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While politicians argue whether make-believe violence in movies and television is harming children, a Washington University study has found that a bigger behavioral influence may be the real-life violence that many inner-city teens face daily in their homes, schools and neighborhoods.
"Violent teens live in a war zone and behave that way," said Arlene Stiffman, Ph.D., an associate professor at the George Warren Brown School of Social Work. "Our study demonstrates a direct link between teenagers' exposure to violence and their own violent behaviors. The more violence that the youths had been exposed to, the more likely they were to be violent themselves, to misuse drugs and alcohol and to lose hope for the future."
Stiffman and a team of researchers at the school's Center for Mental Health Services Research surveyed 797 youths ages 14 to 17 from four St. Louis City arenas that provide youth services: high schools, public health clinics, child welfare agencies and the juvenile justice system.
Teens participating in the study, which was funded by the National Institute of Mental Health (NIMH), reported extremely high rates of exposure to violence:
"Youths who are usually thought of as violent victimizers of others often have been the most victimized themselves," Stiffman said. "They see no hope for the future, feel suicidal, and do not know how to escape from the violence except by being violent themselves or numbing themselves with drugs or alcohol. The victimizers are also the victims."
More than 25 percent of those surveyed reported that they themselves had been attacked or beaten and 20 percent said that they had been hurt or threatened with physical violence in their own homes. In addition to demonstrating a strong relationship between exposure to high levels of violence and a teen's likelihood of engaging in violence, the study also linked exposure to violence to other risky behaviors, such as drug abuse and unsafe sex.
Almost one-third of the youths had engaged in at least one sexual risk behavior in the last six months, and nearly one-quarter reported multiple sexual partners in the same period. Two-thirds had experienced sexual intercourse, Stiffman said.
Stiffman's findings also shatter some popular misconceptions about the source of inner-city violence. The study indicates, for instance, that black males are no more likely to be violent than white males, although males as a group are twice as likely as females to be violent.
The study is one component of a research project designed to assess whether teenagers' needs for mental health services are being met by existing agencies and programs.
"We're definitely finding that existing systems are not identifying the kids' needs," Stiffman said. "Because most service providers don't adequately identify the mental health needs of teens, they are not providing these services. Those providers who do know about the mental health problems of teen clients tell us that there are few resources to provide services. As a result, they don't bother to look for problems."
Stiffman and colleagues identified a wide range of serious mental health problems in the teens they surveyed, including drug or alcohol abuse, conduct disorder, post-traumatic stress, depression and suicidal tendencies.
"Less than half of the teens we identified as having mental health problems had received any services for these problems," Stiffman said.
The study generated strong interest among Stiffman's peers during presentations she made in spring 1995 at meetings of the Council on Social Work Education in San Jose, Calif., and at the International Association for Social Work in Washington, D.C. Stiffman's colleagues acknowledge that teen violence has become a serious problem across the nation, but many expressed concern about the recent rash of legislation designed to "get tough" on juvenile crime.
While many local and state politicians are pushing for more stringent penalties for juvenile offenders, Stiffman contends that stricter law enforcement measures alone are not enough to reverse what she sees as a vicious cycle of teen violence.
"Instead of focusing solely on punishing the youths who are primarily reacting to the violence that they experienced around them, attempts must be made to reduce that environmental violence," Stiffman said. "Our study demonstrates the need for comprehensive interventions to reduce violence in the home, in the community, and in the school."
Stiffman's study of teen violence is part of a larger research effort at the school's Center for Mental Health Research, which was established in 1993 with the help of a $3.7 million grant from the National Institute of Mental Health.
The center's research focuses on the access, integration and effectiveness of mental health services for high-risk populations, including children, adolescents, poor and minority individuals, and those in the community with severe and persistent mental disorders.
"Social workers as a group provide more mental health services than any other profession," said Kenneth G. Lutterman, associate director of research training at the NIMH Division of Applied and Services Research. "Most people with mental health problems first appear in settings other than the traditional mental health services --in the school, welfare, and justice systems," said Lutterman. "This center is helping provide the research that is needed to improve how social workers recognize, diagnose and treat people with mental health problems."
Stiffman's study demonstrates that youths who enter the "gateways" to mental health service provision through contact with school counselors, child welfare workers, juvenile court personnel or primary healthcare providers are likely to have many problems associated with exposure to violence. She suggests that teens entering these gateways be assessed routinely for exposure to violence.
"Helping professionals need to be aware of that violence and recognize its mitigating influence on the youths' well-being and on any intervention that fails to take it into consideration," Stiffman said. "We cannot expect youths who experience violence, death and fear every day of their lives to be able to make plans for their future and to cope with that trauma without help."
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