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Online Mental Illness Training for Law Enforcement: Easy Access to a Difficult Topic

PRODUCED BY AND REPRINTED WITH THE PERMISSION OF THE MINNESOTA CHIEFS OF POLICE ASSOCIATION

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In Favor of a Collaborative Law Enforcement Approach to Assisting Those with Mental Illness

PRODUCED BY AND REPRINTED WITH THE PERMISSION OF THE MINNESOTA CHIEFS OF POLICE ASSOCIATION

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Youth Trauma Linked to Later Ills

Article by: JEREMY OLSON , Star Tribune

Survey: Childhood stress can increase disease, anxiety and drinking in adulthood. Stress and trauma in childhood tend to lead to anxiety and poor health in adulthood, according to Minnesota’s first-ever survey of adults about “adverse experiences” in their youth.

More than half of the 13,520 Minnesotans reported at least one traumatic experience in their childhood, including physical abuse, parental divorce or the incarceration of a household member. Those who reported multiple events had higher rates of chronic diseases such as asthma and mental disorders such as depression.

“They’re at the heart of many of the leading causes of death and disability,” said Dr. David McCollum, who works in the injury prevention unit of the Minnesota Department of Health.

The department released the data Monday, making Minnesota the 18th state to survey adults about youth trauma. The survey builds on research by the U.S. Centers for Disease Control and Prevention showing that traumatic events in childhood can cause toxic levels of stress that actually alter children’s brain chemistry. Other research has correlated such childhood events with suicide, unintended pregnancies, illicit drug use and sexually transmitted diseases.

“Stress becomes hard-wired in the body, and that is expressed throughout life,” said Laura Porter, former director of the Washington State Family Policy Council. Her state was among the first to study the relationships.

Verbal abuse was the most common among the nine categories of childhood events in the survey, followed by living with someone who has a drinking problem. One in 10 respondents reported sexual abuse in childhood and one in seven reported physical abuse. McCollum said the type of events didn’t matter; the higher the number, the more likely they were to correlate with problems in adulthood.

One in four Minnesotans in the survey reported four or more adverse experiences. They were twice as likely to be chronic drinkers and at least five times as likely to suffer anxiety.

The research doesn’t prove that childhood traumas cause adulthood problems, only that there is a statistical relationship. These experiences also had a profound link to overall well-being, said the Health Department’s Pete Rode, and were associated with a higher likelihood of dropping out of high school, being unemployed or worrying about paying for rent and food.

Research on the impact of childhood experiences began in the 1990s with a California doctor who wondered why some adults were dropping out of his otherwise successful weight-loss program. A review of medical records showed strong correlation with problems in childhood.

Porter said the research in Washington gave parents a new appreciation of the power of childhood experiences. Some parents revamped the way they treated their children; neighbors often showed more compassion to people with traumatic upbringings.

One concrete change in Washington was alternative sentencing for mothers convicted of nonviolent crimes, so they could raise their children and prevent the severe stress of separation.

Minnesota’s report recommended no such specific changes. It urged a similar effort to raise public awareness, along with financial and other resources to deal with the lingering problems of childhood trauma.

McCollum said the findings do not mean that someone has an unchangeable “destiny” just because of problems in youth. It does mean the state needs to understand the risk factors and help children and adults cope, he said. People can’t just say, “Time will heal things. Just put it behind you. Pull yourselves up by your bootstraps,” he said. “It doesn’t work.”

Jeremy Olson • 612-673-7744

Share of Minnesotans who reported childhood exposure to:

  • Household member – 7% incarcerated
  • Sexual abuse –  10%
  • Physical abuse –  16%
  • Mental illness – 17%
  • Problem drinking –  24%

Source: Minnesota Department of Health

OFFICERS IN COLUMBIA HEIGHTS LEARN HOW TO RESPOND BETTER TO PEOPLE IN CRISES WITH MENTAL ILLNESS

BY KASSIE PETERMANN – SUN NEWSPAPERS

The Columbia Heights Police Department, along with the Anoka County Sheriff’s Department, is leading an effort to better prepare officers when they encounter people who are suffering from mental illness.

