黑料正能量 Note: The article below offers devastating but excellent details and statistics of how mental health programs in schools and communities can prevent behavior that leads to the incarceration of youth. Mental health screening and treatment options are sorely needed for young people, particularly as behavior that is related to mental health and trauma is often criminalized and/or inaccurately pathologized when not addressed early. Another way to reduce institutionalization and prevent unnecessary recidivism, social exclusion from education and employment, and wasted taxpayer dollars is to of youthful offender status, an initiative with broad support in NYS and a legislative priority for the 黑料正能量 community.
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Harvard Political Review; Olivia Herrington, 3/2/2015
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A single instance of incarceration in a young person鈥檚 life听听the risk of future imprisonment, at a听听to taxpayers of $240.99 per day. Living in jail听听the mental, emotional, and behavioral problems with which these children and adolescents must struggle. And mental disorders and youth incarceration already share an alarmingly strong link. As James Barrett, a psychologist at the Cambridge Health Alliance and in Harvard Medical School鈥檚 Department of Psychiatry, said in an interview with the HPR, a 鈥渕assive overlap鈥 exists between the two groups. While just听听of all American youth live with one or more mental disorders, that proportion jumps to听听for the juvenile justice population.
Most of these minors鈥 mental illnesses could have been mitigated through earlier treatment, particularly in schools; however, in-school support is often inadequate or absent. As Alison Barkoff, the Director of Advocacy at the Bazelon Center for Mental Health Law, told the HPR, 鈥淭he best ways to divert kids with mental health needs from getting into juvenile justice in the first place [are] finding ways to support them in their communities, in their families, [and] in their schools.鈥 For youth at risk of incarceration for mental health-related activities, then, filling that gap is especially vital.
To Face Prison
A small percentage of incarcerated youth are unsurprisingly diagnosed with a conduct disorder, a term that听听a young person who harms or is threateningly aggressive toward others. Yet even听听conduct disorders, 61 percent of males and 70 percent of females involved in the juvenile justice system struggle with mental disorders at the start of detention,听 anxiety disorder, attention deficit hyperactivity disorder (ADHD), bipolar disorder, and major depressive disorder. The rate of psychosis, a severely distressing and debilitating condition, is 听that of the general population.
Furthermore, the majority of these youth are not dangerous. Just听听of those in the juvenile justice system are imprisoned for truly violent offenses. Many听听legal penalties for far less distressing behavior that is听听with fighting a听, such as truancy or other minor school infractions. Youth as young as听听听in the juvenile justice system after struggling with undiagnosed mental disorders. Only a small fraction of children and adolescents who need treatment for mental disorders ever听听it, and the care within the juvenile justice system is often the best their communities can听.
But historically, this approach has not been successful at听听mental illnesses, and it has听proved听听for effecting change. Rather, it may be more useful to provide treatment before young people enter the justice system. University of Massachusetts Medical School professor Thomas Grisso told the HPR that he considers such programs to often be a better solution听and cites听many that have been established recently in locations across the country. 鈥淭hose with mental health problems can be dealt with more adequately in the community,鈥 he explained.
Currently, half of high school students with a mental disorder听听of school, the highest rate of any disability. Their failure to graduate听听them at greater risk of health problems and with little future in the working world, which are听risk factors for delinquent behavior. In keeping with the zero-tolerance policies many schools have adopted for breaking even minor rules, other students who live with mental disorders such as emotional disturbances are听 and sent into the juvenile justice system. Barkoff commented, 鈥淢any kids with mental health needs or behavioral disorders are very badly supported in schools, and what we call the school-to-prison pipeline is happening for a lot of these kids. 鈥 If you look at the referral rate of kids into juvenile justice from school, it鈥檚 a very high proportion of kids with mental health needs.鈥
To Receive Care
Access to school-based mental health care can听听these students support that will let them remain and succeed in school. Schools already recognize the need for better mental health care: many听听for a mental health professional than the typical school nurse, according to Julia Lear of The Center for Health and Health Care in Schools in a 2009 interview with the Monitor on Psychology. Barkoff, too, explained that 鈥渟chool is certainly a very big piece of [supporting youth with mental disorders], but so is the children鈥檚 mental health system.鈥 Merging expertise from both fields, then, may offer an effective way to reach these young people.
