Written By: Rhea Nayak, Juvenile Mental Health Fellow

Psychiatric disorders and mental illness are disproportionately high in minors involved in the juvenile justice system. Minors in the justice system are three times as likely as their peers to meet the criteria for a psychological disorder (Nagel et al., 2016). Adolescence is a time of marked vulnerability to multiple serious psychological disorders – including anxiety, mood disorders, attention deficit hyperactivity disorder (ADHD), personality disorders, and post-traumatic stress disorder (PTSD) (e.g., Anderson, 2016; Luna & Wright, 2016). The average onset age for serious psychological disorders is fourteen (Steinberg, 2014).  

Tragically, childhood trauma is incredibly common, and it is believed to affect more children than not. Over two-thirds of children reported experiencing at least one traumatic event by age 16 (SAMHSA, 2023). Nevertheless, not every child who witnesses or experiences a traumatic event – like abuse and violence – will become traumatized and demonstrate signs of trauma. Children typically develop trauma when the event overwhelms their ability to cope with what they have experienced. 

Traumatic events encompass multiple experiences, including physical abuse, sexual abuse, domestic violence, natural disasters, accidents, and many more (Caporino et al., 2003). These are not mutually exclusive, and one adolescent could have experienced more than one traumatic stressor, which is often the case. Traumatic stressors significantly affect how children think, respond to stress, and their competency to participate in the justice system (Ford, 2002). When childhood trauma occurs, essential aspects of brain and personality development can be compromised (Ford, 2005). Most youth involved with the juvenile justice system who have been diagnosed with PTSD have specifically experienced traumatic victimization (Arroyo, 2001). This type of trauma involves victimization from others, mainly abuse inflicted by others. When compared with other forms of trauma, it is more likely to lead to psychological impairment of the child (Arroyo, 2001). When children are exposed to this type of mistreatment, they may engage in self-protective behaviors by lashing out, taking risks, and breaking rules, especially against authority figures. All these factors combined can somewhat help to explain why children with PTSD end up being represented disproportionately in the juvenile justice system. 

Screening for PTSD and identifying traumatic stressors has been studied thoroughly. Many mental health professionals and researchers are working with community members to design and implement approaches that best meet the needs of children. For example, in Connecticut, a screening process based on the TARGET model has been implemented. This systematic model focuses on having every probation officer, administrator, health care staff, and program provider be trained to be trauma-informed (Ford & Cruz-St. Juste, 2006). Many states and communities have designed similar initiatives, recognizing how many children they interact with have experienced trauma and may be continuing to struggle with the aftereffects in their daily lives. Juvenile Mental Health Courts nationwide have included PTSD as a qualifying diagnosis for admittance, integrating trauma-focused therapies within their approach (Wakefield et al., 2023). These interventions are designed to promote healthy and successful long-term outcomes for children, ensuring they have the resources and tools needed to thrive.

Trauma affects too many children within our communities, especially the juvenile justice system. However, post-traumatic growth is wholly possible. Growing access to mental health services is essential to providing children with the care needed. Expanding mental health care within the juvenile justice system is especially important in reducing recidivism rates while promoting safer and healthier futures for children.

References:

Nagel, A. C., Guarnera, L. A., & Reppucci, A. D. (2016). Adolescent Development, Mental Disorder, and Decision Making in Delinquent Youths. In K. Heilbrun (Ed.), APA Handbook of Psychology and Juvenile Justice (pp. 117–138). Washington, DC: American Psychological Association.

Anderson, S. L. (2016). Commentary on the Special Issue on the Adolescent Brain: Adolescence, Trajectories, and the Importance of Prevention. Neuroscience and Biobehavioral Review, 70, 329–333.

Luna, B., & Wright, C. (2016). Adolescent Brain Development: Implications for the Juvenile Criminal Justice System. In K. Heilbrun (Ed.), APA Handbook of Psychology and Juvenile Justice (pp. 91–116). Washington, DC: American Psychological Association.

Steinberg, L. (2014). Age of Opportunity: Lessons from the New Science of Adolescence. New York, NY: Houghton Mifflin Harcourt.

Caporino, N., Murray, L., & Jensen, P. (2003). The Impact of Different Traumatic Experiences in Childhood and Adolescence. Emot Beh Disord Youth, (Summer): 63-64, 73-76.

Ford, J.D. (2002). Traumatic Victimization in Childhood and Persistent Problems with Oppositional-Defiance. J Trauma, Maltreatment, and Aggression, 11, 25-58.

Arroyo, W. (2001). PTSD in Children and Adolescents in the Juvenile Justice System. In J.M. Oldham & M.B. Riba (Series Eds) & S. Eth (Vol. Ed.), Review of Psychiatry Series: Vol. 20, Number 1. PTSD in Children and Adolescents (pp. 59-86). Washington DC: American Psychiatric Publishing.

Ford, J.D., & Russo, E.M. (in press, 2006). Trauma-Focused, Present-Centered, Emotional Self-regulation Approach to Integrated Treatment for Post-traumatic Stress and Addiction: Trauma Affect Regulation: Guide for Education and Therapy (TARGET). Am J Psychother.

Ford, J. D., & Cruz-St. Juste, M. (2006). Trauma Affect Regulation: Guide for Education and Therapy (TARGET-A/G Version 2.1): 10-Session Experiential Trauma-Focused Psychoeducational Group Therapy for Adolescents. Farmington, CT: University of Connecticut Health Center.

Julian D. Ford, PhD, Department of Psychiatry, University of Connecticut School of Medicine

Ford, J. D. (2005). Treatment Implications of Altered Neurobiology, Affect Regulation and Information Processing Following Child Maltreatment. Psychiatr Ann, 35, 410-419.

Wakefield, S. M., McPherson, P., & Brennan, S. L. (2023, January 27). Factors Associated with Successful Completion of Juvenile Mental Health Court. Journal of the American Academy of Psychiatry and the Law. https://jaapl.org/content/early/2023/01/27/JAAPL.220035-21