In the early 2000’s several reports began to document the existence of thousands of juveniles with diagnosed mental health issues sitting in detention facilities waiting for placement in a mental health facility. For instance, the Pittsburgh Post-Gazette surveyed 172 detention centers nationally and found that more than 40% of them “said children with mental health problems stay in detention longer than others because placements can’t be found for them.” The director of a detention center in Pennsylvania began tracking emotionally ill children at his facility when the numbers increased sharply – shortly after state officials closed a local state hospital’s adolescent unit. Most juveniles stayed an average of 11 days in his facility before placement, but for those with mental problems, the average was between 35 and 40 days.
A 2004 report by the U.S. Senate’s Governmental Affairs Committee concluded “thousands of children with mental illnesses await needed community mental health services in juvenile detention centers across the country.” One expert testified that: “Juvenile detention facilities lack the resources and staff to confront this problem; yet, corrections is being forced to shoulder the burden of the nation’s failure to properly diagnose and care for children with mental or emotional disorders.” The report identified 698 correctional facilities. At the time it was noted that detention centers were overwhelmed. A Pennsylvania administrator noted “mentally ill youth placed in juvenile detention facilities stress our centers more than any other problem.” Warehousing children awaiting mental health services is expensive. Juvenile detention facilities spend an estimated $100 million each year to house youths waiting for mental health services.
Since this time have there been any changes? Not much based upon a few recent reports. For instance, one study estimated 70% or more in secure juvenile detention facilities “may suffer with mental health and related disorders.” Not surprisingly, the costs to keep such youth in detention are greater than other youths. A California study of 18 counties found that the cost per youth was $18,000 greater than other youth; the study also noted that the costs of drugs administered to such youth amounted to an average of $4,387 per month.
One of the worst states (and there are many) is Mississippi. In March of 2010 the Southern Poverty Law Center filed suit against the state charging that: (1) Mississippi discriminates against children with mental illness by unlawfully separating them from their families and communities and by forcing them to cycle through psychiatric institutions that fail to provide adequate services; (2) The state ignores the ongoing needs of children with mental illness by failing to provide federally mandated and medically necessary home- and community-based mental health services. It was also noted that “Mississippi’s mental health system is defined by an over-reliance on institutions where hundreds of children with behavioral and emotional disorders cycle repeatedly through hospitals, emergency rooms, acute care facilities and residential centers. When children leave these facilities, they rarely receive necessary follow-up treatment.” Subsequent blogs will attempt to update this situation, in Mississippi and elsewhere.