A forensic analyst works with samples at Great Lakes Labs in Valparaiso. The lab is working on a study with Porter County Juvenile Court to use genetic testing to better align medical treatment for young offenders. Staff photo by Marc Chase
A forensic analyst works with samples at Great Lakes Labs in Valparaiso. The lab is working on a study with Porter County Juvenile Court to use genetic testing to better align medical treatment for young offenders. Staff photo by Marc Chase
Juvenile offenders in Porter County soon could have the chance to get genetic testing to see what psychiatric medications might work best for them.

The county's juvenile court is partnering with Valparaiso-based Great Lakes Labs to offer so-called pharmacogenetic tests to youths in the criminal justice system.

"Mental health for our kids is really, really important for us, because they grow up," said Porter County Circuit Court Judge Mary Harper. "We need to help them, and we need to help our community, by helping our kids come out as healthy as possible."

Pharmacogenetic tests analyze patients' genetic codes to determine which medications may be more likely to be ineffective or cause harmful side effects. The testing also is done on drugs to treat conditions such as heart disease, pain and erectile dysfunction, but Porter County plans to use the psychiatric screening because of the high rate of mental health disorders among its juvenile offenders. Officials estimate that 70-80% of youths who come through the court system struggle with mental illness.

"What I see time and time again is kids who need psychiatric medications, and the psychiatrists are doing the best they can with the information they have with regards to giving them the medication they feel is necessary," said Alison Cox, director of the Porter County Juvenile Detention Center. "And we see the kids have to go back three to four times to get dosages or medications checked or changed, and the kids are still having outbursts, still having behavioral issues."

"If you could have a doctor prescribe it and get that right the first time, that will be a game-changer," said Amy Beier, executive director of juvenile services for Porter County.

The county hopes to start offering the testing Nov. 1.

Some in the medical community consider the tests unproven because of a lack of a research, and the U.S. Food and Drug Administration has warned the public that that the agency has not evaluated many of these tests and thus they "may not be supported by clinical evidence" (Great Lakes Labs' test, developed in house, has not been reviewed by the FDA).

But Great Lakes Labs officials noted that the nation's largest private insurer, UnitedHealthcare, recently announced its plans to start covering the testing for psychiatric medications, pointing to the success of recent clinical trials, and Medicare also reimburses for the tests in certain instances. They also note that major medical institutions like the Mayo Clinic and Cleveland Clinic offer pharmacogenetic testing.

Michelle Volk, president and CEO of Great Lakes Labs, called pharmacogenetics one of the most impactful developments she has seen in her four decades in the testing field. She said her lab — which also does forensic, OWI and drug testing for the criminal justice system — plans to use the Porter County project as an opportunity to study the efficacy of the tests.

Juvenile justice officials still are determining how to pay for the program. They have secured some county dollars and are looking into possible state and federal funding opportunities. The tests cost about $300 each.

Cox said the price tag should be looked at as an investment, since the test only has to be done once in a person's life and could save money on unnecessary medication refills and doctor appointments, not to mention the expense to society. "It's a good cost upfront to offset costs later down the road," she said.

"Getting it right the first time is everything," said Bob Wichlinski, executive vice president of operations for Great Lakes Labs, noting the wrong type of medication can potentially cause liver damage and other health problems. He said he expects the testing technology to keep getting better, estimating that it's now about 20% mature.

Project officials also are pursuing medical partnerships because the tests have to be ordered by a health care provider. Judge Harper said she would would like to see this test eventually offered to adult offenders as well; unlike juvenile inmates, the county pays for medications for adults in jail.

Jim Biggs, director of business development for Great Lakes Labs and also a Porter County commissioner, noted that if so many juveniles are coming into the system medicated, can the drugs they're on truly be working? He believes the tests could change that equation.

"The results here could be so profound, this could get national attention," he said. "We think we're onto something here, and we think we're going to make a difference in some of these kids' lives."
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