The juvenile justice system is failing to meet the needs of youth with mental health disorders and treatment needs.

The Commonweal Juvenile Justice Program has actively supported law and budget reforms to increase mental health services for children and adolescents and to ensure effective, treatment-based interventions when they become involved in the justice system.

For justice-involved youth the prevalence of mental health problems is high. A multi-state study of juveniles under justice system control concluded that 70 percent had at least one diagnosable mental health disorder (Shuflet and Cocozza, 2006). Recent California surveys of youth in local detention faculties by the Board of State and Community Corrections indicate that nearly half of locally confined youth have “open mental health cases.”

A pervasive problem is inconsistency between justice system and other agencies as to how they diagnose, assess, prosecute, house and treat youth at varying levels of impairment. Recent revisions incorporated into the new “DSM-V” diagnostic manual for disorders, used widely by mental health professionals, may have added to the confusion. Too often, the juvenile justice system—with its available confinement space—serves as the drop zone for mental health cases that other agencies have neglected or rejected. In 2005, California Congressman Henry Waxman commissioned a national survey on the detention of youth with mental health disorders. A key finding was that the juvenile justice system is incapable of providing the range of mental health services needed by detained youth. These finding remains true today.

California probation chiefs being surveyed for a juvenile justice “gap analysis” commissioned by the state Legislature in 2005 identified the lack of mental health services for juvenile offenders as their most troubling deficiency. Yet policymakers have done little to help fill the service gaps. Promising service models, like the collaborative approach tested in the California Endowment’s Healthy Returns Initiative, have failed to gain traction. On the federal level, the so-called “inmate exception” blocks juveniles in custody from access to Medi-Cal payments that can cover mental health treatment. Other mental health funding sources—like EPSDT and California’s fiscally robust Mental Health Services Act (MHSA)—are under-utilized for juvenile justice youth. Judges in delinquency proceedings may lack key assessment and other information that would help them order appropriate care. In short the juvenile justice- mental health caseload in California remains severely under-served.