This Week in PubHub: Mental Health and Juvenile Justice

(Kyoko Uchida manages PubHub, the Foundation Center's online catalog of foundation-sponsored publications. In her last post, she looked at four reports that examined different aspects of child well-being.)

The reports discussed in my last post explored the ways in which childhood poverty can affect educational, employment, and other outcomes later in life. This week, PubHub is featuring a group of reports highlighting the need to address the effects of childhood trauma on mental health and behavioral outcomes in a variety of settings, including schools, the juvenile justice system, and foster care.

There's a growing awareness of the need to identify and refer children suffering from developmental and mental health issues early on. State Case Studies of Infant and Early Childhood Mental Health Systems: Strategies for Change, a report from the Commonwealth Fund, describes efforts to establish early identification and intervention systems for children up to age five in Colorado, Indiana, Massachusetts, and Rhode Island. The report also shares best practices in stakeholder engagement and planning, innovative interagency collaboration, and community-based early childhood health and development services that could serve as models for federal policies and programs.

According to the Justice Policy Institute report Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense, national surveys estimate that up to 34 percent of all children in the United States have experienced, directly or vicariously, at least one traumatic event, whether physical or sexual abuse, violence, maltreatment, the loss of a caregiver, or life-threatening injury, illness, or accident. The report also found that between 35 percent and 46 percent of adolescents report having witnessed an act of violence. Such childhood trauma can affect brain development, the authors argue, resulting in increased risk of involvement with the juvenile justice system. Indeed, between 75 percent and 93 percent of youth entering the juvenile justice system every year are thought to have experienced some form of trauma. Given that people of color are more likely to be victims of crime and violence, that incarceration itself can be traumatic, and that youth who spend time in juvenile facilities have poorer adult outcomes, addressing the effects of trauma before a child becomes involved in the justice system is critical to breaking this cycle. In addition to raising awareness of the issue, the authors call for better screening and assessment procedures for trauma victims; more and better evidence-based treatment programs; a greater emphasis on trauma-sensitive handling, sentencing, and placement within the justice system; and greater support for targeted prevention efforts, including counseling in schools.

The need for targeted intervention services within the juvenile justice system is also a theme of Pathways to Desistance, an initiative of the John D. and Catherine T. MacArthur Foundation. The initiative's December 2009 update, Research on Pathways to Desistance, questions the efficacy of "locking up" juvenile offenders, given that researchers have found no benefit, in terms of recidivism, to placing offenders in institutional settings instead of on probation; in fact, among "low-level offenders," institutional placement slightly raised the level of recidivism.

Youth in foster care, who often experience multiple and complex trauma yet have limited access to mental health services, is the focus of the RAND Corporation's Toolkit for Adapting Cognitive Behavioral Intervention for Trauma in Schools (CBITS) or Supporting Students Exposed to Trauma (SSET) for Implementation With Youth in Foster Care. The report outlines recommendations for implementing school-based targeted prevention programs for youth in foster care -- those designed for school-based mental health professionals as well as those designed to train teachers and school counselors in cognitive behavoral intervention techniques. Both approaches teach youth how to deal with trauma, including methods for relaxation, cognitive restructuring, addressing their fears, social problem-solving, and reducing coping by avoidance.

With four million children and youth thought to have experienced at least one traumatic event, reducing the mental health and behavioral problems associated with trauma is an urgent issue for the well-being of our children and youth, public safety, and society in general. Do you know of other ways these issues are being addressed? Let us know in the comments box below.

And don't forget to check out PubHub for the latest reports on children and youth.

-- Kyoko Uchida