Healthy Returns Initiative developed to address health issues in California's juvenile justice system

The California Endowment issued a report today highlighting the results of a four year initiative created to strengthen the capacity of county juvenile justice systems to provide mental health and other needed services for youth while in custody and in the community. Promising Practices from the Healthy Returns Initiative: Building Connections to Health, Mental Health, and Family Support Services in Juvenile Justice outlines collaborative strategies implemented by probation departments in Humboldt, Los Angeles, Santa Cruz, Santa Clara, and Ventura counties that improved outcomes for youth and their families.

"The Healthy Returns Initiative brought together governmental agencies, community partners, and private providers to develop sustainable practices that address the myriad of issues these youth often face - substance use, lack of comprehensive physical and dental health care, untreated mental health problems, limited educational and employment opportunities, and family stress," explained Laura Garnette, Santa Cruz County probation director.

The Healthy Returns Initiative was developed by The California Endowment to address the alarming trend of youth with unaddressed mental and physical health issues entering and languishing in California's juvenile justice system. Approximately 50 percent of youth detained at the county-level in California have a suspected or diagnosed mental illness and 75 percent have a substance abuse disorder.  

At the same time, county-level juvenile justice programs face numerous challenges in effectively providing services and treatment. State and local budget cuts have severely reduced counties' ability to meet the needs of probation youth in detention and in the community. Almost two thirds of probation departments report insufficient staff to handle the number and severity of mental health issues in their systems. They are hindered by a lack of appropriate placement options for youth with severe mental illness and have limited access to community-based services for youth with less severe mental health and substance abuse disorders. Due to lack of funding, 30 of 45 counties report the lack of an appropriate selection of services in terms of type, quality, or capacity available for mental health issues. These inadequacies contribute to longer and more costly stays in detention facilities and the ineffective use of probation resources.

"The results of this initiative show that there are some simple, common sense practices that can be implemented to ensure that youth with mental health and other critical issues are identified and receive appropriate services," said Barbara Raymond, program director with The California Endowment. "In this time of diminished resources, it is critical that county agencies and community-based providers work together to develop and implement smarter, collaborative, and more responsive models of care."

By implementing the promising practices highlighted in the newly released report, the Healthy Returns Initiative accomplished a range of positive outcomes for youth and their families. Counties were able to more systematically identify youth with health, mental health, and other critical needs and better manage those conditions by connecting them to appropriate care and resources in the community. In addition, counties reported reductions of self-harm behaviors and other incident reports inside juvenile hall and fewer days in custody for participating youth, which ultimately resulted in probation cost savings.

"Increasingly, youth with mental health problems are ending up in juvenile halls because no one else wants to deal with them," said David Steinhart, director of the Commonweal's Juvenile Justice Program and chair of the Healthy Returns Initiative policy group. "Without appropriate mental health care, they run the risk of filling up our jails and prisons at enormous public cost."

The counties participating in the Healthy Returns Initiative worked to strengthen their juvenile justice programs through a variety of strategies, including using a validated tool to screen youth for mental health and substance abuse issues; enhancing access to mental health treatment, health care services, and evidenced-based programs; working in multidisciplinary teams to share information and better coordinate services; connecting youth and families to needed resources, such as health coverage, income assistance, and housing; educating and training staff on best practices for addressing and working with youth with mental health needs; and ensuring continuity of care for youth and their families during their transition back to the community.

The California Endowment will be sharing the promising practices from the Healthy Returns Initiative at Beyond the Bench, an annual, multidisciplinary conference sponsored by the Administrative Office of the Courts, Center for Families, Children & the Courts. The conference, which will be held June 3-4 in San Diego, brings together juvenile dependency and delinquency professionals from across California to learn about the latest research and best practices with regard to improving juvenile justice and child abuse and neglect proceedings.