March 19, 1999

APA has endorsed a new bill in-troduced by Senator Paul Wellstone (D-Minn.) last month that would mandate comprehensive mental health and substance abuse screening and treatment programs for youth in the juvenile justice system.

APA President Rodrigo A. Muņoz, M.D., commented in a letter to the senator last month, "As psychiatric physicians, we are very concerned about the nearly 60 percent of juvenile offenders who have emotional, behavioral, or mental disorders. In light of these astounding and tragic numbers, it is critical that we look at how to reach these children before they enter the juvenile justice system.

"We must also ensure that incarcerated children receive appropriate mental health treatment, which may break the cycle of delinquency and help them to lead satisfying and productive lives," continued Muņoz.

David Fassler, M.D., chair of APA's Council on Children, Adolescents, and Their Families, who joined Wellstone when he announced the bill's introduction last month at a press conference, applauded the proposed Mental Health Juvenile Justice Act.

"The federal strategy, which he has proposed for giving critical assistance to children with mental illnesses in our juvenile justice system, is long overdue," Fassler said in a statement.

According to Wellstone, more than one million children enter the justice system each year, and more than 100,000 youths are placed in some type of correctional facility. Studies have shown that the rate of mental disorders in this population is two to three times higher than in the general population.

The Mental Health America, a supporter of Wellstone's bill, released the results of a survey last month showing that up to three-fourths of youth in some juvenile systems have mental health problems, yet most do not receive treatment.

The vast majority of children are locked up for committing nonviolent offenses, said Wellstone at the news briefing. "Many of these children are, in effect, dumped on the justice system because of cuts in mental health services in the community. These children are overwhelmingly poor, a disproportionate number are children of color, and most come from troubled homes."

Department of Justice investigations have shown that most states have inadequate screening, assessment, and treatment for children with mental disorders. A federal study of 14 states found that about one-third of all youth placed in state juvenile facilities could have been placed safely in less secure settings, resulting in more appropriate rehabilitation and less cost to taxpayers, according to Wellstone's legislative summary.

Moreover, 1996 research on juvenile programs showed that when treatment is provided, recidivism is reduced by 25 percent, the summary noted.

Wellstone commented at the briefing, "It is in our interest as a society to identify and treat these children now or we will pay the price later in repeated incarcerations, high prison costs, and broken lives."

• Training of state judges, probation officers, and others to identify and assess the need for appropriate treatment of mental disorders and substance abuse, and the use of community-based alternatives to juvenile correctional facilities.



• Providing block grants and competitive grants to states and localities to develop mental health diversion programs for children and juveniles. This would strengthen the collaboration of community agencies serving troubled children and mental health treatment programs for incarcerated children with emotional disorders.



• Establishing a Federal Interdepartmental Council on the Criminalization of Youth With Mental Disorders to report to Congress with recommendations on improving the treatment of mentally ill children who enter the justice system.



• Allowing states receiving federal prison construction funds under the Violent Offender Incarceration and Truth-in-Sentencing Grants program to use the funds to implement mental health screening and treatment of adult and juvenile offenders.



• Removing the most damaging provisions of the Prison Litigation Reform Act (PLRA) of 1996 by giving back authority to the federal courts to remedy abusive conditions in state facilities where juvenile offenders and mentally ill prisoners are being held.

The legislation was inspired by Wellstone's visit last July to a privately owned juvenile correctional facility in Tallulah, La. "I couldn't believe that in 1998 children in America were living under such brutal conditions. Children with mental health disorders received no treatment, and many were subject to physical and sexual abuse," said Wellstone.

In addition to APA, more than 40 organizations have endorsed the bill, including the American Academy of Child and Adolescent Psychiatry, American Psychological Association, National Alliance on Mental Illness, Children's Defense Fund, and American Bar Association.

The text of Wellstone's bill and an update of the bill's status is posted at thomas.loc.gov; search on the bill's number, S.464.-C.L.