By Ray Stern
By Ray Stern
By New Times
By Amy Silverman
By Stephen Lemons
By Stephen Lemons
By Monica Alonzo
By Chris Parker
On April 24, a boy arrived at Adobe Mountain. Here's an excerpt from his intake report:
Youth states he was hearing voices and crying. Youth indicated he had been hearing voices for quite some time and instructed him to kill himself. On Tuesday 04/21/09 youth jumped off a second floor balcony at the direction of his voices . . . Youth further indicated he has asked his father for medications the other day and his father had refused and would not take him for medical assistance. Youth was attempting to get to a hospital for assistance when he was arrested. Youth was informed by his cousin that he had burglarized a home without any memory of the incident. He appears to be suffering from some type of psychosis and needs to be closely watched and evaluated ASAP for medications.
For this story, New Times reviewed hundreds of pages of agency reports on suicidal behavior, threats, and injuries, obtained through a public-records request. Other reports — such as the one involving the girl who ran through the grounds of Black Canyon, dripping blood — were obtained from sources inside the agency. About a half-dozen current ADJC employees from three of the agency's four facilities were interviewed extensively, some over the course of several months. In almost all cases, names of youth were redacted from reports; New Times will not name any youth in this story, or the employees, who fear for their jobs.
New Times examined six months' worth of reports of suicidal behavior at the ADJC in 2009, and the incidents mentioned in this story only scratch the surface of what is clearly a gaping wound. The agency has documented cases of kids self-abusing by cutting, scratching, choking, and hitting themselves on pretty much a daily basis.
It's hard to know exactly what's going on, and how it compares nationally, without formal statistic-gathering. An organization called Performance Based Standards does just that on a host of issues, including suicidal behavior, for participating juvenile corrections facilities across the country. The Arizona Department of Juvenile Corrections participated in PBS in the past but hasn't for years. (Department administrators say it's not cost-effective to take part in the national comparison; the ADJC uses its own system to measure data, which they say is more precise.)
National and local experts on mental-health care for teens were interviewed for this story. The general consensus is that services are sorely lacking, both in the private and public sectors, as well as at correctional facilities. To further complicate matters: Once a child is sent to the correctional system, legally, the public health system will no longer cover mental healthcare.
Problems appear to be particularly serious in Arizona, but the state is far from alone. Parents everywhere are at a real loss as to how to help their kids.
Earlier stories in this series explored one family's successful attempt to place their son in a government-paid residential treatment facility that can address his serious mental illness and violent tendencies ("Saving Alex," October 8) and another family's less-successful efforts to save their daughter from substance abuse and mental illness by sending her to a private wilderness-therapy camp ("Losing Erica," November 5).
The truth is that both Alex Varlotta and Erica Harvey could easily have ended up at the Arizona Department of Juvenile Corrections. The department estimates that 30 percent of the children in its care suffer from serious mental illness, with a diagnosis falling under the rubric of the DSM-IV, the American Psychiatric Association's official manual of mental disorders. Even more have suicidal tendencies, and about 84 percent of all the children at the ADJC have a substance abuse problem.
While conditions have improved somewhat at the ADJC, following a federal investigation several years ago, the agency is clearly unable to provide adequate care for seriously mentally ill kids. And yet it is the agency's legal mandate to take these kids.
"We have to be responsible for what comes through the door," says Kellie Warren, the ADJC's deputy director in charge of mental-health services.
"It's not an appropriate place for these kids," she admits. "Those kids that are significantly mentally ill, they end up decompensating here."
And yet, Warren acknowledges, this is where they land — at an increasing rate. "You're seeing the justice system becoming almost the new asylums," she says.
She's not exaggerating. The state recently closed the adolescent unit at the Arizona State Hospital. Maricopa County has no comparable unit for adolescents at its own facility. If you qualify for Medicaid, you can get your mentally ill kid services — maybe. If you don't qualify for Medicaid, the private options are even more limited. If your kid is violent, services may be all but non-existent.
Warren says juvenile court judges hear of the compendium of services her agency provides (and she certainly does a good sales job on it, if her interview with New Times is any indication), and they figure it's the best option for the mentally ill kids who come through their courtrooms.
Even that option could go away.
This summer, Governor Jan Brewer asked state agencies to submit a plan describing how they would cut 15 percent of their budget over a six-month period. The ADJC's plan includes closing three of its four facilities, as well as its mental-health unit for boys. It's widely believed that the plans the governor asked for are designed to be a scare tactic for the Arizona Legislature, which is eager to avoid raising taxes — but you never know.