U.S. Department of Justice 

Office of Justice Programs 

Office of Juvenile Justice and Delinquency Prevention 

Jeff Slowikowski, Acting Administrator April 2010 

Office of Justice Programs Innovation	•	Partnerships	•	Safer	Neighborhoods	 www.ojp.usdoj.gov

Youth’s Needs and Services 

Findings From the survey oF youth in residential Placement 

Andrea J. Sedlak and Karla S. McPherson 

The Survey of Youth in Residential Placement (SYRP) is the third component in the 

Office of Juvenile Justice and Delinquency Prevention’s constellation of surveys providing 

updated statistics on youth in custody in the juvenile justice system. It joins the Census of 

Juveniles in Residential Placement and the Juvenile Residential Facility Census, which 

are biennial mail surveys of residential facility administrators conducted in alternating years. SYRP is a unique addition, gathering information directly from youth through 

anonymous interviews. This bulletin series reports on the first national SYRP, covering its 

development and design and providing detailed information on the youth’s characteristics, 

backgrounds, and expectations; the conditions of their confinement; their needs and the 

services they receive; and their experiences of victimization in placement. 

This bulletin describes key findings from 

the first Survey of Youth in Residential 

Placement about the needs and service 

experiences of youth in custody. SYRP 

surveyed youth about their psychological 

state, substance abuse problems, their 

needs, and the services their facilities provided to them. Specifically, this bulletin 

details youth reports regarding: 

◆	 Their overall emotional and psychological problems and the counseling they 

receive in custody. 

◆	 Their substance abuse problems prior 

to entering custody and the substance 

abuse counseling they receive in their 

facility. 

◆	 Their medical needs and services. 

◆ Their educational background and the 

educational services the facility provides to them. 

SYRP’s findings are based on interviews 

with a nationally representative sample of 

7,073 youth in custody during spring 2003, 

using audio computer-assisted self-interview methodology.1 Researchers analyzed 

youth’s answers and assessed differences 

among subgroups of youth offenders in 

custody based on their age, gender, and 

placement program (i.e., detention, corrections, community-based, camp, or residential treatment facilities). When other 

studies offered corresponding data about

youth in the general population, analysts 

compared these data to the SYRP results 

for youth in custody. For more information, see the sidebar “Surveying Youth in 

Residential Placement: Methodology.” 

A Message From OJJDP 

In undertaking a thorough assessment of juvenile offenders in custody, 

it is not sufficient to examine their 

conditions of confinement or even 

the histories and characteristics of 

the offenders. It is also necessary to 

consider their needs and the services 

that address them. 

OJJDP’s Survey of Youth in Residential Placement (SYRP) is the first comprehensive national survey to gather 

information about youth in custody by 

surveying the detained offenders. 

This bulletin draws on SYRP’s findings 

to take a closer look at the needs of 

youth in residential placement and the 

services they receive. In the process, it 

reports on the psychological and substance abuse problems experienced 

by youth in custody and the mental 

health and substance abuse counseling they receive to address them, 

as well as other medical needs and 

services. The bulletin also describes 

the educational background of youth in 

residential placement and the schooling they receive while in confinement. 

The findings reported in this bulletin 

describe how youth’s needs have 

been addressed and indicate areas 

in which services could be improved. 

SYRP found substantive needs in 

each of the areas it examined— 

mental health, substance abuse, 

health care, and education. 

It is OJJDP’s hope that the information provided in these pages will 

contribute to strengthening policies 

and enhancing practices to better 

serve the needs of youth in residential 

placement. 

Access OJJDP publications online at www.ojp.usdoj.gov/ojjdp
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SYRP provides the first nationally representative findings on the needs of the 

population of youth who are in custody 

because they are charged with or adjudicated for offenses.2

 These findings are also 

unique because they come from youth 

self-reports. The results in this bulletin reveal substantial needs in all four domains 

that SYRP examined—mental health, substance abuse, health care, and education. 

(See the list of research questions on p. 8.) 

Mental Health 

In recent years, the juvenile justice and 

mental health fields have increasingly 

recognized the scope of the mental health 

needs of youth involved in the juvenile 

justice system and the inadequacy of 

services to meet these needs (Mears, 

2001). As a result, standardized screening instruments have gained wide acceptance, more service providers have 

turned toward evidence-based treatment 

approaches, and more juvenile justice and 

mental health agencies have collaborated 

to devise solutions (Skowyra and Cocozza, 

2006, 2007). 

SYRP shows that youth in residential 

placement report problems in many 

mental and/or emotional areas. Although 

the SYRP questions about mental and 

emotional symptoms are not diagnostic 

of specific mental health disorders, they 

indicate the general scope of self-reported 

problems in a number of domains. Most 

SYRP questions on recent symptoms 

derive from the Massachusetts Youth 

Screening Instrument (MAYSI) (Grisso et 

al., 2001; Grisso and Barnum, 2006).3 

SYRP answers show that problems with 

anger are especially prevalent within this 

population, with more than 60 percent of 

youth reporting that they were easily upset, quick to lose their temper, and often 

angry (table 1). This is consistent with the 

fact, reported in Youth’s Characteristics 

and Backgrounds: Findings from the Survey 

of Youth in Residential Placement (Sedlak 

and Bruce, forthcoming), that 43 percent 

of youth are currently in placement for a 

violent offense (i.e., murder, rape, kidnapping, robbery, or assault). Symptoms of 

