Youth in the News
Volume 2, Number 20, December 16-31 , 2007
Contents
State Watch
Research
Government
STATE WATCH
- Officials in the District of Columbia debate the effectiveness of their juvenile justice court.
- Missouri's community based detention centers successfully rehabilitate juvenile offenders.
- A local program in Massachusetts has high school students teaching kids in kindergarten through second grade about internet safety.
- A county juvenile court in Ohio has an intervention center that assesses the potential services a juvenile offender may need as they enter into the system.
- Three free clinics in Austin, Texas offer medical services to homeless and at-risk youth.
- Indiana's National Guard Youth ChalleNGe program graduates its first class of former at-risk youth.
RESEARCH
- The U.S. Department of Education released a report on high school drop-out rates showing that over 540,000 students dropped out between 2004 and 2005.
- Research on the adolescent brain shows that juveniles are still maturing well into their 20's.
- A new study suggests that youth on antidepressants are not being monitored as closely as the FDA recommends.
- An Ohio report finds problems with the state's youth prisons.
GOVERNMENT
- Several state legislatures enacted legislation making the distinction between sexual predators and adolescent having consensual sexual relations.
- In California, a new law prohibiting smoking in cars with anyone under the age of 18 will go into effect on January 1.
ARTICLES
DISTRICT OF COLUMBIA
Effectiveness of juvenile justice court debated
December 31, 2007
By Scott McCabe and Bill Myers, Examiner.com
More than a century after the first juvenile justice court opened its doors, the jury is still out on whether a separate system for children is effective.
Jane Addams, the founder of modern social work, got her native Chicago to create the country's first juvenile court in the early 20th century. The argument, which hasn't changed since, was that young offenders could still be "saved” from a life of crime.
But the counterargument, that some people in their late teens are so predatory that they need to be locked up to protect others, has also persisted.
Juvenile courts, including the District of Columbia's, are less focused on meting out punishment as they are focused on getting services to keep a young offender on the straight-and-narrow path.
Yet D.C. has struggled mightily with youth crime. An October 2006 analysis by the D.C. police department found that nearly one quarter of D.C.'s killers were children. Up to 70 percent of children who are arrested in D.C. have prior records, said Peter Nickles, the next acting attorney general for the city.
Some, like Nickles, blame harsh punitive approaches taken in the last two decades. They say that kids go into tougher jails and become more hardened criminals when they get out.
"It's always easier to get a headline by talking about youth violence and saying, ‘They're out of control and you need to lock them up,' ” Nickles told The Examiner. "We've been doing that, and what did we get? A lot more youth violence.”
On the other side are those who say that the rehabilitative approach to juvenile justice creates a culture of impunity.
"The softer approach has been a disaster for the last 25 years,” said Kristopher K. Baumann, chair of the D.C. police union.
MISSOURI
Mo. Tries New Approach on Teen Offenders
December 29, 2007
By Todd Lewan, www.foxnews.com
At age 9, Korey Davis came home from school with gang writing on his arm. At 10, he jacked his first car. At 13, he and some buddies got guns, used them to relieve a man of his Jeep, and later, while trying to outrun a police helicopter, smacked their hot wheels into a fire hydrant.
For his exploits, the tough-talking teen pulled not only a 15-year sentence (the police subsequently connected him to three previous car thefts) but got "certified" as an adult offender and shipped off to the St. Louis City workhouse to inspire a change of heart.
It didn't have the desired effect.
"I wasn't wanting to listen to nobody. If you wasn't my momma, or anybody in my family, I wasn't gonna listen to you, period," says Korey, now 19. "I was very rebellious."
At that stage, most states would have written Korey off and begun shuttling him from one adult prison to the next, where he likely would have sat in sterile cells, joined a gang, and spent his days and nights plotting his next crime.
But this is Missouri, a place where teen offenders are viewed not just as inmates but as works in progress where troubled kids are rehabilitated in small, homelike settings that stress group therapy and personal development over isolation and punishment.
With prisons around the country filled to bursting, and with states desperate for ways to bring down recidivism rates that rise to 70 and 80 percent, some policymakers are taking a fresh look at treatment-oriented approaches like Missouri's as a way out of America's juvenile justice crisis.
Here, large, prison-style "gladiator schools" have been abandoned in favor of 42 community-based centers spread around the state so that now, even parents of inner-city offenders can easily visit their children and participate in family therapy.
The ratio of staff to kids is low: one-to-five. Wards, referred to as "clients," are grouped in teams of 10, not unlike a scout troop. Barring outbursts, they're rarely separated: They go to classes together, play basketball together, eat together, and bunk in communal "cottages." Evenings, they attend therapy and counseling sessions as a group.
Missouri doesn't set timetables for release; children stay until they demonstrate a fundamental shift in character a policy that detainees say gives kids an added incentive to take the program seriously.
Those who are let out don't go unwatched: College students or other volunteers who live in the released youths' community track these youths for three years, helping with job placement, therapy referrals, school issues and drug or alcohol treatment.
The results?
About 8.6 percent of teens who complete Missouri's program are incarcerated in adult prisons within three years of release, according to 2006 figures. (In New York, 75 percent are re-arrested as adults, 42 percent for a violent felony. California's rates are similar.)
Last year, 7.3 percent of teen offenders released from Missouri's youth facilities were recommitted to juvenile centers for new offenses. Texas, which spends about 20 percent more to keep a child in juvenile corrections, has a recidivism rate that tops 50 percent.
No Missouri teens have committed suicide while in custody since 1983, when the state began overhauling its system. From 1995 to 1999 alone, at least 110 young people killed themselves in juvenile facilities nationwide, according to figures from the National Center on Institutions and Alternatives.
Does this "law-and-order" state know something others don't?
Hardly, says Mark Steward, who, as director of the state's Division of Youth Services from 1987 to 2005, oversaw the development of what many experts regard as the best juvenile rehabilitation system in America.
"This isn't rocket science," Steward says. "It's about giving young people structure, and love and attention, and not allowing them to hurt themselves or other people. Pretty basic stuff, really. It's just that a lot of these kids haven't gotten the basic stuff."
