Over the last decade, the percentage of youth in jail and detention has risen thirty-seven percent. At the same time, youth with a mental illness or a serious emotional disturbance are over-represented in the juvenile justice system. In the non-incarcerated youth population, only twenty percent of youth have a mental health problem, with nine to thirteen percent experiencing a serious emotional disturbance. However, between fifty to seventy-five percent of youth in the justice system have a diagnosable mental health disorder, and a startling twenty percent suffer from a serious emotional disturbance like manic depression or schizophrenia. In jail or detention, these youth are exposed to inconsistent psychiatric services, abuse by jail staff, and improper administration of medication. Such conditions may worsen young people’s problems and impair their reintegration into their communities.

Staff in the Court Employment Project (CEP) have also noted a rise in the number of youth who are on psychiatric medications or present with signs of severe mental illnesses. In order to better understand the prevalence of mental health problems within CEP, we analyzed participants’ scores on the Massachusetts Youth Screening Instrument II (MAYSI-2), which assesses psychological distress among youth in the justice system along seven subscales. The MAYSI-2 provides a caution score to alert staff to a clinically significant mental health problem, and a warning, which indicates the potential for a more serious mental health problem. Our analysis of MAYSI-2 scores showed us 69% scored a caution or warning in at least one subscale, 44% scored at least two cautions or warnings, and 30% scored at least three cautions or warnings. In addition, 23% showed co-morbid substance abuse and mental health problems, many of whom told us that they used drugs and alcohol to medicate severe symptoms of primary mental health problems. Not surprisingly, the more cautions or warnings a participant scores, the less likely he/she is to graduate CEP.

Although many of our young people are in need of community-based mental health treatment services, the adolescent mental health treatment system is difficult to access and navigate without clinical expertise in assessing mental health problems among youth, strong advocacy skills, and a thorough knowledge of the adolescent mental health system. Without access to mental health treatment in their communities, youth with mental health problems are in jeopardy of continued, untreated illness, which may make it impossible for them to fulfill court sanctions or lead to their further criminal activity.

Art Therapy:

Art Therapy is the specialized, professional and psycho-therapuetic use of art media, the creative process and client's responses to art productions. Art productions and process are seen as reflections of an individual's development, abilities, personality, interests, concerns and conflicts. Art Therapy is based on a knowledge of human development, psychotherapy, and theories which are implemented in assessment and treatment. It is used as a primary mode of therapy or as an adjunctive therapy with other health care professionals. Art Therapy is used for identifying and reconciling emotional conflicts, fostering self-awareness, developing social skills, managing behavior, problem solving, reducing anxiety, aiding reality orientation, and increasing self-esteem. CASES has begun using Art Therapy for youth enrolled in the SED Youth program. Adolescents already have a strong creative drive and they may use artmaking to express and experiment with the central developmental process of identity formation. Artmaking can also be an empowering structure that promotes collaboration and decreases power struggles and resistance to therapy.