depression and anxiety are also common, 

with 51 percent of the custody population 

reporting that nervous or worried feelings have kept them from doing what they 

want to do over the past few months, and 

52 percent indicating that they feel lonely 

“too much of the time.” Additionally, 48 

percent of the population scored in the 

“caution” or “warning” range on SYRP’s 

version of the MAYSI Depressed-Anxious 

Scale.4 

Suicide is the third leading cause of death 

among adolescents, and a prior suicide 

attempt is the single most important risk 

factor for death by suicide (Wintersteen, 

Diamond, and Fein, 2007). One-fifth of 

youth in placement admit having two or 

more recent suicidal feelings, which MAYSI 

classifies as “caution” and “warning” range 

scores. The prevalence of past suicide attempts (22 percent) is more than twice the 

highest rate for their peers in local surveys 

of the general youth population and nearly 

quadruple the rate in national samples.5 

The majority of youth responding to this 

survey (70 percent) report some type of 

past traumatic experience (table 1), which 

may include physical or sexual abuse. 

Nearly one-third (30 percent) indicate 

some history of prior abuse, whether 

frequent or injurious physical abuse, 

sexual abuse, or both (figure 1). SYRP 

data also indicate significant correlations 

between youth’s histories of past abuse 

and the suicide-related indicators, both 

their recent suicidal feelings and their past 

suicide attempts. 

Mental Health Services 

Mental health services in the form of evaluation, ongoing therapy, or counseling are 

nearly universally available in the facilities, 

with 97 percent of youth living in places 

However, despite the relatively high suicide 

risk in the placement population, individual 

screening for suicide risk is not common. 

More than one-fourth (26 percent) of youth 

are in facilities that do not screen all youth 

for suicide risk. Despite the importance 

of early identification, 45 percent of youth 

are in facilities that fail to screen all youth 

within 24 hours and 26 percent are in 

facilities that do not screen any youth at 

intake (first 24 hours). 

Screening for general mental health needs 

is also limited. Less than half (47 percent) 

of youth are in facilities that provide 

mental health evaluations or appraisals for 

all residents. Youth are equally likely to 

receive counseling in their current facility 

regardless of their answers about their 

recent mental and emotional problems or 

previous traumatic experiences. Slightly 

more than half (53 percent) of youth in 

custody say they have personally met with 

a counselor at their current facility to help 

them contend with their feelings or emotional problems. Those who received counseling report relatively frequent sessions, 

and 80 percent consider their counseling 

to be “very” or at least “somewhat” helpful. 

Of those youth who have not met with a 

counselor, one-fifth (20 percent) say it is 

because they do not know how to arrange 

to talk to a counselor. 

2 

Surveying Youth in Residential Placement: Methodology 

The Survey of Youth in Residential Placement (SYRP) is the only national survey 

that gathers data directly from youth in custody, using anonymous interviews. The 

Office of Juvenile Justice and Delinquency Prevention designed the survey in 

2000 and 2001. SYRP surveys offender youth between ages 10 and 20. It draws a 

nationally representative sample from state and local facilities that are identified by 

the Census of Juveniles in Residential Placement and Juvenile Residential Facility 

Census surveys. 

SYRP interviewed youth from a selection of 205 eligible, responsive facilities listed 

on the census as of September 2002. The survey team interviewed 7,073 youth 

between the beginning of March and mid-June 2003. Surveys were electronic and 

used an audio computer-assisted self-interview system to ask questions and record 

answers. 

When using this system, youth wear headphones and hear a prerecorded interviewer’s voice read the words on the screen. Youth indicate their response choice 

by touching it on the screen. The computer program automatically navigates to the 

next appropriate question based on the youth’s earlier answers, storing all the data 

anonymously and securely. 

Statisticians assigned weights to reflect the sampling probabilities of the facility 

and the youth respondents and to adjust for nonresponse. In this way, the survey 

of 7,073 provided accurate estimates of the size and characteristics of the national 

youth offender population in custody (estimated as more than 100,000 youth). 

that provide one or more of these services either inside or outside the facility.6 
 

 

 

 

Table 1: Youth’s Mental and Emotional Problems and Traumatic Experiences Figure 1: 	 Youth’s Experiences 

of Prior Sexual or 

Physical Abuse 

Percentage of 

Youth in 

Question:* (“Have you. . .”) Custody 

Attention Problems 

...had a hard time paying attention at school or work? 45 

...had a hard time staying organized or getting everything done? 41 

...been unable to stay in a seat or where you were supposed 32 to stay? 

Hallucinations 

...seen things other people say are not really there? 14 

...heard voices other people can’t hear? 12 

Anger 

...been easily upset? 68 

...lost your temper easily or “had a short fuse”? 61 

...felt angry a lot? 61 

...hurt or broken something on purpose, just because you 30 were mad? 

Anxiety 

...had nervous or worried feelings keep you from doing things 51 you want to do?
 

...had nightmares that are bad enough to make you afraid to go 
 17 to sleep? 

Isolation/Depression 

...felt lonely too much of the time? 52 

...felt that you don’t have fun with your friends anymore? 32 

Trauma 

...had something very bad or terrifying happen to you?† 70 

...seen someone severely injured or killed (in person—not in the 67 movies or on TV)?†
 

...had a lot of bad thoughts or dreams about a bad or scary 
 32 event that happened to you? 

