Access to services for juvenile court-involved youth in the United States: a social and neurobiological case for the juvenile mental health advocacy project model
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Youth involved in the juvenile justice system have a well-documented need for mental, behavioral, and emotional health services, but they face barriers to accessing appropriate and timely care. Research indicates a high need among youth involved in both the juvenile justice and mental health systems—or youth with dual involvement—and few programs addressing their need exist. The social risk factors of juvenile justice involvement are well-defined and studies indicate that the intersectionality of historically oppressed identities put certain youth at high risk for dual involvement. In particular, racial/ethnic minorities and female youth with mental health needs appear to be at-risk populations for dual involvement; they also have substantial barriers to care. Moreover, the neurobiological characteristics of mental illness among youth have begun to be characterized. Studies of the functional and structural markers of mental illness show that youth with conduct disorder, oppositional defiant disorder, attention deficit hyperactivity disorder, and depression show neurological changes that have behavioral correlates predisposing young people with these diagnoses to juvenile justice involvement where they have limited healthcare resources. Evidence from these fields—social science and neuroscience—provide a justification for programs that work across systems to provide dually involved youth access to health, educational, and social services. In Massachusetts, the Juvenile Mental Health Advocacy Project (J-MHAP) operates a pilot program in the Middlesex and Essex County Juvenile Courts, with the primary goal of providing these youth access to the multidisciplinary care they require. Distal goals include preventing further movement into the criminal justice system, and saving costs across various agencies and interest groups. Operating through court-appointed Mental Health Advocates (MHAs), J-MHAP is a unique model that uses advocates within the court system to coordinate services and improve access. It is a model that could make strides toward reducing injustices within the legal and healthcare systems.