Objective:
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.
Methods:
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.
Conclusions:
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.
Preceptor:
Ken Rogers, Ph.D, Massachusetts Department of Youth Services
