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A Safe Place for Troubled Teens

Alameda County's path-breaking new mental-health court seeks to help youth with psychiatric problems who have broken the law.



In 2008, Judith Crane made one of the hardest decisions of her life. She called the police on her teenage daughter Cindy. Doing so meant her daughter would soon be headed for juvenile detention for violating probation.

Cindy had flown into a rage and grabbed her mother by the hair. Medical records from various psychiatric hospitalizations and evaluations describe how she has overturned furniture, broken electrical equipment, thrown knives at her sister and threatened to break her neck, and cut her own wrists. Of the many diagnoses assigned to the teenager, two remain: post-traumatic stress disorder from physical violence she and her family suffered at the hands of her late father, and "mood disorder, not otherwise specified."

"It's one of the hardest things for a parent to go through," Judith recalled, her eyes welling with tears at the memory. "That you want them to go somewhere to get help, that you can't help them anymore. And then the guilt comes in massive waves. I thought I was going to die from it. I couldn't stop crying after she left."

On any given day in the United States, more than 120,000 minors throng the cells of juvenile detention and other locked facilities. The majority have at least one diagnosable mental-health disorder, according to a 2002 study of the county's juvenile justice system. And the kids are often in custody because desperate parents like Judith had nowhere else to turn. After they get out of "juvi," they are often warehoused in foster care and group homes without ever getting adequate treatment or support. Many drop out of school and end up in the adult criminal justice system. But now there's help from an unexpected source: mental-health court.

In Alameda County and about fourteen other US counties, attorneys have teamed up with judges, social workers, psychologists, psychiatrists, and families to offer treatment and services to minors with psychiatric problems who've broken the law. The idea is to get teenagers like Cindy out of the penal system and help them lead productive lives. Instead of watching kids get thrown out of school for behavior problems, advocates attempt to create environments that would enable them to stay in school. Rather than cycling through group homes, these kids get help so they can live with their families. Instead of simply handing out referrals for psychiatric help, mental-health court makes sure that teens actually attend their appointments. And rather than simply sentencing kids to jail for violating probation, mental-health court tries to address the problems that caused the violation.

Children's unmet mental-health needs too often cause parents to make choices no parent should have to make. A 2003 report by the General Accounting Office noted that during a one-year period parents placed more than 12,700 children in child welfare or juvenile justice systems seeking mental-health services.

Judith Crane was seeking help for Cindy when she made the call that sent her to detention. She had no idea how fortuitous that move would prove to be. Among the more than 2,900 children who pass through the doors of the Alameda County Juvenile Hall of Justice detention center annually, Cindy was one of a handful identified to work with the new court.

She became a client of the court in February 2008 at the age of sixteen. Known as the Alameda County Juvenile Collaborative Court, it serves children who have treatable mental-health problems but who are not considered threats to public safety. Children and their guardians must be willing to have the child live at home, and agree to a plan for sorting out their often enormous constellation of problems.

In exchange, a team that includes the court's judge, probation officers, legal aid advocates, law students, the district attorney, and mental-health counselors help the family chart a path to recovery. The goal? For the family to survive together, and the child to remain in school.

Without some kind of intervention, such youth almost inevitably wind up back in court. According to a study from the National Center on Secondary Education and Transition at the University of Minnesota, "The dropout rate for students with emotional/behavioral disabilities is approximately twice that of general education students." And failure to complete school makes it much more likely that these kids will end up in the criminal justice system. Within three to five years of dropping out, "the cumulative arrest rate for youth with serious emotional disturbance was 73 percent," the report said.

"To put them on probation is setting them up for being in the system long-term," said Matthew Golde, the assistant district attorney for Alameda County Juvenile Justice Division, part of the Collaborative Court team

Each family brings its own history to the table. But all arrived at a breaking point. And most of the plans designed to help them have been shaped and reshaped due to an ever-shifting landscape of family problems, a maze of eligibility requirements, and a new and imperfect understanding of how to identify and treat mental-health problems in children and teens.

Take Cindy Crane — whose name, along with that of her mother, has been changed to protect her privacy. When she was doing well, she helped keep classmates out of trouble, acted as a witness when someone was treated unfairly, and tutored other kids in math. She is philosophical about her unmanaged anger, which has led to behavior that's caused police or a probation officer to show up at her house. "I have anger issues," she explained. "But I get angry for legitimate reasons."

From the time she was a young girl, Cindy was abused by a violent father who lashed out at her mother and his children. When Cindy was an infant, Judith tried to soothe her so her crying wouldn't anger her sleeping father, who worked the graveyard shift. On a medical record from when she was hospitalized at age thirteen for slitting her wrists, it notes that abuse by her father had led to calls to Child Protective Services, and that as a small child she had "stepped in between her parents to try and protect her mom." Once Judith left the children's father due to domestic abuse, she had to get three different restraining orders against him over a period of nine years for hurting her children.

So the court set up therapy sessions to help the family communicate. In one session, Judith learned that Cindy becomes enraged when she hears the words, "calm down."

"I learned that the hard way in family therapy when she screamed it at me," Judith said. "I warn others, too, that you can say relax, take a deep breath, but never use the words 'calm down.' We've also learned to respect each other more. I don't like her using God's name in vain. She does periodically and she says, 'I'm sorry.' That's just respecting each other more."

On the last day of 2008, juvenile detention at the Alameda County Juvenile Justice Center in San Leandro was more than half full. Some 255 minor teens had been locked up for breaking the law or violating probation. Some were in between placements in group homes. Some were there because their families could no longer handle them. Girls walked in single file down a long hall, their hands clasped together against their backs. Most looked down.

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