Suicide Related 

...felt like life was not worth living? 26 

...wished you were dead? 20 

...felt like hurting yourself? 16 

...felt like killing yourself? 15 

...tried to kill yourself?† 22 

Notes: Facility concerns prevented asking the suicide-related questions of 120 sample youth 

(representing 3 percent of the population of youth in custody). Between 11 and 131 sample youth 

refused or answered “don’t know” in response to these questions (representing less than 2 percent 

of the population in custody). In each case, the percentage given is based on youth who provided 

substantive answers. 

* Except as noted, questions asked youth about their recent feelings and experiences (i.e., “In the 

past few months have you. . .”). 

† These questions ask youth about their lifetime experiences (i.e., “Have you EVER, in your 

whole life. . .”). 

18% 

70% 

7% 

5% 

Neither 

Physical abuse only 

Sexual abuse only 

Both 

Many youth do not receive counseling 

from qualified mental health providers. 

Seventy-seven percent of youth are in 

facilities where trained mental health 

professionals provide ongoing therapy 

to some youth, but 88 percent of youth 

reside in facilities where some or all counselors are not mental health professionals. 

Additionally, the qualifications of staff 

conducting suicide screenings are generally even lower. More than one-fourth (27 

percent) of youth are in places where the 

staff conducting suicide screening are 

untrained, while a little less than one-third 

(31 percent) are in facilities that assign 

only mental health professionals to this 

important screening function. 

Overall, current mental health services 

for youth in custody still fall short of key 

recommendations for practice, which 

suggest that all youth offenders receive 

suicide risk and other mental health 

screens and that all mental health screens 

and assessments be administered by properly trained staff (National Commission on 

Correctional Healthcare, 2004; Skowyra 

and Cocozza, 2006, 2007). Any movement 

toward this goal would constitute a major 

improvement in the juvenile custody system (Desai et al., 2006). 

Substance Abuse 

Researchers have documented a significant relationship between drug use and 

serious delinquent behavior (Huizinga 

et al., 2000). SYRP results indicate that 

youth offenders in custody use drugs and 

3 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

alcohol at higher rates than the general 

population (table 2). Nearly three-fourths 

(74 percent) of youth in custody have 

tried alcohol, compared to 56 percent of 

youth in the general population.7

 Additionally, 84 percent of youth in custody admit 

using marijuana, compared to 30 percent 

of youth in the general population. Rates 

of other drug use are also significantly 

higher for youth in custody; 50 percent 

admit trying illegal drugs other than 

marijuana—nearly double the rate of experimentation of their general population 

peers (27 percent). 

More than half of youth (59 percent) say 

they were drunk or high on drugs several 

times a week or more during the months 

before they were taken into custody. Twothirds of youth in custody (68 percent) 

report problems related to this substance 

use, such as getting into trouble while they 

were high, not meeting their responsibilities, or having a blackout experience.8 

Substance Abuse 

Counseling 

Despite the high rate of substance-related 

problems, nearly one-fifth (19 percent) of 

youth in custody are in facilities that do 

not screen any youth for substance use 

problems and more than one-third (36 

percent) are in facilities that screen some, 

but not all, youth (table 3). 

Although screening tools have proliferated 

(McBride et al., 1999), only 50 percent of 

youth in custody are in places that use 

standardized assessment tools to identify 

youth with substance use problems. While 

most youth are in facilities that conduct 

urine tests to identify drug problems in certain circumstances, only about one-third of 

youth are in facilities that test all youth—29 

percent of youth are in facilities that test 

youth upon arrival, 37 percent of youth are 

in facilities that test residents at random 

during their stay, and 22 percent of youth 

are in facilities where they are tested each 

time they reenter. 

Additionally, SYRP data show that facilities more commonly provide substance 

abuse counseling to youth who report 

substance abuse problems and that youth 

who report substance-related problems 

are more likely to receive frequent substance counseling sessions when their 

problems are more severe. However, only 

62 percent of youth who report four or 

more recent substance-related problems 

Table 2: Lifetime Use of Alcohol and Drugs by Youth in Custody and in the 

General Population 

Percentage of 12- to 

Percentage of Youth 20-Year-Olds in the 

Measure in Custody General Population 

Alcohol and drug use 

Alcohol only 3 21 

Drugs only 13 5 

Alcohol and drugs 72 35 

Neither 12 39 

Lifetime substance use 

Alcohol 74 56 

Marijuana or hashish 84 30 

Cocaine or crack 30 6 

Ecstasy 26 6 

Crystal meth 22 2 

Acid or LSD 19 4 

Inhalants 19 12 

Heroin 7 <1 

Other illegal drug 23 NA 

Any illegal drug 85 40 

Any illegal drug other than 

marijuana 50 27 

Notes: Estimated percentages are rounded to the nearest whole percentage. General population 

percentages are computed from the National Survey on Drug Use and Health, 2003, at the Substance 

Abuse and Mental Health Data Archive Online Data Analysis System. For more information, see 

http://webapp.icpsr.umich.edu/cocoon/SAMHDA/DAS3/00064.xml. 

Table 3:	 Youth in Custody by Their Facility’s Practices for Screening Youth 

To Identify Substance Abuse Problems 

Facility Screening Practice	 Percent 

Who does the facility screen? When? 

All youth, definitely within 24 hours 27 

All youth, at least some in 24 hours 13 

All youth, none in 24 hours 24 

Some youth, some in 24 hours 7 

Some youth, none in 24 hours 10 

No youth 19 

What screening methods are used? 

