Youth who’ve spent time in detention centers tend to have severe physical and mental health conditions.
Youth incarceration is a significant issue in the United States. According to the Sentencing Project, on any given day, nearly 41,000 youth are held in juvenile detention facilities around the nation. This high rate of young people behind bars impacts not only the physical and mental health of the incarcerated individuals themselves but take a substantial toll on the entire family, disrupting overall dynamics, as well as the person’s ability to go to school or secure a job post-sentence.
Researcher Samantha Boch of the University of Cincinnati led a new study focusing on the health disparities, specifically, faced on young people who’ve ended up in a detention center. The study was published in the journal Academic Pediatrics.
Examining electronic medical records (EMR) from Cincinnati Children’s Hospital, Boch and her team focused on youth under 21 years old whose health records revealed some sort of involvement in the justice system. The team analyzed over 1.7 million records from 2009 to 2020, searching for justice-related keywords such as “prison,” “jail,” “probation,” and “parole.” They identified that 38,263 youth (2.2% of the records) likely had personal or family involvement with the justice system.
Finding these keywords presented a challenge in itself, Boch discovered, as families often avoid disclosing such information due to fear of stigma or involving agencies like child protective services (CPS) that investigate that entire family unit. The team also quickly discovered that, despite representing a small fraction of the population, in the records they did find, these youth accounted for a disproportionate number of physical and mental health diagnoses and healthcare visits.
The study specifically revealed that 2.2% of youth incarceration cases were responsible for 63.3% of behavioral health inpatient admissions, 23.7% of hospitalization days, and 45.5% of foster care visits. These youths had 1.5 to 16.2 times the prevalence of various health disorders compared to a matched sample without justice system keywords. The findings also highlighted that these youth had 428.2 more physical health diagnoses and 269.2 more mental health diagnoses per 100 youth than their peers. Specific health issues were notably more prevalent among this group, including schizophrenia, bipolar disorder, trauma and stress-related disorders, suicide, and self-injury. In fact, these youth represented 42.9% of all cases of schizophrenia spectrum disorders, 42.1% of bipolar disorders, and 44.9% of shaken baby syndrome cases documented at Cincinnati Children’s.
Given that it was difficult to even find records indicating involvement in the justice system, the researchers surmised that there must be a general lack of awareness among medical providers as well as inadequate provider training to unveil this information and lack of funding for future research around this issue. Further contributing to this issue, there are no protocols for properly screening for justice system involvement when young people present for care.
According to the American Academy of Pediatrics, which parallels Boch’s findings, incarcerated youth experience higher rates of mental health disorders, including depression, anxiety, and PTSD, than their peers, with up to 70% meeting the criteria for at least one mental health disorder. Additionally, these youth often face higher rates of chronic physical conditions such as asthma and infectious diseases. However, without screening for incarceration, it is more difficult for providers to determine why patients end up in the healthcare system with symptoms associated with these conditions.
The team’s findings build upon existing evidence that youth incarceration is highly correlated with severe physical and mental health conditions and offers insight into the specific conditions associated with this factor. Increased awareness, routine screening measures, and systemic reforms are needed to ensure there is both adequate information in patients’ files and all relevant contributors are being addressed in treatment plans.
Sources:
Study offers insight into incarceration’s toll on youth health
Pediatric Health and System Impacts of Mass Incarceration, 2009–2020: A Matched Cohort Study
Nearly three-quarters of youth behind bars suffer from mental health issues
How Does Incarcerating Young People Affect Their Adult Health Outcomes?
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