The effort combines online training and hands-on scenarios with actors trained by the Barbara Schneider Foundation, which works to improve the response to those in mental health crisis and prevent mental health crises. The Foundation was formed in response to the death of Barbara Schneider in 2000, when police shot her during a confrontation in a mental health crisis call.

The online curriculum, created by Metropolitan State University, takes four to five hours and can be completed in increments by officers between calls or during time designated by their agency. Participating agencies include police departments in Fridley, Blaine, Coon Rapids, Lino Lakes and Ramsey.

Columbia Heights Police Chief Scott Nadeau said he went through the one-week Crisis Intervention Team (CIT) training about 10 years ago, which was developed by the Memphis Police Department in 1988.

Nadeau said he saw a lot of Anoka County agencies were not providing officers the training, and that sometimes when people with mental illness experience crises, officers often have little or no training in how to recognize or de-escalate those types of situations.

He said sending people suffering from mental health issues to jail or giving them a ticket isn’t always the best way to handle the situation.

“Many officers lack information on agencies and resources that are needed for successful problem solving,” Nadeau said. “This training program was created to prepare offices to recognize mental health issues and respond as effectively as possible.”

Training sessions were 7:30 a.m. to 4:30 p.m. Feb. 28 and March 29 at the Columbia Heights Police Department. Officers only needed to attend one of the sessions.

Corey Mills, an on-site coordinator with the Barbara Schneider Foundation, began as an actor and now coordinates trainings and provides the actors with feedback.

He said it’s about providing a safe place for officers to step out of their comfort zone. There were five actors and five coaches at both of the training days.

Mills said de-escalating a crisis involves connecting with the individual and treating them like a human, listening, establishing trust and recognizing they might be dealing with a mental illness. These techniques are used to talk people to a calmer place so they can get the help they need, which may involve getting them to a hospital.

Additional partners that helped facilitate the training program were Anoka County Human Services, People Incorporated, and the Lee Carlson Center for Mental Health and Well-Being, based in Fridley.

Patty Halvorson, marketing and development manager with the Lee Carlson Center, said the training program included a panel discussion to further delve into mental health related interactions with police. She said a number of clients are involved in crisis type calls, adding that “inherent with mental health issues are crises and problems that require help.”

Debbie Kidder volunteers as an advocate for the Center. Her son, Eric, was a heroin addict and died in March 2009 at age 20. He was a 2007 Fridley High School graduate.

Kidder said her son had various interactions with local police departments, and she attends programs to share Eric’s story so people can learn from it.

Asked why she chose to participate in the officer training program in Columbia Heights, Kidder said, “… It’s more of a sense of appreciation for the support (the officers) provided us during a difficult year. I’m grateful for the way they treated Eric with such dignity and respect during his most difficult times. That’s really why I do it, to try to give back to them.

“The face of drug addiction is unrecognizable,” she added. “It can be anybody.

“I see the police as very anxious to sharpen their skills in recognizing crisis and mental illness.”

Three of Deb Fjeld’s four children have significant mental health issues. She said she would like people to understand that mental illness affects children as well as adults, so it’s important to have that perspective.

“Mental illness is not a parenting problem. … It’s a mental health issue,” she said.

Of the officer training program, Fjeld said, “This is a fabulous idea. … The more we educate our officers about mental illness, the better off they will be.

“I hope that when they come into a situation with a person who is acting erratically, they use some of these techniques as a first line (of defense) rather than resorting to force or threats.

“I think this program should be expanded to train group home individuals and school personnel because it’s got a lot of value,” Fjeld added.

Maggie Beranek, an officer with the Columbia Heights Police Department for 2 1/2 years, participated in CIT training in November 2011.

“As police officers, a very large percentage of the people we deal with on a daily basis are suffering from mental illness and are in crisis,” she said.

“A big goal is to use these skills to try to not have to get into use of force situations … if you can de-escalate somebody by talking with them.

Beranek said she looks at the CIT training as “another tool in her belt” and used it a week after completing the training.

