CHILDREN’S HEALTH // TOPIC DISCUSSION
Mental health and the criminal justice system: Would increasing access to mental health services reduce the number of children in the justice system?
June 1, 2018 / Author: Anna Walton
The Intersection of Children’s Mental Health & Criminal Justice
Each maturing generation reveals a preview of America’s future; with up to one in five children in America experiencing indicators of mental health disorders each year, the vast majority of which go untreated, there’s no question that mental healthcare for children needs to improve.
What is contributing to the high prevalence of mental health issues in the nation’s youth?
Approximately 46% of children in Tennessee experience at least one adverse childhood experience (ACE), the most common being economic hardship, parental divorce/separation, and/or guardian or parental incarceration. As ACEs increase, so does the likelihood of developing mental health issues, such as depression, substance abuse, and suicidal thoughts. Therefore, many children in Tennessee are at risk of these behaviors, and the majority of them go untreated– approximately 80% of children needing help will not get it. This statistic is particularly alarming since untreated mental health problems often lead to a lifetime of struggle with both physical and mental health issues that could more easily be countered with early treatment.
Mental disorders are a major factor that contributes to the number of children encountering the juvenile justice system; of the two million children involved, approximately 50-75% of them struggle with a mental disorder. This number could be decreased, as many of the youths falling into this statistic have simple treatable mental health issues. Only about 10% of them suffer from more serious mental disorders that will require a lifetime of consistent treatment.
Children involved in the juvenile justice system are significantly more likely to enter the criminal justice system. Incarceration, especially at a young age, leads to poor mental and physical health later in life. This is seen in youths incarcerated for at least a year who show a significantly higher risk of depression, suicide attempts, and physical or mental limitations that impact daily functioning. In addition, incarceration makes it markedly more difficult to find and keep employment. It’s no secret that mental illness is rampant in state prisons and local jails, and studies show that greater access to mental health services will decrease the climbing number of inmates.
The best opportunity to avert mental health issues in children is through early-life prevention, which could most effectively be made available in the education system. Mental health is generally ignored in schools around the nation, mostly due to a lack of resources. Most teachers don’t receive training on how to recognize and assist in the treatment of mental health issues, while school nurses are often busy and have trouble discerning poor mental health from physical ailments. School counselors and psychologists are best equipped to recognize and diagnose potential mental health problems, but due to lack of funding, they often have to monitor too many students. As a result, many struggling children are overlooked.
School-associated mental health resources are extremely valuable to improve access to care. A 2003 study in the Journal of Adolescent Health (Vol. 32 No. 6) found that students were 21 times more likely to seek help in a school-related resource than a community resource. Therefore, it is paramount that schools effectively provide and maintain these resources.
Without enough funding, many schools are struggling to implement and improve treatments for mental disorders. Hamilton County Schools, however, have found a solution.
Hamilton County Schools is one of the largest school districts in Tennessee to seek reimbursements from TennCare (Tennessee’s Medicaid program) for services they provide to special education students. The reimbursements they receive fund multiple services, one being occupational therapy for students with autism. With slashes in funding, the reimbursements are a great way to bring money back into the schools and help many students and families access medical care. More schools around America have been seeking Medicaid reimbursements as a proven viable option for countering budget cuts.
Education & Funding
Another approach is through education itself. ParentCorps, a family-centered preschool program in New York City, showed that positive childhood experiences with family members and teachers can shield children from ACEs and poverty-induced stress. ParentCorps involves both preschool children and their parents, teaching them behavioral and emotional regulation skills. Researchers found that participation in ParentCorps lowered a child’s chances of developing mental health problems and committing a crime later on and increased academic performance. High-quality preschool programs are appearing around the country, with uniformly positive results.
Efforts to lower the number of adolescents grappling with mental health issues are increasing, but not at an adequate rate; this rate will only grow when funding for schools and availability of mental health resources increase. When funding finally matches the need, we will see fewer children involved with the juvenile justice system and a brighter future for both the adolescents themselves and America as a whole.