On July 7, the Senate Governmental Affairs Committee held a hearing entitled, “Juvenile Detention Centers: Are They Warehousing Children with Mental Illness?”
During the hearing, Chair Susan Collins (R-ME) and Rep. Henry Waxman (D-CA) released a House Government Reform Committee staff report on the incarceration of youth who are awaiting community mental health services. Approximately 500 juvenile detention facility administrators in 49 states were surveyed for the report, which contains a number of key findings:
Sen. Collins explained that “over the six-month period covered by our report, nearly 15,000 incarcerated youth were detained solely because they are waiting for mental health services. Many were held without any charges, and the children incarcerated unnecessarily while waiting for treatment were as young as seven years old. Finally, the report estimates that juvenile detention facilities are spending an estimated $100 million of the taxpayers’ money each year simply to warehouse these children and teenagers while they are waiting for services.”
Arguing that Congress must ensure that adequate mental health services are available to all children, Rep. Waxman stated, “We must reform a confusing and bewildering mental health care system so that it works for the benefit of children and their families…We must insist upon accountability, so that someone is held responsible each and every time a child is jailed to wait for mental health services. We must work together not as Democrats or as Republicans, but as Americans who care about children and their families to end this warehousing of youth who are in need of treatment.”
Testifying on behalf of the National Alliance for the Mentally Ill, Executive Director Carol Carothers argued that juvenile detention centers are the worst possible environment for children with mental illnesses: “In criminal justice facilities the symptoms of mental illnesses are often misinterpreted by inadequately trained staff as disobedience, defiance or even threats. I have seen this first hand. Often well meaning, but untrained corrections’ staff, respond to these behaviors with anger, discipline, or even force. When staff are allowed to resort too quickly to threats and force in the face of non-compliant adolescent behavior, minor incidents escalate and the risk of harm increases for both the child and the officer. Many of the techniques used in correctional settings like prolonged isolation and restraint actually lead to increased, not decreased acting out and self-harm, particularly among youth with mental illness.” She also noted that families would have less contact with their children once they are housed in a juvenile detention facility, and younger children are especially vulnerable to physical and sexual assaults inside the facility. Ms. Carothers cited research that found that “serving kids in the community and close to home whenever possible leads to more stable lives and better outcomes and often saves the state money over institutional care. It costs fifty to eighty thousand dollars a year to lock a child up in a detention facility and about $30,000 to provide intensive in-home services for a family for one year.”
Tammy Seltzer, an attorney with the Judge David L. Bazelon Center for Mental Health Law, said that for children with mental illness to remain outside of the juvenile justice system, “children and families must have ready access to mental health services and supports, and this access must be based on ‘kid time,’ not bankers’ hours. Services and supports must be designed to enable children to succeed at home and school, not just avoid detention. Child-serving agencies must be held accountable for serving children well and not rewarded for pushing them off of the agency rolls and into the juvenile justice budget. In particular, schools must be responsible for educating and supporting all of their students; communities must not allow schools to shirk their duties by suspending, expelling, and calling the police on students whose behavior could be effectively addressed using positive behavioral supports. In addition, states and the federal government need to do more to end insurance discrimination and to serve the uninsured.”
Leonard Dixon, executive director of the National Juvenile Detention Association, explained that female youth with mental illness pose a challenge to the juvenile justice system that is not often specifically addressed: “There is a serious need for specialized services to address the fastest growing population in the field of juvenile justice girls and youth with mental health issues. Most females entering the juvenile justice system have been physically and sexually abused and require protection from perpetrators, often in their own families. Specialized and gender-specific services for girls are limited and male programs cannot be painted pink to give the impression that they were designed for a female population.” He recommended that gender-specific mental health services for girls be developed to address “the multi-layered problems underlying their delinquent behaviors.”
Many of the witnesses expressed their support for legislation pending before Congress, including: 1) the Keeping Families Together Act (H.R. 3243/S. 1704), which is designed to end the practice of forcing families to give up custody of their children to access mental health services; 2) the Senator Paul Wellstone Mental Health Equitable Treatment Act (H.R. 953/S. 486), which would end the discriminatory caps on private insurance coverage for mental health services; and 3) the Mentally Ill Offender Treatment and Crime Reduction Act (H.R. 2387/S. 1194), which would promote collaboration among criminal justice, juvenile justice, mental health care, and substance abuse treatment systems in order to provide individuals with mental health services.
