How TJJD and UTMB Are Advancing Youth Mental Health Practices
By TJJD Communications, in collaboration with Scott LePor, TJJD Medical Director
In recognition of Mental Health Awareness Month, the Texas Juvenile Justice Department (TJJD) is highlighting its longstanding partnership with the University of Texas Medical Branch Center for Correctional Medicine (UTMB-CMC) and the collaborative work being done to further understand, develop, and provide the best approach in achieving optimal outcome trajectories for TJJD youth.
UTMB-CMC has been TJJD’s partner for over 3 decades providing quality healthcare services for youth in secure facilities across Texas. Together, we are focusing on quality treatment services that allow youth to acquire the skills needed to successfully return and be a part of a healthy community.
Comprehensive care for Texas youth
UTMB-CMC provides a wide variety of healthcare services for youth in TJJD facilities, including medical, psychiatric, dental, nursing, and optometric care, while coordinated care is overseen by the TJJD medical director.
For youth with mental health needs, UTMB-CMC psychiatry currently provides three board-certified child and adolescent psychiatrists, along with a psychiatric nurse practitioner, who works closely with TJJD treatment and programming psychology providers.
Psychiatric services are delivered through telehealth visits for both initial and recurring visits, just as they would occur in the community. In addition, on-call psychiatric services are available 24 hours a day, seven days a week, while nursing staff are available onsite daily throughout the year.
For continuity of care purposes, youth who have a history of psychiatric mental health needs are identified at intake and connected with providers immediately. Additionally, during intake, all TJJD youth are screened for any substance use, behavioral, or mental health needs. Youth who are assessed as needing additional psychiatric services establish care with an attending psychiatric provider, while any youth with specific risks, needs, or histories will begin scheduled specialized treatment programming.
Integrated treatment built around individual needs
A key component of our partnership is the emphasis on integrated treatment and coordinated care, with UTMB medical teams and TJJD direct care and psychology teams coming together to work on approaches that are tailored to each youth’s needs.
This occurs when staff from regular patterns meet with treatment teams to discuss the progress, challenges, and needs of individual youth. At TJJD, we utilize integrated treatment plans that allow multiple disciplines across the broader TJJD Treatment and Operations team to collaborate creating a well-informed treatment process focused on achieving the best possible outcomes for each youth.
“Incarcerated youth are a poorly understood, understudied, and inherently high risk population due to the myriad of family, social, mental health, medical, other health care and treatment needs stemming from trauma exposures and other adverse childhood and adolescent experiences (ACEs),” says Joseph V Penn, Director of Mental Health Services and clinical professor at UTMB-CMC.
This collaborative structure is outlined in the Texas Model, and it helps inform how clinical staff are an important part of the milieu model that we follow. The UTMB psychiatrists, nurses, and other medical staff we have at TJJD ensure that treatment decisions are informed by clinical needs and each youth’s personal history, experiences, and potential outcomes.
Using research to improve treatment and outcomes
In addition to direct care services, TJJD’s research team and the UTMB Center for Correctional Healthcare Excellence (CCHE) have recently partnered to do a coordinated review of available data to better understand the distribution of mental health needs and assess outcomes and efficacy of treatment modalities.
UTMB-CCHE has also partnered with TJJD leadership to create a hub for interdisciplinary engagement among clinicians, educators, researchers, and system leaders. These groups are working to address the unique challenges and opportunities present within correctional environments while advancing excellence in healthcare and treatment services.
“Advancing the evidence base in juvenile justice settings requires a multidisciplinary collaboration among clinicians, researchers, correctional systems, public health agencies, educators, and community stakeholders. Expanding rigorous clinical research in this area has substantial potential to improve individual outcomes, reduce health disparities, and inform policy reforms that support rehabilitation, recovery, and successful reintegration into society.” Dr. Penn with UMTB-CMC said.
As the partnership continues to grow, both agencies are working toward more in-depth approaches to understanding how adverse childhood experiences can alter a youth’s physical and mental health throughout their lives. “This research partnership has expanded upon a well-established relationship at our secure facilities. We now have two agencies, that are recognized national experts, leading the way in operational practice and empirical research,” says Dr. Evan Norton, Deputy Executive Director over treatment at TJJD.
Expanding evidence-based care
TJJD and UTMB continue exploring treatment models that provide greater context and individualized support for youth.
One example is the use of more robust history and assessment models, such as the Neurosequential Model of Therapeutics, which can help target more impactful treatment for each youth with greater context, understanding, and individualized approaches
The partnership also emphasizes evidence-based treatment approaches that focus on improving outcomes, supporting engagement and skill development for our youth in areas such as self-regulation and beneficial life choice decision making.
Maintaining environments with direct care staff that contribute to safety and connection allow youth to have a better success rate in learning healthy social engagement skills with peers and staff.
Supporting the whole youth
The partnership between TJJD and UTMB has also expanded into additional services focused on overall wellness and long-term success for youth.
Recent efforts include enhanced nutritional services, moving away from highly processed foods and excess sugars while increasing access to whole foods and medically appropriate diets. Specialty diets and medical need diets are assessed routinely and provided when needed.
UTMB-CMC has also begun focusing on tattoo removal services for youth who may be seeking separation from previous gang involvement, human trafficking experiences, or other aspects of their past. For many youth, tattoo removal can be symbolic, representing a step toward internal life change and new life goals.
Building strong futures
Mental Health Awareness Month serves as a reminder that healing and long-term success begin with access to compassionate, effective care. As we continue our partnership with UTMB, working together to strengthen mental health services for youth across Texas, that commitment remains at the center of the work being done every day.
“I look forward to boosting the literature on juvenile justice best practices and improving our facilities using data driven decision making. This allows us to fulfill our mission of transforming young lives and creating safer communities.” Dr. Evan Norton said.
Through collaboration, research, evidence-based treatment, and integrated care, TJJD and UTMB teams are improving long-term outcomes, and helping youth build stronger futures.
For more information about UTMB CMC, visit: Home – Correctional Managed Care – UTMB.