Behavioral Health Service Utilization Among Detained Adolescents: A Meta-Analysis of Prevalence and Potential Moderators

Abstract

Purpose: Utilization of behavioral health treatment services among adolescents who have been detained or incarcerated within the juvenile justice system is poorly understood, with estimated utilization rates varying widely across studies. This meta-analysis was conducted to review and synthesize the literature on the prevalence of service utilization among this population.

Methods: Data from 27 studies of 28 distinct samples were abstracted and coded. A meta-analysis was conducted to calculate individual prevalence estimates of behavioral health service utilization, which were combined using random effects models. A moderator analysis was also conducted.

Results: Prevalence effect sizes (pr) for service utilization were low, with effect sizes pr = 33.1% for mental health services, pr = 27.95% for substance use-related services, and pr = 45.32% for unspecified services. The moderator analysis showed significant heterogeneity in prevalence of behavioral health service utilization.

Conclusions: The findings suggest limited service utilization by adolescents who had been detained or incarcerated, whether assessed before, during, or after confinement. Future research should focus on assessing the quality of, and youth access to, behavioral health services within and outside of juvenile justice facilities. Improved programs to ensure consistent treatment for previously detained or incarcerated adolescents are warranted.

Keywords: Detained; Mental health; Meta-analysis; Moderator analysis; Prevalence; Service utilization; Substance use.