Research roundup: Youth incarceration can cause lasting damage to mental health

Young people with mental health conditions are often criminalized, yet detaining youth can lead to new or worsened mental health problems. In turn, youth incarceration leads to worse outcomes in adulthood, including depression, suicidality, and deeper criminal legal system involvement.

by Emily Widra, November 12, 2026

Advocates, researchers, and other experts have long argued that incarceration of youth has serious and far-reaching consequences for children and young people, their families, and their communities, while not making communities any safer. The separate juvenile legal system was created because the nation recognized that children shouldn’t be treated like adults.¹ Despite the widely-accepted understanding that children must be treated differently, too often the U.S. still defaults to criminalizing and confining children for a wide variety of behaviors. And while states have scaled back their use of confinement for youth, partly in response to its obvious harms and counterproductive results, some lawmakers seem determined to return to the extreme measures of the past, abandoning successful reforms in favor of 1990s-style “tough on youth crime” approaches.² In this briefing, we highlight and summarize research from the past three decades to remind policymakers of the many known problems with confinement when it comes to youth mental health.

Most of the relevant research was published during the late 1990s and early 2000s, when the rates of locking up children were skyrocketing. While much of that work has not been updated in more than a decade, those studies still provide crucial insights into the mental health of confined youth. Along with newer research, these studies show that many children enter youth prisons with histories of trauma and existing mental health disorders only to have their mental health deteriorate further while locked up. Then, they are eventually released back into communities without adequate care or support — leading many to be criminalized again as adults.

Ultimately, these studies underscore how much of the criminalization of youth is rooted in unmet mental and behavioral health needs, for which youth confinement and incarceration are not the answer: the conditions of confinement are not suitable for mental health treatment. This review of the existing research loosely follows the chronological order of youth contact with the juvenile legal system, from before police contact to the juvenile courts, and then through confinement, release, and adulthood. The evidence throughout this progression calls attention to the critical need to address childhood mental health and mitigate contact with the legal system early and consistently throughout childhood and adolescence.

Trauma and mental health issues are widespread among children entering detention

Kids experiencing mental health issues or who have witnessed violence are overrepresented in youth confinement facilities: prior experiences of trauma and existing mental health conditions are risk factors for involvement in the juvenile legal system. This is partly a reflection of the shortage of accessible, high-quality community-based services and supports for youth. For many families, confinement is seen as the only option when mental health services are unavailable: in a 1991 National Alliance on Mental Illness (NAMI) survey, more than one third of parents of children with mental illness reported that their children were placed in the juvenile legal system “because mental health services were unavailable in the community.” This problem persists today: In 2025, more than 650,000 adolescents in the U.S. had major depressive disorder and felt they had an unmet mental health need. But 43% of them did not know how or where to get treatment and over half did not think treatment would help them. Even before entering these facilities, then, many children are facing serious mental health challenges that are only made worse by confinement.

Two out of every three children³ in youth confinement meets the criteria for at least one mental health disorder, while only one in every five children in the U.S. meets these criteria.⁴ In an international analysis of studies on confined youth and mental health,⁵ researchers found that compared to all youth, detained adolescents have higher rates of psychotic illness, major depression, ADHD, and post-traumatic stress disorder (PTSD). And it’s possible that the rates of mental health conditions among confined youth are on the rise: in Ohio, the Department of Youth Services reported that the percentage of youth in juvenile facilities who need mental health treatment grew from 67% in 2019 to 78% in 2025.

Among confined youth with mental health conditions, the vast majority (80%) actually meet criteria for multiple mental health diagnoses, which, in and of itself, puts them at higher risk for arrest and legal system involvement. Clearly, mental health needs for confined youth are significantly complicated by co-occurring conditions, including substance use disorders, and inadequate access to treatment in the community.

