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Professional NewsFull Access

AACAP Urges Alternatives For Troubled Youth

Published Online:https://doi.org/10.1176/pn.36.23.0014

Juvenile offenders need rehabilitation not incarceration. That is the message of a new video released by the Task Force on Juvenile Justice Reform of the American Academy of Child and Adolescent Psychiatry (AACAP) at its annual meeting in October in Honolulu.

“We want federal, state, and county agencies to know there are better alternatives to incarcerating youth who may also have mental illness and substance abuse problems,” task force co-chair William Arroyo, M.D., told Psychiatric News. He is also a corresponding member of the APA Committee on Juvenile Justice Issues.

The 30-minute video focuses on an innovative day-treatment program in Santa Cruz, Calif. That program was chosen because it is community based and represents a collaboration between the county probation, mental health, and education departments, said Arroyo.

The video will be distributed to judges, state attorneys general, departments of mental health and corrections, and national associations willing to advocate for similar partnerships, said Arroyo.

The goal of the program is to reintegrate the offenders into the community. Eighteen juveniles receive a variety of services including drug treatment, anger management, tutoring, and counseling. They are required to make restitution to their victims and communities, according to Arroyo.

Many of the juvenile offenders live at home, and their parents are involved in their evaluation and treatment, said Arroyo. “Working with the entire family is often critical to a juvenile’s rehabilitation.”

The video is complemented by a new monograph titled “Recommendations for Juvenile Justice Reform,” also released at the October meeting by the AACAP juvenile justice reform task force. The task force wants to reverse several disturbing trends including disproportionate confinement of minority youth, the increasing number of females entering the juvenile justice system, waivers to adult courts, and the execution of several teens since 1988, and it devotes a chapter to each of these issues. Other chapters present standards for juvenile detention, confinement, and seclusion and restraint; alternatives to adjudication; and a model treatment program.

Louis Kraus, M.D.: “We certainly disagree with the Supreme Court ruling and believe the death penalty constitutes cruel and unusual punishment.”

Louis Kraus, M.D., chair of the APA Committee on Juvenile Justice Issues and co-chair of the AACAP Task Force on Juvenile Justice Reform, told Psychiatric News, “We believe that most juveniles can be rehabilitated if given developmentally appropriate health, mental health, and educational services.”

Punitive Approach

Society has increasingly taken a punitive approach toward juveniles since the 1980s as it deals with rising youth violence and crime. Many states began allowing the courts to transfer violent offenders from juvenile to adult court for trial and sentencing. The number of youth in adult prisons has doubled in the last decade, according to the monograph.

“There is no evidence that these transfers are reducing youth violence and crime. In fact, some studies suggest that the opposite is true, that these youth have higher rates of recidivism and are more likely to be physically and sexually victimized than youth tried in the juvenile justice system,” said Kraus.

The task force recommends that waivers to adult court be considered on a case-by-case basis and that other options be considered.

Another disturbing development occurred in 1988, when the U.S. Supreme Court ruled that juveniles aged 16 to 18 could be executed for capital offenses. The high court decided that the death penalty was not cruel and unusual punishment under the Eighth Amendment, according to the AACAP policy statement on juvenile death sentences included in the monograph.

In 1999 an estimated 70 people were on death row for crimes committed when they were 16 or 17, according to the monograph.

AACAP and APA oppose the death penalty for juvenile offenders, said Kraus. The APA Board of Trustees approved a policy statement on juvenile death sentences at its July meeting similar to the statement approved by the AACAP board last year.

“We certainly disagree with the Supreme Court ruling and believe the death penalty constitutes cruel and unusual punishment. Teenagers’ decision-making capacities are still developing, and they often act impulsively, without regard for the consequences,” said Kraus.

They also may have learning disabilities and histories of trauma and abuse that affect their reactions to perceived threats, added Kraus. He noted that the Supreme Court ruling represented a significant departure for the courts that traditionally favored rehabilitation.

More Females and Minorities

Another pressing problem is that females are increasingly entering the juvenile justice system, many with histories of being victims of physical or sexual abuse. But few community-based programs address their unique needs, contributing to the cycle of recidivism, said Kraus.

Minorities continue to be disproportionately represented in the juvenile justice system, he added. They represent about one-third of all children and adolescents in the United States but two-thirds of the juvenile justice population, Kraus noted.

The 1992 Juvenile Justice Delinquency and Prevention Act mandated that states study the problem and develop strategies to reverse the trend. While five states did conduct pilot projects, the vast majority made limited attempts to study the problem. A few municipalities, including Santa Cruz County, Calif., and Cook County, Ill., have been able to reduce minority confinement in juvenile facilities, said Kraus. Santa Cruz County has significantly reduced the number of Latino youth in the juvenile system.

The monograph also addresses forensic evaluations of juveniles and their competency to stand trial.

“Recommendations for Reforming the Juvenile Justice System” is posted on the AACAP Web site at www.aacap.org/legislation/articles/everything6.PDF. The videotape can be ordered at no charge from Mary Crosby, AACAP deputy executive director, by phone at (202) 966-7300, ext. 127, or by e-mail at .