CHICAGO --- Mental health professionals speculate that many children with serious emotional disorders are arrested instead of treated.
Now, with a five-year grant with an approved budget of nearly $14.5 million from a unique consortium of eight federal agencies, a groundbreaking Northwestern University Medical School study will investigate the extent of alcohol, drug and mental disorders among delinquent youth and the services they need as they age.
The new grant will add a longitudinal component to an ongoing Northwestern study funded by the National Institute of Mental Health. The longitudinal study, headed by Linda A. Teplin, professor of psychiatry and behavioral sciences and director of the Psycho-Legal Studies Program at the Medical School, is the first comprehensive study of psychiatric disorders and outcomes among delinquent youth.
"Many researchers study the causes of delinquency, but few people study the health needs of delinquent children over time," Teplin said.
"This is a serious omission because these youth are at high risk for developing additional psychiatric disorders and sexually transmitted diseases and becoming victims of violence," she said.
The sample consists of 1,800 racially and ethnically diverse youth (1,200 boys and 600 girls) ranging in age from 10 to 17, who were first interviewed between 1995 and 1998 and have been followed up since then. Over 95 percent of the youth who were sampled agreed to participate in the study.
Teplin and her colleagues have already compiled extensive baseline data on the diagnoses, substance use, criminal history and HIV/AIDS risk behaviors of these youth. They are now conducting periodic follow-up interviews with all study participants, whether they are in the community or incarcerated. County and State correctional facilities have agreed to provide access to those who are in jail or prison, and all official records will be made available.
The longitudinal study will examine fundamental questions: What types of services and prevention programs best meet the needs of delinquent youth as they age? Do delinquent youth receive adequate services for their disorders when they are back in their communities? How do HIV/AIDS risk behaviors develop over time? When and under what circumstances are these children vulnerable to becoming victims of violence?
"We must know more about the alcohol, drug and mental health treatment needs of youth involved in the juvenile justice system. We also must understand how substance abuse and mental health problems make children more vulnerable to violence," said Shay Bilchik, administrator of the U.S. Justice Department's Office of Juvenile Justice and Delinquency Prevention.
Teplin noted that already 23 of the subjects in the study have died, almost all from gunshot wounds.
"All delinquent children are at high risk for violent victimization, even death. Understanding patterns of violence over time is the first step toward prevention," Teplin said.
The Justice Department currently estimates that annually there are over 2.8 million arrests of children younger than 18. On an average day in the United States, 108,000 children are detained in juvenile facilities. Researchers estimate that as many as 75 percent of these youth may suffer from alcohol, drug and mental disorders and require services.
Once released, these youth may receive services from a variety of systems -- mental health, child welfare, schools and the justice system. The Northwestern study is the first to provide accurate data on the services these children require and how well the systems are serving them.
Teplin said the study is asking the following questions: How well integrated are these systems? Do these children receive adequate services or just fall between the cracks?
Teplin's co-researchers in the department of psychiatry and behavioral sciences at the Medical School are Karen M. Abram, assistant professor; Gary M. McClelland, research assistant professor; Mina C. Dulcan, M.D., professor; and Heather J. Walter, M.D., associate professor.
Consultants on the project include Robert Booth, University of Colorado; Felton Earls, M.D., Harvard University; Celia Fisher, Fordham University; Robert Gibbons, University of Illinois-Chicago; David Huizinga, University of Colorado; John Landsverk, San Diego State University; Rolf Loeber, University of Pittsburgh Medical Center; and David G. Ostrow, M.D., Loyola University School of Medicine.
The new grant was spearheaded by the National Institute of Mental Health.
"This study will tell us a lot of things we need to know about youth already in trouble," said Steven Hyman, M.D., director of the National Institute of Mental Health.
"These young people have long lives ahead, and the more we can learn that will help them get back on the right track, the better," Hyman said.
Co-funding for the grant is provided by the Office of Juvenile Justice and Delinquency Prevention of the U.S. Department of Justice, the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the National Institutes of Health Office of Research on Women's Health, the Center for Mental Health Services, the Center for Substance Abuse Prevention and the Centers for Disease Control and Prevention. Additional funds were provided by the Open Society Institute, the John D. and Catherine T. MacArthur Foundation, the William T. Grant Foundation and The Chicago Community Trust.