Years after juvenile detention, adults struggle, study finds

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By Jeremy Loudenback

Children who have been admitted to a juvenile detention center often struggle with a range of issues years after being detained, according to results from a study published in JAMA Pediatrics.

The longitudinal study affords a rare look at how youth who experienced juvenile detention fared in terms of eight positive outcomes five and 12 years after detention.

The eight domains included the following: educational attainment, residential independence, gainful activity, desistance from criminal activity, mental health, abstaining from substance abuse, interpersonal functioning, and parenting responsibility.

A team of researchers from Northwestern University tracked more than 1,800 youth who were admitted to the Cook County Detention Center in Chicago from 1995 to 1998. The average of youth of these youth was about 15 years old.

In interviews both five and 12 years after detainment, the study attempted to determine if these youth had attained age-appropriate psychosocial outcomes in the years after detention, and how much these outcomes varied by race and sex.

According to analysis, only 21.9 percent of males and 54.7 percent of females had attained positive outcomes in the eight domains. Of all groups surveyed, African Americans were the least likely to achieve positive outcomes in the years after detention.

Robert Sampson, the Harvard sociologist who has written about both life-long trajectories of delinquent youth and spatial inequality in Chicago, wrote an editorial comment on the study in the same issue of JAMA Pediatrics. The long-term consequences of detention for delinquent youth, or “the juvenile equivalent of re-entry among ex-prisoners,” remains a topic of little research, according to Sampson.

“Juvenile detention has operated in the shadow of adult incarceration,” Sampson wrote.

In their study, the Northwestern researchers say that longitudinal studies of youth incarcerated in juvenile facilities have generally focused on recidivism, rather than on how youth adjust to life after returning to their communities. They argue that pediatric health care professionals have a role to play in promoting psychosocial health among these youth.

“To improve outcomes, pediatric health care professionals should recognize the importance of psychosocial health, partner with on-site psychosocial services in their practices, and facilitate access to services in the community,” the researchers wrote.

Just one year of child abuse costs San Francisco, CA, $300 million….but it doesn’t have to

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In 2015, 5,545 children in San Francisco, CA, were reported to have experienced abuse. Of those, the reports of 753 children were substantiated. The expense to San Francisco for not preventing that abuse will cost $400,533 per child over his or her lifetime. That adds up to $301.6 million for just that one year, according to “The Economics of Child Abuse: A Study of San Francisco.”

And, because child abuse is profoundly underreported, the costs are likely to be as much as $5.6 billion for one year of children experiencing trauma, the report found.

The report, released today, provides the first calculation of the economic burden of child abuse in San Francisco. It was put together by the San Francisco Child Abuse Prevention Center and the Social Sector Solutions program at the Haas School of Business at the University of California, Berkeley. The HAND Foundation contributed to the effort.

“Although we have quantified the cost of a child abuse victim, it’s impossible to quantify the impact of abuse to a child, their family and our community — with one single case our society has been degraded,” said Katie Albright, executive director of the San Francisco Child Abuse Prevention Center. “This report proves that not only morally, but fiscally, it is our mandate as a community to end child abuse once and for all.”

The report echoes other economic analyses. Let’s look at only the children who were abused in the U.S. in 2008. Add up the total lifetime economic burden resulting from their maltreatment. It’s a whopping $124 billion. Include all the people who were abused each year even for just 10 years, and the number begins rolling into the trillions.

The CDC’s National Center for Injury Prevention and Control, which did those calculations, broke down that unfathomably large number into this:

The lifetime cost for one child who was a victim of maltreatment is $210,012 in 2010 dollars. This includes:

  • $32,648 in childhood health care costs;
  • $10,530 in adult medical costs;
  • $144,360 in productivity losses;
  • $7,728 in child welfare costs;
  • $6,747 in criminal justice costs;
  • $7,999 in special education costs.

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In San Francisco, the costs (in current dollars) are:

  • $54,553 in health care costs (child and adult);
  • $314,417 in lifetime productivity losses;
  • $11,035 in child welfare costs;
  • $7,637 in criminal justice costs;
  • $12,891 in education costs

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Dear doctor: A letter from a survivor of sexual trauma to all medical professionals

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Dear Doctor,

As a medical professional you have taken an oath to do no harm, but there are ways in which you can hurt your patients without even recognizing you are doing so. What seems to you as a simple exam may cause injury to those who have been victimized by someone’s touch. This is a subject that we, survivors of sexual violence, have been meaning to discuss with you for some time now, but your authority can be more intimidating than you may know. I am also unsure if you are aware just how much power you, as a physician, hold and to the extent that you affect the lives of all of your patients. Your interactions with us travel much deeper than the physical core.

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Artists in the ACEs and resilience movement: Creative avenues to change

 

From "Airings...Voices of our Youth", created by staff from the Bellingham and Mount Baker School Districts (WA), the Whatcom Family and Community Network, faculty at Western Washington University’s Psychology Department and, more than 20 teenagers from the community who have shared their stories (Photo: Angela Kiser and Nolan McNally).

From “Airings…Voices of our Youth”, created by staff from the Bellingham and Mount Baker School Districts (WA), the Whatcom Family and Community Network, faculty at Western Washington University’s Psychology Department and, more than 20 teenagers from the community who have shared their stories (Photo: Angela Kiser and Nolan McNally).

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At a June summit in Whatcom County, WA, titled “Our Resilient Community: A Community Conversation on Resilience and Equity,” the arts played a starring role.

Kristi Slette, executive director of the Whatcom Family and Community Network, one of two Washington sites participating in the Mobilizing Action for Resilient Communities (MARC) project, says the arts—music, dance, sculpture, storytelling—can help audiences understand trauma, resilience and hope in a visceral way.

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Pueblo, CO, clinic rewrites the book on primary medical care by asking patients about their childhood adversity

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In October 2015 in Pueblo, CO, the staff members of a primary care medical clinic – Southern Colorado Family Medicine at the St. Mary-Corwin Medical Center – start asking parents of newborn babies to kids five years old about the parents’ adverse childhood experiences and the resilience factors in their lives. They ask the same questions of pregnant women and their partners in the hospital’s high-risk obstetrics clinic.

The results are so positive after the first year that the clinic starts asking parents of kids up to 18 years old. The plans are to do the same in the hospital’s emergency room.

Why? They think it gives kids a leg up on a healthier start in life. They think it helps adults understand and manage their own health better. They think it helps physicians better understand and help their patients. Oh yeah – and it looks like it’s going to save money. Probably a lot of money.

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We have to partner with law enforcement around trauma

jjie_kathy-mcnamara-2-16-12-13Is there a need for trauma-informed training for police officers? Let me share an example of a situation where the outcome could have been very different if the responding officer had been trauma-informed.

I was working with a young man on probation who was a trauma survivor. He was being tested for drugs, and, unfortunately, the environment triggered a traumatic response. He came running out of the bathroom and I followed him as he wandered around in a highly agitated state. I was able to talk with him and was working on helping him reconnect with his environment.

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