The daylong training, she said, gives her the ability to train her partners, and with budget cuts, not all departments can send some officers or all officers to the weeklong training.

“It’s not necessarily new information, but a new way of looking at it,” Beranek said. “It really forces us to step out of our comfort zone. People learn the most when they step out of their comfort zone.”

Nadeau said this first program in Anoka County trained about 50 officers; all of the Columbia Heights officers have received training. Another training program is being planned for later this year in Ramsey.

CONGRESSIONAL STAFF BRIEFED ON LAW ENFORCEMENT RESPONSES TO PEOPLE WITH MENTAL ILLNESSES

Washington, D.C. — Law enforcement officials, judicial leaders, and behavioral health experts came together on March 6 to brief Congressional staff on the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA) and the collaborative criminal justice-mental health programs that it supports.Dr. Fred Osherof the Council of State Governments Justice Center, Chief J. Thomas Manger of the Montgomery County (MD) Department of Police, Inspector Bryan Schafer of the Minneapolis (MN) Police Department, and Judge Steven Leifman of Miami-Dade County Court spoke to key stakeholders and staff from numerous congressional offices, representing members of both parties.

As some of the nation’s foremost experts on implementing collaborative criminal justice-mental health programs, the panelists each shared their perspectives and/or experiences. Their testimonies underscored the fact that programs supported by MIOTCRA and similar grant initiatives are contributing in significant ways towards ending the cycles of arrest and incarceration for people with mental illnesses.

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From left to right: Inspector Bryan Schafer of the Minneapolis Police Department, Judge Steven Leifman of Miami-Dade County Court, Chief J. Thomas Manger of the Montgomery County Department of Police, and Dr. Fred Osher of the Council of State Governments Justice Center.

Dr. Osher opened the dialogue with an overview of the issue. He addressed major factors involved in the high rates of incarceration among people with mental illnesses, including limited access to community-based treatment and high rates of homelessness and substance abuse. Dr. Osher then highlighted the initiatives that MIOTCRA funds through its Justice and Mental Health Collaboration Program to bridge the gaps across service systems. In addition to community- and corrections-based treatment programs, MIOTCRA has also supported jurisdictions across the U.S. developing or expanding programs such as mental health courts, crisis receiving centers, and specialized law enforcement responses such as crisis intervention teams (CITs).

Chief Manger and Inspector Schafer offered their perspectives on implementing specialized police-based response programs. Modeled after the widely recognized model in Memphis, TN, the Montgomery County CIT program provides officers 40 hours of training to help them better identify mental illnesses and deploy de-escalation tactics. Chief Manger spoke to the benefits he has seen from the CIT program, in public and police safety and in outcomes for people with mental illnesses.

Inspector Schafer emphasized the importance of programs that encourage information sharing between mental health and law enforcement agencies, which often do not have a clear understanding of how the other system handles and treats people with mental illnesses after the initial contact has been made. Creating connections across systems is a crucial component of MIOTCRA’s grant program, as they allow agencies to share resources and improve the quality and access to services. Inspector Schafer reported that leaders in Minneapolis are also planning crisis receiving centers and a program that pairs mental health professionals to co-respond to calls with local law enforcement officials, modeled after a similar program already in place for calls relating to domestic violence.

Judge Leifman from Miami-Dade County, FL, which has one of the highest rates of mental illness of any urban region in the U.S., provided his unique insight into how collaborative programs that divert individuals from arrest or jail can reduce local government spending. To address the prevalence of people with mental illnesses involved in the justice system, Miami-Dade county officials expanded its jail diversion program to include a CIT program and post-arrest diversion for both misdemeanor and felony charges. According to Judge Leifman, the diversion programs today redirect approximately 500 individuals each year from jail to treatment services. The CIT program — now the largest in the country — has trained over 3,500 officers to date. The impact of this training initiative has been astounding: As Judge Leifman testified, two of the county’s law enforcement departments responded to 10,000 calls involving an individual with a mental illness last year, yet only 45 arrests resulted from these calls. Furthermore, the judge discussed how prior to the implementation of the CIT program, the county experienced eight to ten shootings during encounters between officers and individuals with mental illnesses per year; in the past eight years, there have been only such two instances.

