Implementing Systematic Mental Health Screening in Juvenile Detention: Lessons Learned and Preliminary Outcomes

Introduction: The dual objectives of juvenile justice are to assure the youth’s safety while in custody, and facilitate rehabilitation. As 70% of detained youth have one diagnosable mental health disorder, mental health care is a critical component of rehabilitation. Systematic behavioral health screening is necessary to ensure that youth are provided appropriate behavioral health treatment while detained, and referred to the appropriate services once released to the community or placed in a treatment facility. Recommendations for behavioral health screenings in juvenile detention exist, but there is little guidance regarding how to implement these systematic screening protocols among mental health professionals. Even less is known about the outcomes of systematic screening efforts in juvenile detention, both with respect to implementation outcomes (i.e., using them as intended) and youth outcomes (i.e., youth access to therapy services and behavioral health outcomes).

Methods: We took a community partnered approach to developing a systematic screening protocol within a behavioral health unit in a large (180 bed), juvenile detention center housed in an urban city in Pennsylvania. We are conducting a pre-post, cross-sectional chart review study among all discharged youth who accessed services within the behavioral health unit during the six months before (pre) and six months after (post) the initial implementation of the systemic screening protocol (April 1, 2018 to March 31, 2019). We will examine the implementation outcomes of penetration (i.e., % of youth who received some form of systematic behavioral health screening), as well as fidelity (% youth who received the all required components of the behavioral health screening battery). We will also examine youth outcomes, including length of stay in detention, % of youth offered therapy, type of therapy received while detained (e.g., Trauma-Focused Cognitive Behavioral Therapy), referral to psychiatry, type of supervision recommended (e.g., one-on-one supervision, general), and placement (e.g., community placement, residential treatment facility placement).

Results: We will discuss the process of developing our community partnership and the screening protocol. Further, we will present findings of ongoing data collection related to implementation and youth outcome findings.

Conclusions: Lessons learned and implications of our findings for the implementation of evidence-based practices in juvenile detention will be discussed.