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Access in Brief: Health Care Needs and Use of Services by Adolescents Involved with the Juvenile Justice System

Medicaid and the juvenile justice system share responsibility for providing health care to justice-involved youth. With few exceptions, Medicaid is the payer of health care services for eligible and enrolled individuals living in the community, while correctional institutions, including juvenile detention facilities and local jails, must pay for health care costs while youth are confined to these facilities. Many youth served in the juvenile justice system have significant health care needs. However, fewer than half of juvenile detention facilities provide mental health evaluations to all youth.

This issue brief uses five years (2015 – 2019) of data from the National Survey on Drug Use and Health (NSDUH) to analyze the experience of children age 12–17 who reported that they stayed overnight in jail or juvenile detention in the past 12 months. Specifically, our analysis examines selected demographic and health characteristics, and prevalence and treatment rates for behavioral health conditions among these children, comparing the experience of youth covered by Medicaid or the State Children’s Health Insurance Program (CHIP) to those with other forms of coverage. Where sample size permits, we also report estimates by race, ethnicity, and sex.

Medicaid and CHIP cover 60.4 percent of children or youth who had stayed overnight in jail or juvenile detention. Among the findings:

  • Roughly 21.7 percent of youth who stayed in jail or juvenile detention reported experiencing a major depressive episode (MDE) at some point in their lifetime, and approximately 16.4 percent reported experiencing one in the past year.
  • Among Medicaid beneficiaries who stayed in jail or juvenile detention, females were nearly three times as likely to experience a MDE in the past year compared to their male peers. They also reported receipt of specialty mental health treatment at higher rates.
  • Few Medicaid beneficiaries report receipt of mental health treatment while in jail or juvenile detention.
  •  Roughly one-in-five beneficiaries who stayed in jail or juvenile detention had a substance use disorder in the past 12 months. However, only 16.9 percent received treatment in the past year.