Can Improved Mental Healthcare for Youth Reduce Juvenile Detention?

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Author: Andrea Poteet


According to the CDC, approximately one in five children 3-17 years of age suffer from a mental, emotional, or behavioral challenge in any given year. And approximately 75-80 percent of these youth that need help are not getting it. While these figures indicate that twenty percent of this population have disorders, studies indicate that a full 66-70 percent of youth in detention centers have at least one diagnosable mental health issue. What accounts for this discrepancy and what can we do to help keep these children from returning again and again to the justice system?

The Link Between Mental Health and the Juvenile Justice System

Many kids with emotional disorders don't end up in the correctional system and many that commit crimes don't have mental health disorders. For this reason alone, we can't say that mental health disorders actually cause the youth to be locked up. Yet, the figures in the above paragraph show that there is some type of connection between juvenile incarceration and mental health issues.

A study of 1300 youth who had committed serious crimes showed that 76 percent had substance use disorder, 33 percent had high anxiety, 14 percent had ADHD, and 12 percent had either depression or PTSD. Many were diagnosed with more than one of these disorders. The AMA determined that substance abuse issues co-occurring with a mental health disorder were often a greater predictor of recidivism than mental health disorder alone. This indicates that addiction is a major issue with these youth.

Why Many Young People Get Detained Rather Than Helped

There are a couple of reasons that add to the large number of youths in the juvenile justice system. The first is that parents are often caught with no way to get mental health help for their children and will be forced into placing these children into state custody, where they are often held in detention until placement can be found. In 2001, more than 12,700 children were placed in state custody for this reason. A 2004 report to Congress documented that about 7 percent of youth in detention were only awaiting treatment placement.

According to the National Center for Mental Health and Juvenile Justice, the zero-tolerance policies in place in most schools adds to the problem as more disciplinary arrests for low-level actions occur. Youth with behavioral issues that include mental health problems, substance use disorder, and PTSD are at increased risk of school discipline. Students with emotional disturbances were particularly prevalent with 48 percent of elementary school and 73 percent of high school Emotional Support students facing legal problems. The NCMHJJ goes on to state that while 12 percent of any school population is made up of emotional support students, these same students make up 25 percent of those arrested and referred to law enforcement. A Texas study found that 48 percent of those classified as ES eventually came into contact with the juvenile justice system.

With these things in mind, society has been looking for ways to decrease the likelihood of those in the above categories from ever reaching the juvenile justice system, or diverting them from being incarcerated if they do.

Newer Methods

Two newer models of intervention have been showing promise. Although they are still too new to fully know the outcome, they are gaining popularity and being endorsed by both the American Bar Association and the American Medical Association.

In 2001, the first Juvenile Mental Health Court was established. The idea behind its inception was that treatment rather than punishment is much more effective in reducing recidivism. They noted that many children with mental health issues find it difficult to respond to traditional forms of punishment. Some of these children find it difficult to make appropriate decisions because of their illness. Still others can be made worse by some of the methods used in juvenile detention, such as strong physical holds and isolation. Going through the Juvenile Mental Health Court enables the courts to provide a team of professionals that can design an intervention program that meets the child's needs. This can be anything from outpatient counseling to psychiatric stabilization, substance abuse counseling and family therapy. If confinement is necessary, a therapeutic setting is utilized rather than detention. The model program in Alameda County, CA showed detentions declining by 76 percent and new violations decreasing by 68 percent, according to the American Bar Association.

The AMA Journal of Ethics states that diversion programs prevent recidivism in a couple of ways. They state that by allowing youth who are at risk to be placed in a diversion program at the first sign of problems, they have a chance to get the mental health treatment they need. With successful completion of the agreed upon terms of the program, they are no longer facing a record. This eliminates the chance the child will begin thinking of themselves as "bad.” It also reduces the stigmatization that a child with a criminal record faces in school, and society in general. They also state that the quality of the services received is important and so is treatment for any substance abuse, as this is so prevalent. They note that in one Texas program, the rate of repeat offending was reduced by 49.5 percent.

Two programs that intervene before a child reaches the juvenile justice system have also shown great promise. A Connecticut program has shown a 45 percent reduction in court referrals and a 94 percent increase in mental health referrals in the first year. The Ohio Responder program has shown that 66 percent of those who were referred to their program remained free of juvenile justice charges a year later.

What Does the Future Hold?

Current intervention trends are still too new to fully understand if they will entirely reduce the rate of recidivism in youth with mental health issues. The initial reports do appear to be promising. With greater access to mental health care, and more choices for parents who have children with these issues, we may be able to reduce the number of youth who face a lifetime of additional issues by being placed in detention centers.