Mental Health Disparities in Services for Youth Involved in the Juvenile Justice System

Introduction: Justice system involved youth face significant mental health disparities compared to their uninvolved peers. Many youth experience challenges that are associated with lawbreaking behaviors and mental health burden. These youth also face disproportionate barriers to treatment. Their challenges include access to services, particularly from clinicians who are effectively equipped to support them. Data exists regarding the prevalence of mental health disparities among these youth, little is known regarding the etiology of their delinquency and mental health inequalities, or the experiences of agency outreach workers, which could impact service delivery. Our studies address a gap in literature by assessing the mental health disparities of these youth on probation and in corrections.

Methods: In study 1, 10 outreach workers from a local youth serving agency (M=50%, F=50%; 30% White, 50% African American, 10%, Other, & 10% no information); 2 focus groups were completed and analyzed. Study 2 comprised of 11,607 youth on probation (M=87.58%, F=12.42%; 73.92% African American, 6.55% White, 11.83% Hispanic, and 7.7% mixed/other), with 5.79% (n=672) reporting suicidal thoughts and behaviors, and employed logistic regression. In study 3, 503 youth in corrections (M=93.5%, F=6.5%; 57.8% African American, 31.7% White, & 10.4% Other). Over 50% reported offenses against people.

Results: Study 1 revealed that practitioners experienced high levels of work-related stress, but were committed to serving homeless youth, despite decreased funding and policies that inhibit care. Study 2 tested the association of psychological distress (e.g. mental health and substance misuse) with suicidal thoughts and behaviors (STB). Analysis found that youth who reported psychological distress were at increased odds of STB as compared to those without distress. Females had more STB (OR = 3.41, CI [2.80, 4.16]), and White, Hispanic, and mixed/other ethnic groups were more likely to have STB than African American adolescents. Mental health burden was evident in study 3 as more than half of males (49%) and the total sample of females received mental health services, across offense types.

Conclusions: Results indicate that staff working with vulnerable youth require support and resources to provide adequate care. Mental health disparities are prevalent with youth probationers that endorsed STB, suggesting a need for adequate services based on the setting in which they are placed. Youth endorsing STB, especially females, require gender specific services to address their complex needs. Though youth in corrections participate in services, future work is needed to investigate the quality of these services across race and gender.