Take Korey Davis. He didn't meet his dad until he was 5. He and his siblings were raised largely by aunts and uncles. If the judge handling his case had left him in county detention centers until he reached adult age 17, in Missouri then had him serve the rest of his sentence in prison, few eyebrows would have been raised.
But a chance to save a life would have been missed. "In jail, I wouldn't never have changed what I always done," Davis says. "There was no treatment at all." He contemplates this for a second, and adds with a near-whisper: "Right now, I'd probably be dead."
In Missouri, judges can keep serious felons in the juvenile system until they are 21. That's what happened with Davis. At 15, he was sent to the Montgomery City Project, where robbers, rapists and the like get one last shot.
At first, he didn't want it.
But a year into his stay, two things knocked him back on his heels: the news that his younger brother had been shot and wounded in a gang fight, and an invitation from a counselor to sit down, after class, to read a book out loud with her.
To a boy accustomed to hiding his illiteracy, the offer felt awkward. But because this woman had given him a chance, he responded, and "when I actually learned how to read, it made everything in the world easier for me."
Three years later, Davis is a group leader and no softy with his peers, either. "We don't let each other get by with slick stuff, just doing the bare minimum," he says. He reads voraciously (recently, "The Bond," about three fatherless teens in Newark, N.J.). He's been accepted by a community technical college, plans to study carpentry. And, he's proud to say, his kid brother has taken to heart this advice:
"Put the guns down."
Many states are trying to bring down high rates of repeat offending by juveniles.
Wisconsin now treats some repeat offenders with mental health counselors in hospitals, instead of corrections officers in jails.
Illinois offers them drug treatment, job placement or an expedited return to custody.
And Washington state targets kids at risk of becoming its most serious offenders with early, intensive anger-management, drug and family therapy.
Research guided these approaches. One 2006 study, for example, found that anger-management, foster-care treatment and family group therapy cut recidivism drastically among teens, resulting in taxpayer savings up to $78,000 per child. Programs that tried to scare kids into living a clean life were money losers, according to the study, conducted by the Washington State Institute for Public Policy.
Missouri employs similar carrot-and-stick techniques. But it takes rehabilitation one step further by normalizing the environments of children in custody, says Barry Krisberg, president of the National Council on Crime and Delinquency, a nonprofit based in Oakland, Calif.
"It's a pretty simple concept: The more normal the environment, the more likely these young people will be able to return home and not be sucked into a criminal subculture," he says.
Montgomery City, built for Missouri's worst juvenile offenders, could be mistaken for a college campus.
In a literature class, students analyze plot lines in "Julius Caesar" and "A Farewell to Arms." In a computer lab, they write resumes and peck out cover letters to employers. In a central courtyard, they celebrate "Victim Empathy Week" by huddling in a circle with lit candles, praying silently for those harmed by their crimes.
The cottages where they sleep resemble college dorms, with one notable difference: These are all immaculate.
Ten teens are assigned to a cottage. Each gets a bed with quilt, pillow, nightstand, and an understood "space." In this space are often collected the precious remnants of a truncated childhood: dream catchers, stuffed animals, Dr. Seuss books.
"When you walk into these facilities and see 17- and 18-year-olds with dolls on their pillows, that's when it hits you: 'Hey, these really are just kids,'" says Ned Loughran, executive director of the Council of Juvenile Correctional Administrators.
Some things you won't see in this detention center: razor wire, barred windows, uniformed guards, billyclubs, or kids in orange jumpsuits with broken noses.
"We're all about creating a safe environment for our kids," Larry Strecker, Missouri's northeastern regional administrator, explains.
Here, boys wear well, what boys wear: jeans, knee-length Bermudas, an occasional earring, T-shirts. Staff members dress almost as casually.
To the teens, many of whom have done long stretches in adult jails awaiting adjudication, the sight and feel of Montgomery City come as a shock.
It was for Josh Stroder, who at 15 was arrested by a SWAT team in 2004 at his home in Dexter, Mo., and charged with 12 crimes, including terrorism. He confessed to improvising a bomb, which took off the front door of an appellate judge's home. No one was hurt by the blast. Police also found a car bomb in his basement.
The youth was detained in a juvenile center for a year, then sat in the Dexter City jail for 5 months before being sent to Montgomery City.
In a 6-by-9 cell, says Stroder, now 18, "there's really nothing to challenge you, nothing to stimulate you. It becomes easy to succumb to apathy, bitterness, or whatever is boiling in your brain."
He contrasts that with Montgomery City: "Here, you are faced with the possibility of reconciliation with so many people, and forgiveness. I was expecting a treatment program, but not so intense not the way it is here. I expected maybe to crack the surface of the ice, but not go in so deep."
Treatment comes in "group builders" sessions in which detainees open up to one another about traumas, crimes and family conflicts that have scarred them. Kids can also call a "circle," in which team members stand and face each other to air grievances, fears, anguish.
Two staff specialists, college graduates in counseling, psychology or social work, sit in on the circles, but the kids generally run them. "Adults lived in a different generation they can only tell us so much," says Korey Davis.
Teams that interact more are rewarded day furloughs to visit family, fishing trips, bicycle excursions, an afternoon volunteering at a food bank or a soup kitchen. Those who pull against the program generally, new arrivals quickly find themselves pressured by their peers to shape up.
"We know that when we do positive things as a group, we earn things," says Chan Meas, 17. Three years ago, he ran with a gang in Columbia, Mo., smoked dope, broke into people's homes. "Now, I look for positive people that care about others."
Montgomery City is no fairyland. It's a "Level 4" facility, meaning high security. It has isolation rooms, and every door locks automatically. Video cameras in walls and ceilings film everything, everywhere, 24-7. Kids need passes to go from one room to the next.
Kids are trained to restrain peers who threaten the team's safety. Only staff may authorize a restraint, but once they do, team members grab arms and legs and pin their peer to the floor until the child stops resisting.
This practice has its critics, such as Loughran, a former commissioner of the Massachusetts state Department of Youth Services, who called it "very, very dangerous."
"The juveniles have learned violence all their lives, and we're going to use them to control other residents? It's a confusion of roles," he says.
But Tim Decker, Missouri's youth services director, says there's never been a serious injury during a restraint, and rates of injury are markedly lower here than in states that rely on billyclubs and mace.