(all that apply) 

Staff-administered questions/interview 63 

Standardized self-report instruments 50 

Visual observation, medical exam, drug tests 47 

Self-report checklist inventory 41 

Records of previous tests, treatments 5 

4 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

say that they have received substance 

abuse counseling in their current facility. Figure 2 illustrates the relationship 

between the severity of youth’s substance 

abuse problems and whether they received counseling. 

The standards of substance abuse 

treatment or counseling range widely. A 

comprehensive, reliable assessment is just 

a first step (McBride et al., 1999). Effective intervention requires that the case 

manager use the assessment to guide the 

development of a comprehensive treatment plan. A plan works best when a case 

manager ensures that the youth receives 

the appropriate services on schedule and 

remains engaged in the treatment process. 

Less than two-thirds (64 percent) of youth 

are in facilities that develop individualized 

substance abuse treatment plans, and less 

than half (47 percent) are in facilities that 

assign case managers to oversee and monitor plan compliance. Youth who reported 

the highest need for substance abuse 

counseling gave their counseling sessions 

the poorest ratings.9 Youth who reported 

that they were “high” several times a week 

or more often before their current custody 

rarely rated their substance abuse counseling as “very helpful” (35 percent vs. 51 

percent of other counseled youth). More 

of these youth rated their substance abuse 

counseling as “not very helpful” compared 

to other youth in custody who received 

substance abuse counseling (28 percent 

vs. 16 percent). 

Figure 2: 	 Percentage of Youth Who Receive Substance Abuse Counseling as a Function of 

Their Recent Substance Abuse History and Substance Use 

70 70

10 

0 

Every Several About About Never 

day times once once 0 a week a week a month None One Two Three Four Five 

Number of Recent Problems From Substance Abuse How Often a Youth Was Drunk or High Percentage of Youth Receiving 
 Substance Abuse Couseling
 

60 60 

50

Percentage of Youth Receiving 

Substance Abuse Couseling 

50 

40 

30 

20 

40 

30 

20 

10 

Health Care 

SYRP findings indicate that more than 

two-thirds (69 percent) of youth offenders 

in custody have some type of healthcare 

need. More than one-third (37 percent) 

reported that they needed dental, vision, 

or hearing care. More than one-fourth of 

those interviewed needed care for illness 

(28 percent), injury (25 percent), or some 

other physical healthcare need not listed 

in the SYRP interview (29 percent).10 For 

specific needs of youth in different types 

of facility programs, see figure 3. 

Healthcare Services 

Despite the recent attention to the health 

needs of incarcerated youth, there is no 

universal standard of care. SYRP findings show that the unmet needs of the 

population in custody are significant. More 

than one-third (36 percent) of youth who 

reported one or more types of healthcare 

needs say they did not receive all the care 

they needed. Unaddressed dental, vision, 

and hearing needs were more frequent (32 

percent of those with these needs), compared to unmet healthcare needs in other 

areas (26 percent of youth needing care for 

illness, 28 percent of those with an injury 

needing medical attention). 

Education 

The link between education and delinquency problems is well established. 

Youth with low commitment to school are 

at risk for delinquency (Wasserman et al., 

2003; Hawkins et al., 1998). Researchers 

have documented that youth with educational difficulties have a heightened risk of 

behavior problems (Byrd, Weitzman, and 

Auinger, 1997), violence (Borowski, Ireland, and Resnick, 2002), and crime (Levitt 

and Lochner, 2001; Lochner and Moretti, 

2004). SYRP’s findings reveal the extent of 

educational deficits in the national population of youth in juvenile justice custody. 

Youth in custody have a high nonenrollment 

rate (21 percent) at the time they enter 

custody, more than four times the rate of 

peers in the general population (5 percent). 

Nearly one-half (48 percent) of youth in 

custody are currently functioning below the 

grade level appropriate for their age, compared to 28 percent of youth in the general 

population (U.S. Census Bureau, 2005). 

5 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The majority (61 percent) of youth in custody say they were expelled or suspended 

during the year before they entered custody, which is dramatically higher than 

the rate of less than 8 percent observed in 

the general population (U.S. Department 

of Education, 2007). Also, 25 percent of 

youth in custody report that they were 

held back a year in school, compared to 11 

percent in the general population of youth 

(Lugaila, 2003). 

0 

10 

20 

30 

40 

50 

60 

70 

80 

Percentage of Youth in Program 

Any Eyes, teeth, 

hearing 

Illness Injury 

Health Need 

Other 

Detention Corrections Community Camp

based 

Residential 

treatment 

Figure 3: Health Needs of Youth in Different Programs 

Education Services 

A typical school day is 6 to 7 hours long 

(U.S. Department of Education, 2003), but 

less than half (45 percent) of youth offenders spend at least 6 hours a day in school. 

Only 51 percent of all youth in custody 

think that their facility has a good school 

program, but 58 percent of those who 

attend school for at least 6 hours a day 

consider their facility’s school program 

good. Nonetheless, SYRP indicates that 

the majority (92 percent) of youth attend 

school when in custody. This differs from 

their situation at the time they entered 

custody, when 21 percent were not enrolled at all and 61 percent were suspended 

or expelled in the previous year. In addition, more than one-fifth (22 percent) of 

youth 16 or older who are in a facility for 

at least 180 days report earning their high 

school credentials during their time in 

custody. 

Nearly one-third (30 percent) of youth in 

custody say they were diagnosed with a 

learning disability. This rate is more than 

seven times that of learning disabilities 

observed in the general population (U.S. 

