Introduction

Youth in the U.S. juvenile justice system have mental health disorders at disproportionately high rates compared to their peers. Studies indicate that approximately 70% of youth in detention have one or more mental health diagnoses, far exceeding the general youth population. A vast majority of these juveniles suffer from anxiety, depression, trauma-related disorders, and behavioral disorders, which are exacerbated by adverse childhood experiences such as violence exposure, abuse, and neglect. The justice system has long recognized the necessity for mental health treatment but does not have adequate resources and well-organized policies to address these issues appropriately. Pre-sentencing mental health assessments are essential in identifying youth at risk, highlighting their inconsistent use. Youth who are justice-involved also do not receive required treatment while incarcerated, and mental health treatment upon release is rarely accessed. Race, socioeconomic status, and gender disparities consistently block equal access to mental health treatment, recycling through prison systems and shortchanging them during releases. The current review concludes that the gaps in mental health screenings, on-facility treatments, and releases must be addressed regarding how policy must change to better ensure rehabilitation efficacy. The article cites interventions such as Cognitive Behavioral Therapy and Multisystemic Therapy as highly effective in reducing recidivism and improving mental health outcomes. The overall purpose is to make recommendations for real-world strategies toward enhancing mental health services in the juvenile justice system and facilitating successful reintegration into society.

Key Points

Pre-sentencing screening for mental health is important during evaluation for appropriate intervention for youth who come in contact with justice, yet is not consistently practiced. The most widely used of the Massachusetts Youth Screening Instrument-Version 2 and the Youth Level of Service/Case Management Inventory are not sufficient to address the diverse needs and are gender-insensitive and culturally insensible in evaluation. These evaluations are central to identifying at-risk youth early and steering them away from incarceration into rehabilitative services that more comprehensively treat the roots of their behavior. Within custody, numerous juvenile facilities experience thin mental health services, sporadic screening protocols, and limited access to evidence-based treatment. Trauma-informed care is particularly critical with the prevalence of adverse childhood experiences among youth in the justice system. Integrated models, such as the Juvenile Rehabilitation Integrated Treatment Model, have been successful by incorporating mental health treatment, substance abuse treatment, and education into a more integrated system of rehabilitation. Post-release mental health services remain one of the weakest areas in the system. Too many youth in the justice system go without follow-up care, making them more likely to reoffend. Multisystemic Therapy has been most effective at reducing long-term recidivism through engagement of communities and families into the rehabilitation process but remains difficult to access. Systematic community-based programs as well as mentor programs like Aftercare for Indiana through Mentoring have been seen to be of assistance in reducing the re-incarceration probabilities by re-socialization. Early intervention and prevention largely depend on school programs as well as those community programs that attempt to reform at the start of deviancy. Screening for universal mental health in schools has the ability to detect at-risk youth before they become ensnared in the justice system. Social-emotional learning instructional programs and traditional mentoring programs have been shown effective at fostering resilience, reducing problem behaviors, and increasing long-term mental health. As these practices have been introduced, inequities in access to mental health services remain an urgent priority issue. African American and Hispanic youth are disproportionately represented within the juvenile justice system and experience further obstacles to accessing mental health services. Girls are more likely to have experienced trauma but less likely to have received ongoing mental health services upon release. Socioeconomic conditions further restrict access to needed services, perpetuating cycles of justice involvement and unmet mental health needs.

Takeaways

Mental health is dealt with in the juvenile justice system in a multi-pronged manner including early screening, treatment in facilities, and long-term care on release. Mandatory and routine mental health screening at all stages of the process would allow for immediate intervention and diversion to treatment. Expansion of integrated models of care that combine mental health service with education, substance abuse treatment, and skills training is critical in addressing the needs of justice-involved youth. Double investment in post-release initiatives such as Multisystemic Therapy and mentorship programs would provide the youth with the much-needed push to prevent them from re-offending and channel them towards long-lasting rehabilitation. Greater coordination between the juvenile justice system, schools, and community organizations would create care that addresses youth at all tiers. Closing racial, gender, and socioeconomic disparities in access to mental health services is critical in ensuring that all justice-system youth get the treatment they need. Prioritizing mental health in the juvenile justice system can realign the attention away from punishment towards rehabilitation and, as a consequence, ensure better outcomes for young people and society. Utilizing evidence-based practices and interagency collaboration, the juvenile justice system can become a place of help and healing rather than a revolving door of arrest and untreated mental health issues.

For the full review, click here.