From the outside, the director of the Mendota Juvenile Treatment Centre says it looks like any other high-security correctional facility.

But inside, the Wisconsin-based centre has done something remarkable, Dr. Greg Van Rybroek says — taking the worst of the worst youth offenders, young men who have committed terrible acts, and transforming them into functioning members of society.

It's a model the Manitoba advocate for children and youth thinks could, and should, be replicated here.

In her February report into Manitoba youth correctional facilities, Daphne Penrose found that youth in custody "are more traumatized, vulnerable, and marginalized than youth in the general population."

"Many of these youth have significant cognitive or developmental disabilities and are living with significant childhood trauma and mental illnesses," she wrote.

Further, the lack of supports for these youth once they are in custody is "glaring," Penrose states.

'Staff inside [youth] facilities, they want to help kids, and these kids present with such significant issues that it's beyond the scope of what what they're trained to do and what they're able to do,' says Daphne Penrose, Manitoba's advocate for children and youth. (Jeff Stapleton/CBC News)

In an interview, Penrose said the purpose of sentencing youth to time in custody is to get them the intensive rehabilitation they need, but that can't happen without the proper programming and training in place.

"You know, staff inside these facilities, they want to help kids, and these kids present with such significant issues that it's beyond the scope of what what they're trained to do and what they're able to do," she said.

Positive results with worst offenders

In looking for examples of places that are doing something right, Penrose said she came across Mendota.

The 29-bed secure treatment facility located in Madison, Wis., delivers comprehensive mental health services to teen boys who haven't responded to standard forms of treatment or rehabilitation.

Many of the youth end up there as a last resort after committing violent — in some cases horrific — acts.

A 2013 article published in Psychotherapy Networker magazine notes roughly half of the centre's inmates, all boys between the ages of 12 and 17, landed there after killing or seriously injuring people: stabbing, shooting, or breaking bones.

"Two raped their own grandmothers. Several set cats on fire," the article says.

"Asked to describe the most exciting thing he'd ever done, one boy could barely stop laughing long enough to tell his therapist how, at the age of 13, he'd poured lighter fluid on a stranger's leg and then tossed a lit match, burning the man badly enough to require a month in a hospital."

If you and I were born in hell, the odds would go way up that we would be this youth. - Dr. Greg Van Rybroek , MJTC director

The centre takes the state's most challenging cases, and sees positive results.

A study published in the International Journal of Law and Psychiatry in 2004 followed 101 youth who had undergone treatment at Mendota to 147 who had only been seen briefly by therapists during their time incarcerated.

In the four years following their release, there were no homicides among the youth who had been at Mendota. Among the 147 youth who weren't, there were 16 homicides.

Treatment 'tailored to the youth'

In her report, Penrose praised Mendota's "highly individualized therapeutic intervention delivered by highly trained mental health professionals."

It's operated in a correctional facility, but run by the staff of an adolescent psychiatric unit. As well, she said, "therapeutic treatment is highly individualized, tailored to the youth" and based on their specific needs.

It's a treatment process Van Rybroek, the centre's director, compares to the constellation of Orion.

"The juvenile treatment program has a lot of stars, and each star is a component that has to do with trying to help this youth stay safe," he said.

The exterior of the Mendota Juvenile Treatment Centre in Madison, Wis., treats teen boys with complex mental health and behavioural issues who haven't responded to standard treatment within Wisconsin's juvenile corrections system. (Submitted by the Wisconsin Department of Health Services)

A large component of the program involves "decompression" treatment, where youth are gradually moved from a prison cell to other environments, like a classroom or office, where they can experience increasing levels of freedom.

Another piece involves measuring the youth's behavior twice daily, and adjusting their privileges accordingly.

For example, youth making good progress may be moved to a less restrictive setting.

They also have access to 32-inch "smart" TVs, which Mendota's staff control — but which allow the youth to learn about choice by deciding what kind of entertainment or education material they want to experience.

It's not like we have a special elixir here that that everybody just drinks.… It's a complex endeavour with lots of components. - Dr. Greg Van Rybroek , MJTC director

"Our data shows in about two to three months, a lot of the behavior doesn't go away. It's not like it's erased in a two- or three-month period, but it lifts, and the youth becomes more available for what we would call traditional treatment," Van Rybroek said.

The centre is also in the process of establishing a house in a highly secure area where the youth can learn life skills, like preparing food and doing their laundry.

The young people who come through Mendota come from incredibly adverse backgrounds, and may not have learned those skills outside of custody, Van Rybroek said.

In one instance, one of the young men told staff the only Christmas present he'd ever received was one he got while at the centre.

"That represents the adverse experiences he's had his whole life," he said.

"If we can see the world through that youth's eyes, the way they actually experienced it, then we can come closer to understanding what they need, rather than seeing the world through our own eyes about their terrible acts — which to be sure are terrible," said Van Rybroek.

"But I often say, if you and I were born in hell, the odds would go way up that we would be this youth."

'A bit heartbreaking'

Mitch Bourbonniere is a social worker in Winnipeg who has worked with youth in the justice system and CFS care for decades — the kind of kids that come through Mendota.

Many of the youth he's dealt with have cognitive disabilities that haven't been properly diagnosed and treated, which makes them more likely to end up involved with the justice system.

"They're more at risk of being involved with the justice system because of their thought process, and, you know, their inability sometimes just to stay organized and to stay on task — so their actual condition might lend itself towards making mistakes," he said.

"It's a little bit heartbreaking, because I've had CFS kids go into prison at 15 or 16, and come out at 18 or 19, and now they're no longer part of CFS and the proper assessments haven't been done, and they're going into adulthood undiagnosed and untreated."

Mitch Bourbonniere, a longtime social worker in Winnipeg, says it's heartbreaking to see youth drift from CFS care to the justice system without proper supports to deal with their issues. (CBC)

Without guidance, it's hard for these youth to stop making the same mistakes over and over, Bourbonniere said.

"I think if you took a youth who did not have mental health and cognitive issues, and did not provide support to them, that they would also have a lot of difficulty. But I think it's just an extra layer when there are brain and thinking issues on top of that," he said.

"It's a double whammy of having the actual condition but also the lack of support and guidance and mentorship, all wrapped up in one big problem."

'This is possible'

Doing the type of work Mendota does isn't easy, or cheap, as it requires a lot of resources and time. But Van Rybroek says there's no reason why the model can't be copied elsewhere.

"It's not like we have a special elixir here that that everybody just drinks. It's not that at all — it's a complex endeavour with lots of components that take time and consideration, and then serious consideration, to get done," he said.

"And there has to be buy-in and allegiance to it at the highest levels, all the way down to the level on the unit."

Penrose thinks the model could be adopted here in Manitoba, which is why she highlighted it in her report.

"Some of the kids that end up in custody are very, very complex-needs children.

"And even for psychologists and psychiatrists … to begin to treat them, they have to see the child and what their individual needs are, and then to be able to develop that sort of individualized treatment plan," she said.

"Certainly this is possible because it is happening. The issue is the willingness to do it."