Criminalizing mental health disorders among children

The significant overlap between juvenile legal system involvement and mental health conditions points to the tension between the criminalization and medicalization of children’s behavior. For children and adolescents, a number of symptoms of mental health conditions – like mood disorders (depression or anxiety) and PTSD – may be expressed as anger, irritability, hostility, property damage, and even physical aggression. Many children in confinement are also diagnosed with “disruptive” behavioral disorders like conduct disorder or oppositional defiant disorder. Such diagnoses are reliant on a number of criteria including difficulty regulating emotions, behaviors, and impulses, as well as the violation of “basic rights of others” and “social norms.” Diagnostic criteria for conduct disorder, for example, include examples of “aggression to people,” a symptom that describes a number of behaviors that also drive legal system involvement like physical fights, possession of weapons, stealing, destruction of property, absence from school (“truancy”), and more. These behaviors frequently provoke intervention from police or school resource officers, who “rely on their police training and skills, rather than evidence-based practices” for responding to children with mental health concerns: police are responsible for nearly 9 out of every 10 referrals to juvenile court. In other words, symptoms of children’s mental and behavioral health problems are often treated as criminal or “delinquent” behaviors that merit court intervention and punishment, instead of mental health treatment and other community-based support services.

“Disruptive disorders” (such as conduct disorder and oppositional defiant disorder) drive a lot of the criminalization of youth – and the racial disparities in the juvenile system. In 2006, the most common mental health conditions among youth in the juvenile legal system were these “disruptive disorders,” with over 46% of confined youth meeting the criteria. A more recent international meta-analysis supports these older findings, reporting that the prevalence rate of any lifetime conduct disorder diagnosis was much higher among those confined as children (nearly two-thirds) compared to the general population of adolescents (approximately 10% in the U.S.). Black and Hispanic or Latino youth are disproportionately diagnosed with “disruptive disorders” (driven in part by bias) and subsequently experience poorer health outcomes than white youth with conduct disorder diagnoses. These same children, particularly Black children, are also overrepresented in the juvenile legal system: while 14% of all youth under 18 in the U.S. are Black, 47% of boys and 39% of girls in juvenile facilities are Black.

The tension between criminalizing and medicalizing youth behavior, particularly with behavioral disorders, certainly complicates the robust correlations between mental health disorders and juvenile legal system involvement. In most available research, the data do not allow a causal analysis, meaning researchers frequently cannot identify whether mental health disorders drive juvenile legal system involvement or juvenile legal system involvement leads to mental health disorders. But it is clear that youth with mental health conditions are overrepresented in youth confinement, and the conditions of confinement are unlikely to improve their mental health.

Rates of depression and suicide spike when children are locked up in adult facilities

Nearly 2,500 confined youth are incarcerated in adult jails and prisons, where they face significant safety risks⁶ and have less access to age-appropriate services and supports.⁷ The greatly elevated risk of depression and suicide among youth in adult facilities is frequently attributed to exposure to violence and vulnerability to physical and sexual victimization. In addition, the environment of adult facilities – with few age-appropriate programming options, limited treatment access, and few social opportunities for youth – can aggravate existing mental health issues. A number of studies illustrate the detrimental impact of confinement in adult carceral facilities on children’s mental health:

• Rates of youth depression surge in adult correctional facilities: Among confined youth in Michigan, the likelihood of experiencing depression for youth confined in adult facilities was at least 20 times that of non-incarcerated youth and youth in juvenile facilities. Even children with fewer risk factors faced higher odds of depression when incarcerated in adult facilities than those in juvenile facilities, indicating that the incarceration of children in adult prisons itself contributes to the increased risk of depression.
• Children die by suicide in adult jails at an unacceptable rate: Every year since 2010, an average of three children have died in adult jails; two out of three by suicide. Children in adult jails are 36 times more likely to die by suicide in an adult jail than in a juvenile facility.
• Incarcerating youth in adult facilities is linked to worse overall mental health in young adulthood: People who were incarcerated in adult facilities as children had poorer average mental health in young adulthood, and longer periods of incarceration in adult facilities were associated with even more symptoms of mental health conditions, when compared to young adults who were confined in juvenile facilities or not confined at all as children. Because the researchers controlled for a number of variables including parental factors, housing, substance use, school experiences, and more, these findings strongly suggest that children incarcerated in an adult facility suffer from worse mental health in early adulthood because of that time spent in adult jail or prison.

