Juvenile Justice

As part of the reauthorization of the Juvenile Justice and Delinquency Prevention Act of 1974, GAO was required to study admission of minors with preadult disorders--problems that are generally associated with minors, such as conduct or attention deficit disorders--to private psychiatric hospitals. This fact sheet provides data on (1) the frequency with which minors with preadult disorders have been admitted to private psychiatric hospitals; (2) the average lengths of stay and methods of payment; (3) the statutory procedural protection afforded such persons in selected states; and (4) the conditions of confinement, such as service provided, sleeping arrangements, and visitation policies, at selected hospitals.

GAO found that: (1) sufficient data do not exist to determine the extent to which minors with preadult disorders are admitted to private psychiatric hospitals or the methods they use to pay for their care; (2) California was the only state that could provide data on the number of minors with preadult disorders admitted to private psychiatric hospitals; (3) in California, the number of minors with preadult disorders admitted to private psychiatric hospitals decreased significantly between 1986 and 1991; (4) nearly two-thirds of the minors' hospitalization costs were paid by private health insurance; (5) the increase in the number of psychiatric facilities and the number of minors admitted to them in the 1980s was due to overly aggressive marketing by the health care industry; (6) health care officials believe that improvements in medication management and external insurance carrier reviews have led to reductions in the number of minors being admitted to private psychiatric hospitals; (7) state statutes that protect minors admitted to psychiatric hospitals vary; and (8) all of the four hospitals reviewed had similar conditions of confinement and provided their minor patients with a variety of treatment and educational services.