One area of the juvenile correction systems today, which is in need of repair, is the mental health aspect. Like the adult systems, many of the members of the juvenile justice population have mental health and substance use disorders. The numbers vary from study to study, but suggest that at least 60% of the offenders within the juvenile justice system are suffering from at least one disorder. There is little being done to address this obvious issue, seemingly due to communication issues between multiple organizations being involved with each individual. The problem is both in the functions of the mental heath care systems and the coordination and bureaucracy involved in linking multiple organizations.
How is mental health a justice system concern? When it is present in the majority of one’s population, it is likely a key factor in causation. While punishing the offense is a primary goal of corrections for juvenile or adult facilities, reform and prevention are close behind, and strongly focused on in juvenile justice. A 2006 study by Cocozza and Shufelt, found 70% of those in the overall population of offenders in the juvenile justice system had at least one mental health or substance use disorder (Juvenile Justice, 2016.). Another study published in 2002, showed similar trends with lower numbers, coming in at the 50-60% range for 1829 participants. And, another study conducted in 2000, using 18,607 participants, showed 70% of males and 81% of females qualifying for at least one mental or substance use disorder (Cauffman, 2004.).
The studies focused on lack of access to mental health services and treatment, prior to committing the criminal acts, as a major reason why it was so prevalent in the juvenile population. They also cited the lack of proper treatments for juveniles, once in the system, for it remaining there. The origins of the disorders were a spectrum of the mental health theories, in that they varied from inborn to environmental in cause, and the lack of treatment ranged from physical to financial access restrictions as well as other obstacles.
The solution to the mental health issues in the juvenile (as well as adult) justice system, is not within a justice system entity. The mental health system needs overhauled, so it can function as a treatment rather than a band-aid. Michael Welch’s text Corrections: A Critical Approach refers to the view of prisons, jails, and other detention centers as being the new poor houses. As they are densely populated by the lower-class, poor, un/under-educated, and those with mental health and substance abuse issues, they are a dumping ground that is quickly bursting at the seams.
Deinstitutionalization of psychiatric facilities and hospitals was passed by congress in 1963, making forced institutionalization illegal, resulting in the release of thousands of patients. Forcing patients to stay beyond minimum holds (ranging from 24 hours to a few weeks) was no longer an option for those who were still capable of making personal legal decisions. Before deinstitutionalization, once one entered a psychiatric facility it was very unlikely that one would leave (regardless of improvement). This was the fueling factor to deinstitutionalization, but the result was an over correction in the other direction. It is now almost impossible to get mental health care for those whom obviously need it, but are still cognitive enough to say ‘no’.
What mental health care treatment that is accessible, is difficult to obtain, and even harder to maintain. Many are in need of a facility that can provide inpatient treatment from months up to years, and few facilities can provide this. Many need some form of caregiver to ensure they attend sessions and take medications. All of this is above and beyond the funding for these systems. While there are facilities out there to provide such services, they are mostly non-charitable and un-affordable to those in the most need of them. Those that are charitable, have waiting lists years long.
Those that are court ordered or in another way obligated to receive treatment, are released from treatment at a set time, there is no way to ensure follow up and much (if any) progress made is likely to be lost. There is no long term care in place for mental health (or substance) issues that doesn’t require a level of patient (family) participation that can be beyond those in the most need. And they are some of the ‘time bombs’ we see coming but can’t stop/help.
Institutionalization is not the answer, but neither is ‘only’ self-responsibility, when it comes to mental health. There is a needed level of supervision/guidance in treating both mental health and substance use issues. This is one area that the patients are going to require help in a more personal manner than the justice system is able to provide. The research is there, but the funding and structure is lacking. Many of the properly aligned political improvements get twisted when moving up to congress, or buried under amendments and tack-ins to unrelated things, that get the whole package quashed before it leaves the ground. Solving the mental health issue is the root to the legal issues in many cases, but compliance with legal requirements supersedes treatment completion, resulting in reform failures. While juvenile justice systems have more funding to pay for the programs for offenders, funds are limited and the programs are strict. While continued treatment may be encouraged, once the requirements are met and the individual is removed from the justice system, the funding goes with it (and a strong motivating factor to attend – on both the juvenile and their guardian).
Reorganizing priorities with regard to funding and moving those funds into areas like mental health, substance abuse treatment, education, the justice system, and so on, we could make some progress. Better funding to education, mental health, and substance treatment will greatly reduce the number of individuals even reaching the justice system, let alone becoming long term residents.
If 60% of those in the juvenile justice system have mental health and/or substance use issues, and they had received proper treatment before they entered the justice system, they likely never would have made it that far. Imagine how much better the juvenile (and adult) justice system could work with half their population. There would be more room (overcrowding is a huge factor in many detention facility issues), and there would be more funding available for those there. There could also be facilities afforded for those who committed criminal acts, but were not suitable for ‘general population’ facilities, thus providing mental health treatment and segregating them away from an environment that is counterproductive to improvement. Removing the mentally ill from the general populations of prisons, jails, and other detention facilities makes for a more stable and productive reform environment for those not in need of treatment, as well.
That 60% of juvenile offenders have mental health and substance issues (often the latter leads to the former and visa-v), is a blaring signal that mental health treatment reform would hold a significant effect over the juvenile justice system in a positive way for all involved. We have the research that shows what is effective in treatment (thus far), and know how to diagnose many things. We just don’t have the funding to provide services to those who need it. Or the authority to treat those who exhibit
hostile intent prior to action. One cruel irony of underfunded mental health treatment, is that many of those suffering from mental illness are unable to maintain income (employment), due to their untreated mental illnesses. Another is it it less accessible to parents of children exhibiting signs of distress or schools from properly accessing students, resulting in a lost opportunity to begin treatment before things have a chance to escalate or worsen.
Resources
Cauffman, Elizabeth. “A Statewide Screening of Mental Health Symptoms Among Juvenile Offenders in Detention.” ScienceDirect. Science Direct, Apr. 2004. Web.
“Juvenile Justice Information Exchange » Key Issues.” Juvenile Justice Information Exchange. N.p., n.d. Web. 14 Mar. 2016.
“Psychiatric Disorders in Youth in Juvenile Detention.” JAMA Network. N.p., 01 Dec. 2002. Web.
Welch, Michael. Corrections: A Critical Approach. New York: McGraw Hill, 2011. Print
- Jocelyn Johnson
Dirtsa's 