Besides, he says, the restraint policy reinforces the notion that "everyone in the facility takes responsibility for keeping it safe."
A half hour west of Montgomery City, in the university town of Fulton, there is a house that looks just right for a summer camp. It's brick, with a maple tree out front, a wide lawn and a wrought-iron sign that reads, "Welcome Friends."
Inside are comfy sofas, bookcases holding trophies, vases full of flowers, and 11 girls, ranging in age from 12 to 17, who've been convicted of truancy, assault, drug crimes, theft and forgery bright kids carrying darkness around inside.
This is the Rosa Parks Center, a detention home on the campus of William Woods University. Here, the girls get counseling, schooling, a feeling of togetherness.
"I had a lot of problems being angry," says Brooklyn Schaller, 15, who was arrested on drug charges and for violating a parental curfew. "I would be aggressive. I didn't care about anyone else, or anything else." But after just a year, even she has noticed a change.
"Last weekend I went home for a furlough, and me and Mom got into an argument, and so I left her alone. I let her have her space, and she came back and I listened to everything she had to say and she listened to me. And that was the most amazing thing, to sit down and talk and have someone listen to you."
What's been the difference?
Good role models help: The girls get to mingle with college students in the campus dining hall and attend campus plays and other cultural events. At the start of the school year they describe their experiences to incoming students during orientation week.
But the biggest plus, Schaller says, is that "you have people to talk to here, you have people who truly do care."
Rosa Parks Center opened in 2001, part of Missouri's response to the notion resurrected about a decade ago that it might be worthwhile to punish teen offenders by locking them up in adult prisons or in remote, sprawling juvenile prisons.
In the early '90s, a series of high-profile crimes had prompted dire predictions of teen "superpredators." Legislators across the country backed "scare-kids-straight" approaches.
But Missouri was on a different path by then, and stayed with it.
It had tried the traditional approach: From 1887 to 1983, young offenders from truants to attempted murderers were confined either at the Boonville Training School for Boys, or the Chillicothe Training School for Girls.
Boonville warehoused 650 boys, most of them minorities, in grim, two-story brick structures. There was rape and other brutality by guards, and a solitary confinement room atop the facility's administration building known as "The Hole," until judges demanded its closure.
"You had rural, white staff with inner-city kids of color, thrown in together with kids from all across the state who were disconnected from their families and neighborhoods," recalls Steward, the former director of youth services. "It wasn't a terribly successful formula."
Which is why conservatives such as John Ashcroft, the former Missouri senator and U.S. attorney general, and state Supreme Court Justice Stephen Limbaugh, a cousin of radio commentator Rush Limbaugh, joined with liberals such as the late Gov. Mel Carnahan to stick by systemwide reforms initiated in the late 1970s.
"What is remarkable about Missouri's system is that is has been sustained by conservative and liberal governments," says Krisberg, of the national crime and delinquency council. "They've seen that this is not a left-right issue. In many ways, its a commonsense issue."
A common-cents issue, too since it costs states between $100 and $300 a day to keep a juvenile in so-called "punitive" correctional facilities, according to a 2005 report by the Youth Transition Funders Group, a philanthropy network.
Missouri's per capita cost of its juvenile rehabilitation program is $130 a day.
"The fact is that most kids from punitive states get out, get re-arrested, and get thrown back into correctional facilities," Krisberg says. "What amazes me is that taxpayers in these punitive states put up with such rates of failure."
Miriam Rollin, vice president at Fight Crime: Invest in Kids, a nonprofit in Washington, D.C., with a membership of 3,500 police officials, prosecutors and crime victims, agrees:
"Twenty years ago, people threw up their hands and said, 'We don't know what works.' But now, we actually do know ... We're just not doing it or not doing enough of it."
MASSACHUSETTS
Youth Internet Initiative Gets $38K Boost
December 21, 2007
By Tammy Daniels, www.iberkshires.com
A local initiative that has teens teaching youngsters about the dangers of the Internet got a $38,000 boost on Thursday.
The office of District Attorney David E. Capeless was awarded the Edward J. Byrne Memorial Justice Assistance Grant on Thursday to launch the Student Mentor Internet Safety Program, which will train high school student mentors to teach their younger peers in kindergarten through second grade the importance of online safety.
The program is the brainchild of Steven Del Negro, the statewide coordinator for the U.S. Department of Justice's Internet Crimes Against Children Task Force.
Del Negro, of Williamstown, said the district attorney's office did a great job in going after the "highly competitive" grant, part of $3.5 million in federal money awarded to fund grassroots, innovative anti-crime programs across the state.
According to Capeless, the new program will be offered in conjunction with the state police Internet Crimes Against Children Task Force and will use Netsmartz Workshop, an educational safety resource from the National Center for Missing and Exploited Children. The mentor program is part of the district attorney's ongoing countywide Bullying Prevention Initiative.
"The internet is wonderful tool that offers children unlimited opportunities for learning and personal growth, but also poses many potential dangers," said Capeless in a statement.
The older students will teach the younger ones appropriate Internet use and how to stay safe online using video games and activities through Netsmartz. A digital multimedia presentation and equipment will be purchased for use by participating high schools to help them develop their own elementary school presentations.
It's unusual for initiatives to filter east, rather than west, across the state, said Del Negro. The grant is an endorsement of the program and sends a message that Western Mass. is out front in educating children about Internet dangers.
"We're getting good feedback for this program and we're getting funding," he said.
Gov. Deval Patrick announced $5.1 million in grant funding on Thursday designed to combat youth violence across the state. In addition to the Byrne grants, awarded through the state Executive Office of Public Safety, the Department of Public Health granted $1.6 million for youth anti-violence coalitions and programs.
"In many cases, a violent act takes only seconds, but the impact on individuals, families and communities can last a lifetime," said Patrick in a statement. "The violence that we are seeing on our streets must end, and we know that it will take more than law enforcement to create a lasting peace. These grants underscore our belief that violence is both a public safety problem and a public health problem."
Capeless' office was the only Berkshire agency or organization to receive a grant. Several were awarded to statewide programs, but the bulk were distributed to heavily urban areas in central and Eastern Mass.
