Reimagining Reentry

Addressing Youth Mental Health

by Adene Karhan, LCSW

Rising Rates of Youth Mental Health Conditions

Rates of mental health have risen over the last several decades, but factors related to the pandemic and surrounding events have caused rates of depression, anxiety, and suicidal ideation to skyrocket1. In 2021, a CDC study2 of mental health rates found that 37% of high school students reported experiencing poor mental health in the midst of the pandemic, and 44% reported persistent feelings of sadness or hopelessness throughout the previous year. The rates of depression and anxiety among all youth are high, but risk is even higher for youth within juvenile justice facilities, who experience a rate of mental health conditions two to four times higher than that of the general population.3 Many of the youth who enter the juvenile justice system due to significant behavioral challenges are experiencing mental health conditions that have never been comprehensively assessed, diagnosed or treated. Shockingly, even though one out of five incarcerated youth admit to having thoughts of suicide, many juvenile justice facilities do not have adequate screening measures in place to provide necessary treatment and support.4

National Shortage in Youth Mental Health Treatment Reaches Crisis Level

Given the high rate of mental health symptoms experienced by youth within the justice system, and the rising rates of mental health among the youth population in general, securing adequate mental health support is an essential component of ensuring successful reentry for many youth when returning to their community. Yet youth who are re-entering the community today face a significant mental health crisis as they compete with other youth within the general population to receive appropriate mental and behavioral health services. For years, states have been reporting a shortage of available mental health supports for adolescents, but in the wake of COVID-19, the rising rate of mental health issues among youth coupled with the lack of available supports has created the perfect storm for a national mental health crisis for young people. In recent years, hospital emergency rooms have become increasingly utilized as gateways for accessing mental health treatment for mental and behavioral crisis for youth. As the number of youth seeking mental health treatment rise, ER units are having more and more difficulty securing appropriate treatment facilities, and this is leading to longer stays in the ER.5 In 2020, the number of adolescents visiting the ER for mental health-related symptoms increased by 31%6, and in March of 2021, a study of pediatric hospitals across the US and Canada revealed that all but one of eighty-eight hospitals reported an average of four youth under the age of 18 boarding daily for an average of 24-72 hours as they awaited placement in mental health treatment facilities7. Some youth are reportedly waiting much longer. As youth await placement in a mental health treatment program, families report that youth receive minimal mental health treatment aside from observation and safety procedures, and the experience of spending extended periods of time in ER settings is often traumatic for youth who are experiencing significant emotional distress. Doctors and hospital staff acknowledge that most ER staff are improperly trained to meet the psychiatric needs of youth, and that lengthy stays threaten the safety of the youth and delay appropriate treatment, but as the nation faces increasing shortages in available beds in mental health facilities, the situation has become even more critical, with some youth waiting for up to a month for an available bed.

Like the rest of the nation, New York State is experiencing a youth mental health crisis. At the end of April 2022, Ellis Hospital, one of the primary providers of adolescent psychiatric care in the Capital Region, released a statement to the press stating that they are temporarily closing the unit due to the healthcare shortage and lack of available staffing. They remain closed over six months later. Other nearby hospitals report high numbers of young patients in their emergency rooms, yet, because their facility is not licensed to treat them, the youth remain in the ER for days or weeks until they either stabilize or are referred to a treatment facility, which may be hours away from their home.9

Mental Health Crisis Poses Increased Risk of Criminalizing Behavior (Especially for Marginalized Groups)

With a universal shortage of services impacting even the most privileged individuals (e.g., those with medical insurance and adequate financial means of paying for medical and mental health services, those with family and caregivers who are able to advocate for them during times of mental health crisis, those with transportation to the hospital, etc.), other services in the community are left to fill in the gaps. Typically, these services would include mobile crisis response teams and other community organizations, but they are currently facing the same staffing shortages as the health care industry, and by default, many crisis calls are being diverted to the police, who are often not adequately trained in responding to individuals with mental health conditions. As a result, this increases the risk of individuals with mental health and/or disability symptoms being funneled through the juvenile justice system, especially if they have a history of connection to the system (e.g., those on probation or parole and re-entering the community).

Mental Health Resources While You Wait

The mental health challenges faced by the nation are staggering and there are no quick or easy solutions. There are some resources which can be helpful for youth and young adults as well as their families and friends in order to provide some basic information and strategies to help individuals remain safe as they wait for crisis services to become available.

National Suicide & Crisis Lifeline (SAMHSA)

Individuals can receive support and resources from trained counselors at any time through phone or text through this nationwide hotline.

Project Hope

This statewide resource offers round-the-clock crisis counseling support as well as online wellness groups and a provider directory.

Footnotes

Youth who are re-entering the community today face a significant mental health crisis as they compete with other youth within the general population to receive appropriate mental and behavioral health services.