ROBERT SIEGEL, host:
It used to be that kids with psychological problems who ran afoul of the law ended up in one place: juvenile hall. There, they found little help. But slowly that has been changing, as more and more states try to treat the mental health issues at the root of chronic lawlessness.
In California, for example, counties are working to diagnose and help their mentally ill juvenile offenders.
From member station KQED, Sarah Varney reports that efforts in the nation's second largest city, Los Angeles, are fitful and imperfect but promising.
SARAH VARNEY: We're sitting around a cramped kitchen table in Compton, California, a drug infested neighborhood in south L.A. Four-year old Matthew has swiped my microphone.
VARNEY: His older brother, Jesse, stands in the doorway and laughs easily. Jesse is 17. He has soft brown eyes and shoulders the size of a linebacker. It's hard to imagine now that his run-ins with the law nearly crushed this family.
JESSE: I got on probation when I was in the 10th grade. I was caught with a knife at school. Ever since that I started getting in trouble more and more often.
VARNEY: He used drugs and got in fights. Finally, he was arrested for vandalism and sent to juvenile hall.
JESSE: They put you in a room with a psychiatrist, and then they start basically with a computer, you take a test. And then they start asking you all these questions.
VARNEY: Questions like: Have you felt like hurting yourself? Have you ever seen someone killed? Like many teen offenders, this was the first time ever that anyone asked Jesse about his mental health. These psychological tests are now used in 42 states, and they show that untreated depression or trauma is rampant among juvenile offenders.
The tests signal a much larger effort around the nation to identify those with undiagnosed mental illness and get them help. That's how Jesse who is still a minor and didn't want his last name used ended up in months of court-ordered family therapy.
Jesse's mom Marisol sits next to him on the couch. Marisol was reluctant at first to let a therapist in her home, but she says the treatment is easing her son's depression.
MARISOL: He usually listens and goes to school, which was one of the biggest issues. And he's not using anymore.
VARNEY: Meaning, he's not using drugs. And she says, he's not lying.
Academic researchers say about half of L.A.'s young offenders suffer from depression, post-traumatic stress disorder or other forms of mental illness. But it's difficult to say who gets help. In any given year, Los Angeles has some 20,000 juvenile offenders. Fifteen thousand are released on probation, and the county has no reliable data on who receives treatment and whether it works.
Mr. DAVE MITCHELL (Los Angeles County Probation Department): That's kind of where we are weak right now, is when the kids leave our facilities and go to the community, they don't always stay connected.
VARNEY: Dave Mitchell is an eager and prepared bureaucrat. He sits in an office at the Los Angeles County Probation Department, a hulking, feature-less building behind a snarl of barbed wire fence.
Mr. MITCHELL: I would say 10 years ago, we were more aligned with law enforcement and a lot of that was because that's where the funding was. We've been in a transformation for about the last 10 years to align ourselves with rehabilitation.
VARNEY: The alignment is working, but it's expensive. The department draws federal, state and county funding and still there aren't enough programs and therapists to meet the need. What's more, many of these kids are uninsured and have no way to pay for their medication and therapy.
All of this comes as California's lawmakers are slashing budgets. Mitchell says if a proposed tax extension isn't approved, Los Angeles County alone will lose $100 million in juvenile justice funding.
Mr. MITCHELL: And a lot of the community-based services that we've worked so hard for in the last five or six years will go away because we'll be doing the minimum supervision.
VARNEY: Despite the shortcomings, I spoke with many experts who say the changes going on in Los Angeles, and in many California counties, are significant.
Pamela Robertson works for Starview Community Services, a non-profit mental health provider. She says county leaders have made it clear that mental health is a priority.
Ms. PAMELA ROBERTSON (Starview Community Services): The word is going out into the ranks of probation officers that this is a good thing: Utilize these services. And they're starting to respond very well to that, sending more and more referrals in.
VARNEY: There are other changes too. Some of those probation officers are now trained therapists. A special phone line connects kids to treatment, and there's intensive outpatient care for 1,200 particularly troubled teens.
The most concentrated effort though is with kids in jails. There are now four times the number of mental health staff in county jails, and special areas for those on suicide watch. But even there, the quality of care remains a big question mark.
Francheska Lamb spent many dark nights on suicide watch. At 21, she has a fresh and freckled face, and a cute 18-month old son, Aiden. But for all that seeming promise, Francheska has spent half her life in L.A.'s juvenile justice system.
Ms. FRANCHESKA LAMB: They wanted to put me on all kinds of medicine because I couldn't sleep and I was all drugged up. I was cutting on myself real bad, because it came to me that nobody wants me and that's just how it is.
VARNEY: Francheska was first taken from her mom at age four and turned over to her grandmother. By 11, she was doing crystal meth in the school bathroom and ended up in L.A. juvie hall. When a special facility opened for incarcerated teens with serious mental health problems, a result of the big changes taking place in Los Angeles, Francheska went there. She got some help, she says, but not enough.
Ms. LAMB: The only thing that they would do for me was lock me up in a room with a camera. They would try to talk to me but they weren't talking to me with respect. Like, they'll just yell at me, like, why are you doing this?
VARNEY: Los Angeles County says it's doing all it can for those in its care and mental health experts add, recovery is a tough road. It can take years of therapy and medication for troubled youth to right themselves. For Francesca, something along the line seems to have worked. She's out of jail now, she stopped doing drugs and self-mutilating, and she's earning her high school diploma. It's a rare and delicate moment in her life, the closest thing she's experienced to calm, a perilous and uneasy calm.
For NPR News, I'm Sarah Varney.