Department of Education, 2005). According 

to the Federal Individuals with Disabilities 

Education Act, learning-disabled youth 

offenders must be identified, even in shortterm facilities, and given special education 

and related services when eligible (Burrell 

and Warboys, 2000). Current educational 

services for youth in custody need improvement to meet this goal. Youth’s selfreports in SYRP show that less than onehalf (46 percent) of those with a diagnosed 

learning disability are attending a special 

education program while in custody. 

Females in Custody 

The needs of female offenders differ from 

those of males, as do the services they 

receive. SYRP’s findings on the national 

population in custody validate findings in 

local populations that show that female 

offenders in placement have more mental 

health and substance use problems (Hubbard and Pratt, 2002; Teplin et al., 2002) 

and worse abuse histories (Blum, Ireland, 

and Blum, 2003; Hennessey et al., 2004). 

Higher percentages of females report an 

above-average number of mental or emotional problems and traumatic experiences, 

compared to males (figure 4). Moreover, 

females reveal nearly twice the rate of past 

physical abuse (42 percent vs. 22 percent), 

more than twice the rate of past suicide 

attempts (44 percent vs. 19 percent), and 

more than four times the rate of prior sex 

abuse (35 percent vs. 8 percent) as males. 

Female juvenile offenders are more commonly placed in residential treatment 

programs (compared to other types of 

programs), and nearly all youth in residential treatment programs are in facilities 

that provide onsite mental health services. 

Nevertheless, SYRP found no differences 

in the percentages of males and females 

who report receiving counseling in their 

facilities. The reasons youth give for why 

The Survey of Youth in Residential Placement 

Further information about the Survey of Youth in Residential Placement can be 

found in the Survey of Youth in Residential Placement: Technical Report and other 

bulletins in this series, which include: 

◆ Introduction to the Survey of Youth in Residential Placement. 

◆ Youth’s Characteristics and Backgrounds: Findings From the Survey of Youth 

in Residential Placement. 

◆ Conditions of Confinement: Findings From the Survey of Youth in Residential 

Placement. 

◆ Nature and Risk of Victimization: Findings From the Survey of Youth in Residential Placement. 

For more complete results of the survey findings on youth’s needs and services, go 

to: www.syrp.org. 

6 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

they do not receive counseling were also 

similar for both genders. More females 

receive individual counseling (85 percent 

vs. 67 percent) and fewer receive group 

counseling (40 percent vs. 49 percent). 

Females also give their counseling less 

positive ratings. 

Females report significantly more drug experience than males, with 91 percent saying they had used at least one of the drugs 

listed (including marijuana, cocaine/crack, 

ecstasy, meth, heroin, inhalants, and an 

“other illegal drug” category) compared 

to 87 percent of males. More females than 

males report using nearly every substance 

listed and 47 percent (compared to 33 percent of males) report having ever used four 

or more of the listed substances. Although 

males and females use drugs and/or alcohol at the same frequency just before 

entering custody, more females report 

recent substance-related problems (71 

percent vs. 67 percent). Notably higher 

percentages of females report that using 

drugs or alcohol kept them from meeting 

their responsibilities (46 percent of females 

vs. 37 percent of males) and report having 

a recent blackout experience (41 percent 

of females vs. 33 percent of males). 

Despite females’ greater substance abuse 

problems, they are often housed in facilities that provide less access to substance 

abuse treatment. In comparison to males, 

fewer females are housed in facilities that 

offer substance-abuse education (77 percent 

vs. 88 percent), provide specialized units 

for substance-abusing youth (7 percent vs. 

19 percent), or offer ongoing treatment for 

substance abuse (75 percent vs. 84 percent). 

While similar percentages of males and 

females say they have directly received 

substance abuse counseling while in 

custody, a larger percentage of females 

report having had more than one type 

of counseling—various combinations of 

group, individual, or family sessions 

(38 percent vs. 26 percent). 

Females in custody have different healthcare needs than males in custody. Males 

more commonly need treatment for injuries, but females have greater healthcare 

needs in other areas: illness (33 percent 

of females vs. 27 percent of males) and 

vision, dental, and hearing (44 percent vs. 

35 percent). More females take regular 

medication compared to males (56 percent 

vs. 34 percent), generally to treat emotional 

or mental problems (59 percent). Additionally, females are less likely to report that 

they receive all the care they need (59 percent of females vs. 65 percent of males). 

Education is the only area where females 

in custody do not exhibit greater needs 

than their male counterparts. More males 

are below grade level (50 percent of males 

vs. 41 percent of females), more males 

have been expelled (29 percent vs. 23 percent), and more males say they have been 

diagnosed with a learning disability (31 

percent vs. 25 percent). Males and females 

attend school in custody and earn high 

school credentials at equal rates; however, more males than females receive job 

training (20 percent vs. 13 percent). More 

females receive no educational service 

beyond their regular school hours 

(57 percent vs. 45 percent). 

 

0 10 20 30 40 50 60 70 

Females Males

Attention 

Hallucinations 

Anger 

Anxiety 

Isolation/

Depression 

Trauma 

Suicidal 

Thoughts/

Feelings 

Percentage With Above-Average “Yes” Answers in Domain 

Mental/Emotional Domain 

Figure 4: Percentage of Males and Females With Above-Average 

Numbers of “Yes” Responses to Mental and Emotional 

Survey Questions 

Conclusion 

SYRP provides a unique perspective on 

circumstances of juveniles in custody because it asks youth offenders about their 

mental, emotional, and physical problems 

and whether they are getting the services 

they need. It places youth’s needs in context by combining their answers with what 

facility administrators report about their 

screening protocols and the services provided at the facilities. The results reveal a 

broad range of needs in the custody population, show the extent to which existing 

services address these needs, and identify 

a number of areas in which improvements 

should be made. 

