Mental health is one important issue in a bundle of issues affecting public understanding of juvenile crime and juvenile justice. Others in the same bundle include substance abuse, family violence, head injuries and various forms of trauma. Together, these influence juvenile justice policy and practice in profound ways. They are also easily misunderstood.
Psychologist Gail Wasserman and her colleagues at Columbia University published a study in 2010 showing that mental health disorders are found in larger numbers as researchers look more deeply into the justice system. From intake, to detention and corrections, the prevalence of disorders grows as studies collect mental health screening data at ever-deeper stages of the justice process. By the time researchers analyze prevalence data in the deepest part of the system (secure facilities) mental health and substance abuse disorders affect two-thirds or more of the population.
So, what’s the problem? It’s the sloppy way that practitioners and policymakers sometimes discuss these findings. Advocates in the mental health sector often characterize such studies as showing that the vast majority of youth in “the juvenile justice system” have diagnosable mental health disorders. Upon hearing this claim, it is natural to infer that mental health problems must be the main reason that young people end up in juvenile justice. Thus, our efforts to prevent and reduce juvenile crime should focus on mental health.
Mental health issues cannot be the main reason young people come into the justice system if, as Wasserman and her colleagues demonstrated, only one-third of youth at an early stage of justice processing (intake) have any diagnosable disorders. (If we had good mental health screening data at an even earlier stage of processing — i.e., arrest — the number of affected youth would likely be lower and probably closer to the figures found in the general population - 15 - 20 percent.)
Equating the deepest end of juvenile justice with “the system” distorts the significance of whatever problems affect the youth in secure care. Young people in secure facilities represent a small proportion of the entire youthful offender population. We know from national data stored at the National Center for Juvenile Justice that just 20 percent all youth referred to juvenile court are held in detention for any time at all while awaiting court proceedings, and fewer than 5 percent end up in secure facilities.
The high prevalence rate of mental health disorders in secure facilities suggests that the justice process is likely to divert young people with fewer problems while holding onto those with more problems. This is, in fact, what we want the justice system to do. Service needs in the deep end, however, are not a suitable guide for designing interventions for all youth coming into contact with the larger system. Prevention and early intervention should focus on supportive and restorative services, youth development and skill-building approaches, while services in the deep end should include a stronger focus on mental health and substance abuse. As juvenile justice professionals, we need to pay close attention to our words and to the policy conclusions they may suggest.