The briefing was co-hosted by the offices of Senators Roy Blunt (R-MO), Chris Coons (D-DE), and Al Franken (D-MN). The Council of State Governments Justice Center co-sponsored the event with the National Alliance on Mental Illness, the Bazelon Center for Mental Health Law, the National Association of Counties, and Mental Health America.

YOU ARE NOT A PSYCHOLOGIST

But as ill equipped as you are to cope with the mentally ill, you often find yourself playing the role of therapist on the street.

Photo: Mark W. Clark
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Link to full article:

http://www.policemag.com/Channel/Patrol/articles/2012/03/You-Are-Not-a-Psychologist.aspx

PRESS RELEASE FROM THE CITY OF SAINT PAUL AND RAMSEY COUNTY EMERGENCY COMMUNICATIONS

New Program will make background information available to first responders to those with a mental illness if that information is voluntarily provided to the 911 system in advance

FOR IMMEDIATE RELEASE

More information: Mark Hughes 651-407-2473

Vital Emergency Response Information Form for Ramsey County Residents with Disabilities

Emergency Form May Cut Down Emergency Response Time in Emergencies Affecting People with Disabilities

Time is of the essence in an emergency.  Sometimes a few minutes can make the difference in whether a person lives or dies.  For people with disabilities needing accessible and adapted emergency services, precious time is wasted if emergency responders do not have the information they need before they arrive at the scene.

To address this need, the Saint Paul Mayor’s Advisory Committee for People with Disabilities and the Ramsey County Emergency Communications Center have developed a form for use by Ramsey County residents with disabilities.  This form allows a person with a disability living in Ramsey County to inform the Ramsey County Emergency Communications Center of any special conditions, medications, and/or allergies that should be taken into account by emergency responders.  It also informs the Emergency Communications Center of medical contacts and of trusted individuals that can assist police officers, firefighters, paramedics, and other emergency personnel in entering or securing the individual’s home during an emergency.

This form should be filled out as soon as possible, before an emergency ever occurs.  If there is an emergency, the Emergency Communications Center will have the emergency response information available to assist with the emergency response.

The Residential Emergency Response Information Form can be found at:www.co.ramsey.mn.us/ecc/What_to_expect.htm.  Scroll to the bottom of the page and click on “Residential Emergency Response Information Form.”

Background:
From: Gustafson, Randy
Sent: Friday, January 28, 2011 11:58 AM
Subject: Ramsey County Introduces Residential Emergency Response Form

News Release Attached (and content follows in this email) about a new service that Ramsey County is providing for our citizens with disabilities. It is a form that people voluntarily fill out and file with our Ramsey County Emergency Communications Center (which handles 9-1-1 calls and dispatches for the county) so that when first responders are on their way they will be informed of special conditions to be aware of. A copy of the form is also attached.

The office of Ramsey County Sheriff Matt Bostrom is assisting this joint effort of the Saint Paul Mayor’s Advisory Committee for People with Disabilities and the Ramsey County Emergency Communication Center to help spread the word about this positive public safety initiative. Ramsey County is the first county in the United States to implement a program such as this. Currently the form is available via the Ramsey County Website and soon will be available in the libraries throughout the county.

Your contacts for more information on the Residential Emergency Response Form are these members of the Mayor’s Advisory Committee:

Mark Hughes – 651-470-2473 (his original idea started the form)

Scott Coleman (Chair of Advisory Committee, MN Dept of Employment & Econ Dev) – email: Scott.Coleman@state.mn.us

Thank you for your time and consideration.
Randy

Randy Gustafson
Public Information Officer
Ramsey County Sheriff Office
425 Grove Street Saint Paul MN 55102 Phone: 651-266-9421

Violence Prevention

A Commentary Statement jointly developed by

The Minnesota Psychiatric Society, The Barbara Schneider Foundation

SAVE – Suicide Awareness Voices of Education

Minnesota is not immune from individual or mass violence.  The last mass shooting in this state was March 21, 2005, at Red Lake where 9 people were murdered, 5 wounded and 1 died by suicide.  The recent  violence in Arizona is an important reminder to us of the challenges and opportunities that we have in better responding to members of our communities who live with severe mental illnesses.

