Addressing A Mental Health Intervention Gap in Juvenile Detention: A Pilot Study

ABSTRACT

Research suggests that 60–70% of adolescents detained in the juvenile justice system meet criteria for a mental health disorder compared to 20% of the general adolescent population; however, the vast majority do not receive services. Unfortunately, mental health symptoms often worsen during detainment, and detainment is linked to lower levels of educational attainment and increased risk of adult recidivism. Thus, not only are these adolescents unlikely to receive needed mental health care but also the lack of interventions in detention may exacerbate inequities of contact with the criminal justice system in adulthood. In addition to these youth being an underserved population broadly, youth of color are also disproportionately incarcerated compared to their white counterparts. The current paper describes results of a pilot study of an Acceptance and Commitment Therapy (ACT)-based behavioral skills intervention, aimed at providing evidence-based mental health treatment for anadolescent population at risk of long-term adverse mental health outcomes. The study included 128 males aged 14–17 who resided in juvenile detention. Results demonstrated that the intervention was acceptable to participants, feasible to provide in detention, and could be implemented with fidelity and competency. Intervention participants demonstrated declines in symptoms of mental health, and ACT-specific constructs of experiential avoidance, cognitive fusion, and perceived barriers to moving toward their values. These results have important implications for the possibility of an effective intervention that could disrupt systemic inequity in youth mental health, and thus support further testing of this intervention in a randomized controlled trial.

Disclosure statement

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

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Notes

¹ Note that the statistical analysis plan changed due to missing data.

² Numbers do not sum to 100% due to missing data.

³ Some data could not be collected, due to the participant turning 18 years old or because they had a common name and were, therefore, not distinguishable from other youths.

Additional information

Funding

This work was supported by the Institute for Mental Health Research [2015-CBEL-01]. Karey L. O’Hara’s work on this paper was supported in part by a postdoctoral fellowship provided by the National Institute on Drug Abuse (T32DA039772) and by a career development award provided by the National Institute of Mental Health (K01MH120321).