OHIO
Juvenile system tries not to lock 'em up, toss key
An example: A 10-year-old punches a teacher, but after medical and psychological help he is doing much better.
December 30, 2007
By James Cummings
When he punched a teacher in May, it was a new low point for a 10-year-old local boy whose mental health had been deteriorating for years, the boy's mother said.
But when the child was arrested on assault charges, it brought him under the jurisdiction of the Montgomery County Juvenile Court, and that, the mother said, has been the salvation of the child and his family.
The mother, whose name is being withheld to protect the identity of her son, said the boy "became violent with me when I was pregnant with his sister. He would kick me, hit me in the back, hit me with objects."
He constantly went into screaming "meltdowns" of uncontrollable rage, and he occasionally tried to hurt other children. He was disrespectful of his teachers, even the ones he seemed to like.
His mother said the boy's behavior had been bad since about second grade, but it's gotten so bad that he had to be hospitalized in a mental health facility last December, April and a third time after the assault in May.
"From December to May was the unhappiest time of my life," said the woman, who lives in the Prairies housing area of Wright-Patterson Air Force Base. "We were helpless. We were thinking about putting him in a residential treatment center.
"It wouldn't even have been in the state. The closest centers for him were in Indiana or Kentucky. I couldn't have stood it."
Under Juvenile Judges Nick Kuntz and Anthony Capizzi, the philosophy of the Montgomery County juvenile justice system is to identify the underlying issues that cause the behavior problems exhibited by children such as this out-of-control 10-year-old boy.
The local juvenile court locks up older, more serious youthful offenders when the judges and 14 magistrates think incarceration is appropriate, but many youths are funneled into programs designed to try to turn them around with counseling and other services to the youth and to their families.
Much of the work to determine the best path through the system for each individual child is handled by the intervention center, an operation court officials say is one of a kind. The center is the first stop for youths entering the system, and center staffers do rapid assessments of the offenders to outline what combination of punishments and support services are called for.
Greg Scott, director of the intervention center, said the center evolved from a program started here 10 years ago to provide a place for police officers to drop off unruly youths when they couldn't be left with parents. Scott said it now has a staff of 38.
Other courts have operations that assess incoming offenders. "But I'm not aware of anyone else who does it in the 24/7 manner we do with the number of services we provide," Scott said.
One staff member is Andie Jones, senior specialist with the care coordination team, which manages cases of juvenile offenders 10 and younger.
The mother from the Prairies said Jones has kept in regular contact with the family since assessing her son after the 10-year-old's arrest for assault in May.
"The programs she's gotten us involved in have been extremely helpful," the mother said. "He's not perfect now, by any means, but we've seen no violence since May."
The child has been diagnosed with a bipolar condition, attention deficit disorder, depression and intermittent explosive disorder. His mother says he receives therapy and tutoring through South Community Behavioral Health Care, and a combination of medications have been found that have made his behavior manageable.
Jones said the assault charge in the boy's case was the doorway that let her get involved. "The charge is a way for us to get in and get the family the help and support they need to keep their child out of the system when they're juveniles and out of jail later on," Jones said.
"There's so much help available, but our families aren't always aware of it. Some of the families are defensive, especially at first, but they find out we really can make things better."
The crisis care team deals with children 10 and younger and includes Jones and another specialist Luci Horstman plus staff from the county's children services division and a Samaritan Behavioral Health crisis care therapist. Jones said the experts on the team have become skilled at uncovering hidden problems in the children.
"It's alarming the number of times a child has spontaneously divulged abuse the family didn't know about," Jones said. "Physical abuse, sexual abuse. ... We see it all."
Judge Kuntz said the intervention center allows the court to assess youth offenders quickly and to avoid incarcerating youths who don't really need to be locked up.
Kuntz said that's better for the youth, and it means the new Juvenile Justice Center can be significantly smaller than was envisioned when county officials began talking about building it nine years ago.
Kuntz said the center gains additional efficiency by combining juvenile court, detention and probation operations that had been spread among several buildings.
"Our old detention center was built 50 years ago, and you can't take care of today's kids in a facility designed for the kids of the 1950s," Kuntz said.
The judge said some legislators in Ohio and elsewhere in recent years have pushed for stricter rules and harsher punishments for youthful offenders. Kuntz and Capizzi said there are cases where stiff terms behind bars are appropriate, but other cases where punishment does more harm than good.
"You have to remember we're dealing with all kinds of kinds of children," Kuntz said. "We don't want to traumatize the minor offender because we want to punish the older, more serious offender."
TEXAS
No appointment necessary at this clinic for homeless, at-risk youth
Three free Austin clinics see young people with hepatitis C, drug addictions, other ailments
December 23, 2007
By Mary Ann Roser, www.statesman.com
In a twist on mainstream medical care in the United States, this clinic takes no appointments, no insurance and no money. And for nearly two hours on a Thursday in December, the doctor and the staff did the waiting.
"We'll probably be slammed in an hour," said Eninja Ervin, a certified medical assistant who tests blood pressure levels, runs lab tests and helps with patients at the weekly clinic in a modest space on the third floor of an Austin church building.
Christina Gomez-Mira, left, is a health educator at the People's Community Clinic at Congregational Church of Austin, where Daniel Clark, 23, waits to have his blood tested by medical assistant Eninja Ervin. The clinic, which requires neither an appointment nor insurance, is open on Thursdays.
Daniel Clark and his girlfriend, Lilly Fagg, 18, came to the clinic for help before leaving town. They said they were being evicted from their apartment. Clark has hepatitis C, and Fagg was prescribed medicine for a case of hives.
Unlike at the typical doctor's office, Christina Gomez-Mira, clinic coordinator and health educator, waits for patients.
Patient Lilly Fagg, left, talks with medical assistant Eninja Ervin at the outreach clinic. Fagg had her birth control prescription refilled. The clinic keeps a small pharmacy with antibiotics, ibuprofen and other basic medicines.
The staff at the branch of People's Community Clinic never knows when, or even if, a patient will come in, but that's by design. The goal is to encourage visits by troubled young people, including those who are homeless, substance abusers or "travelers" passing through Austin who need medical care. They don't respond well to appointments.
