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Mental Health and Incarcerated Youth - Journal of Child and...

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Journal of Child and Family Studies, Vol. 8, No. 2, 1999. pp. 205-215 Mental Health and Incarcerated Youth. II: Service Utilization Andres J. Pumariega, M.D., 1,8 D. Lanette Atkins, M.D., 2 Kenneth Rogers, M.D., 3 Larry Montgomery, M.D., 4 Cheryl Nybro, Ph.D., 5 Robert Caesar, Ph.D., 6 and Donald Millus, B.S. 7 The incarceration of mentally ill youth is a serious problem not receiving the same attention as in adults. In this study, we examine the level of prior service utilization in incarcerated youth versus youth receiving community mental health services. We randomly recruited youth from middle South Carolina served by a local community mental health center (CMHC; n = 60), hospitalized in the state adolescent inpatient program (n = 50), and incarcerated in the S.C. Dept. of Ju- venile Justice facilities (n = 75). We used a Services History to evaluate episodes of prior utilization of mental health, social service, educational, residential, and volunteer services, as well as the DISC-PC 2.3 to evaluate DSM-III-R diagnoses and symptoms and the CBCL and YSR to evaluate behavioral symptomatology. Incarcerated, hospitalized, and CMHC youth utilized similar levels of educational services and social services. Incarcerated youth had a significantly lower lifetime utilization of outpatient and acute mental health services and significantly higher utilization of out-of-home residential services than the other groups. These ser- vices utilization variables, along with gender and age, significantly distinguish incarcerated youth from the clinical groups, with clinical variables not serving to 1 Professor and Chair, Department of Psychiatry and Behavioral Sciences, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee. 2 Medical Director, New Hope Midlands Residential Treatment Center, West Columbia, South Carolina. 3 Assistant Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina. 4 Director of Inpatient Facilities, South Carolina Department of Mental Health, Columbia, South Carolina. 5 Engineer, KHARAR Engineering, Columbia, South Carolina. 6 Deputy Associate Director for Child and Adolescent Services, William S. Hall Psychiatric Institute, South Carolina, Department of Mental Health, Columbia, South Carolina. 7 Medical Student, University of South Carolina School of Medicine, Columbia, South Carolina. 8 Correspondence should be directed to Andres J. Pumariega, East Tennessee State University, P.O. Box 70567, Johnson City, Tennessee 37614. 205 l062-1024/99/0600-0205$16.00/0 © 1999 Human Sciences Press, Inc.
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Pumariega, Atkins, Rogers, Montgomery, Nybro, Caesar, and Millus The high prevalence of mental illness/serious emotional disturbance in incar- cerated youth raises questions of how such youth have failed to be identified and served previously (Atkins et al., 1999). The fact that mentally ill youth are being incarcerated at all brings up serious concerns about the failure of community men- tal health and social services designed to prevent such outcomes (Duchnowski, Johnson, Hall, Kutash, & Friedman, 1993).
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