There are thousands of youth sitting in detention centers and juvenile correctional facilities throughout the country. Each child has a different history and undoubtedly a vivid story to tell. However, what many outsiders may not realize is that most of these children are struggling with a severe mental health disorder. In fact, according to the National Alliance for the Mentally Ill (NAMI), nearly 70 percent of incarcerated youth also experience some type of severe and diagnosable mental health disorder. It makes you wonder – is their emotional instability contributing to the poor choices that ultimately lead to their incarceration?
Even more disturbing than this statistic is that the vast behavioral health needs of these youth are going untreated. Due to overcrowding, a lack of Psychiatrists who specialize in the specific mental health needs of juveniles, a general unawareness of the importance of addressing behavioral health needs, a lack of Qualified Mental Health Professionals employed by the juvenile facilities, and other institution specific factors, many incarcerated youth are not receiving the mental health care that they need for genuine rehabilitation and behavioral transformation.
The National Commission on Correctional Health Care (NCCHC) has published standards of care that includes guidelines to ensure that incarcerated youth have access to proper behavioral and mental health care. The minimum requirements of care include:
- Youth should be screened within one hour of admission to determine if mental health concerns are present and to determine if the youth is on psychotropic medication. When possible, current medication regimen should not be disrupted. An in depth mental health appraisal should then be conducted within seven days of admission.
- Treatment plans should be developed by Qualified Mental Health Professional staff. The plan should be documented for accountability, reviewed regularly for effectiveness, and communicated to all of the staff who work with the youth.
- Acute psychiatric symptoms should be treated promptly. This treatment can be provided within the facility when a Qualified Mental Health Professional is available to supervise the treatment. If a Qualified Mental Health Professional is unavailable to supervise treatment within the facility then treatment in an alternate clinical setting such as a psychiatric hospital should be provided.
- The prescribing and administering of psychotropic medication should be in accordance with professional standards to treat symptoms of a mental health disorder and not merely to control unruly behavior.
- Suicide protocols should be in place as precautions and prevention measures.
- Prior to a youth’s discharge, referrals for continued mental health care in the community should be established to ensure appropriate follow up care is provided after release.
Unfortunately, due to the barriers mentioned earlier in this article, these provisions are not in place in a comprehensive manner in many juvenile correctional facilities throughout the country. In fact, a study published by The Journal for American Academy of Psychiatry and the Law indicated that although informal interactions with Mental Health Professionals tend to be relatively common among facilities, more specialized treatment is less common. Treatment for substance abuse seems to be widely offered however treatment for other specific behavioral health concerns is not as widely available. In addition, many youth do not have access to Mental Health Providers on a daily basis and some only have access on an on-call basis. Therefore, many facilities are not accredited as meeting the minimum standards of care that has been established by the NCCHC and youth are being released back into the community with their behavioral health not fully addressed. Unfortunately, their unmet behavioral health needs combined with the various environmental factors that are present in the community upon release likely contribute to the high recidivism rates among youth.
Youth are being detained at an alarming rate and many of them are being re-incarcerated after their first and even second release. Is it possible that their needs are being neglected in many facilities nationwide due to various systemic failures? In order to make sure that youth are receiving proper mental health care, facilities need to have more Qualified Mental Health Professionals on staff, more staff training for correctional staff, and an improved institutional culture that emphasizes the importance of mental health care for youth. Mandatory NCCHC accreditation, so that all incarcerated youth will receive at the very least the minimum standards of mental health care, is a great start to improving the lives of children and reducing the rate of recidivism.