Federal action is needed to investigate and correct a range of
systemic problems affecting people with mental illness, including the
increased use of detention facilities for mentally ill juveniles, according to
a report by the National Council on Disability (NCD) released last month.
As part of its annual recommendations, the independent federal agency urged
more creativity in program design, more accountability in measuring the impact
of civil-rights compliance for people with disabilities, and greater
cross-agency coordination in managing disability programs.
The report found "disturbing evidence" that detention
facilities are increasingly used in a "warehousing role" for
juveniles with mental illness. According to the report, two-thirds of juvenile
detention facilities are holding youth primarily because appropriate mental
health services are unavailable, not because the youngsters have been accused
of or determined to have committed offenses.
"It is something that has been a growing problem," said Martin
Gould, director of research and technology for NCD. "We noticed it this
year in part because of some of the legislation introduced around the
treatment of children and parents having to give up their custody of children
with mental health needs so the children could receive the services that they
required but the parents couldn't provide."
The report said its findings were based in part on those of a 2004
Department of Justice report to Congress believed to be the first national
study on the issue. Its data came from survey responses from juvenile
detention facility administrators. The NCD report said the problem appeared to
have developed unnoticed over many years.
The NCD report recommended that Congress hold hearings on "the
causes, extent, and, most of all, the potential solutions to this problem, and
that the administration make it a priority to ensure that effective and
accountable measures are put in place for steadily reducing and eliminating
the use of incarceration for non-delinquent children and youth deemed in need
of mental health services."
Gould said other related problems include the federal effort to prevent and
stop child abuse and punish its perpetrators. It is unclear the extent to
which disability— defined by federal law as, in part, a condition that
places "substantial limitation" on a major life
activity—adds to the risk of child neglect or abuse, according to the
report, but anecdotal evidence suggests that it does. "And few could
doubt that maltreatment in early life can contribute directly to the
occurrence or severity of disability, through the effects of emotional or
physical trauma," according to the report.
The NCD Web site describes it as an independent federal agency that makes
recommendations to the president and Congress to enhance the quality of life
for Americans with disabilities and their families. NCD's purpose, in part, is
to "promote policies, programs, practices, and procedures that guarantee
equal opportunity for all individuals with disabilities, regardless of the
nature or severity of the disability; and to empower individuals with
disabilities to achieve economic self-sufficiency, independent living, and
inclusion and integration into all aspects of society."
Although federal programs are increasingly responding to the problem of
neglect and abuse by including provisions to prevent these through
legislation, such as the Indian Child Protection and Family Violence
Protection Act of 2004, NCD researchers found that statistics required by
several federal laws are undercollected and underreported.
For example, "There are children with mental health needs and mental
health issues who are part of the foster-care system who are being abused but
that information is not being reported to Congress," Gould said.
A federal law, the Child Abuse Prevention and Treatment Act, requires
states to report child-welfare statistics. The lack of information, however,
limits the effectiveness of tracking reports by the Administration on
Children, Youth and Families, which is charged with reporting to Congress on
child maltreatment issues.
"Certainly, no one wishes to increase paperwork requirements borne by
states, by local law enforcement or social services agencies, or by other
entities," said the report.
Gould said it is unclear why the data are not being provided, which was
part of the reason that the NCD recommended that the secretary of Health and
Human Services review existing data-collection requirements to ensure required
data are collected or that alternatives are found.
"If there are children and youth with disabilities who are being
affected negatively and that info is not being reported to Congress, then
Congress or the executive branch can't be expected to respond to those
[concerns]," Gould said.
The report found incremental progress in some areas, although gaps in
necessary services and supports continue to leave many Americans with
disabilities undereducated and unemployed.
The report called for new allocations of responsibility among federal,
state, and private-sector partners, including consumers. New criteria for
measuring program outcomes are also needed.
"National Disability Policy: A Progress Report, December
2003-December 2004" is posted at<www.ncd.gov/newsroom/publications/2005/progress_report.htm>.▪