A Practical Framework for Therapeutic Engagement in Juvenile Justice Mental Health Care

Justice-involved youth face significant barriers to mental health treatment, including stigma (both from providers toward this population and from this population toward mental health), limited access to high-quality, evidence-based care, and the broader influence of larger socioeconomic factors. This Clinical Perspective proposes a framework for enhancing therapeutic engagement in juvenile justice settings through a practical emphasis on voluntary participation, transparency, collaboration, informed consent, and acknowledgment of treatment limitations. This framework can improve mental health care in juvenile justice settings by fostering higher levels of direct clinical engagement; empowering patients, their families, and their communities; and imbuing clinicians with a greater sense of collaboration, advocacy, and social value in their work. On a broader level, this framework can be considered in any setting where child and adolescent psychiatry is practiced, with relevance to public psychiatry and other environments where similar factors may pose a meaningful barrier to providing care.