Use of Psychiatric Medications in Juvenile Detention Facilities and the Impact of State Placement Policy

The use of psychotropic medications is a significant factor in the overall effort to respond to detained youth with mental illness, yet there are very few studies of psychotropic medication use in juvenile detention settings. It is important to understand the factors that influence the use of mental health services and psychoactive medications in these settings since youth with emotional problems are overrepresented in them. This paper addresses the proportion of youth in these settings who receive mental health services and psychoactive medications. In addition, the impact of a major statewide policy change—the shift of juvenile placement responsibility from the state to local government—on these proportions was examined using 8 years of publicly available data from county probation departments. Multivariate regression analyses of 1,760 observations of quarterly reports from 55 counties showed that the use of both mental health services and psychoactive medications in detention facilities increased concurrently with the policy change. While these proportions had already been gradually increasing in these facilities, it appears that after the policy change they increased even more. This contradicts the aim of most juvenile justice planners—to divert non-violent youth offenders with emotional problems away from incarceration settings and towards community based treatment alternatives. If adequately available, these support services could provide diversion alternatives to prevent inappropriate detentions, and to provide post-detention treatment to prevent lapses in continuity of care and, ultimately, to prevent reoffending.