The Children鈥檚 Defense Fund, a national organization that advocates for children鈥檚 rights, 听improving access to mental health care to be among the 鈥渒ey immediate action steps鈥 with potential to prevent what the organization calls the 鈥淐radle to Prison Pipeline.鈥 Students are听听to use a school health center鈥檚 mental health services than similar services offered elsewhere in a community, since they feel more comfortable when they are familiar with听the setting in which they receive care. And even with the current shortcomings of schools鈥 mental health capabilities, the majority of young people who are in treatment for mental disorders still听听that help through their schools. Therapists and teachers can 听to address a range of needs, keeping youth both psychologically healthy and academically successful鈥攖wo significant factors that听听against juvenile delinquency.
Of school health centers operating now,听听include some kind of mental health care, but fewer than 2,000 centers听听as of 2009. Many schools throughout the country听听even the number of guidance counselors that the U.S. Department of Education considers adequate. Raising the percentage of licensed clinical social workers, psychologists, and child and adolescent psychiatrists in schools is vital in providing the level of support required for young people battling mental disorders. That support is unattainable without intentional and sustained effort: the听听of American counties lack even one child and adolescent psychiatrist, and neither social workers nor psychologists are permitted to prescribe medication, a step that is sometimes needed. According to Barrett, even in Cambridge, Massachusetts鈥攁 city with extensive mental health resources鈥攎ental health professionals 鈥済et filled up quickly in terms of caseloads, and sometimes we鈥檒l hear these stories of families on month-long [or] two-month-long wait lists.鈥
School-based mental health care also offers a cost-effective way to treat children and adolescents. Though the model requires government funding, the sum that the Department of Education听听to provide the needed staff is relatively small. On the other hand, juvenile incarceration听听an average of $148,767 per year per person (10 times the cost of attending public school for 13 years) and lacks the transformative and equalizing power that school-based mental health care possesses. Children growing up in low-income households听听more likely to struggle with a mental disorder and less likely to receive adequate insurance to support treatment. Health centers in these children鈥檚 schools thus are able to reduce, or even eliminate, that discrepancy in a manner that avoids detention.
To Gain Protection
Barrett adds that an integral piece of this effort is 鈥済etting people to talk to one another鈥 through facilitated communication among school officials, mental health professionals, and police departments鈥 youth officers. He was part of a team in Cambridge that created the Cambridge Safety Net Collaborative, an initiative that achieves this very goal. In the last five years, Barrett reports, Cambridge鈥檚 juvenile incarceration rate has dropped roughly 60 percent, while its rate of referral to mental health resources has risen. The Cambridge Safety Net Collaborative does not yet possess data explicitly linking these two trends, but the inverse relationship between them is encouraging. And studies in听听and听听have shown mental health treatment to be effective in preventing juvenile crime, establishing strong support for this sort of program. 鈥淚t really comes down to these issues of identification and access,鈥 said Barrett. 鈥淭he more schools can identify kids who are at risk before they show delinquency, the better able we would be to get them hooked up with services.鈥
Minnesota has already听听a school-based program to keep young people with serious mental health needs out of the juvenile justice system. The model is designed to be applicable to any school in the nation and depends on collaboration among mental health professionals, school officials, families, and the students themselves. Students who engage in behavior involving a serious infraction receive mental health and trauma screening, a practice University of Massachusetts Medical School professor Gina Vincent supports. In an interview with the HPR, she explained, 鈥淚 think generally the kids start acting out and, for some reason, they come to the attention of a teacher or principal or a school psychologist or school counselor and, from there, they should get screened. Mental health screenings in schools, set up in a thoughtful way, would be 鈥 [a] very good way to divert kids from getting into juvenile justice.鈥
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