Many important research questions about 

youth in custody remain unanswered. 

These include: 

◆	 Did youth receive any mental health or 

substance abuse treatment before they 

entered custody? What are their treatment needs when they are released 

from custody? Is there continuity in the 

services they receive after returning to 

the community? 

◆	 What percentage of youth with prior 

physical or sexual abuse had contact 

with the child protective services 

system because of that abuse? What 

percentage of youth had contact with 

the child protective services system for 

other reasons (e.g., caretaker neglect, 

incapacity, or absence)? 

◆	 When youth attend school in custody, what kind of curriculum do they 

receive? Does it coordinate with the 

course of study they would get in their 

home school? How do they score on 

basic literacy and mathematical skills? 

7 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

◆	 What healthcare needs do youth have 

when they enter custody? What injuries 

or illnesses do they acquire during 

their time in custody? How did they 

obtain health care before they entered 

custody? Did they have health insurance? What healthcare coverage will 

they have after release from custody? 

The following recommendations are based 

on SYRP’s findings in this bulletin. They indicate several ways in which policies and 

programs could better address the needs 

of youth in custody: 

◆	 Improve coverage of mental health 

services. SYRP findings suggest that 

mental health services are not reaching 

the youth who need them. Although 

mental health services are generally 

available across facilities, nearly half 

of youth have not met with a counselor 

at their current facility and less than 

half are in facilities that provide mental 

health evaluations or appraisals for all 

residents. Additionally, these appraisals seem to make little difference for 

SYRP Research Questions Addressing Youth’s Needs and the Services They 

Receive in Custody 

General Research Question Specific Research Questions 

What are youth’s emo­ ◆ What is the incidence of youth’s recent problems with anger, isolation, anxiety/feartional and psychologi­ fulness, and other psychological difficulties? 

cal problems and what 

counseling have they 

received? 

◆ What are their prior experiences of abuse? How do females and males differ 

in their prior abuse experiences? How does the prevalence of prior physical and 

sexual abuse among youth in placement compare with that in the general population? 

◆ What percentages report prior suicide attempts and/or recent suicidal thoughts or 

feelings? What are the differences between females and males in placement? How 

does this compare with their age peers in the general population of youth? 

◆ Have they received any counseling in their current facility? If so, what is its format, 

frequency, and when did they last see a counselor? How helpful do youth think their 

psychological counseling is? 

◆ What are their facility’s practices on screening and evaluating residents for suicide 

risk and other mental health needs? 

What are youth’s prob­ ◆ What is the youth’s history with drug and/or alcohol use? How does this compare 

lems with drugs and/or with use in the general population? 

alcohol? ◆ How frequently were they using drugs and/or alcohol at the time they were taken into 

custody? 

◆ What problems did they experience from their substance use (e.g., blackouts, failure 

to meet responsibilities) before coming into custody? 

◆ Have they received any drug/alcohol counseling in their current facility? If so, what 

is its format, frequency, and when did they last see that counselor? How helpful do 

youth think their substance abuse counseling is? 

◆ What substance abuse services does their facility provide? Does their facility use 

substance abuse treatment professionals? 

◆ What are their facility’s practices on screening and evaluating residents for 

substance abuse problems? 

What are youth’s medical ◆ What percentage of youth report needs for medical care due to illness, injury, 

needs, and what services or problems with eyes, teeth, hearing, or other physical conditions? 

have they received in 

their current facility? ◆ Did they receive the care they needed? If not, why not? 

◆ Are they on any regular medication? What is the medication for? Does the facility 

have outside medical professionals prescribe and/or monitor psychotropic medications for their residents? 

What educational servic­ ◆ What percentage of youth are attending school in placement? How many hours do 

es have youth received in they attend? What kind of educational program(s) are they attending? 

their current facility? ◆ What percentage of those with a diagnosed learning disability are in a special education program? 

◆ What percentage of youth feel that their facility has a good school program? 

8 
9 

 

 

 

whether a youth receives counseling— 

youth are equally likely to receive 

counseling in their current facility 

regardless of their answers about their 

recent mental and emotional problems 

or previous traumatic experiences. 

◆	 Raise standards for the qualifications 

of mental health providers. SYRP 

documents considerable unevenness 

in the qualifications of mental health 

providers. Nearly 9 in 10 youth (88 

percent) are in facilities where staff 

who counsel youth about their mental 

health problems are not mental health 

professionals. Youth whose survey 

answers indicate a need for counseling 

give poorer ratings to any counseling 

they do receive. 

◆	 Target substance abuse counseling 

and treatment more effectively. SYRP 

documented extensive substance abuse 

problems in the custody population, 

but existing intervention and treatment programs are not serving large 

sectors of youth who need them. Only 

about half of youth who report recent 

problems related to drug or alcohol use 

have received substance abuse counseling in their current facility. 