"Essentially, the at-risk adolescent we're trying to serve needs to be reached in their own environment on their own terms," said Regina Rogoff, executive director of People's Community Clinic.
That's why the organization established three outreach clinics in places where young adults gather, including this one — its first — at the Congregational Church of Austin at 23rd and San Antonio streets. At each one, People's Community Clinic partners with an organization geared toward serving youths who are in crisis: the LifeWorks Street Outreach Program at the church, which aids homeless youths, runaways and their families; American YouthWorks, which has a school for at-risk youths; and Phoenix Academy, which offers recovery to substance abusers.
The LifeWorks clinic has been at different sites near the University of Texas campus since the early 1990s and now uses the outreach program's office space.
The LifeWorks patients are "street-dependent youth," said Dr. Celia Neavel, medical director of outreach clinics for People's Community Clinic. Some live on the streets; others "couch surf" from one home to another. About a third of the patients have aged out of foster care and have no place to go, Neavel said. Others have mental illnesses; many are addicted to substances.
"Some are lost souls," said Neavel, 48, who also is a clinical assistant professor of pediatrics at the University of Texas Medical Branch-Austin. She supervises physicians in training who treat clinic patients as part of their residency requirement.
Not long after Ervin, 23, predicted a rush at the church-based clinic, the first patients arrived — travelers who have been in Austin since August.
"It's almost, like, I don't want to go anywhere else" for care, said Daniel Clark, 23.
"Where are you staying now?" asked Christina Gomez-Mira, 29, the clinic coordinator and health educator.
Clark said he and his girlfriend, Lilly Fagg, 18, were being evicted from their apartment in two days and would be moving on in less than two weeks, first to Colorado and then to California.
Clark said that for 10 years, he has had hepatitis C, one of the most common ailments clinic workers see. It is the most common blood-borne infection in the U.S., affecting 4.1 million, or about 1.5 percent, of Americans. It is generally spread when the blood of an infected person mixes with another person's. It can be deadly.
Clark told the nurse that he was nauseated. He was excited to hear that he had gained a pound.
Fagg said she had a "weird rash" just above her knees that itched constantly.
The two fit the mold of travelers the staff had described earlier: polite, intelligent and generally interested in their health.
Nurse practitioner Marcy Keefe examined Clark and then Fagg. Keefe prescribed a cream for what she diagnosed as hives. She also refilled Fagg's birth control prescription.
The pharmacy is a small set of storage drawers sitting on a file cabinet that hold antibiotics, steroid cream, birth control, ibuprofen and other basic medicines.
"It's amazing how much medicine you can practice out of those little boxes," Neavel said.
Rogoff estimates that 900 young people will have come through the three clinics by year's end.
Other U.S. cities have outreach clinics, Neavel said, "but I don't think there are tons of them."
She has three children between the ages of 14 and 20 and said she feels blessed to have such a rich, diverse job. But it can be wrenching to see young people made frail from living on the streets or being enslaved by their addictions, she said.
"We see and hear things that are very disturbing," she said.
She has learned to celebrate the small victories. "Sometimes," Neavel said, "the best thing you do is get somebody on birth control that day."
INDIANA
First Class Graduates from the Hoosier Youth ChalleNGe Academy
By Spc. William E. Henry
Many teens face a variety of hardships in their young lives. Some face extreme pressures due to drugs, gangs, violence, trouble in the home, or any other number of distractions, causing a lack of focus on scholastic accomplishments.
Where can young people turn when all hope is seemingly lost? Where can they look to receive guidance in accomplishing what is needed most?
This is the point where the Indiana National Guard Hoosier Youth ChalleNGe Academy raises its hand and answers those questions, giving Indiana teens an alternative opportunity to realign their sights on life-changing goals.
The academy has achieved its first successful objective, graduating a class of 35 teen cadets from 24 counties throughout the state. The ceremony was held at the Community Church of Greenwood, Saturday, December 8.
All the participating cadets volunteered for the 17 month quasi-military course that helped them achieve their high school diploma or equivalent. Thirteen cadets even earned college credits through the academy's partnership with Ivy Tech State College.
Three cadets, Deven Brown, Shawntay Dillard and Devon Hobbs, received scholarships to help further their college education.
The course focuses on eight core components in three phases. These components center on academic excellence, life coping skills, job skills, community service, physical fitness, health and hygiene, leadership/followership and responsible citizenship.
These are values that 18-year-old cadet Randal'lee Neeley says helped him identify discipline skills and his own self-potential.
"This is a very, very, very good program; it's helped me in so many ways," said Neeley. "When you come to this program you've got to want to change," he added. A change this young father said was crucial for him to get his life on track for his 1-year-old son, Marshall Ray Neeley.
With emotion, he said, "Ten years down the road I can take him down and show him the academy and say, 'This is where daddy got his life together for you.'"
Neeley, who received both the Academic Excellence and the Ironman Physical Fitness awards, said he was thankful they started the program and was appreciative of all the encouragement and guidance he received throughout the course.
Another cadet that could concur with the outstanding success of the program was Chris Slider of Indianapolis, who said he gained the willingness to push himself harder and beyond what he ever had before.
"One of the hardest things was being able to endure the extremes - the heat, the cold and the marches. Doing the things no one wants to do but you know you have to," said Slider. "It all came down to teamwork."
"I'm absolutely glad I came to this program, it was the best decision of my life," he added.
Slider's mother, Kelly Walker, said she could notice the difference in her son's demeanor during Thanksgiving when he returned home briefly on break.
"I saw the biggest change, he was polite and respectful. That was just wonderful," she said. "He was transformed from being a high school kid to an adult. I'm thankful for the staff and the governor for setting up this program."
Both cadets mentioned have great plans for their futures and both plan to further their careers in the military.
According to Indiana Governor, Mitch Daniels, keynote speaker for the ceremony, these outstanding cadets earmarked a page in history as the first class to graduate from the academy and lead the way for many more to follow.
"You are the pioneers, you are the trailblazers," proudly stated Gov. Daniels, who also said this will be the first graduation in a long line of classes to come.
The director of the academy, retired Col. Wayne Hill, said he utilized his 38 years of military experience to aide in his program to help these teens succeed.
