Far too many youth with mental illness are landing in the juvenile justice system. Research shows that 70 percent of youth in the juvenile justice system have one or more psychiatric disorders. At least 20 percent of these youth have a serious mental illness, including those who are suicidal, struggling with psychotic disorders, and experiencing symptoms that significantly interfere with their day‐to‐day functioning.

Many of these youth are incarcerated for minor, non‐violent offenses, while others have not been charged with a crime. Schools and families are often forced to involve police when a child is experiencing a psychiatric crisis because alternatives do not exist. The police are accustomed to handcuffing and transporting these youth to the juvenile justice system. This is known as the school to prison pipeline. It disproportionably impacts youth with mental health treatment needs.

Yet, with more than 52 million students in schools in the U.S., schools are in a unique and key position to identify mental health concerns early and to link students with appropriate services. Goal 4 of the President’s New Freedom Commission Report on Mental Health, issued in July 2003, calls for schools to play a larger role in the early identification of mental health treatment needs in children and to link them to appropriate services. Engaging schools in identifying children and adolescents with mental health treatment needs promises to help reduce the lag time, often eight to ten years, from when an individual first experiences the symptoms of mental illness to when they first seek and receive treatment. Children and adolescents with mental illness are not faring well in many communities across the country. This is true for a number of reasons. Mental health services for children are fragmented and may be available in multiple systems, including mental health, education, child welfare, juvenile justice, and primary care. The fragmentation of services and lack of cross‐ Table 1. Positive Behavioral Interventions and Supports13 Positive Behavioral Interventions and Supports (PBIS) s a school‐based practice model that emphasizes school‐wide systems of support with proactive strategies to create a positive school environment and address students’ challenging behaviors . PBIS focuses on first understanding the underlying cause of a student’s negative behavior and then developing a positive intervention plan that uses a collaborative team approach to address the student’s individual needs. The PBIS approach is data‐driven and has produced the following results:

• Research conducted over the past 15 years has shown that PBIS is effective in promoting positive behavior in students and schools.
• Schools report increased time engaged in academic activities and improved academic performance.
• Schools indicate reductions in office discipline referrals of 20 to 60 percent.
• PBIS leads to dramatic improvements that have long‐term effects on the lifestyle, communication skills, and problem behavior in individuals with disabilities.
• PBIS makes it easier to identify students who need intensive interventions and works collaboratively with other service systems.

Systems collaboration has often led to a lack of accountability. It has also led to many families being forced to act as case managers for their children. There is also a lack of capacity in the home and community‐based services available for youth. All of these factors have led to extremely poor outcomes for youth with mental illness, as outlined in Table 2. Research shows that 10 percent of youth have a serious mental illness.15 However, only 20 to 30 percent of these youth receive any mental health services; leaving over 70 percent of children and adolescents with a diagnosable mental illness without services.16 Meanwhile, other child‐serving systems like juvenile justice and child welfare must provide the mental health treatment needs of youth, often without the training or personnel to do so. Research shows that youth with mental illness fail more classes, earn lower grade point averages, miss more days of school, and are retained more often at grade level than other students with disabilities.14 School personnel and administrators have expressed frustration with poor academic performance and disruptive behaviors of groups of students, including those with serious mental health treatment needs. Law enforcement personnel express concern that they are often used as the “big stick” in schools and communities when addressing youth with mental illness. They are repeatedly contacted about the same individuals who are not linked to mental health services and supports, resulting in repeated confrontations that often lead to the unnecessary, costly incarceration of these youth in the juvenile justice system. Community members become outraged when law enforcement personnel unnecessarily injure or kill an individual who was acting out because of a mental illness and needed mental health services. This situation can create great community unrest. Families are frustrated that they are left with few alternatives other than to call the police when their children are experiencing a psychiatric crisis. They are often not informed of other Table 2. Negative Outcomes for Youth with Mental Illness 10% of children and adolescents in the U.S. live with a serious mental illness that causes significant impairment in their dayto‐ day lives, yet only 20% of them are identified and receive mental health services.17

• 50% of students with a mental illness age 14 and older drop out of high school—the highest dropout rate of any disability group.18 73% of those who drop out are arrested within five years.19
• Children with mental illness are more than three times as likely to be arrested before leaving school as other students.20
• Children with mental illness fail more courses, earn lower grade point averages, miss more days of school, and are retained at grade level more often that other students with disabilities.21
• Suicide is the third leading cause of death in youth aged 10 to 24.22 90% of people who die by suicide have a diagnosable and treatable mental illness at the time of their death.23
• 70% of youth involved in state and local juvenile justice systems have a serious mental illness, with at least 20% experiencing symptoms so severe that their ability to function is significantly impaired.24

Children with mental illness are twice as likely to be living in a correctional facility, halfway house, drug treatment center, or “on the street” after leaving school compared to students with other disabilities.

Resources or services that are designed to meet the needs of their children during a crisis. These frustrations and the negative outcomes for youth with untreated mental illness underline the critical importance of law enforcement, schools, communities, and families embracing effective crisis intervention programs. These programs provide law enforcement personnel and other first responders with the tools they need to respond compassionately and effectively to youth in psychiatric crisis. They also promise to help break the steady flow of youth with mental illness into the juvenile justice system. They will also lead to safer outcomes when law enforcement must get involved. Children’s mental health advocates play an important role in building the momentum and interest in crisis intervention programs for youth and in bringing together the stakeholders needed to ensure the effective implementation and sustainability of these programs.