By Benjamin Chambers, November 18 2009
This report on adolescent substance abuse and mental health issues in the federal legislation governing the juvenile justice system is reprinted, with permission, from the Spring/Summer 2009 issue of The Link: Connecting Juvenile Justice and Child Welfare, published by the Child Welfare League of America. The final fact sheet, suitable for printing, can be found on the Act-4-JJ website.
The first part, below, describes the justification and the key issues; the second part contains recommendations for strengthening the Juvenile Justice and Delinquency Prevention Act.
When Congress considers legislation later this year to reauthorize the Juvenile Justice and Delinquency Prevention Act (JJDPA), mental health and substance abuse issues will be a top priority.
Available data from single site and multisite studies indicate that 70% or more of youth who are securely detained in a juvenile justice facility may suffer with mental health and related disorders; rates of mental health and substance abuse disorders appear to be somewhat higher for girls than boys; and more than 20% of such youth suffer disorders so severe that their ability to function is significantly impaired (Abram, Teplin, McClelland, & Dulcan, 2003; Skowyra & Cocozza, 2007; Teplin, Abram, McClelland, Dulcan, & Mericle, 2002).
Among youth under nonresidential court supervision (e.g., on probation), the rate of diagnosable mental health and substance abuse disorders is approximately 50%.
By comparison, in the general youth population, approximately 20% of youth suffer with mental health and substance abuse disorders. In addition, justice system involved youth may experience behavioral/emotional disorders for the first time because of contact with the juvenile justice system.
Juvenile justice agencies and facilities are generally ill-equipped to effectively manage the mental health and substance abuse needs of youth. Agencies identify the following as barriers: insufficient resources, inadequate administrative capacity, lack of appropriate staffing, and lack of training for staff (Federal Advisory Committee on Juvenile Justice, 2006).
Recognition of the unmet mental health and substance abuse needs of youth in the juvenile justice population has grown over the last 15 years, with calls for increased action, better data on the prevalence and manifestation of disorders, and greater availability of screening, assessment, and treatment approaches. Major reports from Presidents Bill Clinton and George W. Bush recommended that juvenile justice agencies partner with other child-serving agencies to transform mental health care for children and adolescents, particularly focusing on early identification and referral to home and community-connected services (President’s New Freedom Commission on Mental Health, 2003; U.S. Public Health Service, 2000).
Issues of Key Importance
In 2003, the Government Accountability Office (GAO) reported that parents relinquish custody rights of their children to the delinquency court to access mental health services, which could be more appropriately provided by the children’s mental health and child welfare systems. In 2001, more than 12,700 children with mental illnesses were placed in state custody because their parents could not otherwise obtain appropriate treatment for them. About 70% of these children entered state custody via the juvenile justice system; others entered via the child welfare system (GAO, 2003).
Two-thirds of juvenile detention facilities report having held children as young as age 7 awaiting a mental health placement. A 2004 report to Congress documented that about 7% of youth in detention were locked up simply awaiting an appropriate treatment placement (U.S. Congress Committee on Governmental Reform, 2004).
Many youth enter the juvenile justice system with mental health, substance use, and other mental/emotional disabilities that were overlooked, misdiagnosed, or inadequately addressed by other social service agencies, including child welfare, schools, and mental health systems (Spangenberg Group, 2001).
Youth in the juvenile justice system suffer from various mental health disorders and co-occurring disorders. Approaches must be tailored to individual needs because practices that may ameliorate symptoms of certain disorders may exacerbate symptoms of other disorders. For example, exploration of past trauma in talk therapy may worsen symptoms of post traumatic stress disorder. Similarly, for a young person experiencing multiple mental health or substance abuse disorders, certain interventions used to address the symptoms of one disorder can worsen symptoms of the co-occurring disorder (Abram, Washburn, Teplin, Emanuel, Romero, & McClelland, 2007).
Youth with unmet mental health and substance abuse needs are at greater risk of contact with the juvenile justice system than those without such needs. Behaviors that cause youth to be arrested or referred to the juvenile court may be manifestations of disorders in need of treatment (Grisso, 2008).
Youth with significant mental and emotional disorders can be vulnerable to abuse and exploitation by others while incarcerated and are more prone to experience adverse consequences of confinement (Coalition for Juvenile Justice, 2001).
A wealth of evidence supports the effectiveness and cost savings associated with prevention and appropriate diversion of youth with mental health and substance abuse needs to home- and community-based interventions, including positive behavioral supports, cognitive behavioral therapy, drug education, individual and group therapy, functional family therapy, multisystemic therapy, and multidimensional treatment foster care (Center for the Study and Prevention of Violence, n.d.; Gagnon & Richards, 2008; Greenwood, 2008; U.S. Department of Justice, n.d.).
See part 2 for recommendations.
Click for the references for this post.
The report was prepared for ACT 4 JJ by the American Psychological Association, Bazelon Center for Mental Health Law, Center for Children’s Law and Policy, Coalition for Juvenile Justice, Mental Health America, National Center for Mental Health and Juvenile Justice, and National Disability Rights Network. ACT 4 JJ, or Act for Juvenile Justice, is a campaign of the National Juvenile Justice and Delinquency Prevention Coalition.
Updated: February 08 2018