Characteristics of Children and Adolescents in a Psychiatric Hospital and a Corrections Facility

doi:10.1097/00004583-199011000-00012

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 29, Issue 6, November 1990, Pages 909-913

https://doi.org/10.1097/00004583-199011000-00012 Get rights and content

Abstract

Popular opinion holds that youngsters in corrections programs are delinquents in need of reform, whereas youngsters in psychiatric settings have mental health problems and need therapy. Yet some literature suggests that youth in the two settings may not differ greatly in their mental health status. The authors compared demographic, emotional, and behavioral characteristics of youngsters placed in public psychiatric hospital and corrections settings, and they found few differences. Child Behavior Checklist scores for social competence and total problems were high and quite similar for youngsters in the two settings. White children scored significantly worse than black children on Child Behavior Checklist Internalizing, Externalizing, and total problems in corrections settings but not in the psychiatric hospital. Moreover, race was the only variable that predicted the site in which youth were placed. The findings suggest a need to study (1) the mental health needs of youngsters in nonmental health settings and (2) the procedures by which youth are assigned to service settings. J. Am. Acad. Child Adolesc. Psychiatry, 1990, 29, 6:909–913.

References (14)

M. Rutter
Isle of Wight revisited: 25 years of child psychiatric epidemiology
J. Am. Acad. Child Adolesc. Psychiatry
(1989)
T.M. Achenbach et al.
Behavioral problems and competencies reported by parents of normal and disturbed children aged 4 through 16
Monogr. Soc. Res. Child Dev.
(1981)
T.M. Achenbach et al.
Manual for the Child Behavior Checklist and Revised Child Behavior Profile
(1983)
T.M. Achenbach et al.
Child/adolescent behavioral and emotional problems: implications of cross informant correlations for situational specificity
Psychol. Bull.
(1987)
R.M. Friedman
Major issues in mental health services for children
Administration in Mental Health
(1986)
T.B. Gillung et al.
Assessing the impact and effectiveness of critical variables that affect placement decisions of emotionally disturbed students
(1987)
Institute of Medicine
Research on children and adolescents with mental, behavioral, and development disorders: mobilizing a national initiative
(1989)

There are more references available in the full text version of this article.

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This research was supported in part by the Virginia Commonwealth University Grants and Aid Program for Faculty, Grant No. 88–038.

We are grateful for the assistance of Dennis Waite, Ph.D., Chief Psychologist, Behavioral Services Unit, Division of Youth Services, and the staff of the Reception and Diagnostic Center for their assistance in arranging for data collection for youngsters placed in the Center. We appreciate the efforts of Trudy McDaniel, Kim Dell, Cynthia Evans, and Virginia Friend in assisting with data collection at the psychiatric hospital for children. John Bander assisted in computer programming. A special note of gratitude is due to Nirbhay Singh who made comments on the draft of this paper. We appreciate the assistance of Carol Ishler in the preparation of this manuscript.

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ArticleCharacteristics of Children and Adolescents in a Psychiatric Hospital and a Corrections Facility

Abstract

J. Am. Acad. Child Adolesc. Psychiatry

Behavioral problems and competencies reported by parents of normal and disturbed children aged 4 through 16

Monogr. Soc. Res. Child Dev.

Manual for the Child Behavior Checklist and Revised Child Behavior Profile

Child/adolescent behavioral and emotional problems: implications of cross informant correlations for situational specificity

Psychol. Bull.

Major issues in mental health services for children

Administration in Mental Health

Assessing the impact and effectiveness of critical variables that affect placement decisions of emotionally disturbed students

Research on children and adolescents with mental, behavioral, and development disorders: mobilizing a national initiative

Article
Characteristics of Children and Adolescents in a Psychiatric Hospital and a Corrections Facility