Women's Health in Juvenile Detention: How a System Designed for Boys Is Failing Girls

[LeftyMom]

http://www.theatlantic.com/health/archive/2012/11/womens-health-in-juvenile-detention-how-a-system-designed-for-boys-is-failing-girls/265668/

Incarcerated girls like Jessica are "one of the most vulnerable and unfortunately invisible populations in the country," and up to 90 percent have experienced physical, sexual, or emotional abuse, according to Catherine Pierce, a senior advisor at the federal government's Office of Juvenile Justice and Delinquency Prevention.

The health statistics are particularly grim: 41 percent of girls in detention have signs of vaginal injury consistent with sexual assault, up to a third have been or are currently pregnant, eight percent have had positive skin tests for tuberculosis and 30 percent need glasses but do not have them, according to research from the National Girls Health and Justice Institute.

For many incarcerated girls, detention may be the only time they interact with the health care system. But the health care provided to children, and girls in particular, in juvenile detention is often ill-equipped to deal with their complex health needs.

A 2004 study in the journal Pediatrics found that fewer than half of facilities surveyed were compliant with recommended health screening and assessments, and few met even minimum levels of care.

"I don't think detention facilities really understand enough about [girls'] history of victimization," says Pierce. "We have a lot of work to do."

[1StrongBlackMan]

1. I am happy to say ...

the State of Arizona (well, at least Pima County) is attempting to change the national model for Juvenile Justice. It has made the evidence-based decision to move from a "corrections" (i.e., lock 'em up and punish 'em) model to a "holistic rehabilitation" model, that works to "heal" the family unit, as it works to teach the detained youth life and decision-making skills, while providing the youth with therapeutic regimes ... most notably, mental health screening and treatment.

Yeah, someone smart administrator and judge had an epiphany ... "How can a system "correct" conduct that a youth sees everyday as normal?" And, "What is gained through that "correction" when the detained youth is released back into a home environment where the "corrected" conduct is vital for the youth to survive?"

And guess what ... much to the dismay of the "lock 'em up, that'll learn 'em" crowd, it's working!

[FloridaJudy]

2. I used to work in a juvenile detention center for girls

It was probably one of the better ones. The warden was a kind, enlightened woman who viewed her charges as damaged human beings in need of rehab, rather than as caged animals, and she did her best to hire staff that shared her philosophy.

That 90% estimate is too low! As the charge nurse, I had access to the kids' court records, as well as their medical histories. Reading through them was heart breaking. Of the scores of kids who went through there, I can't think of a single one who wasn't the survivor of some sort of horrific abuse. Sure, we had a few budding sociopaths, but reading through their files, I'd think "Hell, in her shoes I'd be more than a little psycho myself".

The place was good. They had dedicated teachers, and offered a full range of health services. We had a local psychiatrist as a consultant, though to be fair, about the only thing the poor woman could do was order a cartload of meds. It would probably take 40 hours of therapy a week per girl to make a dent in their in their problems. They even had an arrangement with the local dental school for regular cleanings, and to care for the most horrendous of their cavities.

The thing is, places like that one are expensive to run. I suspect it no longer exists, at least in that form. Legislators are reluctant to spend money on non-taxpaying juvenile delinquents when they could giving their billionaire buddies lavish tax breaks. You don't have to ask me whether I'd rather Susie gets a decent shot at life, or Joe Moneybags gets a second Ferrari. But then I don't make the rules in this state.

Obviously.

[Gormy Cuss]

3. It's such a missed opportunity.

Both boys and girls should get dental care and eye care. All teens in detention should have access to contraception and screening to detect physical, emotional and sexual abuse as well as routine screening for sexually transmitted diseases.

Teen girls absolutely should have access to intake and periodic pregnancy testing and if pregnant, extra nutrition and access to abortion, adoption, and healthy maternity programs.