Supporting Crisis Stabilization for Youth and Young Adults during Reentry

Research points to an overrepresentation of youth with behavioral health needs in the justice system, with nearly 70 percent having a diagnosable mental health disorder.¹ Because of this, youth and young adults who have had contact with the justice system, have been diverted from the justice system, or are reentering the community from correctional facilities are often at an increased risk of experiencing a crisis.² In addition to their increased risk for crisis, this population also has unique and specific crisis stabilization needs when compared to those of adults due to pre-existing and untreated trauma, witnessing violence or being victimized during incarceration, or lack of developmentally appropriate treatment and services that address their behavioral health needs during placement and after release.³

In fiscal year 2022, the Bureau of Justice Assistance (BJA), a component of the Department of Justice’s Office of Justice Programs, launched the Second Chance Act Improving Adult and Juvenile Crisis Stabilization and Community Reentry (SCA CSCR) grant to help communities improve efforts to address youth and young adult crises and reduce the overrepresentation of youth with behavioral health needs in the justice system. SCA CSCR provides funding to government and community-based entities to deliver clinical and recovery support services that establish treatment, suicide prevention, and continuity of recovery in the community for youth with mental illnesses, substance use disorders, or co-occurring disorders upon their release from a detention or correctional facility, or who have current or prior involvement with the justice system.⁴ It also provides training and technical assistance to grantees and the field at large to advance work in this domain.

This brief, developed with support from BJA, provides justice professionals who are responsible for youth and young adult case planning with best practice guidance on how to engage, collaborate, and partner with the systems that can address reentry needs and prevent crises that may lead to future justice system involvement. This guidance is drawn from both relevant research and lessons learned from BJA-funded programs focused on reentry and crisis stabilization among youth and young adults.

Six Best Practices Justice and Crisis System Professionals Can Implement

Many community-based organizations and government agencies lack the services and resources that youth and young adults need for stabilization and ongoing recovery during reentry.

These needs include reengagement with or referrals to educational providers, job readiness training and supported employment opportunities, as well as warm hand-offs to behavioral health care providers that have expertise in serving people their age. Youth and young adults reentering their communities also often require assistance with reintegration into positive social supports; collaborative engagement of family or caregivers, who may require support themselves to ensure the young person’s stability; and rebuilding the relationships that were negatively impacted by the trauma of the young person’s experience with the justice system.

Strong cross-coordination between the justice and crisis systems is critical to address the breadth and scope of crisis stabilization needs for youth and young adults. It is also imperative for all agencies to ensure equitable access to culturally responsive, gender-affirming care⁵ and supportive services for LGBTQ+ and youth and young adults of color that are reentering the community. Additionally, gender-focused reentry services for girls is necessary to address the disproportionate impact of trauma and resulting mental health issues among that population.⁶

Below are six best practices that reentry and crisis system collaborators can implement to support crisis stabilization needs for youth and young adults reentering the community.

1. Build cross-system reentry planning teams to address each person’s unique needs.

As with any successful reentry plan, the planning process for youth and young adults should begin at the time a young person is admitted to a facility or out-of-home program.⁷ Teams may include a mix of representatives from correctional or residential facilities, reentry service provider agencies, case managers, behavioral health providers, peer support specialists, various crisis response or triage and stabilization agencies, supported employment agencies,⁸ housing providers, child welfare, family courts, education, community organizations, faith-based organizations, and other entities identified as important by the young person at the center of the reentry planning process. Cross-system teams should be developed with consideration of each agency’s capacity to support the unique needs of youth and young adults who are reentering the community after justice system involvement.

2. Coordinate behavioral health care to bridge the transition from the facility to the community.

Youth and young adults should receive validated mental health and substance use screenings—and assessments if warranted by the screening results—within the detention, correctional, or residential facility. Young people who are assessed for and diagnosed with behavioral health conditions should then be connected to treatment within the facility. Since traumatic brain injury and intellectual and developmental disabilities can also lead to the onset of mental health needs or can co-occur with behavioral health diagnoses, it is critical for correctional and residential facilities to also screen for and rule out brain injury.

As part of release planning, reentry teams can provide in-reach or take part in reentry case planning; this reentry process should begin with sufficient time to properly assess youth needs and match appropriate services and supports in the community,⁹ however, in order to ensure continuity of care (for mental health, substance use, or co-occurring substance use and mental health services) with community-based providers that can support long-term recovery and crisis prevention and stabilization.

This warm hand-off process involves benefit and care coordination with community-based organizations and behavioral health providers, hospitals, crisis centers, and juvenile assessment centers to identify which program eligibility requirements need to be met for admission into services. For example, new Medicaid rules require that young people in confinement receive screening and diagnostic assessments, targeted case management, and other services 30 days before and up to 30 days after release, while also suspending—not terminating—Medicaid coverage during confinement.¹⁰ Reentry planning teams should stay up to date on these and other benefits changes to ensure that the young person can seamlessly receive care upon release. Reentry teams should also incorporate proactive crisis prevention planning into all transition plans for youth and young adults with behavioral health needs, including safety planning for young people with histories of intimate partner violence.

3. Provide developmentally appropriate gender-affirming, culturally responsive, and gender-focused reentry services as part of case management planning.

LGBTQ+ and youth and young adults of color are disproportionately incarcerated¹¹ and less likely to be connected to appropriate behavioral health care when compared to their non-LGBTQ+ and White peers.¹² Therefore, it is imperative that reentry teams identify and collaborate with agencies that can provide gender-affirming and culturally responsive services as appropriate. Case management plans should include information on services that are developmentally appropriate and incorporate cultural humility, gender identity, and sexual orientation. The case planning process should also consider the impacts of racial disparities on social determinants of health.¹³

Identified providers should not only have expertise in these areas, including lived experience, but also demonstrate the use of best practices and evidence-based practices that have demonstrated efficacy with LGBTQ+ and youth and young adults of color. LGBTQ+ and youth and young adults of color who receive affirming, supportive, and culturally responsive services tend to have better behavioral health outcomes and lower recidivism rates than those who do not.¹⁴