A Safe Place for Troubled Teens 

Alameda County's path-breaking new mental-health court seeks to help youth with psychiatric problems who have broken the law.

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In Unit 6, the mental-health unit, a boy peered out the window of his cell, his hands pressed against the glass. "It's really quiet right now," one staff member observed. "But if one of the kids goes down, twenty go down. It can be a real roller coaster."

Before the Juvenile Collaborative Court began in January 2007, probation officer Kevin Day had few options for dealing with mentally ill teens, other than putting them into custody. Now he has other ways to get them help. Unlike regular probation, where kids who break the rules often end up in detention, the collaborative court team examines possible causes for the slipups. A tipping point for bad behavior could be an inappropriate school placement that the court members work on correcting. Or perhaps a change in diagnosis. Or different medication.

One teenage girl was hospitalized in November 2008 for trying to strangle herself. In addition to being suicidal, she had been aggressive and at risk for "going AWOL." But with new medication, her behavior improved enough for her to be transferred to a short-term treatment facility before going home again.

One of the program's biggest challenges is getting past the stigma about taking medication in some communities served by the court.

"I know in the African-American and Latino communities, when you ask about medication people kind of steer away from it or view it in a negative way," said Audrey Banks, the Collaborative Court's case manager. "I know just being an African American myself, and connecting with some of the African-American clients and their parents. They seem to be uniformly negative until we sit down and talk about how the medication can calm this child down, help this child function better in school and in the community, and help this child avoid returning back to jail."

But re-entry can be a challenge. A child who goes from jail to a household ravaged by emotional and economic strife is still a child at grave risk, unless there's some kind of safety net.

That net is what mental-health court tries to provide. For example, shortly after Cindy Crane was released from juvenile hall, her family was evicted from its ranch-style home after their landlord received a foreclosure notice. From the time Cindy was accepted into the mental-health court through the end of the year, Brian Blalock, an attorney with Bay Area Legal Aid who is the court's civil legal services coordinator, negotiated more time for the eviction and for move-out expenses. He also helped Cindy and her sister secure survivor benefits after their father died. And just after Cindy was released from detention, Blalock helped prevent her from losing a good school placement because of confrontations with her school therapist. "I advised the mom what her rights were as a parent to ask for another therapist," Blalock said.

That teens with mental-health problems have trouble in school is hardly surprising. But if they're not able to finish high school, the prospects for family unity become more tenuous. "One of the first things that happens is families get calls from school saying, 'Please come and pick up your child,'" said Darcy Gruttadaro, the director of the National Child and Adolescent Action Center of the National Alliance for the Mentally Ill. "There's disruption in the work day, and also days where kids with serious mental-health needs don't want to go to school. Ultimately, the needs become so serious they realize they can't focus at work because the child needs them. We hear quite frequently that parents lose their job, divorce, families fall apart."

So keeping kids in school is one of the missions of the Collaborative Court. To help keep Cindy on track, Day, the court's probation officer, required her to call him every other day to tell him if she was having any problems at home or in school. Once, when she was late for school and was demanding her mother drive her there, he made it clear that it was Cindy's responsibility to make it to school on time. And yet he's also driven her around to pick up job applications for part-time work.

A lot of what Day does involves reframing teens' behavior in order to keep pushing for better and better results. "Any time there's a problem, I honestly believe it's opening a door for resolution as long as the behavior isn't overly threatening." He says, for example, that rather than telling a kid they're bad — which is what they hear from many authority figures they encounter — he often says something like, "You've made a mistake, we're moving on. Do you think we can show the judge that I made the right decision by not putting you in custody?"

On the walls opposite the courtroom where Collaborative Court is held, a series of images shows models of good behavior replacing bad: A boy is absorbed in reading a book; a girl wearing a mortarboard grasps her diploma; a boy holding a bullhorn to his mouth tells a crowd, "Men of quality respect women's equality."

For children burdened with the challenge of mental-health problems, the model behavior depicted in these murals is harder to achieve, but it does occur. A teenage girl in Commissioner Paul Seeman's courtroom stood as he announced that her probation was over and she had been dismissed from court. The girl broke down in tears of disbelief as the court's probation officer, public defender, and others clapped in praise.

Later, Commissioner Seeman said the girl had displayed repeated behavior problems at home and in school. For years she had cycled through group-home placements, violating probation over and over by getting into fights with other girls. "We were running out of placements for her," he said. "So the court put together a plan that would allow her to live at home with her mom, where she hadn't lived for several years." The court lined up therapy for her and a special school program, and since then there had been no more problems. "She's done great."

But mental-health court is no magic bullet. Cindy Crane has good days and bad days. During one telephone interview, Judith tearfully said that her daughter had just kicked her. In the background, Cindy yelled, "Why don't you tell her the fucking truth?" Judith and her daughter continue to have heated arguments, often over money. Both have called various agencies to intervene when their clashes seemed to be getting out of hand. Still, the fragile net holding the family together is intact. Mental-health court also helped Cindy's mother acknowledge her own depression, which has made it hard for her to find a new job and — at times — cope with Cindy.

But one year after she began Collaborative Court, Cindy also was dismissed, the equivalent of successfully graduating. She graduated from high school in mid-June and made the honor roll. She talked about getting grants to go to college, having an apartment, and finding a part-time job. Cindy attends church with her mom and helps out at a food pantry. Now, when she gets angry, Cindy says, "I'll either talk to [my boyfriend] about it, yell about it, get out of the house and go for a walk, watch TV, or forget about it. Because I know that I'll be out of the house soon."

For his part, Day hopes the program can be expanded. "The vast majority of my kids don't have criminal personalities," he said. "If we extrapolate, I would say it's safe to say that most kids don't have criminal personalities. If we could identify those kids who might respond to a different way of admonishing their negative behavior, I think we would see a significant decrease in the recidivism rate. It's not to say this approach is a panacea, by any stretch of the imagination. But what it can do is reinforce the idea if we make up our minds, we can identify programs that will better service our kids. And they won't be coming back."

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