Center focuses on behavioral causes to make change

More than 60 percent of juveniles in the court system have a diagnosable yet undiagnosed mental illness. The Center for Health in Justice-Involved Youth is sponsored by the University of Tennessee College of Medicine and the Shelby County Juvenile Court System as a way to deal with that concern.
 
Dr. Altha J. Stewart is a physician, associate professor and director of the center. Stewart began work last summer with the center, and started as director Feb. 1 of this year.
 
The center’s primary goal is to become a community leader that is focused on changing behaviors as well as helping to explain some of the issues facing the city’s young people.
 
“We’re not law enforcement,” Stewart said. “At our best we’re a good public health approach at addressing public health concerns. And we can advance the dialogue going on in our community. We’re poised to begin doing some of the hard work and come up with creative solutions.”
 
Children with these issues often end up in juvenile court, foster care or expelled from school. The center partners with the Juvenile Court of Memphis and Shelby County, which will refer children to the center.
 Dr. Altha J. Stewart
Dan Michael is a judge of the Juvenile Court of Memphis and Shelby County where he hears appeals from the nine lower magistrates and presides over the major crimes docket, where he hears the most serious felony cases at the court. Shortly after his election in 2014, he was part of the group that came up with the idea for the center and eventually lured Stewart in.
 
“This is a great idea, the concept of recognizing the trauma that brings these children to our court for whatever reason,” Michael said. “They’re not properly raised by parents or abused by someone or they’ve grown to act out in the community. We have to look at the underlying causes or we won’t fix the problem. What the center offers is a way to get at those underlying causes of juvenile delinquency so we can begin programs and forestall the delinquent behavior.”
 
Stewart brings a wide range of experiences to the organization. She was born and raised in Memphis where she was part of the first class of women to graduate from what was then known as Christian Brothers College.
 
She moved to Philadelphia to attend medical school and completed her residency there. She worked in large public mental health systems in Philadelphia, New York and Detroit before returning home to Memphis.
 
She takes lessons learned in those large cities to work with the Bluff City’s youth.
 
“I’ve been exposed to other large urban areas with the usual and same problems that Memphis has in terms of children with mental health problems and how they become trapped in the juvenile system and need assistance to address those needs,” Stewart said. “We take a public health approach in addressing issues kids in the system have with mental illness, substance abuse and trauma exposure.”
 
The Center for Health in Justice works in partnership with the Juvenile Court and other organizations to create programs that will better meet the needs of families and children.
 
The goal of the center is to serve as a central coordinating body for the work related to the juvenile justice system in three areas: specialized services; hosting, support and identification of opportunities for grant funds for research; and education and training.
 
The UT Center now serves as a central coordinator to connect children and families to organizations providing special services working with certain behaviors. The grant opportunities will drill down to a community level to better understand issues and to help develop community-level interventions.
 
The education and training happens on two fronts. First, Stewart’s work on the faculty at UTHSC helps train the next generation of medical professionals on how to work with children who face various problems and whose families have challenges.
 
Secondly, UTHSC is part of a cohort of universities incorporating more training into curriculum. Those relationships with other education providers such as the University of Memphis Department of Social Work and other colleges provides influence over teaching methods.
 
“I’m working with that group so people in the next generation of providers can understand what’s happening,” Stewart said. “We’re talking about what’s the most challenging and sensitive issues, what’s happening behind closed doors. … The people currently practicing need to now have this new skill in their toolbox. That includes the people who work in various agencies, whether it’s government or nonprofit. We need teachers to understand what might be mental illness showing up in juvenile behavior. We’re not trying to make junior psychologists but they need to recognize issues so they can make the appropriate referral.”
 
While lessons learned in other communities can make a difference in Memphis, in some ways the Bluff City is setting its own course. When Stewart arrived back home she realized the city was the first she has worked in to not have a local entity that ensures certain things are accomplished. While the state sets up guidelines, Stewart’s past experiences in New York, Philadelphia and Detroit came in communities that all have local authorities that provide oversight for services.
 
“That doesn’t exist here so that means communications at a local level has no community voice, no collaborative voice,” she said. “That becomes important when talking about children in juvenile justice. … Without a local authority pushing to identify the problem it is left to local government that may not have the ability to do it, or state government working statewide and these kids may fall through the cracks. If children have mental illness but no access to care what we’re doing is incarcerating kids who are sick, and that’s unacceptable.”
 
Stewart’s work with the center got its local start when in 2011 she began managing a federal grant in Shelby County for children with mental illness and their families. The grant brought $9 million to Shelby County over a six-year period to create a system of care for children’s mental health.
 
Stewart engaged mental health providers in the community, working with children’s services and the juvenile court. The program worked with 400 children and their families with the goal of making sure services were identified.
 
Michael said it’s been gratifying to work in the juvenile system over the past couple of years and to see the country as a whole begin to gravitate more to a restorative justice model.
 
“And now we want to get at the underlying causes of the delinquency as opposed to using the incarceration model to just lock children up,” he said. “There are children who deserve to be kept from society because they present a real and present danger to society. But the vast majority of children we serve aren’t a risk to society in general. If we don’t step in and provide corrective measures they will become a risk for society.”
 
The UT Center will get to the underlying causes of a person’s problems and provide solutions that can be used to correct behaviors.
 
“We like to think that while it’s a huge effort and significant undertaking, we’re doing it step by step,” Stewart said. “What we’re trying to do through the center is spread and disseminate this information to a variety of groups who will then take it and spread to their networks. We don’t have to do this alone.”
 
The UT Center has established collaborations and community partnerships that will create what Stewart called a trauma component.
 
“What happens if we share some general information about what signs and symptoms in the form of behaviors causing challenges in their programs,” she said. “These people then become trauma informed. They’re now part of the front line and they feel more comfortable dealing with kids. They have now other options for how they can deal directly with a child and make referrals for other things for the benefit of the child. They’re not giving up on the child, and maybe others in the community won’t either.”