Keeping children out of adult facilities is important for reasons beyond mental health as well: compared to adult facilities, juvenile facility staff are more likely to receive training in trauma-informed care and adolescent development and juvenile facilities tend to offer more programming opportunities. Accordingly, incarcerating youth in adult facilities is linked to higher rates of recidivism.

Solitary confinement is linked to self-harm and suicide among children

At any age, the stress caused by time spent in solitary confinement can lead to severe and permanent psychological damage. People in solitary confinement are more likely to develop psychiatric disorders than those who are housed in non-solitary units. This holds true for youth held in solitary confinement: the experience of isolation is frightening, traumatizing, and stressful, and can interfere with and damage crucial social, psychological, and neurological developmental processes. The consequences of solitary confinement – which is often used as a “protective measure” for youth in adult facilities – can be serious and even deadly:

• Solitary confinement is associated with youth self-harm: Across all acts of self-harm in the New York City adult jail system from 2010 to 2012, the two strongest predictors of self-harm were solitary confinement and being under 19 years of age.
• Youth solitary confinement appears linked to suicide: In a study of 100 suicide deaths in juvenile facilities from 1995 to 1999, 50% of suicide deaths occured when youth were confined to their rooms, and only 17% of those who died were on “suicide precaution status” at the time of their deaths.

As Solitary Watch reports, it is difficult to know exactly how many kids are currently experiencing isolation due to limited data and reporting on children in solitary confinement, but a 2010 report by the Office of Juvenile Justice and Delinquency Prevention found that 35% of children in juvenile justice facilities have experienced solitary confinement. Given the extreme risks associated with isolation for children, any solitary confinement is too much.

Juvenile facilities – like jails and prisons – are unable to meet the needs of children with mental health conditions

Youth are frequently stuck in juvenile facilities because mental health care is not available in the community: a 2026 Congressional report found that 75 juvenile facilities across 25 states were confining children who could be eligible for release to mental health care programs outside the facility, but remained incarcerated because the care they needed was not yet available. But the reality is that while juvenile facilities are more likely to provide rehabilitation-oriented services and programming than adult jails and prisons, confining children in these facilities is not a good solution to a dearth of community-based mental health or substance use services.

Alarmingly, recent data about access to mental health treatment while in juvenile facilities is extremely limited. One state-specific study from the early 2000s found that a startlingly small proportion of children with mental health diagnoses receive mental health treatment: only 23% of children with a mental health diagnosis received any treatment in one Maryland juvenile facility. The 2022 Census of Juvenile Residential Facilities does not include any data on treatment availability, but shows that less than 70% of juvenile residential facilities evaluate all youth for mental health needs, with only 46% conducting those evaluations within 24 hours of admission. In 2020, nearly 1 in 10 juvenile facilities that conducted mental health evaluations (9.4%) did not have onsite mental health treatment available.⁸

The consequences of childhood incarceration persist into adulthood

Any time spent in confinement as a child can lead to elevated risk of mental health disorders in adolescence and young adulthood, higher rates of depression and suicidality in adulthood, and heightened risk for PTSD. In a longitudinal study beginning in the late 1990s, researchers found that more than 30% of youth confined in Cook County, Illinois, had one or more psychiatric disorders with “impairment” (as measured by the diagnosis-specific criteria), and rates were even higher when including children with psychiatric disorders without impairment. The researchers found that the conditions persisted long after release from the juvenile facility: 64% of boys and 35% of girls with a psychiatric disorder during their detention still had a disorder 15 years later. Repeated childhood confinement or incarceration is associated with increased mental health problems: in a study of thousands of youth admitted to a single juvenile facility from 2007 to 2017, symptoms of depression, anxiety, physical health issues, and suicidality increased across repeat admissions to juvenile facilities.⁹ Research shows particularly troubling relationships between youth incarceration and adulthood experiences of depression, suicidality, and PTSD.

