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Push exists for
mental health screening of
juvenile offenders
(April 2008
Issue)
By Pamela Berard
Understanding the link between depression and risky behavior can
help establish appropriate screenings and treatment for juvenile
offenders and ultimately decrease their risk of contracting HIV.
A study published in the January issue of the Journal of Studies
on Alcohol and Drugs indicated that youths who were arrested who
showed signs of depressive symptoms reported significantly greater
drug and alcohol use and a lower proportion of condom use.
The study included 835 adolescents and young adults and addressed
topics such as depressive symptoms, substance use, sexual risk and
mental health history.
The study's lead author, Marina Tolou-Shams, Ph.D., of the Bradley
Hasbro Children's Research Center and an assistant research professor
of psychiatry at The Warren Alpert Medical School of Brown University,
says that screenings of juvenile offenders often focus more on behavioral
problems and not enough on the emotional and internalizing symptoms,
because the youths are entering the system as a function of their
behaviors. "So screening measures don't tend to look at what's going
on internally with these kids. I think that's a big missing piece,"
she says.
Tolou-Shams says there is a big push to involve mental health screenings
and mental health clinics within the juvenile justice system, particularly
for adolescents. "The work with adolescents is always behind the
adult work," she says. "The adult system has been focused on treating
and screening mental health issues for a little bit longer."
She says the belief is that "if we screen and treat and funnel
these kids to the appropriate treatment providers, that it will
prevent them from landing in the adult system where they may end
up for years and years...The hope is if we can address these underlying
emotional issues that we will be preventing them from a lifelong
incarceration or even just coming back into the system just once."
In terms of these mental health screenings and this push, there
still isn't much of any focus on HIV risk behaviors in this population
of juveniles, she says. "Substance abuse has often been screened
for, but they are not looking at the associated health risk behaviors
and we know in the adult population we are seeing high rates of
(HIV) infection.
"It's just kind of a ticking time bomb in terms of the juvenile
system," she says.
Tolou-Shams notes that in general, youth are using condoms more
frequently than they used to. "But we're still not seeing the infection
rates go down as a result. Juvenile offenders, they tend to be more
impulsive and have difficulty managing their emotions," she says.
"So if you think of it in that regard, they are going to be the
kids who are less likely to use a condom."
According to the study, among juvenile detainees, 62 percent had
had multiple partners in the past 90 days, with 59 percent having
unprotected vaginal sex in the past month.
This was intended to be a high-risk sample. But in addition to
the high rates of sexual activity, these kids are also showing a
lot of psychopathology, according to Tolou-Shams.
"It's really a cluster of things that we need to address, not just
mental health and substance abuse but also the HIV risk behavior."
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