Many adults involved in the criminal justice system were previously detained in the juvenile justice system too. As adults, these individuals tend to experience less favorable economic and education-related outcomes compared to peers who were not involved with the justice system. Many justice-involved youth have not caused physical harm to another and have unmet mental health needs that are not adequately addressed during incarceration. Addressing these needs has the potential to improve outcomes for individuals, families, and communities.

Incarcerated Youth’s Mental Health Care

Mental Health Care in Juvenile Detention Centers

• Approximately 60-70% of justice-involved youth meet criteria for a mental health disorder (compared to 20% for adolescents who are not involved with the justice system).
• Incarceration during adolescence tends to harm youths’ mental health, including being associated with long-term negative physical and mental health outcomes.

Contributors to Poor Mental Health Care in Juvenile Detention Centers

• Understaffing: There are not enough licensed therapists practicing in these facilities.
• Access to care: Treatment may focus solely on medication management when additional care is needed.
• Timing: Therapist turnover or short detentions may not provide enough time to make real progress. This highlights the importance of transitions in care and facilitating connections to resources upon release.
• Unsafe conditions: Facilities can be unsafe for youth, leading to challenges in establishing trust or psychological safety which is needed to make progress in therapy.
• Diagnostic errors: Youth can be mis- or over-diagnosed with behavioral disorders (e.g., oppositional defiant disorder). This leaves the root issues unaddressed (e.g., trauma or mental health conditions).

State Approaches to Improving Incarcerated Youth Mental Health Care

Trauma-Informed Mental Health Care

• Trauma-informed care approaches have shown some success at improving youth mental health.
• These approaches also have the potential to further system goals (e.g., improving public safety and reducing recidivism).

Examples of Trauma-Informed Juvenile Justice Systems Initiatives

• Texas Model and in Texas.
• The Juvenile Justice Trauma Informed Systems Project (Project JUSTIS) in Colorado.
• The Trauma-informed Communities (TIC) Project in North Carolina.
• UConn Health: The Center for Trauma Recovery and Juvenile Justice in Connecticut.

Youth Mental Health Upon Release from Detention

Mental Health Outcomes Upon Release

• Youth may continue to struggle with mental health issues post-release based on experiences that occurred during incarceration.
• Overall, there is consensus that incarceration does not reduce recidivism and often fails youth.

Family Involvement & Support

The Role of Parents and Caregivers in Reentry Planning

• Family engagement in reentry planning from the moment a youth is incarcerated is critical to supporting successful transitions to the community. The family support system often expands beyond primary caregivers to extended family and non-biological family.
• Families need to feel their voices are heard and that they are prepared to have their child back.
• Family involvement can include meetings, therapy, planning, and decision-making.
• Even just increasing family visits while a youth is incarcerated can improve their behavior.

Policy Considerations & Strategies to Improve Outcomes for Justice-Involved Youth

Consider Alternatives to Incarceration

• Offer diversion programs (i.e., structured alternatives to formal court proceedings – typically for low risk youth or less serious offences), which can help reduce incarceration rates.

Encourage Facilities to Adopt Effective Policies & Protocols

• Ensure facilities’ visitation policies are not overly restrictive.
• Review and update facilities’ reentry plans (e.g., strengthen family involvement and incorporate plans to transition care upon release).
  • Engage in throughout the reentry planning process.
  • Ensure that community-based agencies are offering services within facilities so that youth have a touchpoint for services when released.

Provide Evidence-Based Treatment & Programming During Incarceration

• Encourage a therapeutic, rather than punitive, approach.
• Offer programming opportunities within the facilities, including access to quality education.

Address Resource Shortages via Cost-Effective Collaborations  

• Partner with universities where there are graduate mental health training programs. Students’ services cost significantly less than full-time licensed employees and supervisors can expand their reach (e.g., supervising multiple students vs. just their own caseload). However, this can also add to high provider turnover in facilities.

Foster Communication & Training Opportunities  

• Connect with youth and families who have had experience in the system and create an advisory board related to family engagement.
• Provide training for judges on youth mental health and trauma.