Incarceration of youth tied to adulthood depression and suicidal ideation

In three studies using the National Longitudinal Study of Adolescent to Adult Health (Add Health) survey data,¹⁰ researchers found compelling evidence that childhood incarceration is associated with adulthood depression and suicidal ideation. Notably, even short stints of incarceration have long-term effects: for young people (adolescents and young adults under 25 years), the odds of experiencing depressive symptoms in adulthood are 41% higher for those incarcerated for any amount of time less than one month, compared to those never incarcerated. The effects are much worse for youth incarcerated for longer periods and at younger ages. For youth incarcerated for longer than one year, the odds of experiencing adulthood depression is 318% higher – and the odds of adulthood suicidal ideation 134% higher – compared to those never incarcerated. The second study finds that incarceration at younger ages is associated with substantially worse adult mental health outcomes: 38% of people first incarcerated before age 14 reported adulthood depression, compared to 24% of those first incarcerated between age 14 and 32. Similarly, the prevalence of adult suicidal ideation among those first incarcerated before age 14 is more than double (28%) that of those first incarcerated between 14 and 32 (10%). The third of the studies using Add Health data supports the findings from the first two: compared to those who had never been arrested, people arrested before age 25 experienced more depressive symptoms and higher rates of suicidal thoughts during adolescence and more depressive symptoms in adulthood (ages 32-42).

The strong connections between childhood, adolescent, and young adult incarceration and depression and suicidality are not one-directional. As discussed earlier, youth frequently enter confinement with pre-existing mental health conditions or with risk factors for developing mental health conditions, like poverty, lack of access to mental and medical healthcare, bullying, issues in school, substance use, and more. But what these studies show is that any treatment provided to confined children is not achieving the stated goal of promoting mental health and rehabilitation before children return to their communities.

Children frequently experience trauma during confinement and deal with symptoms of PTSD in adolescence and adulthood

The same conditions of confinement that contribute to depression, anxiety, and other mental health conditions – solitary confinement, exposure to violence, and staff neglect, harassment, and abuse – are traumatizing experiences for youth in carceral settings. A survey of over 60 young adults who were confined in a juvenile facility in the year prior found that nearly all youth (97%) reported experiencing some type of abuse during their incarceration, with 14.5% of youth meeting clinical criteria for posttraumatic stress reactions. Youth who reported more frequent abuse during incarceration were more likely to experience posttraumatic stress reactions and depression, and were more likely to have subsequent criminal involvement.¹¹ Among adult women who had repeated juvenile legal system involvement in adolescence, 50% met the diagnostic criteria for posttraumatic stress disorder (PTSD) in adulthood, compared to 10% of women in the U.S. overall. Some researchers suggest that the trauma people experience behind bars can lead to post-incarceration syndrome, a proposed subtype of PTSD that shares many of the same characteristics. While much of this research focuses on people incarcerated as adults, it is worth highlighting the potential of chronic, trauma-related disorders among confined children.

After release, mental health treatment remains out of reach

Research shows that confined youth often find mental health treatment inaccessible before their legal system involvement, and this remains true for children released from juvenile facilities or adult jails and prisons. Despite promises of case management, reentry support, and referrals at the time of release from juvenile facilities, many youth struggle to obtain mental health treatment after leaving these facilities:

