Sick Kids

The detention center is a depressing place; locked doors lead to metal detectors surrounded by security cameras. The predominantly posterless walls are covered in scratches and patches (staff members say they haven't decorated because they're moving to a new building in a few years). In the stairwell, a trash can catches yellow water that drips through the soggy ceiling.

In a dimly lit, noisy area, boys' shouts echo off the empty walls. Here, offenders are given the Massachusetts Youth Screening Instrument, a 52-question true-or-false test that helps identify teens who might have mental or behavioral problems. "It tells us whether we need to ask more, harder questions," Bailey says. "We can decide between those who just want to create victims and those who need help in order to change."

Court-ordered psychological and sanity screenings are mostly performed by MHMRA's Child and Adolescent Services Forensic Unit (staffed by a licensed psychologist, a psychiatrist and two master's-level clinicians). Formerly the clinical supervisor for the forensic unit, Quintana is the only licensed psychologist the detention center employs -- and she does more administrative work than therapy. The probation department's psychiatric staff is composed of a nonlicensed psychologist, three master's-level therapists and two social workers with master's degrees. MHMRA employs a psychiatrist who prescribes and monitors psychotropic medication twice a week.

"For good or bad, for right or wrong, we are feeling overwhelmed by the needs of mentally ill children," Bailey says.

Two Hispanic boys with crew cuts sit on their knees smiling and waving in the window of an observation room at the Harris County Juvenile Detention Center.

"I'm on vacation," says one 15-year-old sitting on a ripped blue cot-length pillow. "I've gotta get away from home a little bit."

He was arrested for stealing a car and violated his probation by missing curfew. Avoiding his probation officer, he ran away from home and would crash with friends or stay awake walking the streets. Facing a murder charge, he's hoping to be deported back to El Salvador.

This morning he broke a toothbrush in half and used it to scratch a dozen shallow cuts onto his left wrist. "The devil did it to me," he says. "'Cause he's mean."

He points to a third boy sitting quietly in the corner clutching his pastor's business card. "He showed me how to do it," he says.

"No, I didn't," the boy says. "Don't lie."

The quiet boy's arms are covered in serious carvings -- his street name, "Little Chaos," is scraped in gothic script. He says he ran away from home because his aunt beat him.

The second smiling, waving boy from the window says he misses his mother; he tried to kill himself by stabbing his shin so he could go to heaven and watch over her.

He starts banging his head against the wall. The first boy with the scratched wrist begins banging his head, too. Soon they're in rhythm, smiling and slamming their skulls.

This is a typical tour of the detention center. "I've been over there twice -- I don't want to go back," says HCPC's Moore. "I couldn't hardly take it. It's dark and dingy-looking. It's blue; it's depressing even if you don't have a problem."

Seeing kids her grandchildren's age sitting in dark rooms staring at walls moved her to do more than just listen to Bailey's plea to get these kids better care than he can give. "It concerned me that there was no visible therapeutic care," Moore says. "When the kids get out, they have nothing to look forward to -- except coming back."

Bailey says he has given the same pitch hundreds of times, but Moore is the first person to take action. She found an empty wing in the 250-bed psychiatric hospital, and within two years of her first tour Commissioners Court approved a $1.9 million contract with HCPC. Since May, the juvenile offenders' wing has been full; 75 teens have received services. The average stay is 28 days, and the goal is to send kids straight home (if the court allows).

According to the National Mental Health Association, treatment programs reduce recidivism by 75 percent. HCPC plans to track teens for five years, hoping to see similar success rates. "If you believe that adolescents and teenagers are still developing and not at a fixed point, then in theory, this is the prime time to intervene," says Dr. Andrew Harper, director of child and adolescent services.

Along with music and recreation therapy, kids learn coping skills and anger management. Therapists try to teach offenders not to blame their actions entirely on their illness and to learn to make better choices.

"We try to expand the kid's ability to solve problems," Harper says. "No psychiatrist, no medicine is going to make you make the right decisions. We don't have the magic pill."