Psychiatric and medical health care policies in juvenile detention facilities

Kathleen A. Pajer*, Kelly Kelleher, Ravindra A. Gupta, Jennifer Rolls, William Gardner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


OBJECTIVES: Many adolescents admitted to detention facilities have serious mental and physical health problems. Little is known about policies for the delivery of mental and physical health care in these settings. Our objective was to describe current health care policies in U.S. detention facilities. METHOD: Telephone interviews were requested from 83 juvenile detention facility administrators across the United States. RESULTS: The response rate was 97.6%. Data were collected over 12 months, from 2003-2004. Policies for admission health screening existed in 99% of facilities; 90% included mental health screening. Most sites had policies about psychopharmacotherapy and 92% had crisis services. Continuation of existing psychotropic medication treatment was provided at 96% of facilities. Seventy-three percent of facilities used physicians to manage medications in-house; in 61% of the centers, these physicians were psychiatrists. Medication administration policies most often specified nurses, but 16% of facilities used guards. Provisions for discharge psychotropic medication existed at 84% of sites, but there was wide variation in dispensing policies. CONCLUSIONS: Detention health care policies for adolescents have significant gaps, particularly for mental health care. Future research should include an epidemiological study of detained youths, evaluating their health needs and the actual care received. Copyright 2007

Original languageEnglish (US)
Pages (from-to)1660-1667
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number12
StatePublished - Dec 2007


  • Health care policy
  • Juvenile detention
  • Mental health care policy

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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