The current budget challenges must not lead to further reductions in our already fragile mental health response system and capacity.  Some have noted that in the Arizona county where the shooting occurred, nearly 50% of mental health recipients were removed from funding because of budgetary concerns and that the rate of suicide attempts, hospitalizations and law enforcement encounters had all gone up.  This is the wrong path to take and as citizens we need to ensure our legislators understand this to protect Minnesotan’s and those who visit our state.  We must create more entry points to the mental health system and make them more accessible. According to the Minnesota Department of Human Services, less than half  (only 36 out of 87 counties) provide mental health crisis services.  Most hospitals lack psychiatric services and even hospital security.  This is a problem that needs to be addressed now, before another Red Lake or Tucson tragedy occurs.  Appropriate mental health crisis response training needs to be conducted in hospitals and for law enforcement the Crisis Intervention Team (CIT) model trains officers how to respond to mental health crises. This model was introduced in Minnesota 10 years ago and has proven effective, yet although several police and sheriff agencies are adopting this model and training CIT officers and 911 dispatchers, most public safety agencies in Minnesota have yet to train their officers in CIT.  To fully protect our state, legislators must endorse and support this important public safety training.

The evidence suggests that many of the people involved in mass shootings have alcohol and drug problems and psychotic symptoms. In addition, their social behavior leads to isolation and conflict at home, school, and work.  They often have contacts with law enforcement because of behavioral problems.  Family members and coworkers are often at a loss in communicating with them and helping them.  Systems available for crisis intervention are not consistently available and the best pathway of care is not always applied.  Families are often left dealing with a developing crisis and cannot get help.

This is a public health and public safety issue.  We need to approach this as we would other public health issues by preventing the crisis.

We believe that the best approach to addressing these incidents is to make them a priority and determine what can be done to prevent them.  This includes:

  • Mobilizing existing resources that are frequently not used prior to the incident, including the consistent application of public education about violence and aggression as possible symptoms of some mental illness, legal interventions including CIT, and psychiatric treatment.
  • Increasing access for individuals with severe mental illnesses to quality psychiatric care and support in the communities where they live.
  • Redefining quality psychiatric care for symptomatic individuals with aggressive behavior and violence.
  • Establishing a national database of incidents for further research on the problem.

We can take concrete steps to reduce the chance of violence.   Let’s make it a priority.

Minnesota Psychiatric Society
George Dawson, MD, F.A.P.A
President

Barbara Schneider Foundation
Mark Anderson, Executive Director

SAVE – Suicide Awareness Voices of Education
Daniel J. Reidenberg, PSY.D., FAPA
Executive Director

RUBEN ROSARIO: SHE SAW NEW ORLEANS’ DARKEST DAYS – AND STILL FOUND HOPE

By Rubén Rosario Updated: 04/03/2010 08:44:16 PM CDT
Ruben-Rosario

Cecile Watters Tebo was battling her own torments when she ‘rolled up’ — as she is fond of saying— at the scene of a suicidal man about to jump from a bridge.

With her flooded, mold-plagued home lost to Hurricane Katrina and facing homelessness in a few days, the 50-year-old mother of three knew she was in the midst of a “dark, deep, paralyzing” depression. Now, as the civilian head of the New Orleans Police Department’s mobile crisis unit, the only one of its kind in the nation, she was facing a man who had lost all hope.

“He was holding an umbrella, and he looked at me with earnest eyes that said: ‘Please, just let me go,’ ” recalled Tebo, a former social worker, ex-debutante and member of a well-heeled and well-established New Orleans family.

“I wondered if I was being hypocritical at taking his hand, because at the time, I was thinking, how in the world do I do my job when my own world is falling apart, while I’m trying to uplift other people who are feeling hopeless and helpless?”

There was a fleeting second where Tebo thought about perhaps joining the man and taking the plunge. But she reached out to comfort and provide refuge.

