Suicide in Juvenile Detention Facilities

Article Analysis

In the article Suicidal Behaviors Among Adolescents in Juvenile Detention: Role of Adverse Life Experiences (Bhatta, Jefferis, Kavadas, Alemango, Shaffer-King, 2014), they asses how multiple adverse life experiences can influence suicide ideation and attempt in urban juvenile detention facilities. Bhatta, Jefferis, Kavadas, Alemango, Shaffer-King (2014), used a study sample of 3,156 adolescents, 694 being female and 2,462 were male, that were processed in an urban area of Ohio between 2003 and 2007. The participants used a self administered questionnaire with 100 items related to their health risk behaviors. They completed this questionnaire by interacting with a voice command computer and was taken anonymously. After reviewing the questionnaires they concluded that 19% of adolescents reported they had suicide ideation and 11.9% reported at least one suicide attempt (Bhatta, Jefferis, Kavadas, Alemango, Shaffer-King, 2014). Bhatta et al. (2014), concluded that females were more likely to report adverse life experiences and had higher levels of risky sexual behaviors. This included physical health symptoms, mental health, and less family support that their male counterparts.

The article also took into consideration factors such as sexual abuse, homelessness, and running away from home which made it 7.81 times more likely for the adolescent to report attempt of suicide than those who did not experience adverse life experiences. This raised the point of using proper screening tools during their intake entering a detention facility and being able to understand their risk factors. Having a proper intake process would put into consideration their adverse life experiences and their association to suicidal behaviors. With the proper screening tools, juvenile detention facilities would be able to put the proper intervention and prevention programs in place. Where the juvenile justice system would make an impact on the adolescent and make them better prepared for when they are released and are forced to deal with the real world again.

Critical Analysis

The authors' purpose of the article and study is to shed light on the lack of resources in juvenile detention facilities. The lack of proper screening tools and prevention programs in urban juvenile detention facilities is becoming a problem when it comes to their statistics on suicide rates. In most cases the adolescent is taken into custody and striped of their belongings. Where they receive a jumpsuit, a handbook and basic necessities. The adolescent may be asked a few question to assess their physical and mental health, but not much is done after that. The information that is received upon arrival is used to find proper placement for the adolescent and to determine if there is a risk for suicide. If there is a risk then they are placed in a special section of the facility where they have much less freedom than the general population. If there was a proper screening tool, the facility would be able to do a much better job in providing programs that help the adolescent cope and prepare for their release.

The article focuses on a population in an urban part of Ohio which is predominantly African American males between the ages of 13 to 17 years old. It did not use an equal amount of male and female participants nor did it include or compare to other juvenile detention facilities. The specific juvenile detention facility used, also did not have a suicide prevention/intervention program in place and did not take into consideration a facility with a program already in place. There was also a heavy focus only on suicidal ideation and attempts and failed to link this to other mental disorders where that might be a symptom. The participants were screened for a history of mental health conditions and if they received any treatment prior to entering the facility.

Article Analysis

The article Correlates of Suicide Risk in Juvenile Detainees and Adolescent Inpatients (Sanislow, Grilo, Fehon, Axelrod, McGlashan, 2003), compares the risk of suicidal behavior in adolescents in a juvenile detention facility with another high risk group of adolescent psychiatric inpatients. The participants included a total of 162 adolescents broken up into two groups; 81 from the juvenile detention facility and 81 from a psychiatric hospital. The participants in the juvenile detention facility ranged from 13 to 16 years old and were pending adjudication, so their length of stay was about two weeks. The group was also equally split with both male and female participants and equal numbers in race representation. The psychiatric hospital group was limited to white male and female participants that were chosen at random. Participants from both groups were asked to complete self report measures between one to four days after their admission (Sanislow, Grilo, Fehon, Axelrod, McGlashan, 2003). The questionnaire was administered and scored by computer with the supervision of a trained examiner.

The study concluded that both groups of participants had clinical evidence of significant levels of psychological distress. The juvenile detention group reported a trend towards less hopelessness and higher risk for suicidal behavior while the psychiatric group showed a higher level of depression than the boys (Sanislow, Grilo, Fehon, Axelrod, McGlashan, 2003). Both groups exhibited factors associated with suicide risk, depression, hopelessness and impulsivity. Although the juvenile detention group did not have a history of mental health they also reported similar levels of psychological distress similar to those adolescents that did suffer from mental health conditions and were place in a psychiatric hospital.

Critical Analysis

The authors of the study conducted decided to only let white male and female participants in the group of psychiatric patients but the group in the juvenile detention facility included a balanced ratio of male and female participants and equal race distribution. The exclusion of race in the psychiatric group was done intentionally and left out a crucial part of their comparison to the group in the juvenile detention facility. The assumptions of the authors reflect a disregard or negligence to include races in a very crucial group for their study. This could be to lack of racial diversity in the psychiatric hospital that was used. Another limitation was age range that was used in the study. The conclusions drawn can only be linked to small age group and might not yield the same results if the test was conducted with another age group. The study also had a strong focus on only future suicidal behavior and did not look at current suicidal ideation. The study was used for prevention and comparison of suicidal risk factors in two very different groups.

