Richard Nunes, MD, MPH


California Endowment Scholar in Health Policy

Chief of Child Psychiatry, Mental Health Administration, Santa Clara Valley Health & Hospital System, San Jose, CA

Dr. Richard Nunes is a child and adolescent psychiatrist and an adult psychiatrist who is a Diplomate of the American Board of Psychiatry and Neurology in Child and Adolescent Psychiatry as well as General Psychiatry. His interests lie in the administration and management of mental health service delivery to adult and adolescent populations as well as to incarcerated mentally ill youth. He has worked as a psychiatrist with developmentally disabled children at the Connecticut Children’s Medical Center School and with adolescent and adult patients at the MidState Behavioral Health System in Connecticut. In addition, he worked as the consulting psychiatrist at the New Haven Juvenile Detention Center and on the psychiatric inpatient unit at the Sacramento County Jail. He completed an adolescent psychiatry fellowship at the Yale Child Study Center. Dr. Nunes wishes to continue his role as both an adult and a child and adolescent psychiatrist as well as transition into a health care management career in response to what he calls a continuing struggle with “a health care system that stigmatizes mental health.”

Dr. Nunes received his medical degree in 1998, and completed his residency in Adult Psychiatry in 2001, at the University of California, Davis School of Medicine. He received an M.P.H. from the Harvard School of Public Health in 2005 as a CES Scholar.

Learn more about the California Endowment Scholars in Health Policy at Harvard University


Addressing the Mental Health Needs of Youth in the Juvenile Justice System


Identifying and responding to the needs of youth with mental disorders in the juvenile justice system is finally being recognized as an important issue at all levels of government as policy makers and practitioners struggle to identify ways to prevent and reduce juvenile delinquency and crime. This increased concern may be attributed to several factors including higher rates of mental disorders among youth in the juvenile justice system. The rate of mental disorders among youth in this system is estimated to be between two and three times higher than among youth in the general population. The increasingly frequent documentation of inadequate care of youth with mental disorders in the juvenile justice system has led to a series of investigations undertaken by the Department of Justice. These investigations have resulted in repeated findings that emphasize a failure on the part of these facilities to adequately address the mental health needs of youth in their care. This project examines multiple aspects of mental health care in the juvenile justice setting from intake to aftercare, including the prevalence of mental illness, screening and assessment, treatment modalities and special populations. A compendium of best practices has been constructed and promulgated.


A thorough review of extant juvenile justice literature was performed in order to identify the current state of mental health assessment and treatment in the juvenile justice population. This literature was used as a reference for formulation of optimal mental health interventions. Employees of the Massachusetts Department of Youth Services, the Massachusetts Department of Mental Health, the California Youth Authority and the Los Angeles Department of Mental Health were contacted and interviewed in order to gain further understanding of the obstacles faced by juvenile justice personnel in implementing best practices as they pertain to the treatment of mental illness. Data and statistics were culled from multiple national organizations including the National Center for Juvenile Justice and Mental Health, the Office of Juvenile Justice and Delinquency Prevention, the National Mental Health Association and the National Center for Juvenile Justice.


Juvenile offenders with mental illness are remarkably undertreated in the juvenile justice system. Obstacles to optimal care include underfunding of mental health programs, inadequately trained mental health clinicians, the stigma of mental illness, and the lack of adequate screening, assessment and treatment modalities. In addition, the overrepresentation of minorities in this population is becoming an increasing concern. Recommendations include the establishment of diversion programs to reduce unnecessary incarceration of youth with mental illness, the development of a national strategy for funding mental health services for incarcerated youth, increasing public awareness of mental illness as a treatable condition, and the identification of evidence-based interventions for screening, assessment and treatment. Further, studies of the problems of disproportionate minority confinement are warranted.


Ken Rogers, Ph.D, Massachusetts Department of Youth Services