King County Department of Youth Services: Juvenile Detention Mental Health Services

Principal Investigator: 
Eric Trupin, Ph.D.
Funding Source: 
King County Juvenile Detention Mental Health Services
Project Period: 
PBHJP Project Faculty and Staff: 
Mental Health Practitioner
Mental Health Practitioner
Mental Health Practitioner Lead
Director and Vice Chair, Department of Psychiatry & Behavioral Sciences
Associate Professor
Project Summary: 

The University of Washington (UW) Division of Public Behavioral Health and Justice Policy (PBHJP) provides mental health services to youth detained in King County Juvenile Detention. Youth may be detained in King County Juvenile Detention (KCJD) for a variety of reasons; including arrest, court-ordered warrant, awaiting court process including, serving a sentence, or sanction for probation violation. Non-offenders, including youth who are truant, at-risk youth, or children in need of services, may also be detained for violating court orders.
Youth involved with the juvenile justice system and/or the child welfare system have high rates of mental health needs. In some studies, upwards of 65-70% of youth involved with the juvenile justice system have a mental health diagnosis, and 20% have a serious mental health disorder. Most youth in KCJD are detained for 30 days or less—the average length-of-stay at detention is 11 days. However, a small number of youth will be detained for months while awaiting trial, and some youth will have multiple detentions of 30 days or less. Understandably, many youth have difficulty adjusting to KCJD and understanding the juvenile court process. Some youth will engage in self-harm. Detention placement is a risk factor for suicide. Furthermore, youth awaiting trial face the uncertainty of not knowing whether they will be released soon to home or be adjudicated to a state detention facility for months or even years. Youth with previously identified mental health needs may or may not continue receiving services from their existing providers. Other youth may be identified in KCJD as benefitting from mental health services after release. Some youth in KCJD may require inpatient psychiatric hospitalization. Given the varied populations and needs, UW PBHJP mental health staff members perform a number of functions in KCJD, including:

  • Screen and assess youth who screen positively on KCJD admission procedures and/or a structured instrument to help identify youth in juvenile justice settings who may have special mental health needs (Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2))
  • Assess youth referred by self, parents, detention staff or other stakeholders
  • Support youth in adjusting to detention
  • Support youth through the court process and/or prolonged detention stays
  • Teach youth skills
  • Provide input to case management services
  • Coordinate with outpatient providers
  • Facilitate referrals to outpatient behavioral health services
  • Refer to acute inpatient psychiatric hospitalization and as indicated, involuntary treatment
  • Coordinate or manage psychiatric services
Public Health Relevance: 

Youth in detention are increased mental health needs and placement in detention is a risk factor for completed suicide, adjustment disorders and exacerbation of existing mental health disorders. Treatment in detention and connecting youth to indicated outpatient or inpatient behavioral health services will improve short- and long-term youth well-being, respectively.

Juvenile Justice
Additional Reports: 
  • Teplin, L., Abram, K., McClelland, G., Dulcan, M., & Mericle, A. (2002). Psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry, 59 (12), 1133-1143.
  • Cocozza, J. & Skowyra, K. (2000). Youth with mental health disorders: Issues and emerging responses. Office of Juvenile Justice and Delinquency Prevention Journal, 7 (1) 3-13.
  • Skowyra, K.R. & Cocozza, J.J. (2005).  Blueprint for Change: A Comprehensive Model for the Identification and Treatment of Youth with Mental Health Needs in Contact with the Juvenile Justice System.  National Center for Mental Health and Juvenile Justice.