Health and the Juvenile Justice System

Confined Concern:
The Health of Youth in U.S. Juvenile Detention Centers
Copyright 2008 Jennifer M Kerner
Please properly cite this blog if using any material, in whole or in part, found within.



Introduction

The United States possesses a complicated web of institutions that support law enforcement and incarceration of those who do not abide national and state laws. One of those institutions is the juvenile detention program. Over the course of the year, United States law enforcement makes 2.5 million arrests of juveniles (Snyder, 2000). As of 2003, it is estimated that 109,000 youths under the age of 18 are incarcerated in the juvenile detention program each day (Abram, 2003). According to Teplin (2002), two-thirds of males and three-quarters of females possess “one or more psychiatric disorders.” In addition, Abram (2003) believes that many of those psychiatric disorders are “comorbid.” Alcohol, tobacco, and other drug addictions run rampant among incarcerated youth. Add this information to the fact that HIV/AIDS is “prevalent among detained youths” (Teplin, 2003) and one can imagine a formula for disaster within the juvenile detention program.
Even with so many health issues affecting the population of the U.S. juvenile detention program, knowledge and resources for dealing with these problems are scarce. Until a series of inquiries beginning in 2002, few studies had delved into the specific epidemiology of mental and physical health issues affecting juvenile detention detainees (Wasserman, 2003). This paper focuses on three major concerns of the U.S. juvenile detention program. The first is the high prevalence of psychiatric disorders. Detainees display a much higher prevalence of mental disorders than youths of the same age outside of the juvenile justice system. This unique demographic requires special attention by the public health community. Second, although several studies have brought to light the extent of the public health issues in the juvenile justice system, few studies have addressed treatment options for these youths (Parent, 1994). More research regarding interventions and treatment programs must be conducted before effective treatment programs may be applied to juvenile detention centers. Finally, suggested answers to the distinctive problems facing the juvenile justice system are discussed and projections for the future of these youths, both during and after incarceration, are made.

High Prevalence of Psychiatric Disorders

The number of incarcerated youth in the United States is staggering. The number of those youths with diagnosed psychiatric disorders is even more disturbing: About 60 percent of males and 70 percent of females within the juvenile justice system possess some psychiatric disorder (Abram, 2003). However, the most alarming fact regarding the U.S. juvenile justice system is that few options exist for the treatment and recovery of these individuals. The argument of whether these youths were arrested and incarcerated due to the presence of psychiatric disorders is irrelevant to this discussion. Rather, the more poignant case is the failure of the juvenile justice system to care for those who need treatment most. In an evaluative report regarding the conditions of the juvenile justice system, Parent, et. al. (1994) found that only 43 percent of admitted youths were given health screenings within one hour of admittance. The nationally recognized standards for the juvenile justice system require that all admitted youths receive health screenings within that first hour time period. Because of the delay in diagnoses, treatment programs (where they exist) cannot be applied in a timely manner. In addition, untrained staff members screen “one-third of juveniles in detention centers”(Parent, 1994). Training programs and adherence to national standards are imperative to the goal of improving health care within the juvenile justice system. Once clear diagnostic methods are created and maintained, federally funded treatment options can begin to form.

Treatment Options

A number of treatment programs and interventions exist for youths who are “at-risk” for dropping out of school, engaging in criminal activities, and becoming members of the juvenile detention program. The difficulty arises when these youths are not reached before they become incarcerated. Within the juvenile detention program, the effective treatment and intervention programs do not exist and these youth are doomed to repeat their actions as soon as they are released from the system. The cycle continues until these youth are old enough to be tried in adult criminal court. The concern lies, not only with the youth who are seemingly trapped in this cyclical progression of government custody, but also with the tax-payers who must pay for the living expenses, court fees, and other costs for these individuals while they are incarcerated. Those tax dollars would be better spent on school-based programs aimed at treatment and interventions before and during the incarceration period. Because of this connection between the health and wellbeing of youth in the juvenile justice system and the financial and social welfare of the general population, government must make aggressive policy changes aimed at treating these individuals. Wasserman (2003) recommends “systematically” implementing the “specific recommendations” for treatment programs as a “necessary first step toward policy changes that will optimize the standard of care for” incarcerated youth. Treatment and intervention programs based on health behavior theories, such as the Health Belief Model, the Theory of Reasoned Action, and the Transtheoretical Model, would promote tools of wellbeing, such as self-efficacy, among youth in the juvenile justice system.

The Future of the Juvenile Justice System

The unfortunate truth behind understanding the juvenile justice system is that there will always be a need for such an institution. However, what happens to young men and women while they are living in confinement can change the future of those individuals and, indeed, can change the future of our communities. The high prevalence of psychiatric disorders among youth in the juvenile justice system deserves the attention of researchers, health professionals and government bodies. Youth with psychiatric disorders require special treatment programs to alleviate any medically treatable conditions, provide tools for self-efficacy, and support needed to break the cycle of crime and incarceration. Treatment options should include qualified health behavior models to provide sustainable solutions to problems associated with psychiatric disorders in young people.
Although individuals within this particular population have been tried and found guilty for crimes requiring incarceration, their lives and wellbeing should be of upmost importance to our federal and state governments. Federally funded programming should be based on empirical data regarding psychiatric disorders among youth in the juvenile justice system across the United States. Nationally recognized standards for the treatment of incarcerated youths must also be upheld without exception. The juvenile justice system is not a purely punitive measure for youth who choose to engage in criminal activity. The juvenile justice system is meant to be a safe and controlled environment where at-risk youth can receive the special treatment and services they require to become self-relying adults. At its best, the U.S. juvenile justice system provides the tools that allow at-risk youth to make better choices for their lives. However, the health and wellbeing of those youth must be addressed before these goals can be achieved.


Works Cited
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