Mental Health and Substance Abuse

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Nearly one-third of teens report episodes of sadness, depression, and hopelessness (Eaton, 2006). Depression is defined as an illness when the feelings of sadness, hopelessness, and despair persist and interfere with a teen's ability to function. It is more than the normal, everyday ups and downs or the "blues," as some may refer to them. It also is not just situational, relating solely to the fact that the youth is incarcerated. The term clinical depression is used when this mood persists for more than a couple of weeks. Clinical depression is a serious health problem that can change behavior, physical health and appearance, academic performance, social activity, and the ability to handle everyday decisions and pressures (DSM-IV, 1994). These feelings may prevent youth from seeking preventive health care and complying with health regimens which can affect behavioral problems and eventual incarceration.

Between two-thirds and three-quarters of detained youths have one or more psychiatric disorders (Wasserman, McReynolds, Lucas, Fisher, & Santos, 2002). Federal courts have affirmed that under the U.S. Constitution's Eighth and Fourteenth Amendments, which bar cruel and unusual punishment and assure the right to substantive due process for youth in the juvenile justice system, detainees with serious mental disorders have a right to receive needed treatment as part of the state's obligation to provide needed medical care (Estelle v. Gamble, 1976; Ruiz v. Estelle, 1980; Madrid v. Gomez, 1995; Bowring v. Godwin, 1977). In addition to this argument that all children with mental illness are deserving of care, to ignore this major affliction may contribute to public health and legal problems such as continuation of antisocial behavior, higher health care use, and criminal recidivism.

Despite these known risks, this population remains largely underserved. According to a study done by Teplin, Abram, McClellan, Washburn, and Pikus (2005), there are two reasons juvenile justice youth may receive even fewer services than youth in the general population. The first is that juvenile justice youth (as previously discussed) are disproportionately poor, as well as undereducated; these characteristics limit the type and scope of mental health services that are sought and provided. Second, as many as 75% of detainees with mental disorders also have substance use disorders, which is a higher rate than found in the community. Capitated mental health care also affects service utilization by youth in the juvenile justice and child welfare systems. The Teplin et al. (2005) research suggested that as many as 13,000 detained youths with major mental disorders do not receive treatment every day. It was also noted that the juvenile courts may process more than 139,000 youths per year whose major mental disorders go untreated.

Many factors may influence service utilization, such as family pressure, environmental stress, having a primary care doctor, health insurance, and experiences with past services. These factors may be seen as hindrances or can conversely aid in recovery. The RWJ report found a greater distance from traditional support systems for teens who experience symptoms of depression (Bethell, Lansky, & Fiorillo, 2001). These juveniles were 12 to 21% less likely to report feeling connected to people in their school and are significantly less likely to report involvement in community activities. Forty-eight percent of adolescents with depressive symptoms said they could talk openly with providers compared to 65% without depressive symptoms.

A range of mental health and substance abuse treatment services are needed in criminal justice settings, as the problem of substance use is more pronounced within the detained population. Survey results among juvenile arrestees provide evidence of illegal drug use with more than half of the males testing positive for at least one drug; marijuana was the most frequently detected drug (National Institute of Justice, 1999). Another study concluded that 60 to 87% of female offenders need substance abuse treatment (Prescott, 1998). Substance abuse treatment services are often among the first to be cut during budget reductions. Security and supervision measures are seen as more important obligations than treatment plans when it comes to allocating funds.

Substance abuse treatment is not legally mandated in most correctional settings although it has been proven to have a tremendous effect on reducing the rate of recidivism among inmates. Treatment partnerships within the criminal justice system are time-consuming, and those involving mental health and substance abuse services require additional work. The decision to cut those services without regard to long-term outcomes usually has a detrimental effect (Chandler, Peters, Field, & Juliano-Bult, 2004).

Mental health and substance abuse were perceived as such a major problem among incarcerated juveniles that in 1997, the New York State Office of Children and Family Services (OCFS) implemented a statewide diversion initiative. The Mental Health Juvenile Justice (MH/JJ) Diversion Project has 10 county sites involving county probation and a mental health provider. While each site has its own structured program tailored to the needs of the youth in their community, there are some areas that are common to all 10. Each site is required to provide, at a minimum, the following: screening; assessment; direct services, including individual, group, and family counseling; and referral to mental health, substance abuse, and other community-based services. The variability is seen when it comes to the type of services available, when the youth is diverted, voluntary or mandatory participation, and treatment models. It has also been noted that youth in community-based treatment fared better than youth whose treatment was provided in institutions (Lipsey, 1992).

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Defeat Depression

Defeat Depression

Learning About How To Defeat Depression Can Have Amazing Benefits For Your Life And Success! Discover ways to cope with depression and melancholic tendencies! Depression and anxiety particularly have become so prevalent that it’s exceedingly common for individuals to be taking medication for one or even both of these mood disorders.

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