“Baby, we’re going to make this day better and brighter. Take my hand,” she said before the man grabbed it that winter day in 2005.

Tebo plans to share her experiences responding to the needs of the mentally ill before and after Katrina at a one-day conference Wednesday at the Minneapolis campus of the University of St. Thomas.

Co-sponsored by the Barbara Schneider Foundation — named after a mentally ill woman fatally shot by Minneapolis cops during a disturbance — the conference focuses on how to provide better mental health services to underserved communities.

Some look upon Tebo as the Big Easy’s Florence Nightingale when it comes to the way she has dealt with mentally ill people whom police and her unit encounter daily.

“Tebo is on fire with her passion for treating those with mental illness and those in crisis with the greatest dignity,” said Mark Anderson, the foundation’s executive director. “She is undaunted by the enormous challenges that postKatrina New Orleans presents to the 911 responders and the whole community there.”

Katrina claimed far more than 1,800 lives while laying waste to brick and mortar. The area’s suicide rate tripled after Katrina. Half the city’s adult population struggled with “clinically significant psychological distress” seven weeks after the storm, according to the U.S. Centers for Disease Control and Prevention.

Another study found that the percentage of Gulf Coast residents with mental health problems had shot up to 31.2 percent a year after the hurricane struck the region.

If that wasn’t bad enough, New Orleans had just 10 public and private hospitals with only 400 psychiatric beds. As of last year, the number of beds reportedly dipped below 170 while demand was steady.

Tebo’s unit, which dropped from 40 volunteers to single digits during the storm, faced resistance and hostility from already-swamped emergency rooms that wanted little to do with psychotic and mentally ill patients.

“By federal law, ERs cannot refuse treatment to anyone who walks in,” Tebo said. “But at times, some of them, knowing we were coming with these people, actually met us on the ramp so that they would not have to take them in. I had to fight at every place just so they could be seen and treated.”

The situation, worsened by the recession and municipal budget cuts, “still remains pretty bad,” Tebo said.

In fact, her anguish at the bridge that day five years ago stemmed from two realizations: Even if they saved the man, where would they take him? And if they found a facility, would he receive proper treatment?

Throw in the then-recent death of her three sons’ beloved pediatrician and close family friend. The middle-age physician’s practice was wiped out by the storm while he was also dealing with physical ailments. He hanged himself in his home.

“He was a beautiful, precious man,” Tebo said.

The burden proved too much. Tebo, curled up in bed, was knocked out of service for some five days.

Then, not unlike the reeling and wounded city of her birth, she slowly began to tap into her faith and resilience and pull herself back up. As bad as things were, other people were in more pain, she thought. She sought help and eventually returned to the streets.

The granddaughter of a 1940s New Orleans police chief, Tebo wanted to be a cop since childhood. But that aspiration was detoured after she cared for disabled children at a hospital in her teens and pledged to help the less fortunate.

She entered social work and worked in the adoption field until the police bug bit again. She enlisted as a volunteer at the age of 40 with the city’s police reserves program. It was there she learned about the mobile crisis unit, formed in the 1970s and still unique among the nation’s police departments. She had no problem trading a service handgun for the brown leather and Velcro restraints she and unit members use on the job.

The unit responds to nearly 250 emergency calls monthly, and its volunteer membership consists of people “from all walks of life,” Tebo said. Volunteers cannot respond unless police officers are at the scene.

Tebo strongly believes mental illness remains very much a stigma and a low priority.

“It has been very clear to me that it is not even on the radar in the medical field, and it’s going to get the last attention in a major emergency,” Tebo said. “It should be just the opposite.”

Although she has been punched and kicked and injured during encounters with those in crisis, Tebo considers what she has done the past decade the “coolest job in the whole wide world.”

“When I roll up on people in a psychotic state and they are covered in urine or feces and no one wants to touch them, I can’t wait to get my arms around them because I truly believe they are God’s angels,” she said. “Their life has meaning. They remind us of what we have and should appreciate and why we should be willing to give them our hand.”

This report includes information from the Washington Times.

