Mercury News Article re Lack of Mental Health Services

June 15, 2009

California’s Locked-Up Children Languish without Mental Health Services

By Karen de Sá  |  Mercury News  —

The lengthy detention of a mentally ill 11-year-old boy in Santa Clara County’s juvenile hall has raised alarm among national juvenile justice experts. But while the jailing, recently reported by the Mercury News, is rare, it reveals a far more common problem: Counties throughout California struggle each day to find appropriate places for juvenile offenders with severe psychiatric problems.

Though few counties have detained a child so young for so long — the round-faced boy arrived in the hall almost 11 months ago — hundreds of young people statewide languish in lockups awaiting mental health treatment.

A 2003 survey of county juvenile facilities found 800 young California offenders queued up for mental health services because of a dearth of residential treatment and community resources. The detention placed those youth at high risk of suicide and aggressive behavior, according to the survey, which was prepared for Congress.

In a subsequent report summarizing problems in 10 California counties, the San Francisco-based Youth Law Center found that mentally ill teens “are regularly thrust into California juvenile hall beds” that are neither designed nor staffed to deal with them. County probation departments reported that “without exception,” the condition of such teens deteriorated while in custody.

Caregivers for the South Bay boy, who is charged with molesting a 4-year-old, say he is getting worse under the strain of a jail-like environment with far older and more hardened teens. The boy has had just two brief stints outside the hall since July. But after runaway attempts and disruptive behavior in a residential treatment center and a group home, he ended up back in the hall.

Probation officials statewide acknowledged the difficulty of finding placements for young people who are both severely mentally disturbed and a potential risk to themselves or others. But few said they had ever jailed such a young child for nearly a year before finding a more therapeutic alternative.

“We would do everything in our power to not criminalize a child of that age, especially if they had a mental illness,” said Phillip Crandall, director of Humboldt County’s health and human services department. The county is a leader in folding youthful offenders into larger systems of care, such as mental health and social service agencies.

“These are young children, so the least appropriate approach is to use the juvenile justice system,” Crandall said.

Statewide, according to the most recent data from the Attorney General’s Office, there were 174 detentions of children under age 12 in locked facilities, out of a total of 45,705 young inmates.

Alameda County Probation Chief Donald Blevins sympathized with the local juvenile court and probation officials charged with finding a better alternative for the 11-year-old.

“Kids with mental health issues are generally the hardest to place,” he said. “There’s a lack of bed space in programs around the state.”

But some places in California and elsewhere have had success finding alternatives to juvenile hall. Among the most successful efforts is “wraparound” care, which involves intensive supervision at home combined with services from community-based agencies. Santa Clara County uses that strategy as well, but the combination of the 11-year-old’s age, mental illness and alleged sexual offense have made such an arrangement difficult.

Other options statewide include therapeutic group and foster homes; high-end psychiatric facilities; or regional centers for short-term crisis intervention.

A Humboldt County program called New Horizons has successfully placed 76 percent of its mentally ill juvenile offenders back with family members after an intensive six-month program at a secure facility. Using family therapy, individual counseling and a six-month aftercare program, New Horizons boasts a 20 percent re-offense rate that contrasts with rates of 50 percent to 80 percent for young offenders nationwide.

A nationally prominent program for disturbed youth, Wraparound Milwaukee, blends all kids into one HMO-like plan, whether they entered the system as a foster youth, juvenile offender or mental patient. The program was founded in 1995 to keep disturbed kids ages 5 to 18 out of correctional facilities and other costly institutions.

Director Bruce Kamradt said the program succeeds by treating each case individually and offering an array of treatment options. The 400 juvenile offenders in the program include 100 sex offenders, 80 percent of whom are placed at home with support services or in homelike settings.

“We put a real strong emphasis on what’s keeping that boy in that institution — and how can we get him back in the community,” Kamradt said. “Our judges won’t let us keep these kids in the hall; they expect us to get them out in 24 to 48 hours.”

Santa Clara County, by contrast, has not tried an alternative setting for the 11-year-old since February, after he ran away from a Northern California treatment center.

Andre Chapman, who has run therapeutic group homes in the South Bay since 1993, said running away and acting out in a new setting away from home is not unusual. Chapman is not familiar with this boy’s case, but he noted that new rules, new staff, new roommates and a new routine could all present challenges for mentally ill young offenders.

The onus, he said, is on officials to consider a range of options: “Kids don’t fail programs; it’s the system that fails the kid. You have to keep trying until you find the right fit.”

Sue Burrell, an attorney with the Youth Law Center, agrees that alternatives to locking up mentally ill kids are hard to come by in California. “People running juvenile halls around the state are in anguish over with what to do with these children,” she said.

But when it comes to an 11-year-old, Burrell said, the hunt for alternatives should become more urgent.

“A kid that young just shouldn’t be in an institution,” she said. “Whatever problems he had before are only going to get worse.”