JUVENILE JUSTICE: Juveniles held in detention centres more likely to suffer mental health problems later

Summary: A Northwestern University study finds that five years after juveniles leave detention, almost 30 per cent of females are affected by one or more psychiatric disorders and more than 45 per cent of males are affected by one or more psychiatric disorders. The most persistent and prevalent psychiatric problem is substance-use disorder, especially for males.

[24 October 2012] - Mental health researcher Erika Ostrander never knows how the interviews she conducts with teenagers who have spent time at the Cook County Temporary Juvenile Detention Center will go.

"Every day is different. I never know what I'm going to run into: from people doing well, to people running into violence, to psychological distress," said Ostrander, who is a clinical field interviewer with the Northwestern Project, an effort at Northwestern University's medical school that its leaders say is the first large-scale, longitudinal study of the mental health needs and outcomes of delinquent youth.

"They share their experience living in parts of the city where violence is prevalent. … You learn a lot about people, in general. It's not always bad. You see someone in a traumatic environment, with a lot of obstacles, who is able to get through them, to stable jobs and families."

A total of 1,829 males and females, who ranged in age from ten to 18 when they were first interviewed at the Cook County Juvenile Temporary Detention Center between 1995 and 1998, have participated in the project. They have since been reinterviewed up to five years later, at most four times.

The work of Ostrander and others on the project, which began in 1995, has resulted in a series of scientific studies, the latest published this month in the Archives of General Psychiatry. That study, titled "Prevalence and Persistence of Psychiatric Disorders in Youth After Detention," found that five years after they leave detention, almost 30 per cent of females are affected by one or more psychiatric disorders and more than 45 percent of males are affected by one or more psychiatric disorders.

"Our study demonstrates that of the kids who come in to detention, many have psychiatric disorders. Many of them do OK. Many have disorders that persist as they age," said Linda Teplin, a professor of psychiatry and behavioral sciences at Northwestern and the lead author of the paper.

The most persistent and prevalent psychiatric problem is substance-use disorder, including both illicit drugs and alcohol, which is two to three times more likely to affect males than females. As they age, young women experience a more dramatic decrease in the occurrence of this disorder than young men do.

"We need to improve services for kids," Teplin said. "People have done a great job recognising girls' needs."

The next step is to address the needs of young men, she said.

Males make up 70 per cent of juvenile arrests and 85 per cent of the youth in correctional facilities, according to the paper and the Census of Juveniles in Residential Placement.

"We need to develop preventive interventions when kids return to communities," Teplin said. She recommends improving the link with mental health services "to prevent a revolving door between correctional facilities and communities."

John Landsverk, director of the Child and Adolescent Services Research Center at Rady Children's Hospital-San Diego, called the study "exceptionally good."

"It was very effective, first-rate epidemiology, Landsverk said. "There is really not another study in the United States of this size and of this rigor, and, I think, pretty interesting outcomes."

Research that involves youth is much more difficult to do, he said. "It takes a lot of money and enormous persistence. It's a very carefully written paper."

The study was funded by the National Institutes of Health, the Substance Abuse and Mental Health Services Administration and the Centers for Disease Control and Prevention.

"We always try to look for positive outcomes," Ostrander said. "I see a lot of people with strong perseverance. They keep trying. I'm a true believer that kids need a role model. It's key that there are role models in the community. When you provide positive role models for kids, if they have a connection, if they have somebody they can look up to, that can really make a difference." 

Further Information: 

• JUVENILE JUSTICE: Mental health resources and young offenders - state of art, challengers and good practices (International Juvenile Justice Observatory, June 2012) 
• HUMAN RIGHTS COUNCIL: Children and the Administration of Jusctice (March 2012) 
• CRIN page on Children in conflict with the law