Rubén Rosario can be reached at 651-228-5454. or rrosario@pioneerpress.com.

Why Juvenile Detention Makes Teens Worse

TIME Magazine www.time.com

Friday, Aug. 07, 2009
By Maia Szalavitz

Parents have always warned teenagers against falling in with the wrong crowd, those kids they consider bad influences. Now a new study of juvenile detention in Montreal adds to the evidence that Mom and Dad may have a point.
Researchers found that rather than rehabilitating young delinquents, juvenile detention — which lumps troubled kids in with other troubled kids — appeared to worsen their behavior problems. Compared with other kids with a similar history of bad behavior, those who entered the juvenile-justice system were nearly seven times more likely to be arrested for crimes as adults. Further, those who ended up being sentenced to juvenile prison were 37 times more likely to be arrested again as adults, compared with similarly misbehaved kids who were either not caught or not put into the system. (Read “Getting the Juvenile-Justice System to Grow Up.”)

“It’s much worse than we would have expected,” says Richard Tremblay, a psychology professor at the University of Montreal and a co-author of the study, which was published in the Journal of Child Psychology and Psychiatry. “By having them live together, they form relationships. It’s more likely to increase the problem.”

The 20-year study followed 779 low-income youth in Montreal with annual interviews from age 10 to age 17, then tracked their arrest records in adulthood. Researchers also interviewed the teenagers’ parents, schoolmates and teachers. The study accounted for variables such as family income, single-parent-home status and earlier behavior problems (such as hyperactivity) that are known to affect delinquency risk. (See pictures of crime in Middle America.)

Kids who entered the juvenile-justice system even briefly — for example, being sentenced to community service or other penance, with limited exposure to other troubled kids — were twice as likely to be arrested as adults, compared with kids with the same behavior problems who remained outside the system. Being put on probation, which involves more contact with misbehaving peers, in counseling groups or even in waiting rooms at probation offices, raised teens’ odds of adult arrest by a factor of 14.

The rehabilitation of troubled teens has long been a contentious issue, pitting the individual needs of problem children and families against a system that does not typically give social workers adequate tools or resources to help. Often, the treatment of difficult or drug-using teens occurs en masse — in residential homes, for example — but instead of scaring kids straight, the group experience tends to glamorize delinquency and drug use. (Read “Teens Behaving Badly?”)

Why? In any such setting, teens establish a predictable social hierarchy, says Tom Dishion, director of research at the Child and Family Center at the University of Oregon, who was not involved with the study. The kids who have behaved worse than others — committing robbery, for instance, vs. smoking cigarettes — earn the most credibility with their peer group, which encourages further bad behavior. “That story [about robbing someone] has a function of making that kid more interesting. He or she gets a lot of attention. [These kids] become higher in the social hierarchy.”

Says Tremblay: “There is that competition of who is going to do the worst stuff — for them, it’s the best stuff — like stealing the biggest or best car.”
Past research has also shown that peer exposure can worsen behavior. In a 1995 study conducted by Dishion involving 158 high-risk families in Oregon, researchers compared the impact on teens’ behavior of four interventions: parenting groups focused on effective discipline, social-skills-training groups for teens, both the parent- and teen-focused group interventions, or no group treatment at all. Overall, the parent-focused group was most effective, leading to reductions in teen smoking and misbehavior at school. The teen-focused group, by contrast, significantly increased participants’ rate of aggressive behavior and smoking; in the combination group, kids showed no improvement, presumably because the exposure to other teens canceled out the positive effect of the parents.

The new study supports these findings, suggesting that family therapy or one-on-one counseling — or any intervention that doesn’t aggregate troubled teens — is safer and more likely to be effective than group activities. But if groups must be used, experts say that high supervision and low child-to-staff ratios are essential to minimize the risk of behavior contagion.

“I think it’s a very important finding, and it’s consistent with other research in the last 10 years on this topic,” says Dishion. “What’s really surprising is that we don’t have more research showing this to be true. Almost everyone you tell about these findings who has worked in [residential or juvenile-justice settings] is not surprised. I think there’s a tacit agreement not to look too carefully.”