The results of the study conclude that suicidal ideation can be disguised in many ways and cannot always be easily seen. Without the proper intervention adolescents can continue their whole lives wondering if their feeling of hopelessness is normal and not seeking out the proper care. It is important to place mental health as important as physical health, in the way that there is proper care available to all people regardless of their socioeconomic status or race. With the stigma of not seeking care in many cultures, there can be the unintended consequence of living with mental health that is not properly taken care of. This could lead to more serious problems later in life and feelings of inadequacy or low self worth.

Class Connection

Erikson's Psychoanalytic Theory puts a strong emphasis on growth from the challenges life brings us. During our class lectures we also discussed Erik Erikson's psychosocial development and its eight stages. These stages range from birth well into adulthood. Within each stage, a person experiences a psychosocial crisis that can greatly impact their development of personality. These impacts can be either negative or positive depending on how the crisis is handled and could last a lifetime (Kayne, 2018). Erikson saw these crisis as conflicting needs of the individual and the needs of society. In the article Correlates of Suicide Risk in Juvenile Detainees and Adolescent Inpatients (Sanislow, Grilo, Fehon, Axelrod, McGlashan, 2003) the participants were all adolescents between 13 and 16 years old, so they would be in stage 5 of their psychosocial development. In this stage there is a psychosocial crisis of identity versus role confusion. Adolescents in this stage are trying to search for sense of self and personal identity through experiences and exploration. If there was a problem with the first stages of the psychosocial crisis Erikson would attribute their misbehavior to their lack of early basic needs (Kayne, 2018).

The first article Suicidal Behaviors Among Adolescents in Juvenile Detention: Role of Adverse Life Experiences (Bhatta, Jefferis, Kavadas, Alemango, Shaffer-King, 2014) put an emphasis on the adverse life experiences of the adolescents which made them more likely to commit suicide or to have suicidal ideation. The textbook The Developing Person Through Childhood and Adolescence (Berger, 2015) has a section on child maltreatment and adverse childhood experiences. Maltreatment often times goes beyond the immediate harm, but can follow the child into adulthood. The biological and academic impairment can lead to deficits in social skills and low self esteem (Berger, 2015). Children who have been maltreated tend to hate themselves and everyone around them. They are often less friendly, more aggressive, and are often isolated from other children. The article took their life experiences into consideration and used them to measure their likelihood of suicidal ideation. The study concluded that children who have experienced only one adverse life experience is already over seven times more likely to think about or commit suicide. Where it put a strong emphasis on the early childhood experiences and the effect they may have in the future.

Apart from their early childhood experiences, there could be ways in which a relationship with an adolescent can be improved or repaired. In Positive Discipline by Jane Nelson (2013), she describes misbehaving teenagers as having mistaken goals of undue attention, misguided power, revenge, or assumed inadequacy. There is often a misconception of anger or hostility that arises when you are a teenager. It always seems like it's you against the world. Because of this misconception the teenager retaliates with anger and can lead to miscommunication. Jane Nelson (2013), believes the best way to combat this is through mutual respect and equality when problem solving. In both the articles the adolescents are already in the juvenile justice system because of a crime they commited. Most of the adolescents in the studies were young around 13 to 17 years old. There is still time to have one person make that change in their life. If they are treated with respect and are shown other options, instead of a life of crime and jail, that can make a big impact on their future.

Conclusion

Both articles and class connections shed a light onto a topic that is very relevant in society today. With the increase of adolescents and adults in mass shootings or other events, there is always an initial blame on mental illness. While in many cases the mental illness is not something that occured over night, but developed over time and life experiences. Suicide is also something that is thrown into the category of mental illness. With shows like 13 Reasons Why and others where there is an increase of awareness of the topic. There is an even greater link when a person thinks of juvenile detention facility and their rates of suicide attempts. It was interesting to see that some juvenile detention facilities do not offer the proper programs to help the youth in rehabilitation in order to reenter society once they are released. Instead they are housed, asked to server time as a punished for a crime and let out when their time has been served. Is this an adequate way or rehabilitating our future generation? Is it lack of funding and knowledge or is it stemmed from the belief that there are consequences to one's actions? An eye for an eye will eventually make the whole blind.

References

Bhatta, M. P., Jefferis, E., Kavadas, A., Alemagno, S. A., & Shaffer-King, P. (2014). Suicidal

Behaviors among Adolescents in Juvenile Detention: Role of Adverse Life Experiences.

PLoS ONE, 9(2), 1–7.https://doi-org.sonoma.idm.oclc.org/10.1371/journal.pone.0089408

Kayne, A. (2018). Early Childhood Biosocial Development: Chapter 8

[Week6EarlyChildhoodBiosocial_Ch8] Retrieved from Canvas.

Nelsen, J. (2013). Positive discipline. New York: Ballantine.

Sanislow, C. A., Grilo, C. M., Fehon, D. C., Axelrod, S. R., & Mcglashan, T. H. (2003).

Correlates of Suicide Risk in Juvenile Detainees and Adolescent Inpatients. Journal of

the American Academy of Child & Adolescent Psychiatry, 42(2), 234-240.

doi:10.1097/00004583-200302000-00018

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