◆	 Provide more comprehensive substance abuse interventions and use 

more qualified substance abuse 

service providers. Substance abuse 

education and counseling are widely 

available, with the large majority of 

youth held in facilities that offer these 

services. However, less than two-thirds 

of youth are in facilities that develop 

specific treatment plans, less than 

half are in facilities that assign a case 

manager to oversee youth’s substance 

treatment, and just one in six youth are 

in living units specialized for substance 

abuse problems. Moreover, three in five 

youth are in facilities where noncertified counselors offer substance abuse 

counseling, whereas less than onefourth of youth are in facilities where 

certified professionals provide all 

substance abuse treatment. 

◆	 Obtain systematic information on 

youth’s educational needs and 

services in placement and define 

more specific minimum standards. 

Little information is available on how 

facilities address the educational needs 

of youth in custody—what curriculums 

they use, whether they match what 

youth would receive in their community, 

and whether they assess and target 

materials and assignments to individual 

youth’s needs. SYRP findings suggest Endnotes 

that most youth in custody spend fewer 1. See the sidebar “Research Ques­ hours in school than their peers in tions Addressing Youth’s Needs and the the general population. In addition to Services They Receive in Custody,” which increasing general education services, lists the research questions that guided facilities should expand special edu­ the design of survey items related to the cation services. Although youth in cus­ topics reported here. tody have seven times the rate of 

diagnosed learning disabilities com­ 2. Not all youth in custody have been 

pared to youth in the general popula­ charged with or adjudicated for offenses. 

tion, less than half receive a special Some have been placed in custody beeducation program while in custody. cause of health and safety concerns (e.g., 

keeping them away from abusive parents Overall, the SYRP results presented in this or guardians).The focus of the SYRP study bulletin illuminate ways that the juvenile was on youth who were placed in custody justice system could improve programs as the result of an offense. and living environments for youth in 

custody. Continuing research on this 3. MAYSI is a 52-question survey desitopic would clarify how treatment and gned to help juvenile justice facilities 

education programs might better address identify youth with special mental health 

youth’s needs and improve their mental needs. 

and physical health, which could help to 4. MAYSI’s Depressed-Anxious Scale is a reduce recidivism. nine-question scale that asks youth about 

their symptoms of depression and anxiety 

WesDax: Providing Survey of Youth in Residential 

Placement Data Online 

WesDax is an online query and analysis system that allows users to construct their own 

results from the Survey of Youth in Residential Placement. The system is designed for audiences without technical or statistical expertise, including policymakers, service providers, 

and the general public. 

The WesDax system: 

◆ Operates in a standard Web browser and requires no special software. 

◆ Offers a tutorial for new users, including a glossary of terms. 

◆ Computes accurate totals and percentages. 

◆ Can provide statistical measures of precision (in the form of standard errors or 


confidence intervals).
 

To use WesDax, see the “Online Analysis” link at www.syrp.org. 
10 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

to determine whether they require mental 

health treatment for these problems. SYRP 

included only part of this MAYSI scale (six 

of the nine items). The percentage of “caution” and “warning” scores would be even 

higher if SYRP had asked all nine MAYSI 

items in this domain. SYRP youth received 

“caution” scores if they answered yes 

to three of the Depressed-Anxious items 

or to two items in the section related to 

suicide; they received “warning” scores if 

they answered yes to six of the DepressedAnxious items or to three or more of the 

suicide items. 

5. Rates of 3 percent to 10 percent have 

been reported for local general population samples (Andrews and Lewinsohn, 

1992; Lewinsohn, Rohde, and Seeley, 1996; 

Reinherz et al., 1995; Meehan et al., 1992; 

Safer, 1997; Shaffer et al., 1990; and Velez 

and Cohen, 1988). The two waves of the 

National Comorbidity Study (NCS–1 and 

NCS–R) show a rate of 6 percent for ages 

represented in SYRP (Harvard School of 

Medicine, 2005). 

6. The authors supplemented the 

information the youth gave in their SYRP 

answers with information regarding security, services, and staffing that the facility 

administrators provided. Combining these 

sources provides a comprehensive view of 

the needs and experiences of youth in residential placement, the available services, 

and resources provided in response to 

those needs. 

7. The authors computed all general 

population percentages in this section 

using data for 12- to 20-year-olds from the 

National Survey on Drug Use and Health, 

2003, at the Substance Abuse and Mental 

Health Data Archive Online Data Analysis 

System, at http://webapp.icpsr.umich.edu/ 

cocoon/SAMHDA/DAS3/00064.xml. 

8. A blackout is a period of memory loss 

for events that occurred while a person 

was intoxicated (White, 2003). Alcohol-related blackouts are common in adolescents 

who are clinically diagnosed with alcohol 

dependence and abuse (Martin et al., 2007). 

9. SYRP responses are based on youth 

reports. A youth’s perception regarding 

the effectiveness of his or her counseling 

may not accurately reflect its true effectiveness. 

10. Although SYRP did not inquire about 

the specific nature of illness or injuries, 

some research (Morris, 2005) suggests 

youth in custody face sexually transmitted 

infections, hepatitis, tuberculosis, orthopedic problems, gastrointestinal disorders, cancer, and dermatologic difficulties. 

References 

Andrews, J.A., and Lewinsohn, P.M. 1992. 

Suicidal attempts among older adolescents: 

Prevalence and co-occurrence with psychiatric 

disorders. Journal of the American Academy of 

Child and Adolescent Psychiatry 31:655–662. 

Blum, J., Ireland, M., and Blum, R.W. 2003. 

Gender differences in juvenile violence: A report 

from Add Health. Journal of Adolescent Health 

32:234–240. 

