Out of Mind, Out of Sight

For a growing number of Texas kids with mental illnesses, the only place to get help is behind bars.

Editor's note: This is the third in a continuing series of stories examining the effects of a massive overhaul of Texas' juvenile justice system in the mid-'90s.
 
With a state-issued razor blade Becky scraped the skin off her knuckles, shaved strips of flesh from inside her arms and carved the names of girlfriends onto her thighs. She buried staples so deeply into her skin that they need to be surgically removed.

The 15-year-old with pale green eyes and sandy blond hair sits in the superintendent's office at the Corsicana Residential Treatment Center, 60 miles south of Dallas, where the state sends mentally ill juvenile offenders. Arms crossed over her chest, she talks about living in Dallas with her grandmother until she was 6. After her grandmother's stroke, her dad, a Houston mechanic, brought her to live in Bellaire where she failed first grade, started smoking cigarettes and was drinking, having sex and getting stoned by the time she was 11. She moved in with her mother and was soon expelled from school for carrying knives. She says she was molested by a friend of her father's, raped in her mother's trailer and sexually assaulted by numerous guys during the many times she ran away from home.

She tried to die six times: hanging herself twice and swallowing bottles of Tylenol, Excedrin and NyQuil. At 13, she was living on the streets of Dallas addicted to crack. Drunk on gin and juice, she stole a Mustang, crashed into a row of parked cars and was arrested when she stopped for gas. Sent to a court-mandated drug rehab center, she ran away two weeks later. She spent a month giving blow jobs to Corpus Christi gang members in exchange for drugs and shelter until she was turned in as a runaway. The judge was going to give Becky a second chance, but Becky's mother told the court Becky couldn't be trusted and that she didn't want her to come home. She wanted her daughter sent to the Texas Youth Commission.

There Becky cried constantly, couldn't sleep and tried to hang herself with her T-shirt. She was diagnosed with depression, uncontrollable anger and post-traumatic stress disorder from sexual abuse and was sent to one of the state's 52 beds for mentally ill female offenders. She takes three different types of medication to stabilize her mood, alleviate her depression and help her sleep. Like many kids in Texas, Becky got the treatment she needed only after she was incarcerated.

"In Texas the only way adolescents get mental health care is if they're arrested," says Mike Griffiths, executive director of the Dallas County Juvenile Probation Department. "Often a parent will be advised by a school counselor or police officer to file an offense report against them and they'll get taken care of. That's not the best way to get mental health care; unfortunately it's the most common way for children in this state."

Texas has always ranked in the bottom five in treating the mentally ill, says state Representative Sylvester Turner, a Houston Democrat. "They can't get the help because it's not there," he says. Turner recently pushed a $35 million plan through the Legislature to identify offenders with mental illness and continue treatment after they're released. "You don't just let them out the door and depend on them," Turner says. "You stay with them all the way through."

Right now, the Texas Youth Commission just lets them go. Almost half of approximately 5,000 adolescents at TYC have a diagnosed mental illness, according to Dr. Linda Reyes, TYC's assistant deputy executive director for rehabilitation. Last year the state spent $1.5 million on psychotropic drugs for 820 incarcerated teens. But the care didn't follow kids into the community. Of 705 juvenile offenders with severe mental illness paroled last year, only 92 received continued care.

In Harris and Dallas counties there are very few beds for indigent children. The University of Texas Harris County Psychiatric Center costs $642 a day, and the average stay is 10 days. Private psychiatric hospitals can run $1,000 a day. Kids like Becky, who lived in a trailer, can't afford $100-an-hour psychiatric visits. "These kids are ignored until they commit a crime," says Joanne Go, community education director for Houston-based Child Builders, a mental health advocacy group.

Teen crime skyrocketed in the 1990s. When George W. Bush became governor, millions were spent building bigger prisons in an effort to reduce crime rates. Judges handing down harsher punishments caused a dramatic drop in violent crime, says Harris County Judge Robert Eckels, chairman of the Harris County Juvenile Board.

But cracking down on crime uncovered a growing problem: With more kids locked up, more have been diagnosed with mental illness. Since 1995, the percentage of kids TYC has identified with major mental illnesses has nearly doubled, Reyes says. Because of the increasing number of mentally ill kids arrested, Dallas County created a psychiatric ward inside the detention center, and Harris County contracted a wing at Harris County Psychiatric Center. TYC sends kids it deems mentally ill to one of two facilities, the Corsicana Residential Treatment Center or the Crockett State School, a 90-minute drive north of Huntsville.

Still, not every emotionally disturbed offender is identified and sent to a treatment program. Differentiating between a kid with a diagnosable disorder and a normal rebellious teen takes more time than many police officers have. On the surface, the two may seem the same, but the difference lies in the intensity, degree and frequency of the bad behavior, says Dr. Mitch Young, a Houston-based specialist in child, adolescent and forensic psychiatry and president-elect of the Texas Society of Child and Adolescent Psychiatry.

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