The Facts
Nationally, it is estimated that around than 70% of children in the juvenile justice system meet the criteria for at least one mental health condition, and, of these, at least 20% are diagnosed with a severe mental illness.* This is significantly higher than the estimated average presence of mental health conditions across all youth, which is about 16.5%.**
Yet, kids involved in the juvenile justice system often cannot access the mental healthcare they need in a reasonable time frame. Lack of coverage by insurance and long wait times further prevent kids from getting the help they need.
45% of mental health providers in Massachusetts do not accept MassHealth, an insurance plan associated with poverty that is used by 80% of families we serve. The rate of coverage has continued to decrease in recent years, making it increasingly difficult for kids and families to get the mental health care they need.
Additionally, kids and adolescents experience longer wait times for mental health care than adults do. These wait times increase more as the proportion of clients who are seen at the practice who have MassHealth insurance increases.
We provide mental health services regardless of a family’s insurance status and treatment can often begin immediately, removing some of the most significant barriers to care.
Delayed treatment can have critical implications on the health and wellbeing of our most underserved youth. Studies have shown that youth involved in the juvenile justice system who do not receive proper mental health care are more likely to reoffend. However, those who receive mental health services within the juvenile justice system show lower rates of recidivism and longer times between offenses.
ACS provides these mental health services at no cost, supporting kids already involved in the juvenile justice system and taking a preventative approach to those at risk for system involvement. The mental health care that ACS provides supports youth today, and into the future, providing them with the lasting skills they need to heal, grow, and thrive.
* Children surveyed range in age from 7 to 17
** Children surveyed range in age from 14 to 17
Who We Serve
Location
ACS serves children and families who are court-involved across the 54 cities and towns of Middlesex County, Massachusetts, the most populous county in New England with the largest population of youth under the age of 18. We directly serve the county’s four Juvenile Courts, located in Cambridge, Framingham, Lowell, and Waltham.
The most recent Community Needs Assessments for Cambridge, Framingham, and Lowell each identified mental health as one of the top needs in these cities. By serving these communities, ACS is directly responding to the urgent mental health needs identified by local assessments, making a tangible impact on the lives of children and families throughout Middlesex County.
Demographics
ACS provides services to youth who are court-involved or at risk of court-involvement and their families. Typically, the youth we serve are between the ages of 7 and 18, the age range of youth most commonly involved in the juvenile justice system.
A majority of the youth we serve come from underserved and under resourced communities. In Fiscal Year 2023:
- 80% of families we served received insurance coverage under MassHealth, a common indicator of poverty.
- 31% of our clients had at least one parent who immigrated to the US.
- 27% experienced homelessness.
- 89% were diagnosed with at least two mental health conditions, including substance use disorder.
- 49% have a history of hospitalization due to a mental health condition.
Many of the children we serve have experienced Adverse Childhood Experiences (ACEs), which can include various forms of abuse, neglect, and household dysfunction. These experiences can have profound and lasting impacts on their mental health and well-being, often leading to involvement with the juvenile justice system. Our programs are designed to address the complex needs of these children, offering them the support and resources they need to envision and work toward a better future.
Click here to learn more about ACEs
Sources
Centers for Disease Control and Prevention. (2024). About mental health. Retrieved July 1, 2024, from https://www.cdc.gov/mentalhealth/learn/index.htm.
Koppelman, J. (2005). Mental health and juvenile justice: Moving toward more effective systems of care. National Health Policy Forum. https://www.ncbi.nlm.nih.gov/books/NBK559790/.
Metrowest Health Foundation (2023). 2023 Metrowest Community Health Assessment. https://d2yy08d49bfqoo.cloudfront.net/documents/publications/FINAL-COPY-101023-updated.pdf.
National Alliance on Mental Illness. (n.d.). Mental health by the numbers. NAMI. Retrieved July 1, 2024, from https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/.
Seiter, L. (2017). Issue Brief: Mental health and juvenile justice: A review of prevalence, promising practices, and areas for improvement. Neglected Delinquent Technical Assistance Center. https://neglected-delinquent.ed.gov/sites/default/files/NDTAC-MentalHealth-JJ-Brief-508.pdf.
Sirkin, J. T., McClellan, S. R., Hunt, M., Sheedy, K., Hoffman, C., & Olsho, L. (2020). Quantifying wait times for outpatient mental health services in Massachusetts. Blue Cross Blue Shield of Massachusetts Foundation. https://www.bluecrossmafoundation.org/sites/g/files/csphws2101/files/2020-09/Quant_MH_Wait_Times_REPORT_v07_final.pdf.
TDC. (2017). City of Cambridge community needs assessment. City of Cambridge, Massachusetts. https://www.cambridgema.gov/~/media/Files/CDD/Planning/needsassessment/needsassessment_20170123_TDC_final_review.pdf.
Tufts Medicine. (2022). Greater Lowell Community Health Needs Assessment. https://www.tuftsmedicine.org/sites/default/files/2023-11/2022-greater-lowell-community-health-needs-assessment-v6a.pdf.
Underwood, L. A., & Washington, A. (2016). Mental Illness and Juvenile Offenders. International Journal of Environmental Research and Public Health, 13(2), 228. https://doi.org/10.3390/ijerph13020228.
