Study Urges Reform in Mental Health Screening for Incarcerated Youth
Findings suggest that the most used mental health screening tools within the juvenile justice system may not be as reliable for everyone as once believed.
Approximately 70% of incarcerated youth in the United States have a mental disorder. The challenges in this population are profound – about 30% report suicidal thoughts, 12% have attempted suicide and 25% experience solitary confinement, a condition strongly associated with increased suicide risk. Depression is also widespread, affecting 10% to 25% of youth with moderate to severe symptoms.
Comprehensive mental health screenings play a vital role in identifying who requires immediate care, as well as those at risk for developing more serious issues. Without timely identification and intervention, these conditions can escalate, leading to long-term psychological harm, impaired functioning and an increased risk of suicide. As such, national guidelines recommend mental health screenings as standard practice within the juvenile justice system.
Several screening tools are used to assess depression and suicide risk in incarcerated youth. Some focus only on suicide, others on depression, and some cover both (like the APS-SF and MAYSI-2). The MAYSI-2 or Massachusetts Youth Screening Instrument – Second Version, is a short questionnaire commonly used in juvenile facilities to quickly check for signs of mental health issues and helps staff identify youth who may need further evaluation or immediate support.
While these tools generally show reliable and valid results, there’s limited research on how well they work specifically for incarcerated youth who are adjudicated delinquent, especially across different ethnic groups.
Researchers from Ƶ Atlantic University, and collaborators, examined the effectiveness of these commonly used screening tools in detecting depression and suicidality among incarcerated youth. They evaluated whether these tools accurately measure the intended mental health constructs by examining how scores related to depression and suicide risk align – focusing on both convergent and divergent validity – and whether these results remain consistent across different demographic groups. The goal is to help practitioners choose the most reliable and balanced tools for assessing mental health needs within the juvenile justice system.
Results of the study, published in the journal , reveal troubling gaps in the accuracy and fairness of mental health screenings used with incarcerated youth who have been adjudicated delinquent. With a significant number of them entering correctional facilities and already facing serious mental health challenges, including high rates of depression and suicide risk, proper identification and timely intervention are critical. However, research findings suggest that the most used screening tools may not be as reliable for everyone as once believed.
The study also found that the strength of these measurements varied depending on the youth’s demographic background. Specifically, African American youth showed significantly lower validity scores on both depression and suicidality measures compared to white youth. For African American participants, the scores were nearly 0.1 lower for depression and almost 0.2 lower for suicidality. These differences raise concerns about whether current tools fairly assess youth from different backgrounds and if they unintentionally cause problems for these individuals during important decisions about their safety and care.
“Our study highlights a critical issue in our juvenile justice system,” said Joseph Calvin Gagnon, Ph.D., senior author and chair and professor, Department of Special Education within FAU’s College of Education. “The core philosophy of juvenile corrections is that youth can and should be rehabilitated – and that promise begins with proper mental health screening at intake. We rely on these tools to guide decisions that affect a young person’s safety, treatment and future. But our findings show that these screenings may not work similarly for all youth, particularly across different backgrounds. If we’re serious about justice and rehabilitation, we need to ensure that our assessments are not only accurate, but also fair. Anything less risks failing the very youth the system is meant to help.”
Despite the widespread use of tools like the MAYSI-2, the study highlights that relying solely on these measures may not be sufficient, and that there is urgent need for improved mental health assessments that are both psychometrically sound and culturally responsive. Moreover, there is a critical need to include additional information when screening incarcerated youth, including observation and clinical interviews with the child and caregiver informants. The researchers also identify the need for future studies using larger samples of adjudicated youth to better understand how these tools function and how they might be improved to identify more accurately those at risk.
“Without valid and fair screening practices, many youth may continue to go unrecognized and untreated, placing their mental health and lives at further risk,” said Gagnon. “Meaningful reform in mental health screening practices is essential to protect and support vulnerable youth in the juvenile justice system.”
Study co-authors are Jia Quan, Ph.D., the University of Kansas; Matthew L. Daley, Ph.D., the University of Ƶ; Corinne Huggins-Manley, Ph.D., the University of Ƶ; David E. Houchins, Ph.D., Georgia State University; Holly B. Lane, Ph.D., the University of Ƶ; Erica D. McCray, Ph.D., the University of Ƶ; and Richard G. Lambert, Ph.D., The University of North Carolina-Charlotte.
This study was supported by the Institute of Education Sciences (IES).
-FAU-
Tags: faculty and staff | education | research