Violent adolescents: psychiatry, philosophy, and politics

Historically, the American Academy of Psychiatry and the Law (AAPL) has not engaged in debates on public policy. In its unique position at the interface of law and medicine, AAPL is able to make important contributions to social policy involving management of violent youths. In the 1990s, increasing rates of violence among adolescents spawned a new era of research into the causes and correlates of violence in youths. The resultant data on risk factors have provided opportunities for establishing empirical assessments and risk-focused treatment programs. Community treatment programs that demonstrate a moderate effect in reducing violence have renewed optimism about the benefit of treatment over punishment. The ongoing development of methodology to assess risk for violence presents opportunities for advancement of rehabilitation. Current social policies that limit the ability to provide treatment and rehabilitation in juvenile settings should be challenged by organized psychiatry.