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The Connection Between Mental Health Problems and Juvie

Health programs could stop problems before they start.
A corridor in a juvenile detention center. (Photo: 1Flatworld/Flickr)

A corridor in a juvenile detention center. (Photo: 1Flatworld/Flickr)

Arash Anoshiravani is the medical director for the juvenile custody system in Santa Clara County, California, which means he and his staff see a lot of troubled teens. Oftentimes, they provide the same services any pediatrician would: vaccines, you-ought-to-use-a-condom talks, fillings for cavities. But it's not only the mundane stuff: At the same time, Anoshiravani, who also conducts research at Stanford University, has been studying the possibility of quantitative differences between the health of patients like his own and those who stay out of detention. Anoshiravani and a team of researchers from Stanford and Duke University gathered and analyzed data about all the hospital visits every Californian aged 11 to 18 made between 1997 and 2011.

Their results, published online this week in the Journal of Adolescent Health, show there is, in fact, a big difference. Sixty-three percent of the hospital visits detained teens make are for mental disorders, including addiction, depression, and conduct disorder. In contrast, mental problems are the cause behind only 20 percent of undetained youth's hospital visits. "What this data shows is that mental health is a huge problem for this population," Anoshiravani says.

Sixty-three percent of the hospital visits detained teens make are for mental disorders, including addiction, depression, and conduct disorder.

Previous studies have found that kids in the juvenile justice system have higher-than-average rates of mental illnesses. This study, however, uncovers that they are not only more likely to have such conditions, but they also tend to have severe cases, requiring a hospital visit.

So, do mental problems lead kids to juvenile hall? There aren't data sets to show that directly, but previous research has found that kids in juvenile detention tend to have traumatic pasts, which are associated with conditions such as substance abuse. Those conditions, in turn, may encourage behaviors that land kids in jail.

Anecdotally, Anoshiravani has noticed those patterns in his patients. He talks about teens who were molested as children, grew up around gang violence, or hadn't seen a parent in years because of immigration issues. "No wonder this kid is high every day. No wonder he's trying to get away from reality," he says.

"It doesn't excuse their behaviors. Some of them have really horrible charges," he adds. "But it does help to explain, 'Why did they end up this way?'"

It also suggests that doctors and social workers could prevent some detentions by providing mental health support when kids need it. "If you have a kid in preschool who's behaving violently at age five or four, that teacher should be able to find resources in a community clinic to address the reason for that behavior," Anoshiravani says.

Kids in juvenile detention get stereotyped as being different, says Anoshiravani; the implication is that their behavior is unchangeable. "The thing that sticks with me the most is just how much alike they are to other kids I've seen in my life except that they have really, really horrific life stories," he says. Any kid might find such experiences difficult to deal with. Timely support could go a long way.

Quick Studies is an award-winning series that sheds light on new research and discoveries that change the way we look at the world.