Pennsylvania's juvenile detention centers now have proof -- hundreds of mentally ill teens are going through their centers each year, and more than a few are intent on killing themselves.
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Elizabeth Cauffman of UPMC's Western Psychiatric Institute and Clinic is a consultant for a statewide project to screen teens entering detention centers for mental health problems. (Steve Mellon, Post-Gazette) |
As part of a statewide mental health screening program that is becoming a national model, the Juvenile Detention Centers Association of Pennsylvania is trying to determine which teens entering detention may be suicidal.
Among the 9,000 or so teens screened since April 2000, 25 percent of girls and 13 percent of boys have said they had thought of killing themselves.
"The fact that these kids are telling us, 'I want to hurt myself' -- that's the most astonishing piece," said Elizabeth Cauffman, assistant professor of psychiatry at UPMC's Western Psychiatric Institute and Clinic and lead consultant for the screening project.
But it also puts detention centers in a difficult position. Historically, their role in juvenile justice has been to temporarily hold youths awaiting either a court hearing or placement in another facility. Yet the frequency and severity of mental illness among the teens is forcing them to rethink what they do.
Cauffman wonders: "Are the staff trained and capable? What's in place? Do they have the resources to handle this percentage of kids coming in with those kinds of threats?"
Pennsylvania has had two juvenile detention deaths ruled as suicides since 1995: Justin Atkinson, 15, who hanged himself at the Allencrest Juvenile Detention Center in Beaver, Beaver County, in May 1996, and Robert Preston, 17, who died during surgery in a Philadelphia hospital the day after trying to hang himself from a vent at Montgomery County Youth Center in Norristown in May 1999.
According to news reports, Preston had told a roommate that he was going to fake the hanging so he would be transferred to Norristown State Hospital, where his girlfriend had been sent.
Atkinson was arrested with two companions -- one of whom had a gun -- on April 21, 1996, following a standoff with police in a convenience store parking lot. According to a lawsuit filed after Atkinson's death, the teen was not given a mental health evaluation or suicide assessment despite "irrational behavior" at admission and a later suicide threat. He hanged himself by weaving his bed sheet through the metal screening covering his window.
The suit was later settled, and neither side will discuss particulars.
The comparatively small number of deaths belies the ever-present threat that teens in detention will try to take their own lives.
Allegheny County's Shuman Center, for example, has had one completed suicide in its history, in 1988. Yet, until a walk-in crisis center was established, the center had seen up to four serious attempts in a single day.
No one tracks how many suicide attempts occur "and that's what we should be trying to understand best," Cauffman said. "Why is this child doing this?"
