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Open Access Research article

Connection to mental health care upon community reentry for detained youth: a qualitative study

Matthew C Aalsma1*, James R Brown2, Evan D Holloway3 and Mary A Ott1

  • * Corresponding author: Matthew C Aalsma maalsma@iu.edu

  • † Equal contributors

Author Affiliations

1 Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

2 Department of Social Work, University of Wisconsin-Oshkosh, Oshkosh, WI, USA

3 Department of Psychology, Fordham University, Bronx, NY, USA

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BMC Public Health 2014, 14:117  doi:10.1186/1471-2458-14-117

Published: 5 February 2014

Abstract

Background

Although detained youth evidence increased rates of mental illness, relatively few adolescents utilize mental health care upon release from detention. Thus, the goal of this study is to understand the process of mental health care engagement upon community reentry for mentally-ill detained youth.

Methods

Qualitative interviews were conducted with 19 youth and caregiver dyads (39 participants) recruited from four Midwest counties affiliated with a state-wide mental health screening project. Previously detained youth (ages 11–17), who had elevated scores on a validated mental health screening measure, and a caregiver were interviewed 30 days post release. A critical realist perspective was used to identify themes on the detention and reentry experiences that impacted youth mental health care acquisition.

Results

Youth perceived detention as a crisis event and having detention-based mental health care increased their motivation to seek mental health care at reentry. Caregivers described receiving very little information regarding their child during detention and felt “out of the loop,” which resulted in mental health care utilization difficulty. Upon community reentry, long wait periods between detention release and initial contact with court or probation officers were associated with decreased motivation for youth to seek care. However, systemic coordination between the family, court and mental health system facilitated mental health care connection.

Conclusions

Utilizing mental health care services can be a daunting process, particularly for youth upon community reentry from detention. The current study illustrates that individual, family-specific and systemic issues interact to facilitate or impair mental health care utilization. As such, in order to aid youth in accessing mental health care at detention release, systemic coordination efforts are necessary. The systematic coordination among caregivers, youth, and individuals within the justice system are needed to reduce barriers given that utilization of mental health care is a complex process.

Keywords:
Juvenile justice; Detention; Mental health screening; Mental health care utilization; Qualitative research