Watching lives crash in slow motion: a pediatrician’s perspective on youth arrests

A study came out recently in Pediatrics, the journal of the American Academy of Pediatrics, saying that by age 23, 1 in 3 youth in the United States has been arrested for a non-traffic offense.

Yes, you read that right. 1 in 3.

Because getting arrested is not good for a person’s health (the study pointed out that it increases the risk of “an unhealthy lifestyle”) and because pediatricians have regular and continuous contact with kids as they grow up, the authors called out to pediatricians to be aware of the risk factors for being arrested, and do something to help.

“Timely intervention by pediatricians in the lives of these youth,” says the last sentence, “may be an opportunity to move young people onto a path toward safer, healthy, productive, and successful lives.”

That sounds totally reasonable. But it’s not really true.

I have done primary care pediatrics in inner-city Boston for more than 20 years. Many of my patients have the “risk factors” the study mentions, like hyperactivity, poor relationships with their parents or general home discord, low academic performance, family violence, teenage parenthood, or neglect.

I have intervened. I’ve gotten kids counseling. I’ve connected them with Big Brothers and Big Sisters and community groups and free art classes and boxing. I’ve worked with their schools, given them medications for ADHD, sent them to specialists, seen them back again and again to try to think of new things to do. I’ve called child protective services. I’ve been as timely as possible in my interventions, and repeated them over and over again.

And yet, I’ve had patients be arrested. They have been arrested for possessing or selling drugs, having a weapon, breaking and entering and theft. They have been arrested for assault, rape and even for murder.

With every single one of those kids who got arrested, I saw it coming. It was like watching a car wreck in slow motion. It is excruciating to watch lives come undone and be destroyed, especially when it happens over years to children I’ve known since they were babies.

The truth is, my interventions are rarely enough.

As a pediatrician, I can’t put broken families back together. I can’t be in homes every day helping parents cope with and support challenging kids. I can’t restore school budgets so that every kid with a learning problem gets the help he or she needs. I can’t build community centers to keep kids off the streets. I can’t create mental health providers or make sure everyone has insurance to pay for them. I can’t create jobs for kids—or their parents. I can’t make sure that every kid has a safe place to live, or enough to eat.

I can’t do that stuff. But there are people who can.

It’s not that I don’t think it’s my job to help. Of course it is, and I’m going to keep trying. But if we want to make a dent in the number of arrests, it’s going to take government and schools and private organizations and neighbors. And it is going to cost real money.

In order to pull yourself up by your bootstraps, you have to have boots. And these are kids. They shouldn’t be pulling themselves up.  We are supposed to take care of them.

To all those who say that we can’t afford to spend money on this now, or that government should stay small and stay out of people’s lives, I say this: You can’t escape 1 in 3. That’s not a fringe thing in bad neighborhoods. You are very likely to know the person arrested (it could be your kid), or be the victim of their crime. And no matter what, you’re going to pay for it. I’m not even talking about the incalculable emotional, financial and other costs of being a victim of crime. Police and courts and jails and probation officers cost tax dollars, lots of them. Teachers and counselors and community services cost a whole lot less.

You can’t escape 1 in 3. That’s not a threat. It’s a fact—and a plea.


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