Health Care for Youth in the Juvenile Justice System

Youth in the juvenile correctional system are a high-risk population who, in many cases, have unmet physical, developmental, and mental health needs. Multiple studies have found that some of these health issues occur at higher rates than in the general adolescent population. Although some youth in the juvenile justice system have interfacedwith health care providers in their community on a regular basis, others have had inconsistent or nonexistent care. The health needs of these youth are commonly identified when they are admitted to a juvenile custodial facility. Pediatricians and other health care providers play an important role in the care of these youth, and continuity between the community and the correctional facility is crucial. This policy statement provides an overview of the health needs of youth in the juvenile correctional system, including existing resources and standards for care, financing of health care within correctional facilities, and evidence-based interventions. Recommendations are provided for the provision of health care services to youth in the juvenile correctional system as well as specific areas for advocacy efforts. Pediatrics 2011; 128:1219–1235 INTRODUCTION Youth in the juvenile correctional system are a high-risk population1–3 who, in many cases, have unmet physical, developmental, and mental health needs. Multiple studies have found that some of these health issues occur at higher rates than in the general adolescent population.3,4–6 Although some youth in the juvenile justice system have interfacedwith health care providers in their community on a regular basis, others have had inconsistent or nonexistent care. The health needs of these youth are commonly identified when they are admitted to a juvenile custodial facility. On-site correctional health care providers must not only try to identify these health issues but also determine if there has been active medical management in the community. Pediatricians and other health care providers play an important role in the care of these youth, and continuity between the community and the correctional facility is crucial. EPIDEMIOLOGY OF JUVENILE ARRESTS In 2008, 11 million juveniles younger than 18 years were arrested.7 Two-thirds of those arrested were referred to juvenile court, and 10% were referred to the adult criminal court system. One-third of all juveniles arrested were female. Gender differences exist in patterns of arrest-related charges such that adolescent girls are more likely to have runaway and prostitution/vice offenses, whereas boys have a COMMITTEE ON ADOLESCENCE