Citation

Jacobs SA. Psychiatr. Serv. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American Psychiatric Association)

DOI

10.1176/appi.ps.20230228

PMID

37587792

Abstract

I have worked in administrative and clinical roles within the juvenile justice and child welfare systems for a combined 17 years in Southern California and Southern Nevada. As a licensed family therapist, I am responsible for providing clinical oversight to youths in the child welfare system who have serious mental health conditions and trauma. My role is important because I am the bridge between child protective services and residential treatment and an advocate for youths who receive treatment in locked psychiatric residential treatment facilities. I participate in monthly treatment team meetings, which are normally facilitated by the treating psychiatrist at the youth's facility. I often coordinate with each youth's team, which comprises their caseworker, who is the legal guardian, and a nurse, who is typically the person legally responsible to give consent for psychotropic medications. Additionally, each youth has a court-appointed attorney, and most youths have a court-appointed special advocate and an educational surrogate. The youths in our care have many needs, and we on the treatment team work together to try to ensure that those needs are met. However, the more extensive the youth's mental health needs, the more difficult this goal is to achieve, even with a multiperson team.

One truth I have learned while working in the child welfare system is that it is not equipped to supply the care required by youths with extensive mental health needs. Youths who require stabilization within psychiatric hospitals and residential treatment settings tend to need the most support. However, they often do not receive that support because they are bounced around from placement to placement, which almost always leads to a disruption in the services provided as the specific service providers change. If an entire system is unable to meet the needs of these youths, how can an individual like me make even the smallest impact?...

Language: en

Keywords

Inpatient treatment; juvenile justice; psychotropic medication; Residential programs