Being a teenager is the worst. For teenagers, everything is changing — both physically and emotionally. Moreover, these young people are confronted with some of the most intense situations in life: discovering heartbreak, experiencing worry, suffering low self-esteem and working to avoid peer pressure along the way.
Teens are often moody due to hormonal and physical changes that happen during puberty, and when mental health issues become involved, it can be difficult to discern “normal teenage behavior” from the symptoms of depression, anxiety and other emotional troubles.
When passionate responses to teenage-angst are exacerbated by mental health problems, youth sometimes act out criminally. Of the 2 million young people touched by the juvenile justice system each year, between 65 percent and 70 percent have a mental health disorder.
For those young people involved with the criminal justice system, detention and incarceration only make matters worse. Particularly in those states where young people can be held in adult facilities, the strain of being placed in isolation — as well as the fear experienced during incarceration generally — can intensify mental health issues.
In order to rehabilitate justice-involved youth with mental health issues, judges and juvenile probationers must limit their use of detention — especially when it involves incarcerating teens in adult facilities — and opt for community-based rehabilitation or diversion programs whenever possible.
Limiting detention is better for teens with mental health issues. Because juvenile detention facilities don’t always provide adequate mental health services for those detained, placing juveniles in detention can aggravate their existing conditions — and even trigger new ones. According to a study released by the Justice Policy Institute, one expert believes that mental health issues and conditions of confinement combine to make it more likely that incarcerated teens will engage in self-harm or commit suicide.
Another psychologist found that one-third of incarcerated youth diagnosed with depression are diagnosed after being incarcerated. When held in adult prisons, teens suffer even more.
Curtailing youth incarceration in adult prisons is paramount. Four states still automatically place 17-year-olds in the adult system, and more than triple that number allow prosecutors to directly file cases against minors in adult court. Moreover, federal law requires that youth incarcerated in adult prisons must be separated by “sight and sound” from adult inmates, meaning that youth often effectively end up not only without access to education or mental health treatment, but in a perpetual state of solitary confinement.
The Journal of the American Academy of Psychiatry and the Law conducted a study on the effects of solitary confinement on those with mental illness and found that “the stress, lack of meaningful social contact, and unstructured days can exacerbate symptoms of illness or provoke recurrence.” The study also found that isolation can further deteriorate a person’s mental condition, leading to hospitalization and even suicide.
In order to best provide for justice-involved teens, the juvenile justice system should rely more heavily on local programming and rehabilitation outside of the detention setting. One option, community-based mental health care, involves a variety of programs and services designed to meet local needs, including individualized counseling, peer support groups and easily accessible continuing care. These programs are run by community agencies and through hospitals or health clinics and offer a promising alternative to incarceration.
Some advocates of community-based health care efforts are building toolkits for communities that are willing to develop these options. For example, Getting To Outcomes (GTO), a collaborative project between researchers at the RAND Corporation and the University of South Carolina, offers a process to “help communities plan, implement and evaluate the impact of” programs that seek to prevent criminal behaviors in youth. GTO models can be used to bolster community-based mental health outreach for at-risk youth and have helped produce outstanding results.
Another type of out-of-detention program for justice-involved teens involves what are known as “diversion programs.” These programs intervene in the lives of young people who have shown some risky behavior but have not yet become severely delinquent. Diversion programs keep young people out of detention facilities, provide meaningful individualized rehabilitation services, and are particularly beneficial when they are completed within a teen’s own community.
Youths passing through the troubling teenage years need all the support they will accept — particularly those young people who may suffer from depression, anxiety, post-traumatic stress disorder or other mental health issues. When involvement with the juvenile court system is added to the already complicated life of a teenager, we should be asking how we as a community can help rather than make things more difficult.