OP-ED: New Hope – Health Care for Justice-Involved Youth

Annalee NeukamWe may not all become astronauts, actresses or the next NBA all-star, but the beliefs we have in ourselves during childhood are often reflections of the paths we take into adulthood. For this reason it is important for the health of a society to nurture, respect and enrich its youth.  Currently in the United States, there is overwhelming statistical evidence that demonstrates this support is not being provided, especially for high-risk, justice-involved youth who have experienced trauma and/or have mental health disorders. This disparity has been fueled by the lack of affordable health care, which has limited this population from receiving treatment and other health care services upon release from correctional facilities. The recent enactment of the Affordable Care Act (ACA) will soon change this disadvantage.

The ACA, often referred to as Obamacare, will pave the way for justice-involved youth to have access to high-quality reentry and aftercare services. Research, such as senior researcher David Murphey’s statistical portrait of 2013 high school graduates, demonstrates the importance of offering these services. The report revealed youth are experiencing trauma in outstanding numbers. The results indicated that 71 percent have experienced physical assault and 28 percent experienced sexual assault. Another 27 percent were involved in a physical altercation and 16 percent carried a weapon within the last year. These statistics help to solidify and connect the issues of childhood trauma, involvement in the juvenile justice system and the importance of receiving treatment.

It is not a coincidence that characteristics of a youth who has experienced trauma are the same as a youth who is deemed a delinquent. These interchangeable distinctions include angry outbursts, aggressive/self-protective behaviors, indifference, defiance of authority or rules, poor school performance, increased impulsive and risk-taking behaviors and altering feelings through substance abuse. Studies show that repeated exposure to traumatic stresses, especially violence, alters the development of the brain, often inducing depression and other mental health disorders. With this knowledge, it is unsurprising to find that, of the 2 million youth exposed to the juvenile justice system each year, 65 to 70 percent have at least one diagnosable mental health disorder, and 20 to 25 percent have serious emotional issues.

A U.S. Department of Justice study found that, of the 1,800 youth followed three years after their detainment, almost all were struggling in one or more major life areas. Of these individuals, 33 percent had developed antisocial personality disorder, and only 8 percent had no major life impairments. After seven years, this group had mortality rates four times higher than the general population. Childhood trauma, continued trauma in correctional facilities and the onset of mental health disorders, combined with the absence of reentry or aftercare services, are the factors fueling these startling statistics.

What these studies, and many others like them, indicate is that the historic overreliance on youth incarceration does not benefit the youth involved or our society as a whole. What will benefit these youth is a system dedicated to addressing the root issues causing their delinquent behavior and ensuring these youth do not feel isolated from the world around them. Luckily, with the inauguration of the ACA, more states are beginning to implement therapeutic responses to delinquent behavior. Evidence-based mental health and substance abuse treatments have proven to reduce recidivism and improve long-term outcomes for incarcerated youth.

Beginning in January 2014, all citizens of the U.S. will have access to health care, whether it is Medicare, state health care options or a private insurance offered through the Health Insurance Marketplace. All insurances will be required to offer comprehensive mental and behavioral treatments in addition to providing funding for various health care services in schools and correctional facilities. These health care installments will help change the landscape of the juvenile justice system as, for the first time in U.S. history, this population will be cared for by public health services. The current limitations of only receiving treatment while detained will be alleviated as services can be expanded into their aftercare services. Young people will have a greater chance of maintaining relationships with health care professionals and thereafter monitored for the success of their long-term health, which in turn will reduce the number of youth trapped in the destructive cycle of the justice system.


Annalee Neukam is a member of the policy team at the Center on Juvenile and Criminal Justice (CJCJ). She recently graduated from San Francisco State University with a Bachelor’s of Science in Health Education.

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