Youth involved with the juvenile justice system die by suicide at a rate two to three times higher than youth in the general population. The risk for suicide is greatest overall for young people on probation, which is the segment of the justice system that allows youth to remain in their community (versus being in residential facilities, such as correctional institutions) while under justice supervision. Although screening for suicide risk and provision of behavioral health services is standard for youth in locked facilities, there is a lack of behavioral health screening and related services for youth on probation.
Despite the fact that eight times as many youths are under community supervision than in detention facilities, and validated tools to identify suicide behavior in these youth, many states lack standard procedures for identifying suicide risk for this subset of youth and when treatment needs are identified, few youth actually make it to treatment. Recent data from 32 counties in six states indicate that among probation youth identified with behavioral health needs, only one in five receive service referrals and fewer than one in 10 get treatment.
Katherine Elkington, PhD, Director of the Center for Behavioral Health and Youth Justice at Columbia University, is working to develop interventions to increase access to behavioral health services for young people on probation by building connections between the justice system and community-based systems of care. Dr. Elkington recently received an award of $5.5M from the National Institute of Mental Health to support the expansion of her and longtime mentor Dr. Wasserman’s research, and the implementation of e-Connect—a digital clinical decision-support system to help identify and reduce risk for suicide among youth by linking at-risk young people to appropriate care.
Young people within the juvenile justice system are at greater risk for suicidal behavior than other youth because of increased prevalence of mood and substance use disorders, adverse childhood experiences, trauma and PTSD, and access to firearms. These factors, combined with a higher number of suicide deaths in youth involved in the justice system and greater rates of attempts, suggest that identifying and addressing suicidal behavior and related behavioral health problems is an important priority for both juvenile justice and public health sectors.
e-Connect employs digital decision support technology to assist probation officers in identifying suicide behavior and behavioral health risk, referring youth to appropriate services, and achieving cross-system linkage to community-based behavioral health system. To put it succinctly, e-Connect identifies youth in one system (juvenile justice) and gets them to treatment in another system (community-based behavioral health). To do this, it employs a systematic approach to develop local referral decisions (pathways) in partnership with local probation and behavioral health system leadership. The pathways reflect different levels of severity of suicide risk within three clinical need classifications (crisis/imminent risk; crisis/non-imminent risk; non-crisis). Based on their level of clinical/suicide risk, youth are directed to appropriate care, within pre-determined specific time frames. This means that limited behavioral health resources are deployed appropriately to help the youth who need them the most.
Population of Focus: Youth in Juvenile Justice System
Links to Resources:
- Learn more about e-Connect
- Learn about the creation of e-Connect
- Read the article, E-Connect: Linking Probation Youth at Risk for Suicide to Behavioral Health Services
- Read the article, Characteristics and Precipitating Circumstances of Suicide Among Incarcerated Youth
- Read the article, Statewide Trends of Trauma History, Suicidality, and Mental Health among Youth Entering the Juvenile Justice System
Date: 2023