A Treatment-To-Prison-Pipeline? Scoping Review and Multimethod Examination of Legal Consequences of Residential Treatment Among Adolescents

ABSTRACT

Objective

Toward the overall goal of interrogating systems that contribute to racial inequity in child and adolescent psychology, we examine the role and function of Residential Treatment Centers (RTCs) in creating or exacerbating race and gender inequities using the language of mental health and the logic that treatment intentions justify children’s confinement.

Methods

In Study 1, we conduct a scoping review to investigate the legal consequences of RTC placement, attending to race and gender in 18 peer-reviewed articles, encompassing data for 27,947 youth. In Study 2, we use a multimethod design focusing on RTCs in one large mixed-geographic county to examine which youth are formally charged with a crime while in RTCs, and the circumstances under which these charges occur, attending to race and gender (N = 318, 95% Black, Latine, Indigenous youth, mean age = 14, range = 8–16).

Results

Across studies, we find evidence for a potential treatment-to-prison pipeline through which youth in RTCs incur new arrests and are charged with crimes during and following treatment. This pattern is pronounced for Black and Latine youth and especially girls, for whom use of physical restraint and boundary violations are recurring challenges.

Conclusions

We argue that the role and function of RTCs via the alliance between mental health and juvenile legal systems, however passive or unintentional, provides a critical exemplar of structural racism; and thus invite a different approach that implicates our field to publicly advocate to end violent policies and practices and recommend actions to address these inequities.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental material for this article can be accessed online at https://doi.org/10.1080/15374416.2023.2178003

Notes

¹ Consistent with their application, we use the term RTC to refer to residential settings, centers and facilities operated under the broad umbrella of congregate care or child welfare, ranging in structure from smaller group home style settings to larger facilities.

² We use this term to encompass a wide range of pathways from residential treatment centers into the juvenile or criminal justice systems (via arrest) and settings (via confinement; e.g., Wald & Losen, 2003).

Additional information

Funding

This work was supported by the National Institute of Health under Grant L40 MH108089 and the Office of Juvenile Justice and Delinquency Prevention 2016-JF-FX-K005.