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The Healthcare Crisis of Juvenile Detention Centers

Juvenile detention centers are short-term holdings used for youths when they have been arrested to await sentencing (The Annies E. Casey Foundation, 2020). It should only be used if officials believe the child is at risk of fleeing or committing more crimes, but unfortunately, they are overused (The Annies E. Casey Foundation, 2020). These centers can throw a child off course, creating adverse immediate and future health outcomes. Detention centers are not being held accountable for their extreme punishment and lack of care for youths, which results in these youths being worse off physically and mentally. 


Before Juvenile centers 

Before being sent to a juvenile detention center, many at-risk youths have pre-existing mental and physical health disorders through previously experienced trauma and violence (Documentary Prison Kids, 2015). Many of these children are not adequately cared for, with 9-29% of these youths having some relation with the child welfare system (Acoca, 2014). Since they have been unable to receive proper care, they have several physical health issues. Over ⅔ of youths in one survey reported a healthcare deficiency, including injury, vision and hearing problems, and other chronic illnesses while entering a juvenile detention facility (Acoca, 2014). 


Physical Health During Juvenile Centers 

Many healthcare facilities do not provide adequate screening and treatment for youths with physical illnesses. Some cases have reported that some centers do not give detainees physical exams, which are crucial to maintaining a child’s health and essential for identifying chronic conditions and possible infections. (Shirk, 2009). Even if good physicals are provided upon arrival at a center, reproductive and sexual health is often neglected, as it was estimated in 2014 that only 25% of centers tested for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Incarcerated youths are at a higher risk for HIV and Hepatitis C infections than non-incarcerated youths (Perry, 2014). Such practices are extremely harmful as delayed diagnoses and lack of adequate treatment for STIs and HIV result in significant long-term negative health impacts. 


Mental Health During Juvenile Centers 

Many youths entering detention centers have preexisting mental health disorders and trauma. The majority of juvenile detainees are diagnosed with attention-deficit/hyperactivity disorder (ADHD), depression, anxiety, or post-traumatic stress disorder (PTSD) (Perry, 2014). In addition, 50 to 75% of these youths have diagnosable mental or substance-use disorders (Acoca, 2014). Many youths entering detention centers are already struggling with access to healthcare, creating opportunities for these centers to play pivotal roles in their lives. They require services and treatment to help them learn coping mechanisms and better control their symptoms, but centers are not doing enough to solve the root cause of these children's mental health conditions. Suicide is the leading cause of death in juvenile justice facilities (Joshi, 2017). Another study found that juveniles who reported significant thought disturbances did not receive additional services (White, 2013). The few facilities that have instituted suicide prevention training and suicide screening after admission saw a lower suicide rate (Braverman, 2011). 


Health After Detention Centers 

After leaving the detention centers, youths are still at risk for multiple health issues and are less likely to receive proper care for their disorders. Detention centers are shown to

increase mental health disorders in imprisoned youths. The Physicians for Human Rights determined that over 1,000 incarcerated youth commit “suicidal actions” each month (Shirk, 2009). This worsening of mental health follows these youths throughout their lives. Unfortunately, once out of the center, it is challenging for them to access proper treatment. The label of being a juvenile detainee follows these children for the rest of their lives. Many psychiatric facilities refuse to accept juvenile detainees because of the stigma that they are children who continually misbehave (Documentary Prison Kids, 2015). State governments terminate Medicaid health insurance for these youths (Golzari, 2013), heightening the barrier for them to receive treatments post-detention. This leads to a further lack of access to healthcare once out of the center, which worsens the problem of these youths having unmanaged medical and mental problems (Golzari, 2013). 


Call to Action 

The healthcare crisis in juvenile detention centers can no longer be ignored. For too long, we have failed to provide comprehensive medical and mental health care to these vulnerable youths. Instead of rehabilitation, our facilities exacerbate trauma and perpetuate cycles of untreated illness and stigma that diminish life prospects. Urgent reform is imperative to align these institutions with their intended mission. Access to quality healthcare, mental health support, trauma-informed care, and continuity of treatment must become mandatory standards. Achieving this will require a multi-pronged effort - securing funding, training personnel, partnering with providers, and destigmatizing these young lives deserving of intervention, not further marginalization. We must treat these children not as problems but as human beings whose health and dignity deserve fierce protection. We can only build rehabilitative juvenile justice systems that heal and nurture every child's potential. The path begins with an unwavering commitment to do better. 


References 

Acoca, L., Stephens, J., & Vleet, A. V. (2014). Health Coverage and Care for Youth in

the Juvenile Justice System: The Role of Medicaid and CHIP. The Kaiser Commission

on Medicaid and the Uninsured. 

Braverman, P. K., & Murray, P. J. (2011). Health Care for youth in the Juvenile Justice

System. Pediatrics, 128(6), 1219–1235. https://doi.org/10.1542/peds.2011-1757

Documentary Prison Kids: A Crime Against America's Children. (2015).

Youtube. Retrieved March 23, 2022, from https://www.youtube.com/watch?

Golzari, M., & Kuo, A. (2013). Healthcare utilization and barriers for youth post-

detention. International Journal of Adolescent Medicine and Health, 25(1), 65–67. 

Joseph-DiCaprio, J., Farrow, J., Rose, E., Feinstein, R., Morris, R., Nesmith, J., Persing,

R., Schichor, A., & Younessi, S. (2000). Health Care for Incarcerated Youth. Journal

of Adolescent Health, 27(1). 

Joshi, K., Billick, S.B. Biopsychosocial Causes of Suicide and Suicide Prevention Outcome

Studies in Juvenile Detention Facilities: A Review. Psychiatr Q 88, 141–153 (2017).

Juvenile detention explained. The Annie E. Casey Foundation. (2020, November 14).

Retrieved March 19, 2022, from https://www.aecf.org/blog/what-is-juvenile-

Morris, R. E. (2005). Health Care for incarcerated adolescents: Significant needs

with considerable obstacles. AMA Journal of Ethics, 7(3). 

Perry, R. C. W., & Morris, R. E. (2014). Health Care for youth involved with the

correctional system. Primary Care: Clinics in Office Practice, 41(3), 691–705. 

Shirk, M. (2009). Health Care in Juvenile Detention Centers. Center for Health

Journalism. Retrieved March 19, 2022, from 

detention-ce nters

White, L. M., & Aalsma, M. C. (2013). 6. Mental Health Screenings in juvenile

detention centers: Predictors of recidivism and mental healthcare utilization among

detained adolescents with mental illness. Journal of Adolescent Health,

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