It used to be that troubled kids who ran afoul of the law ended up in one place: juvenile hall. And there, for the most part, they found little help for their psychological problems. But slowly that attitude has been changing as more and more states are trying to treat the mental health problems at the root of chronic lawlessness.
In California, for example, counties are working to diagnose and aid the ever-increasing needs of their mentally ill juvenile offenders. In Los Angeles, the nation's second largest city, the changes are fitful and imperfect, but promising.
Jesse, 17, stands in the doorway of his kitchen in Compton, a drug-infested neighborhood in south L.A. He has soft, brown eyes and shoulders the size of a linebacker. He laughs easily, and it's hard to imagine that his run-ins with the law nearly crushed this family.
"I got on probation when I was in 10th grade. I was caught with a knife at school. Ever since that I started getting in trouble more and more often," he says.
He used drugs and got in fights. Finally, he was arrested for vandalism and sent to juvenile hall.
"They put you in a room with a psychiatrist, and then they start basically with a computer," he says. "You take a test and then they start asking you all these questions."
Questions like: Have you felt like hurting yourself? Have you ever seen someone killed? Like many teen offenders, this was the first time ever that anyone had asked Jesse about his mental health. These psychological tests are now used in 42 states, and they show that untreated depression or trauma is rampant among juvenile offenders.
The tests signal a much larger effort around the nation to identify those with undiagnosed mental illness and get them help. That's how Jesse — who is still a minor and didn't want his last name used — ended up in months of court-ordered family therapy.
Jesse's mother, Marisol, sits next to him on the couch. Marisol was reluctant at first to let a therapist in her home, but she says the treatment is easing her son's depression.
"He usually listens and goes to school, which was one of the biggest issues," she says. "He's not using [drugs] anymore."
And, she says, he's not lying.
Academic researchers say about half of L.A.'s young offenders suffer from depression, post-traumatic stress disorder or other forms of mental illness. But it's difficult to say who gets help. In any given year, Los Angeles has some 20,000 juvenile offenders. Fifteen thousand are released on probation, and the county has no reliable data on who receives treatment and whether it works.
"That's kind of where we're weak right now. When the kids leave our facilities and go to the community they don't always stay connected," says Dave Mitchell, bureau chief of placement services for the Los Angeles County Probation Department.
"I would say 10 years ago, we were more aligned with law enforcement and a lot of that was because that's where the funding was," he says. "We've been in a transformation for about the last 10 years to align ourselves with rehabilitation."
The alignment is working, but it's expensive. The department draws federal, state and county funding and still there aren't enough programs and therapists to meet the need. What's more, many of these kids are uninsured and have no way to pay for their medication and therapy.
All of this comes as California's lawmakers are slashing budgets. Mitchell says if a proposed tax extension isn't approved, Los Angeles County alone will lose $100 million in juvenile justice funding.
"And a lot of the community-based services that we've worked so hard for in the last five to six years will go away because we'll be doing the minimum supervision," he says.
Despite the shortcomings, many experts say the changes going on in Los Angeles, and in many California counties, are significant. Pamela Robertson, who works for a nonprofit mental health provider called Starview Community Services, says county leaders have made it clear that mental health is a priority.
"The word is going out ... into the ranks of probation officers that this is a good thing: Utilize these services!" she says. "And they're starting to respond to that, sending more referrals in."
There are other changes, too. Some of those probation officers are now trained therapists. A special phone line connects kids to treatment, and there's intensive, outpatient care for 12,000 particularly troubled teens.
The most concentrated effort though is with kids in jails. There are now four times the number of mental health staff in county jails and special areas for those on suicide watch. But even there, the quality of care remains a big question mark.
Road To Recovery
Francheska Lamb spent many dark nights on suicide watch. At 21, she has a fresh and freckled face — and an 18-month-old son, Aiden. Lamb has spent half her life in L.A.'s juvenile justice system.
"They wanted to put me on all kinds of medicine because I couldn't sleep and I was all drugged up," she says. "I was cutting on myself real bad because it came to me that nobody wants me and that's just how it is."
Lamb was first taken from her mother at age 4 and turned over to her grandmother. By 11, she was doing crystal meth in the school bathroom and ended up in L.A. juvenile hall. When a special facility opened for incarcerated teens with serious mental health problems — a result of the big changes taking place in Los Angeles — Lamb went there. She got some help, she says, but not enough.
"The only thing they would do for me was lock me up in a room with a camera," she says. "They would try to talk to me but they weren't talking to me with respect. Like they'll just yell at me, like — 'Why you doing this?' "
Los Angeles County says it's doing all it can for those in its care, and mental health experts add that recovery is a tough road: It can take years of therapy and medication for troubled youth to right themselves.
For Lamb, something along the line seems to have worked. She's out of jail now. She's stopped doing drugs and self-mutilating, and she's earning her high school diploma. It's a rare — and delicate — moment in her life. The closest thing she's experienced to calm. A perilous and uneasy calm.