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Linda Teplin Tracks Health of Youth Who Fall Between the Cracks

May 23, 2007 | by Marla Paul

CHICAGO --- During polite chitchat at cocktail parties, someone will ask Linda Teplin what she does for a living. Teplin then rivets guests with stories about her research on youth in the juvenile justice system - their drug use, mental disorders and violent deaths. Invariably, someone will stop sipping his glass of pinot noir and interject, “Interesting study. But don't we know this already?”

No, actually, we don't. Research abounds on who becomes delinquent, but most of the studies stop there. Teplin's work -- at the Psycho-Legal Studies Program at Northwestern University's Feinberg School of Medicine -- looks at kids not only when they are in a juvenile justice facility, but after they are released and become young adults and even parents.    

“We do studies no one else wants to do or think can't be done,” said Teplin, the Owen L. Coon Professor of Psychiatry and Behavioral Sciences in the department of psychiatry and behavioral sciences.  “We study people that fall between the cracks.” Her groundbreaking, large-scale longitudinal study of juvenile justice youth - called the Northwestern Juvenile Justice Project - was the first comprehensive study of mental health and substance abuse disorders in this population.

Launched in 1995, the pioneering project recruited, tracks and interviews 1,829 participants to examine their ongoing health needs and the trajectories of their lives. It's no small feat keeping in touch with these highly mobile subjects.

But Teplin isn't easily daunted, a trait she credits to her late mother, Shirley Teplin. When Teplin was five years old, she recalls being awed by ballet dancers leaping and spinning on the TV screen.

“I asked my mom, 'How do you learn to do that?' She said, 'Nothing is difficult. Some things just take longer to learn.' Because of my mom, I have the tenacity of a Jack Russell terrier,” Teplin said fondly. “If you say no, I'll persevere until I get what we need.”

Her team of interviewers for the Northwestern Juvenile Justice Project keeps track of participants using a sophisticated computerized system developed by Karen Abram, associate director of the Psycho-Legal Studies Program and an associate professor of psychiatry and behavioral sciences. Abram and her staff stay in touch with their subjects by sending personalized birthday cards, occasional gifts like donated tickets to a White Sox game and refrigerator magnets that remind them “don't forget to call us if you move.” Participants who are incarcerated receive money orders.

To find subjects, these intrepid interviewers visit high-crime neighborhoods, jails and prisons. They trudge up foul-smelling, unlit stairwells in local housing projects. Once they interviewed a stripper on her coffee break.

But the study has lost 76 of its subjects to violent deaths since it began, a number that shocks and saddens Teplin.  Some were as young as 15. “We read the metro section in the newspaper to get leads on who died,” Teplin said. “I remember the day when two of our kids were killed in drive-by shootings.”

“The public is riveted by mass shootings like Columbine and Virginia Tech. But mass school shootings-while tragic -are rare occurrences.  Few people seem concerned about the daily tragedy of inner-city kids dying.”

The latest phase in the Northwestern Juvenile Project, for which Teplin was recently awarded a $5,710,368 grant from the National Institute of Drug Abuse, will focus on the relationship between substance use and HIV/AIDS risk behaviors from adolescence through young adulthood.

The five-year-study will examine participants' sex and injection-risk behaviors, and will test them for HIV/AIDS and other STDs.   The findings will ultimately guide intervention and prevention strategies for people who are at the highest risk for these diseases.

“My goal is to conduct studies that guide national public health policy,” Teplin said. Her research is widely used by government agencies and has been cited in Supreme Court hearings and in five Surgeon General reports.

For the new phase of the project, researchers will interview 758 of the original participants, now ages 20 to 30 years old. The subject base includes a large sample of women. ”Studying females is critical because their numbers in the justice system are increasing at a faster rate than males' and are at an all time high,” Teplin noted.

Studying juveniles in jail might seem an unusual career choice for “a nice girl from Rogers Park,” as Teplin describes herself. Her interest was sparked by her first major study in 1977 for which she rode in police cars for 14 months to see how police managed people with severe mental disorders on the street.

“After deinstitutionalization, police had become street corner psychiatrists. After that study, I decided I wanted to do research that made a difference,” she said.

Teplin's career and her numerous awards - including the prestigious National Institute of Mental Health MERIT Award and the American Psychological Association Fellow -- would have stunned her junior-high school principal.  He called her parents into his office to tell them their daughter wasn't “college material” and belonged in the secretarial track. In high school, Teplin ranked in the bottom half of her class and scored poorly on standardized tests.

But she went to graduate school because she didn't want to be a secretary or any of the traditional occupations for women in the late 1960s. When Teplin emerged with a Ph.D., she joined the medical school faculty at Northwestern.

She never forgets her narrow brush with a life in which she might have fulfilled her former principal's low expectations. “I value every day,” she said.