Mental Health Screenings in Juvenile Detention Centers: Predictors of Mental Health Service Utilization and Recidivism

Abstract

Introduction: About 2 in 3 detained adolescents meet criteria for mental illness. Unfortunately, the juvenile justice system does not consistently provide mental health services for juveniles in need. As a result, juvenile adolescents have low rates of treatment utilization, high rates of recidivism, and a mortality rate 4 times greater than the general population. To understand these issues, the current study tracked a sample of detained adolescents for six months post-detention. Methods: 2089 adolescents held in a detention center completed a mental health screener. The prevalence of youths with different mental health problems was calculated. Logistic regression analyses were conducted to determine predictors of service utilization and recidivism at 3- and 6-month follow-up. Results: Altogether, 1707 (81.7%) reported trauma, 561 (26.9%) endorsed alcohol/drug use, and 393 (18.8%) endorsed significant thought disturbances. Post-detention, 336 (16.1%) utilized mental health services and 770 (36.9%) re-offended. Regression analyses indicated: (1) Hispanic youths, males, and older youths were significantly less likely to utilize services (OR=.37, p=.015 for Hispanic; OR=.53, p <.001 for males; OR=.842, p <.001 for older); (2) youths with anger problems were more likely to utilize services (OR=1.08, p=.011); (3) racial/ethnic minorities were significantly more likely to recidivate (OR=1.12, p=.009); (4) alcohol/drug use increased the likelihood of recidivism (OR=1.12, p<.001); and (5) youths who utilized services were no less likely to recidivate (OR=1.22, p=.116). Conclusions: Juveniles with mental illness problems are not getting the treatment services they need. Furthermore, Hispanic, male, and older youths were less likely to utilize services, minority youths were more likely to be re-arrested, and service use did not impact recidivism. Findings suggest gaps and disparities in mental health services for juvenile adolescents. The juvenile justice system needs to improve public policies and develop mechanisms to ensure all juveniles have an equal opportunity to receive effective mental health services.