• In New York City, researchers surveyed 177 mental health clinics that provide outpatient care for children and adolescents. Of those, nearly 86% accepted youth with juvenile legal system involvement, but nearly half of those clinics (44%) accepted justice-involved children on a conditional basis and wait times could be as long as six or more months. There are also logistical barriers, like finding a clinic close to home: the researchers mapped the home address zipcodes for over 150 children in secure juvenile detention centers in New York City in February 2023 and found that only 58% of clinics were located within their home zip codes.
• Of nearly 2,000 children followed for 20 years after their incarceration in Chicago in 1995, less than 20% received needed mental health services after release. Female, white, and/or Hispanic children were more likely to receive mental health services post-release than their Black and/or male counterparts.
• In a smaller study, researchers conducted surveys with 75 youth and their parents or guardians at the time of their first contact with juvenile court and then again one, two, and three years after that first contact. They found that at the time of the first contact with the court, three-quarters of youth met criteria for a mood, anxiety, or behavioral disorder (based on child or parent report), but only 20% of those youth were involved in mental health treatment during the follow-up interviews.

The juvenile justice system is frequently portrayed as rehabilitative and a pathway to necessary mental health and substance use treatment, despite evidence to the contrary. Children leaving juvenile facilities often do not have improved access to (or participation in) mental health treatment. Children cycle in and out of juvenile facilities, and while very little information is publicly available about access to treatment while confined, clearly, youth frequently leave these facilities without adequate follow-up mental health services in the community.

Conclusion & recommendations

Over the past 25 years, states have reduced their use of youth confinement by over 70%, due to both lower rates of lawbreaking behavior and arrests and intentional policy shifts away from criminalization and toward “informal” processes that hold them accountable without removing them from their homes and support systems.. The research presented in this briefing shows why efforts to return to higher levels of youth criminalization and punishment are deeply misguided. Instead of turning back the clock on the juvenile legal system and returning to last century’s “tough on youth crime” approaches, legislators and decisionmakers within the juvenile legal system should heed the recommendations of youth advocates and:

• Increase availability and affordability of community-based mental health services. Access to these services is essential for preventing juvenile system involvement for mental health conditions and for supporting children released from confinement
• Prevent initial contact between children and the juvenile legal system. Promote school-based programming, restorative justice processes, and wraparound support services for children at risk for legal system contact.
• Require mental health evaluations prior to disposition (sentencing). Mental health screenings and assessments can be implemented throughout the juvenile justice process, long before youth get to juvenile facilities. These evaluations can and should take place early and often, at any point(s) from arrest, before filing charges, during adjudication, before disposition, and at intake. The results of these evaluations should inform the disposition and certainly any out-of-home placement of adjudicated youth.
• Expand alternatives to incarceration for children. Diversion programs that screen and treat children referred to juvenile courts with mental health conditions provide an alternative outside the juvenile legal system, and other diversion programs like mentorship programs, family-focused therapy models, and restorative justice interventions can be fundamental resources for children and their families.
• End the practice of incarcerating children in adult jails and prisons. The practice of automatically transferring children to adult court in 28 states and D.C. should be eliminated. There is no evidence that these practices – which often disproportionately impact youth of color – work to prevent or reduce crime.
• Improve mental health services in juvenile facilities. While avoiding youth confinement should be the top priority, for those in custody, there is room to improve screenings, treatment availability, and family engagement. All children should be screened for mental health concerns soon after admission to any juvenile facility. Any mental health treatment needs to be trauma-focused and should include more than psychoeducation¹² and group therapy.
• Prioritize access to mental health treatment at reentry. Children with mental health concerns leaving these facilities need to have referrals, prescriptions, and wraparound care coordination services. These services need to be funded and staffed so that children are not languishing in facilities waiting for community-based mental health treatment spaces to open up in order to be released.
• Better data collection and dissemination. The prevalence of mental health conditions among incarcerated youth (in juvenile facilities or adult jails and prisons) is not collected and published on a regular basis. There is very little information about the access to and participation in mental health services in juvenile facilities available publicly and more data and information is necessary for transparency, but also to promote community-based alternatives.

Ultimately, children will be best served by the elimination of youth confinement and replacing those systems with fully-funded and accessible social supports and services in the community to reduce violence and promote mental health treatment.