a consortium of federal agencies and private foundations, including the National Institutes of Health, the Office of Juvenile Justice and Delinquency Prevention, the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation and the William T. Grant Foundation--indicates the speculation may be correct.
"To our knowledge, this is the first large-scale study of mental health needs in detained kids," says Teplin. "It fills a hole in the literature. Until now, we knew a lot about who becomes delinquent but there were few studies of the health needs and outcomes of kids once they got into the juvenile justice system."
More than 109,000 youth are in U.S. juvenile facilities on an average day, according to the U.S. Department of Justice. Of that number, more than 60 percent are racial or ethnic minorities and come from low-income families. Youngsters with psychiatric disorders, especially minorities, may fall between the cracks into the juvenile justice net, says Teplin. This suggests there may be substantial health disparities in the community, she adds. The researchers studied prevalence rates of psychiatric disorders in 1,829 ethnically diverse teenagers between the ages of 10 and 18 in Chicago's Cook County Juvenile Temporary Detention Center.
The study found that one half of males and almost one half of females had a substance use disorder. More than 40 percent of males and females met criteria for disruptive behavior disorders and 20 percent of females met criteria for major depressive disorders. Teplin and colleagues say they are especially concerned about the high rates of depression and dysthymia in detained youth. Approximately 17.2 percent of males and 26.3 percent of females experience these disorders. Prevalence rates of many disorders are higher among females, the researchers found.
"Without better access to health-care system services during detention and upon release, teenagers with psychiatric disorders will continue to experience these problems," according to Teplin's colleague and co-author of the study, Karen Abram, PhD, also of Northwestern University.
Teplin echoes Abram's critique. "We are concerned about the future. Each year, more than one million kids cycle through juvenile court. If we continue to cut services, these kids may be likely candidates for the adult justice system."
This paper is the first of what the researchers anticipate will be many. "We have an unprecedented opportunity to examine critical public health issues and outcomes in an exceptionally high-risk group of kids," Teplin notes.
--J. MCKAY AND J. DAW HOLLOWAY
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