Behind Bars, Behind Healing: Why Mental Health Must Be The Center Of Juvenile Justice Reform. Putting The Pieces Together.

Dec 2

**Author:** Felice Upton | Connect on LinkedIn
*Published December 2, 2025*

We like to pretend that juvenile incarceration is where the story begins, as if a young person's first day in detention is the true start of their "justice involvement." But anyone who has spent time inside these systems knows the truth: by the time a young person is detained, the story has already been unfolding for years. We—and by we I mean community as a whole—missed all the warnings.

This piece is not about blame. I want to state that definitively. I do not like calling out issues without solutions, that keeps us stuck, which does not best serve young people.

It shows up in missed diagnoses. In untreated learning disabilities. In trauma no one had time to understand. In families begging for help. In schools overwhelmed and under-resourced. In the silence we maintain around youth mental health until the young person becomes justice involved.

And inside our facilities, we see the consequences of that silence every day.

For more than twenty years, I have worked in youth justice and adult corrections. I've run facilities, overseen investigations, mentored staff, and sat with youth on some of the worst days of their lives. I have begged, literally begged, on more than one Friday night for mental health placements for young people who clearly needed clinical care, not confinement, that would not be accepted. Young people who quite literally could not fit into any environment to be helped. As a community we have to figure this out.

I have watched kids cycle in and out of systems not because they were "dangerous," but because the school, community, and clinical interventions they needed upstream were never available, accessible, or taken seriously. Or sometimes, yes, because they were exhibiting behaviors that were a danger to themselves or others, but rather than being met with proactive solutions, they are met reactively.

If we're going to talk about justice, safety, and reform in this country, then we need to talk honestly about where these systems fail long before a child ever meets anyone who works in the criminal justice system.

The mental health crisis inside juvenile justice...spoiler... it's not new

Nationally, research consistently shows that 60-70% of young people in juvenile detention meet criteria for a diagnosable mental health disorder.1 PTSD, depression, anxiety, ADHD, conduct disorder, substance use disorders, the list is long, and for many, diagnoses overlap. More than 60% of youth meet criteria for three or more diagnoses. I do not have the answer to the number but when we add TBI I think these numbers would be much higher... they have been much higher in systems I have worked in.

But these are not mild clinical presentations. These aren't "small" or "simple" diagnoses. I spent several years in my last position advocating for more clinicians, more clinical support and a medical model rather than a carceral model. I had moved upstream from adult women's incarceration with the hope that intervention earlier in life might stop the pathway...which offered me clarity, having listened to the experts on their own journey on what could or should have been done differently for them.

These are youth with complex trauma histories, chronic behavior dysregulation, family instability, grief, loss, and multi-system involvement. They carry burdens far heavier than most adults realize and can metabolize or comprehend.

And carceral environments often make those symptoms worse.

Research continues to show that incarceration in adolescence increases the likelihood of:

Adult depression
Suicidality
Long-term trauma symptoms
Interrupted psychosocial development
Poorer educational and employment outcomes3

The question is not whether incarceration harms developing brains. The question is why we keep ignoring that it does and why we are not trying to create new systems that would/could better serve them.

The intersection we need to speak more about

When we talk about the school-to-prison pipeline, the conversation often stays at the level of slogans or hashtags. But inside facilities, the reality is stark:

On average, one in three justice-involved youth qualify for special education—over twice the rate observed in the general population. Studies show that up to 85% of youth in juvenile detention facilities have disabilities that make them eligible for special education services, yet only 37% received these services while in school. (National average)

Why and how does this exist? How do we all work together to do better? Again, this is about those we serve, not being defensive or blaming.

I have worked with youth who:

Were expelled instead of evaluated
Were suspended instead of assessed
Received "behavior plans" instead of trauma screening
Were told they were "defiant" instead of dysregulated
Were pushed out of school buildings because their needs exceeded the bandwidth of the adults around them
Had they been from districts with good risk assessment/threat assessment, might not have become system involved

We act surprised when these young people end up in our systems, but we shouldn't be. When special education supports are inconsistent, under-resourced, or weaponized as punishment instead of support, the consequences ripple for years.

Students with disabilities comprise less than 12% of high school students nationwide, but represent 75% of students restrained, 58% of students who are secluded, and more than 13% of students subject to out-of-school suspension.

We talk about the school-to-prison pipeline as if it's an inevitable funnel. It is not inevitable. It is constructed.

And the moment a child is failed by education, mental health, or family support systems, the funnel narrows.

When we work in silos, we create unintended consequences

Here's what I've learned over two decades in this work: Every system that touches a young person's life believes it's doing its best. And most of the time, I believe that's true.

Teachers are overwhelmed. School psychologists carry impossible caseloads. Mental health providers have months-long waitlists. Juvenile probation officers manage too many youth with too few resources. Police officers become de facto crisis responders because no one else is available.

No single system created this problem.

But when education operates over here, mental health over there, and justice somewhere in the middle, when we don't talk to each other, don't share data, don't coordinate care—we create unintended consequences that fall directly on young people and they suffer.