"It's amazing to see them from where they started and where they ended," said Hill, speaking of the progress of the cadets. "I couldn't be more proud of them. They made a lot of friends along the way," he added.
Hill said each cadet completed an average of 58 hours of community service projects for a total of 2,038 hours. The graduates worked on many types of projects like planting trees, and more than 15,000 flower bulbs; working with children in nearby schools; and cleaning up litter and debris from park trails in Johnson County.
At minimum wage, this group of cadets has given back almost $12,000 in services to central Indiana areas.
The academy is currently recruiting for the second class that begins January 20, 2008.
So far, about 195 potential students have expressed interest in the academy's second class. Ninety-six have applied, 72 have attended required orientation and a tour of facilities with their parents and the academy has accepted 51 to date.
Indiana was the 25th state to adopt this type of program, which is administered and managed by the National Guard Bureau.
The academy is free to those accepted to the campus, which is based outside Camp Atterbury Joint Maneuver Training Center in nearby Edinburgh, Ind.
For more information on how you or someone you know (between the ages of 16 and 18, not in trouble with the law, is drug free, unemployed and a high school dropout), can get involved in the Indiana National Guard's HYCA, please visit: http://www.ngycp.org/state/in.
US DEPT OF ED
Report Provides High School Dropout Data
December 17, 2007
The U.S. Department of Education's National Center for Education Statistics has released the report "Numbers and Rates of Public High School Dropouts: School Year 2004–05."
The report draws on diverse sources to provide data on the numbers and rates of public school students who dropped out of high school in school years 2002–03, 2003–04, and 2004–05, and includes dropout rates by state, region, school district size, and several student characteristics.
Resources:
To access the report, visit http://nces.ed.gov/pubs2008/hsdropouts/.
ADOLESCENT BRAIN
Expert: Teen brain key to understanding criminal behavior
December 28, 2007
www.cnn.com
The teenage brain, Laurence Steinberg says, is like a car with a good accelerator but a weak brake. With powerful impulses under poor control, the likely result is a crash.
And, perhaps, a crime.
Steinberg, a Temple University psychology professor, helped draft an American Psychological Association brief for a 2005 case in which the U.S. Supreme Court outlawed the death penalty for crimes committed before age 18.
That ruling relies on the most recent research on the adolescent brain, which indicates the juvenile brain is still maturing in the teen years and reasoning and judgment are developing well into the early to mid 20s. It is often cited as state lawmakers consider scaling back punitive juvenile justice laws passed during the 1990s.
"As any parent knows," wrote Justice Anthony Kennedy for the 5-4 majority, youths are more likely to show "a lack of maturity and an underdeveloped sense of responsibility" than adults. "These qualities often result in impetuous and ill-considered actions and decisions."
He also noted that "juveniles are more vulnerable or susceptible to negative influences and outside pressures, including peer pressure," causing them to have less control over their environment.
Some child advocates have pointed to the Supreme Court decision and the research as evidence that teens -- even those accused of serious crimes -- should not be regarded in the same way as adults in the criminal justice system.
Dr. David Fassler, a psychiatry professor at the University of Vermont College of Medicine who has testified before legislative committees on brain development, says the research doesn't absolve teens but offers some explanation for their behavior.
"It doesn't mean adolescents can't make a rational decision or appreciate the difference between right and wrong," he said. "It does mean, particularly when confronted with stressful or emotional decisions, they are more likely to act impulsively, on instinct, without fully understanding or analyzing the consequences of their actions."
Experts say that even at ages 16 and 17, when compared to adults, juveniles on average are more:
- impulsive.
- aggressive.
- emotionally volatile.
- likely to take risks.
- reactive to stress.
- vulnerable to peer pressure.
- prone to focus on and overestimate short-term payoffs and underplay longer-term consequences of what they do.
- likely to overlook alternative courses of action.
Violence toward others also tends to peak in adolescent years, says psychiatrist Dr. Peter Ash of Emory University. It's mostly likely to start around age 16, and people who haven't committed a violent crime by age 19 only rarely start doing it later, he said.
The good news here, he said, is that a violent adolescent doesn't necessarily become a violent adult. Some two-thirds to three-quarters of violent youth grow out of it, he said. "They get more self-controlled."
Some of the changes found in behavioral studies are paralleled by changes in the brain itself as youths become adults.
In fact, in just the past few years, Steinberg said, brain scans have given biological backing to commonsense notions about teen behavior, like their impulsiveness and vulnerability to peer pressure.
It's one thing to say teens don't control their impulses as well as adults, but another to show that they can't, he said. As for peer pressure, the new brain research "gives credence to the idea that this isn't a choice that kids are making to give in to their friends, that biologically, they're more vulnerable to that," he said.
Consider the lobes at the front of the brain. The nerve circuitry here ties together inputs from other parts of the brain, said Dr. Jay Giedd of the National Institute of Mental Health.
This circuitry weighs how much priority to give incoming messages like "Do this now" versus "Wait! What about the consequences?" In short, the frontal lobes are key for making good decisions and controlling impulses.
Brain scans show that the frontal lobes don't mature until age 25, and their connections to other parts of the brain continue to improve to at least that age, Giedd said.
The inexplicable behavior and poor judgments teens are known for almost always happen when teens are feeling high emotion or intense peer pressure, conditions that overwhelm the still-maturing circuitry in the front part of brain, Giedd said.
As Steinberg sees it, a teenager's brain has a well-developed accelerator but only a partly developed brake.
By around 15 or 16, the parts of the brain that arouse a teen emotionally and make him pay attention to peer pressure and the rewards of action -- the gas pedal -- are probably all set. But the parts related to controlling impulses, long-term thinking, resistance to peer pressure and planning -- the brake, mostly in the frontal lobes -- are still developing.
"It's not like we go from becoming all accelerator to all brake," Steinberg said. "It's that we go from being heavy-foot-on-the-accelerator to being better able to manage the whole car."
Giedd emphasized that scientists can't yet scan an individual's brain and draw conclusions about how mature he is, or his degree of responsibility for his actions.
Brain scans do show group differences between adult and teen brains, he said, "but whether or not that should matter (in the courtroom) is the part that needs to be decided more by the judicial system than the neuroscientist."
