Mental health is a key component in a child’s healthy development. Children need to be emotionally and psychologically healthy in order to learn, grow and lead productive lives. There are effective treatments, services, and supports that can help children and youth with mental health or behavioral issues and those at risk for these challenges to live successfully and THRIVE.
Where Kids Thrive, Inc’s purpose is to address New Jersey’s severe lack of mental health resources, particularly for children, adolescents and their families. The primary platform through which these services will be delivered will be through our IIC (Intensive-In-Community) program.
In 1998, The United States Center for Disease Control conducted the largest study of
itʼs kind ever to show how exposure to trauma, which they called ACE (an acronym for
Adverse Childhood Experience), was the root cause of many common diseases that
prematurely claim the lives of millions of Americans each year. What they proved was
that millions of Americans experience one or more ACEs during childhood. As a result
of these experiences, many went on to develop social and emotional impairments. As a
result of these impairments, some engaged in health risk behaviors (such as street drug
use, drinking, smoking, etc) in an attempt to cope with the ensuing loneliness and
emotional pain. In some cases, these health risk behaviors eventually led to disease
and disability and, as a result in some cases, they even led to premature death (see Figure 1).
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Children and youth who are exposed to traumatic events have a higher probability of developing mental health conditions. Children and youth involved in child welfare or the juvenile justice system are at particular risk of having experienced traumatic events. However, with appropriate care, these children and youth demonstrate:
- Reduced behavioral and emotional problems
- Increased behavioral and emotional skills
- Reduced trauma symptoms
- Reduced substance use problems
- Improved functioning in school and in the community
- Improved ability to build relationships
When services are uniquely tailored to help these children and youth, the savings in terms of cost and suffering are substantial. The cost of one case of abuse or neglect is estimated at more than $210,000 over a lifetime. (Fang, Brown, Florence & Mercy, 2012) The cost of incarcerating a juvenile is estimated at over $94,000 per year. (American Correctional Association, 2011) It is harder to place a value on the lost potential of these youth and the suffering of children and their families when they cannot heal from their painful experiences.
Creating environments in families that build protective factors and promote resilience is critical in mitigating the effects of adversity. Perhaps the most significant protective factor for children and adolescents who have experienced trauma is a healthy relationship with at least one caring adult. “Children’s resilience to trauma is linked to the presence of a healthy parent or adult in their lives” (Margolin and Gordis 1998). This is why a trauma-informed approach to working with parents/caregivers is so vital to both healing and prevention.
COORDINATING SYSTEMS OF CARE TO SUPPORT YOUTH WITH MENTAL HEALTH NEEDS
Research has demonstrated that as many as one in five children/youth have a diagnosable mental health disorder (New Freedom Commission on Mental Health, 2003) and that as many as three million young people may have a serious emotional disturbance that severely disrupts life at home, school, and in the community (American Academy of Child and Adolescent Psychiatry, 2010). The prevalence of mental health needs varies by socio-economic status and by involvement with some formal child-serving systems. Research has found that youth from low-income households are at increased risk for mental health problems (Howell, 2004) and that a greater proportion of children and youth in the child welfare (50%) and juvenile justice (67-70%) systems have mental health problems than children and youth in the general population (Burns et al., 2004; Skowyra & Cocozza, 2006). Typically, these mental health issues arise in childhood or early adolescence and, even when treated, continue to impact young people’s lives as they make the transition into adulthood.
Studies have also shown that the majority of young people in need of mental health services (75-80%) do not receive them (Kataoka, Zhang, & Wells, 2002). This can be particularly true for transition age youth as they become too old to be served by the children’s system and must instead seek services from adult services providers. Mental health and substance abuse needs can greatly impact outcomes for young people throughout their childhood and into adolescence and adulthood. Having mental health issues can
- negatively affect academic achievement and commitment to education,
- increase the likelihood for justice system involvement,
- decrease the likelihood of stability and permanency for youth in or exiting the child welfare system,
- dampen prospects for obtaining and maintaining meaningful and gainful employment, and
- hinder the development of healthy adult relationships (Masi & Cooper, 2006).
