The 13-year-old girl had made her grandmother’s life a living hell.
The girl’s mother left her when she was four, and her grandmother hadn’t let a day go by without reminding her she hadn’t asked for this extra responsibility.
Tension filled their home.
The girl disobeyed teachers at school and fought with family members at home. When her anger bubbled out of control, relatives called the police.
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Desperate to steer her in the right direction, the girl’s grandmother had taken her to a Bibb County intervention program that takes at-risk youth on a day-long immersive tour of the county jail.
She hated it.
Soon after, the girl found herself in a quiet office in Warner Robins, sitting across from her therapist, Elizabeth Bizzell.
“She said, ‘I get way more out of coming and talking to you than I do going to that,’” Bizzell said.
Bizzell called it a light bulb moment.
As Bizzell questioned the patient about her tense relationship with her grandmother, the girl began to connect her behavior with the roots of her rage. Each week, Bizzell noticed improvements.
“And she did not miss a session,” Bizzell said.
Bizzell knows that juvenile delinquents are more than mugshots and headlines. As the Clinical Director of Dynamic Interventions, a behavioral health clinic in Warner Robins, she’s counseled a diverse array of clients, including many youth who have spent time in the juvenile justice system or are on the brink of arrest.
Children and adolescents who brush with the law are often cast off as “bad kids,” said Lisa Carter Greene, intensive family intervention team leader at Dynamic Interventions.
“Our society is so quick to label,” Carter Greene said. “So, once you get that DJJ (Department of Juvenile Justice) label or that delinquency label, then it tends to explain to some people the reason a child is the way he is, but it’s not necessarily the case.”
About 70 percent of youth in the juvenile justice system have been diagnosed with a mental health disorder, according to a 2015 report by the National Center for Mental Health and Juvenile Justice. The suicide rate among youth in juvenile correctional placement is almost three times that of their counterparts in the general population. And about 90 percent have experienced a traumatic event, such as maltreatment, community violence or traumatic loss.
“We see the big, bad things that happen to kids,” Bizzell said. “But, more often than that, we see all these little-T traumas that just are their everyday life.”
Many of Carter Greene’s patients have either witnessed a murder or know someone who was killed. Her patients often feel desensitized to violence. It’s not until they come in for counseling that they start to reflect on what they’ve seen.
Half the battle, though, is getting those youth the help they need.
When youth struggling with mental illness or trauma act up, it can be difficult for adults to determine how best to help them, said Karli Keator, Director of the National Center for Mental Health and Juvenile Justice. They don’t always recognize the signs.
“It’s easier to pick up the phone and call the police, because they’re going to show up,” Keator said. “Or, it’s easier for law enforcement to maybe bring a kid to detention if they don’t have the alternatives in place and if they don’t know who to call.”
Her organization works across systems — schools, law enforcement, the Division of Family and Children’s Services, mental health providers — to help adults connect youth with the resources they need, rather than resorting immediately to juvenile detention.
“The single most important thing we can do is keep kids who have these conditions who don’t need to be in the juvenile justice system, to keep them out of the system,” Keator said.
Kids unable to access mental health services will continue to act out, increasing their chances of suspension or expulsion, Keator said. And once a student is suspended or expelled, his or her chances of contact with the juvenile justice system dramatically increase.
“By virtue of not responding to the mental health needs, we are continuing to push kids out of schools, push kids to the justice system and really not create the opportunities that we need to have safer schools,” she said.
No single system is at fault, Keator added. But she described the failure to provide youth in need with mental health resources as a “missed opportunity.”
“We are then only responding to the crises,” she said. “We’re responding to things that were opportunities, warning signs, ways to intervene much earlier and potentially prevent a lot of what we might be experiencing down the road.”
In many cases, resources are out of reach. Middle Georgia faces a shortage of psychiatrists and school psychologists. And even when services are available, parents sometimes hesitate to seek help for their kids.
“You have so many barriers that stops families from seeking the services, whether it’s a lack of knowledge of mental health, whether it’s poverty, unstable living condition, whether there’s substance abuse, trauma,” said Carter Greene.
Even when mental health providers are locally available, cost of care can impede access. Not all counselors accept insurance, and not all families are insured.
Georgia youth whose households meet income requirements qualify for PeachCare for Kids insurance through age 18, which makes it easier to access counseling. Those who spend time in detention receive mental health care, as well.
Sometimes mental health resources are more accessible in juvenile detention than in the juveniles’ own communities, Keator said.
But it’s not enough for just the kids to receive treatment, Carter Greene said. The family must be part of the process, too, for the real change to occur.
“The family piece always proves to be so important, because you want that family to be prepared to support the changes and skills that a child has learned while away from them,” she said.
Early intervention can help youth before detention becomes their only option, Keator said.
“The sooner we get in there and actually provide the services to kind of mitigate the effects of that traumatic experience, the less likely that experience is to have a negative impact in the long-run on their school outcomes, on their engagement with friends and family, on their physical and mental health outcomes,” Keator said.
The same is true for mental health, she added.
“The sooner we identify the signs and symptoms and the sooner we provide effective services and treatment that’s needed, the less likely it is that that illness is going to progress and worsen, and also have ongoing, you know, compounding negative effects on all aspects of that child’s life,” Keator said.
‘They’re not just throwaway kids’
If juveniles don’t get the help they need, the consequences can be dire.
Mental illnesses, such as depression, often manifest as anger, Keator said.
“Anger’s something that’s not welcome in schools, certainly if it’s expressed in a way that’s aggressive or physical, and could lead to a justice system contact,” she said.
And teens can face adult consequences, regardless of outstanding mental health diagnoses.
“Once they turn 17, if they get an adult charge, there is no advocacy for them from a mental health perspective,” Carter Greene said.
She and Bizzell are determined to help their clients take control of their own behaviors.
“That’s always the goal, is recovery — for families to recover, for kids to recover,” Carter Greene said. “So, even if you find a kid who has found himself already in the Department of Juvenile Justice, through working with them, you can always identify ways for them to take a different path, to make a different choice.”
Carter Greene wishes people could see past the “delinquent” label and recognize “that they’re not just throwaway kids.”
“Every child deserves a chance to do and be something different,” she added.
Bizzell doubts that most juvenile crime is rooted in “pure evil.”
“I think that there was a point in time where they could have been helped,” she said, “where we could have shifted if they had gotten the help that they needed.”
Samantha Max is a Report for America corps member and reports for The Telegraph with support from the News/CoLab at Arizona State University. Follow her on Facebook at https://www.facebook.com/smax1996 and on Twitter @samanthaellimax. You can also join her Facebook group. Learn more about Report for America at www.reportforamerica.org.