Maryland youths with severe mental health needs are “inappropriately sent” to juvenile detention facilities, the report says.

Maryland youths with severe mental health needs are being “inappropriately” sent to detention facilities that are struggling to serve them, according to the state’s Juvenile Justice Monitoring Unit.

And those settings, including the Baltimore City Juvenile Justice Center, are likely to worsen conditions for young people, the agency said in a recent report.

The report said: “Maryland’s juvenile justice system cannot become a permanent part of the mental health system.” “Maryland state government and its various departments need to fully and permanently address the critical shortage of inpatient psychiatric facilities and ensure the provision of comprehensive mental health services for young people.”

A similar problem persists for adults in Maryland. The state does not have enough psychiatric beds and a growing number of defendants waiting to be admitted, The Baltimore Sun reported in July. This has left people with severe mental illness accused of crimes but deemed unfit to stand trial to languish in prisons across the country.

The number of juveniles incarcerated in Maryland is increasing, including in all of the department’s detention facilities. At the state-run Baltimore City Juvenile Justice Center, the city’s center for boys, the average daily intake during the first quarter of 2024 was 98, up from 63 in the same period in 2023 and 58 in 2022.

At the same time, the number of attacks and youth fights increased in this center, as did incidents related to money laundering.

A report by the Juvenile Justice Monitoring Unit, part of the Maryland Attorney General’s Office, did not provide a specific number of youths who would be better served by mental health facilities than in a detention setting. It said youth in need of special mental health services are placed, through court and department management, “in secure facilities where their conditions worsen.”

The monitoring unit is responsible for investigating the needs of children under the supervision of the Department of Juvenile Services, and reports quarterly on how the juveniles are treated in the facilities. Investigators have access to internal records of the Department of Children’s Services, conduct unannounced visits and interview youth, staff and administrators.

The Department of Children’s Services has issued a request for comment on its response to the July report of the Department of Juvenile Justice. In it, the department did not directly respond to the department’s findings, but provided a comprehensive update, including mental health services.

The Department of Children’s Services says there is access to licensed nurses at each facility, while the provider provides services at the detention centers, such as mental-behavioral therapy, in partnership with the school. , psychiatry and pharmaceutical administration.

In the department’s two “pending units,” located at the city’s detention center and the Cheltenham Youth Center in Prince George’s County, the department’s nurses have the same treatment hours as a youth would access in the program after his trial. has been sentenced, the juvenile system time for when the case is concluded, the Department of Children Services added.

The Department of Juvenile Justice has praised pending placement units for reducing the “death time” young people face in custody while waiting for a placement to open up. However, it advised that Cheltenham’s program may need improvement and suggested that the agency should look closely at the contracts for mental health services at its three main centres. captivity.

In another case, described in a recently released report for the first quarter of this year, a teenager was “mixed” in a series of detention centers between November and May.

During those months, he exhibited “self-harming” and disruptive behaviors, such as breaking light fixtures or plastic objects to find small parts that he could use to harm himself, or destroying equipment such as telephones, televisions and computers, the report said.

When he broke the group’s phone and television while being held at the Baltimore City Juvenile Justice Center, he had to be separated from his peers, who “threatened retaliation.”

A Department of Youth Services contractor did not refer the youth for outpatient evaluation or treatment, or provide adequate services for him, despite his “numerous stress-related needs,” in follow the inspection department.

He was later transferred to the Charles H. Hickey Jr. School. In Baltimore County, another state detention center, he was held in solitary confinement in the back of a boarding house.

He and other “at-risk” youths are often released from secure detention facilities, the report said. Decompensation is the medical term for when a person loses normal function or experiences worsening symptoms.

A second youth incarcerated in Hickey was involved in violent incidents earlier this year, including an attempt to beat up a teacher who he said made inappropriate comments about his late mother. The teenager reported that her medication was not helping her, and said she had “severe depression combined with hyperactivity.”

The decline in youth incarceration is at least partly because correctional staff are less able to address behavioral and psychological needs, the report said. Workers use verbal commands, restraints, seclusion and seclusion with youth to gain agreement, the report said, and those practices “can exacerbate youth mental health problems.”

“The goal should be to identify and try to solve the problem,” the report said.

Melissa Goemann, senior policy advisor with the National Association for Juvenile Justice, an advocacy group, said the youth center environment can be a “huge source” of trauma and stress for young people. It isolates them from support systems such as family members, who may or may not be able to visit them, they are treated harshly and, often, there is insufficient screening or treatment.

“The best way to reduce the number of youth with mental health issues in the juvenile justice system is through prevention to keep them out the front door,” Goemann said.

He advocated building youth health responses, separating from law enforcement, adding mental health providers to schools and creating other mechanisms for law enforcement to divert youth from with mental health problems in community resources.

The report also blamed a nationwide lack of community or residential mental health services. Without enough of those in place, young people with mental health needs are “trapped in the youth justice system” and “cycled”, it said.

Joseph Ribsam, the Annie E. Casey Foundation’s director of child welfare and juvenile justice policy, said the problem is nationwide: Behavioral health care for children “falls behind” care. outpatients without medication, leaving few options available until hospitalization.

Treatments can include general supports, home therapy tools, peer interaction for children and parents, and telephone response and stabilization, Ribsam said, instead of incarceration.

“The act of removing a child from their home, from their place, from their community, really exacerbates the underlying trauma,” he said. “Even if you try to do the right thing by bringing in medical services to deal with any mental health problems, it’s possible that a young person will fail so uncontrollably that they can’t receive that treatment. given. .”

Originally published: August 9, 2024 at 5:00 am