Unfortunately, one of the most commonly overlooked contributing factors to the difficulties children and teens experience is exposure to traumatic events.
Youth involved in the Child Welfare System
3.4 million referrals alleging child maltreatment were made in 2012 (with each referral averaging 1.83 children) – this equals 6.3 million children who were allegedly exposed to abuse or neglect.
In general, youth involved in the child welfare system, like their peers in the juvenile justice system, are
- disproportionately minority;
- live at or below the poverty line;
- have strained, limited, or no family connections;
- usually have mental health needs; and
- have negative educational experiences and outcomes.
A 2008-2009 US Dept. of Health and Human Services survey that sampled children and families in the child welfare system found that many did not receive needed services. For example, an estimated 58% of children aged 10 and under at risk of emotional, behavioral or substance abuse problems had not received related services in the past year. These service gaps harm child well-being and make it more difficult to preserve or reunite families. Some of the contributing factors to these service gaps were listed as provider shortages, long waiting lists and lack of transportation.
In a single year, an estimated 2.1 million youth (under the age of 18) are arrested in the US. Of those youth involved in the juvenile justice system, 65-70% have a diagnosable mental health condition and 30% of those experience SEVERE mental health challenges. (Skowyra & Cocozza, 2007).
Many youth who come into contact with the juvenile justice system have experienced academic failure, disengagement from school, and/or school disciplinary problems. Academic outcomes for these youth are generally less positive than those of youth who do not come into contact with the system.
- Nearly half of all students who enter residential juvenile justice facilities have an academic achievement level that is below the grade equivalent for their age. (Sedlack & McPherson, 2010)
- Youth in the juvenile justice system are identified as eligible for special education services at three to seven times the rate of youth outside the system. (Leone & Weinberg, 2010)
- Many incarcerated youth are marginally literate or illiterate and have already experienced school failure. (Leone, Meisal & Drakeford, 2002)
- Many youth who are incarcerated have a history of truancy and grade retention. A study of more than 400 incarcerated ninth-graders found that, in the year prior to incarceration, these students had attended school barely half the time and were failing most of their courses. (Balfanz, Spiridakis, Neild & Legters, 2003)
- When a student is suspended or expelled, there is a significant increase in his or her likelihood of being involved in the juvenile justice system the subsequent year. (Fabelo et al., 2011)
Mental Health & Substance Abuse
Youth involved with the juvenile justice system often have mental health and/or substance abuse problems. These typically affect their academic performance, behavior, and relationships with peers and adults.
- A large number of youth in the juvenile justice system have a history of trauma, emotional, and behavioral problems. (Federal advisory Committee on Juvenile Justice, 2006; Felittit et al., 1998; and Quinn, Rutherford & Leone, 2001).
- Youth in contact with the juvenile justice system experience higher prevalence rates across various types of mental health disorders. Disruptive disorders, such as conduct disorders and substance use disorders, are most common (46.5 percent); followed by anxiety disorders (34.4 percent); and mood disorders (18.3 percent), such as depression. (Shufelt & Cocozza, 2006)
- Most youth in the system meet the criteria for or are diagnosed with more than one mental health disorder. (Shufelt & Cocozza, 2006)
- A majority of court-involved adolescents have recently used illegal substances. The more serious and chronic adolescent offenders have been found to use more substances and are more likely to qualify for a diagnosis of a substance use disorder. (Mulvey, Shubert & Chassin, 2010)
- While juvenile arrests for most offenses declined between 1994 and 2003, the rate of arrests for drug abuse violations increased. The increase was far greater among females than males. (Young, Dembo & Henderson, 2007)
- Higher levels of substance use increase the rate of offending, the severity of the committed offense, and the duration of antisocial behavior. (Young, Dembo & Henderson, 2007)