When an IEP evaluation is delayed, we miss opportunities for stability. When a family can't access therapy, behaviors escalate. When schools lack clinical staff, discipline replaces support. When community providers are scarce, police become the default responders. When one system closes a door, another system opens a cell.

This is not about blame. This is about recognizing that our well-intentioned decisions in one system can inadvertently push a young person deeper into another. And kids...especially Black, brown, disabled, and neurodivergent kids, feel those consequences first and hardest.

Race, gender, and the compounding effect

We cannot talk about mental health in juvenile justice without naming the intersection of race and disability.

Youth of color disproportionately:

Have unmet mental health needs
Are suspended and expelled more often
Are less likely to receive timely evaluations for IEPs
Are more likely to be misunderstood as "willful" instead of "struggling"
Are referred to law enforcement for behaviors white youth receive support for

This is not an accident. It's structural. It's historical. It's baked into how we interpret behavior, how we respond to kids who are different, and who we deem "deserving" of help.

Girls and gender-expansive youth face their own compounded challenges. Research shows that girls are at significantly higher risk (80%) than boys (67%) for mental health disorders, with girls manifesting higher rates of internalizing disorders.

Among justice-involved girls, rates of PTSD are particularly elevated, often stemming from histories of sexual abuse and complex trauma that preceded their system involvement.8

Much about the system is retraumatizing from design to interventions to noise.

Until we address these disparities directly, we cannot claim to be talking about justice at all.

Upstream scarcity is a downstream crisis

It is impossible to overstate the impact of the mental health provider shortage in this country.

When community clinicians are full, families wait months for services. When schools lack social workers and school psychologists, kids with trauma go unnoticed. When families can't get help at age seven or nine or twelve, they show up in detention halls at fifteen.

And then we act like the justice system is the first point of failure.

It's not. It's the final one. And while the juvenile justice system is the deep end for young people, if there is no pattern disruption, it will be the shallow end—i.e., entry point—to the adult system.

Every youth professional knows the reality: if we don't intervene early, we will intervene later... and later is always more expensive, more traumatic, and harder to undo.

It is possible to change

Last year, I designed a program for a 16-bed juvenile facility built intentionally to operate like a locked mental health treatment center, not a youth prison.

It was rooted in a white paper my former clinical mental health team developed—a blueprint for a facility and multiple units grounded in:

Trauma-responsive therapeutic practices
Multidisciplinary clinical staffing
Structured family engagement
Restorative accountability
High-quality education
Individualized treatment plans
Safety protocols modeled after psychiatric care rather than corrections

The young people who would/will potentially be served by that program were not "behavior kids." They were youth with severe trauma, significant mental health needs, complex diagnoses, and nowhere else to go.

Programs like that should not be exceptions. They should be the standard and we must design them everywhere.

Because when you design for healing, healing becomes possible. When you design for control, harm becomes predictable.

The questions we need to be asking together

How many youth in custody have IEPs, and how many should have had one years earlier?
How many behaviors labeled "defiance" are actually trauma responses or learning disabilities? What can we do differently for them? How might we be inadvertently exacerbating those issues?
What supports were unavailable upstream that led to a justice referral downstream?
How do race, disability, and poverty shape who receives help vs. who receives consequences?
Why are families often forced to seek police involvement to access clinical care?
What would it take to create secure therapeutic settings instead of relying on detention for mental health crises?
What does a system look like that keeps kids especially Black, brown, disabled, and neurodivergent kids in classrooms and communities instead of cells?

We need to build bridges, not build blame. Maybe these questions start to get us there... what else should we be asking? I'd love to hear from people across disciplines what we can do.

Why this conversation needs to occur

I understand what works, what doesn't, and critically, what unintended harm we can cause when we don't coordinate our efforts. I would love to have multidisciplinary conversations about how we can stop this cycle.

This moment calls for:

Cross-system collaboration, not finger-pointing
Shared accountability, not blame
Humility about what we don't know
Courage to invest upstream before crisis becomes the only intervention point
Willingness to design systems that catch kids early instead of responding late

If you're leading a system, designing policy, allocating resources, or making decisions about how we serve youth with complex needs, I'd love to help.

We owe young people more

Kids do not become well in places designed for punishment. They become well in places designed for healing.

We have the research. We have the stories. We have the evidence. We have the lived experience.

What we need now is courage.

Courage to invest upstream. Courage to name inequity. Courage to build mental health infrastructure. Courage to design systems that see youth for who they are, not who they were in their worst moment.

I've been part of this work my entire adult life. I've seen what's possible. I've seen what's broken. And I've seen what happens when a community decides to change the story.

I want to be part of that change. Not someday...now.

Because every young person deserves a chance to heal. And justice without healing is not justice at all.

Felice Upton is a transformational systems leader and consultant specializing in justice system reform, juvenile rehabilitation, and organizational transformation. She offers keynote speaking, organizational reviews, executive coaching, strategic facilitation, and program design services through Just Us by Felice Upton Consulting LLC.

Connect with Felice to discuss how collaborative, trauma-informed approaches can transform your systems.

Learn more

Research & Data:

Gender-Responsive Approaches:

School-to-Prison Pipeline & Special Education:

Felice Davis