Steinberg, who frequently testifies on juvenile justice policy and consults with state legislators on the topic, said it's not clear to him how much the research on teen brains affects lawmakers. They seem more swayed by pragmatic issues like the cost of treating teens as adults, he said. But he noted that he has been asked to testify more in the past few years than before.
In any case, experts say, there's nothing particularly magic about the age 18 as a standard dividing line between juveniles and adults in the courtroom.
Different mental capabilities mature at different rates, Steinberg notes. Teens as young as 15 or 16 can generally balance short-term rewards and possible costs as well as adults, but their ability to consider what might happen later on is still developing, he said.
A dividing line of age 18 is better than 15 and not necessarily superior to 19 or 17, but it appears good enough to be justified scientifically, he said.
Steinberg said he thinks courts should be able to punish some 16- or 17- year olds as adults. That would be reserved for repeat violent offenders who've resisted rehabilitation by the juvenile justice system, and who could endanger other youth in the juvenile system if they returned. "I don't think there are a lot of these kids," Steinberg said.
For the rest, he thinks it makes sense to try rehabilitating young offenders in the juvenile justice system. That's better than sending them through the adult system, which can disrupt their development so severely that "they're never going be able to be a productive member of society," Steinberg said. "You're not doing society any favor at all."
Ash said that to decide whom to treat as an adult, courts need some kind of guideline that combines the defendant's age with the crime he's accused of. That should leave room for individual assessments, he said.
But "we don't have very good measuring sticks" for important traits like how impulsive a juvenile is, he said.
In any case, the decision for each defendant should balance a number of reasons for punishment, like retribution, protecting society, deterring future crime, and rehabilitation, said Ash, who's a member of the American Psychiatric Association's Committee on Judicial Action.
Even if a 14-year-old murderer is held morally responsible for the crime, he will have matured by the time he's 18, and in the meantime he may be more amenable to rehabilitation than an adult murderer is, Ash said.
In fact, most experts conclude that rehabilitation works better for juveniles than for adult offenders, he said.
And just as parents know how irrational juveniles can be, Ash said, they also know that rehabilitation is a key goal in punishing them.
"What we really want," he said, "is to turn delinquent kids into good adults."
ANTIDEPRESSANTS
Many Physicians Fail to Heed Call to Monitor Youth on Antidepressants
December 21, 2007
By Jun Yan, pn.psychiatryonline.org
Although the FDA's warning on antidepressant-associated suicide risks in young patients was followed by a dramatic change in prescribing patterns, clinicians have not been seeing patients more often after starting antidepressant prescriptions.
When the Food and Drug Administration (FDA) warned clinicians that antidepressants may increase the risk of suicidality in pediatric patients in 2003, the agency also urged clinicians to closely monitor patients, especially those who are started on these medications, for signs of suicidal ideation. The evidence suggests, however, that the recommendation is often not followed. Patients who were put on antidepressants did not seem to receive more vigilant care from their health care providers, according to a study published in AJP in Advance on November 6.
The effect of the FDA public health advisory and subsequent black-box warning for all antidepressants received extensive attention in the lay media, and clinical practice changes followed. The number of patients, including children and adults, taking these medications has declined ever since (Psychiatric News, September 7, 2007).
Researchers from the University of Colorado at Denver and University of Pittsburgh analyzed a large managed care claims database to determine how frequently patients on antidepressants visited their health care providers between October 1998 and March 2005. They compared visit patterns with the depression-treatment standards recommended by the National Committee on Quality Assurance's Health Plan Employer Data and Information Set (HEDIS) metric.
There were no statistically significant changes in the percentage of pediatric patients who had received "optimal practitioner contacts" before and after October 2003, when the FDA issued the antidepressant advisory. The percentage of adult patients who had follow-up visits as recommended was even lower than that for children.
The HEDIS metric defines optimal practitioner contacts as at least three contacts with care providers in the first 12 weeks after the initial antidepressant prescription. Billable telephone contacts were considered a valid visit.
"We had expected some change in the intensity of monitoring after the FDA's advisory," said Robert Valuck, Ph.D., a coauthor of the study. "We were surprised by the findings given the immediate and accelerated drop in the diagnosis and overall treatment of depression and all the media attention and scrutiny."
The same group of researchers had found that after the FDA advisory was issued in 2003, fewer diagnoses of depression were made and, for those who were diagnosed with new episodes of depression, any treatment decreased as well (Psychiatric News, August 3 and September 7). They found no compensatory increase in treatment alternatives such as psychotherapy to accompany the plunge in antidepressant prescriptions.
Meanwhile, it appears that patients who were prescribed antidepressants in this period did not receive more frequent care from their treatment providers despite the FDA's recommendations. "Our data don't answer why," he said. The authors suggested a number of possibilities, including obstructed access to care, logistical difficulties in arranging for more frequent visits, and insurance-plan restrictions.
The HEDIS quality indicators were derived from expert consensus on clinical practice; the depression-specific indicators have been tracked since 1998. This study found that the quality of follow-up care for patients newly diagnosed with depression, at least in terms of contact frequency between clinicians and patients, did not change significantly after the FDA warnings about increased suicide risk.
The FDA recommended a more intensive schedule (seven visits in the first three months) of follow-up care in a medication guide released in 2003. This recommendation was removed in a revision to the guide earlier this year after psychiatrists complained about the lack of clinical evidence to support this stepped-up schedule.
Trends in follow-up care remained consistently flat across specialties. The study authors found that more psychiatrists kept up with antidepressant monitoring compared with other types of providers. About 80 percent of pediatric patients seen by psychiatrists had follow-up visits that met the HEDIS standard, a percentage higher than those seen by pediatricians (60 percent) and primary care physicians (54 percent). However, changes in the rates of meeting the HEDIS optimal practitioner contact standard before and after October 2003 were not statistically significant within each provider type, indicating a lack of influence on practice by the FDA advisory.
Included in the analyses were more than 27,000 pediatric patients and 193,000 adult patients in the managed care claims database who had a new episode of depression and received antidepressant medication within 30 days of the diagnosis. A new episode of depression was defined as having no depression-related diagnosis during the 120 days before the diagnosis and no antidepressant prescription claims during the 90 days before. "We have a robust dataset that is representative of national managed care populations and trends in clinical practice," said Valuck.
