A QI Initiative to Improve Mental Health Outcomes of Juvenile Offenders in Utah

Problem: The juvenile justice system was established to increase the rehabilitative potential of the court system and prepare youth offenders for re-entry into the community. Legislative changes in recent decades have resulted in increasing numbers of youth being committed to adult prisons. A review of existing literature revealed the estimated percentage of youth offenders with a diagnosable mental health disorder ranged from 50 to 75 percent. Youth housed in adult correctional facilities have limited access to age appropriate programming and treatment services resulting in poorer mental health outcomes. Previous work has failed to collect mental health data of youth offenders at the state level. The purpose of this study was to develop housing and treatment recommendations that would result in improved mental health outcomes for youth offenders in the state of Utah by comparing mental health data of youth offenders housed in a secure care facility with existing national data of youth housed within adult correctional facilities. Methods: A retrospective chart review was completed to gather data related to past psychiatric history, mental health and/or substance use diagnoses, and psychotropic medication use. The number of hours of mental health services provided to youth within the facility were logged for one month. All findings were quantified and visually presented to mental health providers in the facility. A literature review was conducted to evaluate the existing national data regarding the impact of incarceration in adult facilities on juveniles' mental health outcomes. Results: Over a selected five-year period, 145 youth offenders were housed within a secure care facility in the state of Utah, with the most common diagnoses (excluding behavioral disorders and substance use disorder) being sleep disorder, generalized anxiety disorder, and major depressive disorder. It was found that of all the youth, 37% were prescribed an antidepressant and 33% a sleep aid while detained. Conclusion: In order to generate housing and treatment recommendations for youth offenders in the state of Utah, additional research is required. The results of this study were limited due to the current documentation system in place. These limitations helped identify areas within the current documentation system that suggests implementing an electronic medical record (EMR) would improve the quality of care currently being provided. Additionally, implementation of an EMR would provide a more efficient and accurate system to gather and analyze data providing a more comprehensive evaluation of youth within the Utah juvenile justice system in the future.