Hogg Foundation for Mental Health

Back On Track: Nationally Recognized Bexar County Project Helps Troubled Youths Stay on the Path to Recovery

June 1, 2005

The scientific literature is fairly consistent in finding that a continuum of mental health services maximizes the capacities for juveniles recovering from severe emotional disorders to maintain their medication and counseling regimens. Nowhere is the need greater than for youths graduating from residential treatment programs, who often return to home and community without the supervision and structural supports necessary to sustain their recovery. Some estimates suggest that as many as 20 percent of youths in the Texas juvenile justice system suffer from severe emotional disorders.

In 2004, the U.S. House Committee on Government Reform's report, Incarceration of Youth Who are Waiting for Community Mental Health Services in the United States, found similar conditions across the country, with juvenile detention facilities "housing young people in need of treatment for a range of mental health disorders." The failure to adequately support juvenile offenders transitioning back to their communities carries significant financial consequences.

In 1999, the Journal of Quantitative Criminology published a study by Vanderbilt University economist Mark A. Cohen entitled, "The Monetary Value of Saving a High-Risk Youth." In it, Cohen calculated the cost to American taxpayers when a young person drops out of high school and enters a life of crime and substance abuse. His analysis concluded that taken together the present and future costs to government (arrest, trial, prisons) and society (loss of property, violence, etc.) would range from anywhere between $1.7 and $2.5 million.

Unfortunately, integrated transitional services can be difficult to come by. The exception is the Bexar County Juvenile Probation Department's Back on Track Program, which provides a seamless continuum of aftercare services to juveniles released from court-ordered placement in the Cyndi Taylor Krier Juvenile Correctional Treatment Center.

In conjunction with The University of Texas Health Science Center at San Antonio, the Back on Track Program employs aftercare specialists to initiate the juveniles' reintegration into the community and coordinate services – including mental health counseling, substance abuse treatment, employment training, parenting skills and independent living accommodations – that are essential to continued recovery.

"When a juvenile is discharged from a residential treatment center like Krier, the most important priority should be to deploy a level of aftercare supervision and support that does not lose that youth in the community," said Dr. Jeannie Von Stultz, director of Mental Health Services for the Bexar County Juvenile Probation Department.

The Back on Track Program is unique in combining correctional, educational, and medical treatment components to provide juveniles a comprehensive and intensive array of services. In most instances, when a teen is released from the Krier facility, a team of probation officers, counselors, teachers, medical staff, the youth and their families take part in creating an individual treatment program in consultation with psychiatrists with The University of Texas Health Science Center's Division of

Child and Adolescent Psychiatry. The Back on Track Program works to ensure that the youths stay within the boundaries of that program through two aftercare specialists.

Through a partnership with the Center for Health Care Services, some 40 percent of the juveniles in the program receive services from the local mental health authority for disorders ranging from conduct disorder, major depression, psychosis and post-traumatic stress. Some families prefer to access services through private practitioners or non-profit agencies.

Since being awarded a three-year, $180,000 grant from the Hogg Foundation for Mental Health in 2003, the Back on Track Program has not looked back. The program has served nearly 80 juveniles, with a success rate of around 77 percent – an astonishing ratio given intractable obstacles usually experienced when treating this population.

Within the first year, Bexar County was reporting how the majority of youths participating in the program were successfully sustaining their recoveries and moving their lives in positive directions.

The successes are not only measured statistically, but in the lives of those who have gone through the program. Just one example is that of Quenten, whose history of violence and substance abuse landed him in Krier in 2002. While there, Quenten earned his GED and even won a $500 scholarship in a creative writing competition.

But upon his release in 2004, troubles at home meant he could not live with his family. Instead, his aftercare counselor managed to have him placed in San Antonio's Turning Point independent living program. When his mother refused to sign the paperwork for financial aid, his aftercare counselor helped him get financial aid necessary to attend San Antonio's St. Phillip's College. Quenten is now working at an HEB grocery store and taking classes to earn his certification as a medical technician.

The attention the program has received was an integral part of The University of Texas Health Science Center at San Antonio being awarded a four-year, $2 million grant from the Substance Abuse and Mental Health Services Administration to provide family-focused, outpatient substance abuse and mental health treatments, as well as services to enhance educational and vocational outcomes, and access to resources.

"Our emphasis continues to be on the individual needs of the juvenile which means frequent and productive contacts with the juvenile, providing them with a variety of supportive resources," Stultz said. "By frequently and intensely connecting with these youths, we develop a level of trust and a bond of mutual respect. A relationship forms that extends beyond just documenting whether they are attending their appointments or fulfilling the conditions of their probation. These young people begin to realize that they can have a positive impact in their relationships and their environment," Stultz said.

"By helping these juveniles maintain their commitment to recovery and avoid drugs and alcohol, Back on Track helps put them on the right track and avoid behaviors that sent them into the juvenile justice system in the first place," said Carolyn Young, program officer for the Hogg Foundation for Mental Health.

"Such community partnerships are proven to effectively build on local knowledge, capacities, and resources to keep young people moving into training or jobs that can anchor them and lead to productive lives," Young said.