Critical factors in mental health programming for juveniles in corrections facilities.

Abstract

Abstract Juveniles with mental health and other specialized needs are overrepresented in the juvenile justice system, and while juvenile corrections have not historically provided standardized and evidence-based mental health services for its incarcerated youth, the demand is evident. The reality is that juveniles with serious mental illness are committed to youth corrections facilities and justice systems generally do not have the capacity to provide effective mental health care. However, juvenile corrections are aware of the serious refractions involved and are exploring effective interventions. This involves examining the critical components of treatment and implementing promising youth correction programs for juveniles who are incarcerated. The authors review critical treatment factors involved in the mental health care of youth and provide recommendations to the field to further develop promising institutional programs. Keywords: Juvenile, Mental Illness, Dialectical Behavior Therapy (DBT), Mode Deactivation Therapy (MDT), Family Integrative Transition (FIT), Aggression Replacement Training (ART), Thinking For a Change (TFAC), Motivational Enhancement Therapy (MET) Introduction Juvenile offenders with mental illness are a serious concern for juvenile correctional systems. There has been a steady increase of this population throughout the decade of the nineties (Teplin & McClelland, 1998; Timmons-Mitchell, et al., 1997). In 2003 about 2.3 million youth under the age of 18 were arrested and over 130,000 were placed in detention and juvenile correctional facilities (Cocozza, Trupin, & Teodosio, 2003). Concurrently there has been a significant increase in the number of juvenile offenders who have been diagnosed with mental illnesses and substance use disorders (Cocozza, 1997; Faenza & Siegfried, 1998; Libert & Speigler, 1990; Timmons-Mitchell, Brown, Schulz, Webster, Underwood, & Semple, 1997; Teplin, Abram, McClelland, Dulcan, Mericle, 2002; Villani, 1999 & Wasserman, Ko & McReynolds, 2004). Between 50 to 75 percent of all juvenile who enter the justice system has diagnosable mental health issues (Coalition for Juvenile Justice, 2000). The minority population in the juvenile justice system has gone unnoticed. Juvenile offenders who are at risk to maltreatment and negligence among those with mental health disorders are females and African-Americans. Females in the justice system have had their treatment needs overlooked and minimized. Females have higher rates of mood disorders, substance use, sexual abuse, and physical abuse (Timmons-Mitchell, et. al., 1997 & Teplin, et. al., 2002). Furthermore, African-American youth are twice as likely to be arrested and seven times as likely to be placed in youth corrections facilities compared with Caucasian youth. There is a minority overrepresentation, a disproportionate minority confinement, and an under utilization of mental health service identification and implementation. The former refers to the harsher treatment of minorities in comparison to their corresponding Caucasian by the juvenile justice system. The latter is a subset involving only the harsher treatment of minorities detained at secure facilities during pretrial and post-dispositional stages. It is clear that all juveniles with mental health and other specialized needs are overrepresented in the juvenile justice system (Otto, 1992; Teplin, et. al., 2002 & Timmons-Mitchell, et al., 1997). Juvenile justice administrators are faced with the multifaceted problems that arise when dealing with juveniles with serious mental illness. Although the literature on dealing with juvenile offenders with mental health issues is limited, juvenile justice administrators and mental health providers must be flexible in their responses. There has been a shift in the delivery of mental health services from residential and community-based care to the treatment of the serious mentally ill juvenile offender. …