By Dina Sokal, MD
[Winter 2006; Vol. 32, No. 2; Pg 5]
In the fall, a series of articles in the
Baltimore Sunpapers addressed the closing of the Charles H. Hickey Jr. School, a
Department of Juvenile Services (DJS) Detention Facility.
Advocates, judges, and legislators expressed concerns over the closing
and the plans to place some of these youths out of state.
In an article written on September 29, 2005, two Maryland judges,
Baltimore County Circuit Judge Kathleen Cox and Anne Arundel Circuit Judge
Pamela North told legislators that “there are not enough places to send tough
young offenders”. Cox was also
concerned that plans to send the toughest offenders to out of state facilities
would lead to “no meaningful opportunity for family to be involved with
rehabilitation” of youths. Since
then, DJS youths were sent out of state despite families’ protests.
The DHMH Director of the Office of Child and
Adolescent Services at the Mental Hygiene Administration, Al Zachik, MD is more
positive about the closing. He
points out that the Director of Behavioral Health Services for DJS, Andrea
Weissman, Ph.D., is collaborating closely with DHMH to provide mental health
services for those DJS offenders who remain in Maryland.
Edward Hopkins, Director of Communications and
Public Information Officer for DJS, explained why the Hickey School was closed,
stating that the building was in disrepair and the needs of the youths were not
being met when DJS took its management over from a private company.
In addition, the Department of Justice is investigating civil rights
violations at the School and at another DJS facility, Cheltenham.
Due to these problems, Governor Ehrlich closed the school on 6/30/05.
Mr. Hopkins wondered if it made sense to “let the youth stay there and
languish or get into better programs”. He
noted that DJS is working on a facilities master plan to present to the
legislature in 2006.
Dr. Andrea Weissman, Director of the Division
of Behavioral Health Services for DJS since 12/04, sees the closure of the
Hickey school as an opportunity to review the needs of the youths placed there
and provide more adequate services to them.
Her interest in correctional mental health and substance abuse treatment
began in the early 1990’s after learning about the Pelican Bay trial, where
inmates’ conditions of confinement were being questioned as being deplorable
and inadequate. She became
interested in improving the system and became Director of Mental Health Services
at the Oakhill Juvenile Detention Center. For
the past seven years, she was Director of Mental Health Services at the DC jail.
After accepting the position here in Maryland,
Dr. Weissman established behavioral health services as a separate division
within DJS, instead of it being integrated into a general medical division.
All facility based case managers responsible for treatment planning were
placed under her Division. Her focus
is to determine what mental health and substance abuse services are essential
for DJS youths. She is using an
AACAP instrument, the CASII, that measures the level of structure a youth needs
and the level of mental health services. In
this way, placement needs are separated from mental health needs; for example, a
youth who is not at high risk to the community but has emotional problems will
be placed in the community but will receive more mental health services.
Dr. Zachik describes this tool as assessing each youth’s family
functioning, environmental supports, mental health needs, physical health needs,
substance abuse issues and compliance with treatment.
Recently, Dr. Weissman used the CASII to
assess each youth placed at the Hickey School and found that there are two
groups: Youths at high risk to the
community with high behavioral health needs and youths at high risk to the
community with less serious behavioral health issues (such as Conduct Disorder
and/or Attention Deficit Disorder). For
youths with less serious behavioral issues, placements may be modeled more on a
system used in Missouri. There, DJS
committed teens without serious emotional problems are placed in small
facilities with behavioral interventions. For
those youths with more emotional difficulties, Dr. Weissman is working closely
with DHMH to establish new programs and to find current mental health providers
who are willing to provide services to them in existing or new detention centers
to be built by the State. One model
Dr. Weissman is considering is the Dialectical Behavioral Therapeutic Model (DBT)
developed by Marsha Linehan for suicidal and Borderline Personality Disordered
women. Many DJS youth have been
significantly traumatized and they experience suicidal ideation, affective
instability and cognitive processing issues.
Dr. Weissman is also trying newer treatments for DJS youth. One of these
is a Community and Family Resource Center that just opened at the Justice Center
in Baltimore City. Services will
include information and referrals, workshops, family group conferencing to help
families meet the needs of their children in crisis, and family therapies
addressing substance abuse, violence, and mental health issues in family
members.