Senator Wants Mentally Ill Youth to Get Care, Not Prison Term

Recently proposed legislation aims to extend and expand a federal program that diverts children with mental illness from the juvenile justice system, which has seen a massive influx of such young offenders in recent years.

The Juvenile Justice and Delinquency Prevention Reauthorization Act of 2009 (S 678), sponsored by Sen. Patrick Leahy (D-Vt.), would authorize increased funding for training juvenile justice personnel to recognize and refer for treatment youth offenders with signs of mental illness. The measure also would provide grants, for the first time, to fund prevention programs to keep children with psychiatric illness from entering the criminal justice system.

“A prevention component that targets children and youth at risk is long overdue,” said William Arroyo, M.D., co-chair of the Juvenile Justice Committee for the American Academy of Child and Adolescent Psychiatry (AACAP). “It not only aborts a trajectory of suffering and antisocial behavior, but it avoids enormous costs incurred by public systems when youth enter the juvenile justice system. Research supports this strategy.”

The measure would authorize $2.1 billion in juvenile justice grants to states over five years and require any state receiving such funding to develop plans to provide alternatives—when needed—to detention for youth offenders, including diversion to treatment for mental health and substance abuse disorders. Also required would be state plans to reduce the number of children who are housed in jails and awaiting placement in residential treatment programs. States would be expected to engage family members in the design and implementation of prevention and treatment services when a child is released.

States would have to supply a detailed accounting of how they are ensuring that juvenile suspects are offered mental health and substance abuse screening, assessment, referral, and treatment within the state's juvenile justice system. Those efforts must include use of evidence-based mental health and substance abuse screening and further assessments if an initial screening demonstrates a need for further assessment.

“It has become abundantly clear that mental health and drug treatment are fundamental to making real progress toward keeping juvenile offenders from reoffending,” said Leahy in a statement on the Senate floor. “This bill takes new and important steps to prioritize and fund mental health and drug treatment.”

According to Leahy, the bill's mental illness and substance abuse treatment provisions are needed because a growing body of research has found that jails are becoming the nation's largest facilities for people with mental illness. Mental disorders are up to three times more common among children in the justice system than in the general population, and 80 percent of people in the juvenile justice system have substance abuse problems, he said.

The legislation is supported by AACAP due to its emphasis on detection and treatment of mental illness and addictions as a way to help end the downward spiral of children with untreated health problems that drop them—sometimes repeatedly—into the nation's prisons.

Juvenile inmates “have higher rates of mental health diagnoses including learning disabilities and substance abuse compared with their peers,” said Louis Kraus, M.D., co-chair of AACAP's Juvenile Justice Committee. “Early education and intervention programs that target at-risk children and adolescents and work with them before, during, and after the adjudication process will reduce recidivism.”

The legislation to reauthorize the juvenile justice grant program is expected to advance because it has some bipartisan support and its sponsor is chair of the committee with primary oversight of this issue. But a repeat of Republican opposition that developed last year could derail it. In 2008 Republicans objected to an earlier version of the bill because it lacked measures to tighten management of the 30-year-old juvenile justice grant program, and it did not address previously identified instances of unauthorized spending by states of the juvenile grants.

Leahy's staff told Psychiatric News that the latest version of the bill is fairly similar to last year's measure.

The text of the Juvenile Justice and Delinquency Prevention Reauthorization Act of 2009 can be accessed at<http://thomas.loc.gov> by searching on the bill number, S 678. ▪