Page 24 - Juvenile Practice is not Child's Play

Clients with Mental Health Disorders

Mental health disorders in children often differ from those in adults in presentation, diagnosis, and treatment. For

example, depression in adults may be expressed as sadness or hopelessness, while depression in adolescents may
manifest as aggressive or irritated behavior or loss of interest. What we traditionally understand to be mental health
illness in an adult typically involves disturbances in the neurochemistry of the brain (e.g. mood disorders such as major
depressive disorder, generalized anxiety disorder, and personality disorders such as schizophrenia). While children and

adolescents may also be diagnosed with such brain disorders (though, personality disorders before the age of 18 is
typically rare) if a child is given such a diagnosis, it is often inaccurate as it is more difficult to accurately diagnose
children because of the multiple factors that may result in the same or similar symptoms, such as acting out or emotional

instability. Many symptoms of mental health disorders, such as outbursts of aggression, difficulty in paying attention,
or fearfulness, may be normal at various points in a child’s development and, because of this, a mental health disorder
may go unrecognized. Or, attorneys and court officials may just consider these symptoms of mental health disorders
to be an indication that they are dealing with a “bad” child.

National estimates of how many in the youth justice system have mental health disorders vary widely depending on
which mental health disorders are included in any given study. In Texas, the relatively broad definitions of mental

health disorders in children include at least the following:

Title 7 (Mental Health and Intellectual Disability) of the Texas Health and Safety Code defines mental health illness as
the following:

571.003 (14) "mental illness" means an illness, disease, or condition, other than epilepsy, dementia, substance
abuse, or intellectual disability, that:
(A) substantially impairs a person's thought, perception of reality, emotional process, or judgment; or
(B) grossly impairs behavior as demonstrated by recent disturbed behavior.

Mental health illness exists on a continuum and is the result of a complex interplay of brain functioning and
environmental factors. Often, a combination of medication and clinical treatment such as psychotherapy is used to
treat mental health illnesses; however, practitioners should pay close attention to weighing the benefits of cognitive and
behavioral intervention and attempt to make therapy the focus of the child’s treatment. Some professionals may shy

away from an official diagnosis because of the stigma associated with mental health illnesses.

Mental health disorders are especially prevalent in youth send to TJJD. Three out of four youth in the justice system

are affected by one or more mental health disorders.