According to data recently released by the Centers for Disease Control and Prevention, suicide rates among youth increased by 8 percent from 2003 to 2004, which paralleled the drop in antidepressant prescriptions after the FDA warning (Psychiatric News, October 5). The public health effects of the mandated black-box warnings for antidepressants are still hotly debated.
OHIO
Report finds widespread flaws in state youth prisons
December 31, 2007
By Andrew Welsh-Huggins
Ohio's youth prisons are overcrowded and understaffed and fail to educate children behind bars or keep them safe, according to a new report that found widespread problems in the system serving about 1,700 youths.
Excessive use of force is common and ingrained in the operations of the Department of Youth Services, according to the report by consultant Fred Cohen released Monday. The report found that guards regularly place children in solitary confinement for inappropriately long periods of time.
Such confinement "is unconstitutional on its face" and should cease immediately, the report concluded.
At one center, the Ohio River Valley Juvenile Correctional Facility in southern Ohio, fear is "an all-consuming fire," the report said.
There, "youth fear other youth, youth fear staff, and staff fear youth," the report said.
Cohen's report also found that the department's eight detention centers have no functioning mental health program and a school system in disarray.
The report also said guards learn a "we-they" attitude from the time they start working in the system. The guards function more like police officers or prison guards than members of a team trying to rehabilitate children, the report said.
Youths' "physical and psychological well-being is at risk and often damaged at the present time," the report concluded. "This environment, in turn, dramatically impedes whatever efforts are made to provide treatment and programs."
The system, with about 770 guards, is understaffed by at least 188 guards, the report said.
The state hired Cohen to investigate after attorneys representing imprisoned youth sought to expand an existing 2004 civil rights lawsuit over conditions in the juvenile centers.
Youth Services director Tom Stickrath says he agrees with the report's findings and is pushing for major changes.
"I don't want to just look at improving the footprint that we have. I don't want to take what we're doing today and only do it better," Stickrath said Monday. "There's an opportunity to really change the landscape upfront."
The system has a troubled history.
In 2004, lawyers with the Children's Law Center of Kentucky sued the state over allegations of excessive force being used against girls at the Scioto Juvenile Correctional Facility.
Around the same time, the Department of Justice launched an investigation over the same allegations.
Twelve employees at the Scioto facility were eventually charged with abusing and endangering inmates and in early 2005 the agency's director was forced to resign.
In April, the Children's Law Center and other groups updated the 2004 suit to include the entire agency, saying the state had made inadequate progress on its promises to address their concerns.
In response, the state agreed to let Cohen investigate the entire system. Cohen also reviewed problems at the Scioto facility in 2004.
Cincinnati attorney Al Gerhardstein, a veteran civil rights attorney now leading the lawsuit, praised Stickrath's decision to undertake the review.
"It takes a brave public servant to open up the doors and say, 'Look under every nook and cranny, and I'll abide by what you find,'" Gerhardstein said.
He agreed that the system needs widespread changes, not just fixing how current programs work.
"The system doesn't work," Gerhardstein said Monday. "So I'm not sure that just more money would make this a system that prepares kids for success when they're released, and isn't that the bottom line?"
SEXUAL PREDATORS
Some states reconsider youth sex laws
December 27, 2007
By John Gramlich, Stateline.org Staff Writer
Lawmakers across the country continue to mete out harsh punishments to sex offenders--
from satellite tracking to the death penalty -- but a handful of states have eased up on penalties in cases of youths prosecuted for consensual sex.
Connecticut, Florida, Indiana and Texas enacted laws in 2007 that make a distinction between sexual predators and adolescents who do not pose a risk, such as those caught in so-called "Romeo and Juliet” relationships, in which one partner is of consenting age and the other is not.
The case in Georgia of former high school football star and homecoming king Genarlow Wilson served as a rallying symbol for supporters of more nuanced state laws, and could have lasting repercussions in statehouses nationwide, criminal justice experts said.
Wilson was convicted of aggravated child molestation in 2005 for receiving consensual oral sex from a 15-year-old girl in 2003 when he was 17. State law at the time required Wilson to serve 10 years behind bars without the possibility of probation or parole.
The sentence sparked national outrage and the Georgia Supreme Court freed Wilson in October after he had spent more than two years in prison, finding that his sentence was "grossly disproportionate to his crime.” Wilson's case was frequently cited by lawmakers in states that have taken steps to prevent low-risk adolescents from facing the same penalties as serious offenders.
Connecticut's new law widens the permissible age gap between consenting sexual partners from two years to three, in an attempt to trim the number of "Romeo and Juliet” cases prosecuted. Florida's updated law allows those involved in consensual sexual encounters, with no more than four years between them, to petition to have their names removed from state and national sex-offender registries.
Indiana decriminalized consensual sex between adolescents if they are found by a court to be in a "dating relationship” and have an age difference of four years or less. Texas overhauled a risk-assessment system that, according to critics, allowed some juvenile offenders, including those having consensual sex with a younger partner, to receive a higher risk rating than many serious predators.
Georgia, meanwhile, revised the law that was used to prosecute Wilson, introducing a maximum 12-month punishment for similar offenses.
CALIFORNIA
December 25, 2007
Abclocal.go.com
Californians with New Year's resolutions to quite smoking will have an additional impetus this year: a new law prohibiting smoking in cars with minors goes into effect Jan. 1.
The new law would allow fines of up to $100 for anyone smoking cigarettes, cigars or pipes inside a motor vehicle when anyone under age 18 is present.
According to the American Lung Association of California, the law is the strictest smoke-free care legislation in the United States.
"Passengers, especially youth, are exposed to dangerous levels of toxic air contaminants when someone is smoking in a car," said Paul Knepprath, the group's vice president of governmental relations.
"Fortunately California leads the world in creating healthier, smoke-free environments for its citizens, and we are pleased that California youth will benefit from this vital new health protection," Knepprath added.
Additional benefits from fewer people lighting up in cars could be less cigarette litter and lower risk of wildfires, according to the American Lung Association.
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