Borowski, I.W., Ireland, M., and Resnick, M.D. 

2002. Violence risk and protective factors 

among youth held back in school. Ambulatory 

Pediatrics 2(6):475–484. 

Burrell, S., and Warboys, L. 2000. Special Education and the Juvenile Justice System. bulletin. 

Washington, DC: U.S. Department of Justice, 

Office of Justice Programs, Office of Juvenile 

Justice and Delinquency Prevention. 

Byrd, R.S., Weitzman, M., and Auinger, P. 1997. 

Increased behavior problems associated with delayed school entry and delayed school progress. 

Pediatrics 100(4):654–661. 

Desai, R.A., Goulet, J.L., Robbins, J., Chapman, 

J.F., Migdole, S.J., and Hoge, M.A. 2006. Mental 

healthcare in juvenile detention facilities: A 

review. Journal of the American Academy of Psychiatry Law 34:204–214. 

Grisso, T., and Barnum, R. 2006. Massachusetts 

Youth Screening Instrument, Version 2 (MAYSI–2): 

User’s Manual and Technical Report, 2006 

Revised Edition. Sarasota, FL: Professional 

Resource Press. 

Grisso, T., Barnum, R., Fletcher, K.E., Cauffman, 

E., and Peuschold, D. 2001. Massachusetts Youth 

Screening Instrument for mental health needs of 

juvenile justice youths. Journal of the American 

Academy of Child and Adolescent Psychiatry 

40(5):541–548. 

Harvard School of Medicine. 2005. National 

Comorbidity Survey (NCS) and National Comorbidity Survey Replication (NCS–R). Available 

online: www.hcp.med.harvard.edu/ncs. 

Hawkins, J.D., Herrenkohl, T., Farrington, D.P., 

Brewer, D., Catalano, R.F., and Harachi, T.W. 

1998. A review of predictors of youth violence. 

In Serious and Violent Juvenile Offenders: Risk 

Factors and Successful Interventions, edited by R. 

Loeber and D.P. Farrington. Thousand Oaks, CA: 

Sage Publications, Inc., pp. 106–146. 

Hennessey, M., Ford, J.D., Mahoney, K., Ko, S.J., 

and Siegfried, C.B. 2004. Trauma Among Girls 

in the Juvenile Justice System. Los Angeles, CA: 

National Child Traumatic Stress Network. 

Hubbard, D.J., and Pratt, T.C. 2002. A metaanalysis of the predictors of delinquency among 

girls. Journal of Offender Rehabilitation 34:1–13. 

Huizinga, D., Loeber, R., Thornberry, T.P., and 

Cothern, L. 2000. Co-Occurrence of Delinquency 

and Other Problem Behaviors. bulletin. Washington, DC: U.S. Department of Justice, Office of 

Justice Programs, Office of Juvenile Justice and 

Delinquency Prevention. 

Levitt, S.D., and Lochner, L. 2001. The determinants of juvenile crime. In Risky Behavior 

Among Youths: An Economic Analysis, edited 

by J. Gruber. Chicago, IL: University of Chicago 

Press, pp. 327–373. 

Lewinsohn, P.M., Rohde, P., and Seeley, J.R. 

1996. Adolescent suicidal ideation and attempts: 
11 

 

 

 

 

 

 

 

 

Prevalence, risk factors, and clinical implications. 

Clinical Psychology: Science and Practice 3:25–46. 

Lochner, L., and Moretti, E. 2004. The effect 

of education on crime: Evidence from prison 

inmates, arrests, and self-reports. American 

Economic Review 94(1):155–189. 

Lugaila, T.A. 2003. A Child’s Day: 2000 (Selected 

Indicators of Child Well-being). Household 

Economic Studies. Washington, DC: U.S. Department of Commerce, Economics and Statistics 

Administration, U.S. Census Bureau. 

Martin, C.S., Kaczynski, N.A., Maisto, S.A., 

Bukstein, O.M., and Moss, H.B. 2007. Patterns of 

DMS–IV alcohol abuse and dependence symptoms in adolescent drinkers. Journal of Studies 

on Alcohol 56(6):672–680. 

McBride, D.C., VanderWaal, C.J., Terry, Y.M., 

and VanBuren, H. 1999. Breaking the Cycle of 

Drug Use Among Juvenile Offenders. Technical 

Report. Washington, DC: U.S. Department of 

Justice, Office of Justice Programs, National 

Institute of Justice. 

Mears, D. 2001. Critical challenges in addressing 

the mental health needs of juvenile offenders. 

Justice Policy Journal 1(1). 

Meehan, P.J., Lamb, J.A., Saltzman, L.E., and 

O’Carroll, P.W. 1992. Attempted suicide among 

young adults: Progress towards a meaningful 

estimate of prevalence. American Journal of 

Psychiatry 149:41–44. 

Morris, R.E. 2005. Healthcare for incarcerated 

adolescents: Significant needs with considerable obstacles. Virtual Mentor, American Medical 

Association Journal of Ethics 7:3. 

National Commission on Correctional Healthcare. 2004. Standards for Health Services in 

Juvenile Detention and Confinement Facilities. 

Chicago, IL: National Commission on Correctional Healthcare. 

Reinherz, H.Z., Giaconia, R.M., Silverman, A.B., 

Friedman, A., Pakiz, B., Frost, A.K., and Cohen, 

E. 1995. Early psychosocial risks for adolescent 

suicidal ideation and attempts. Journal of the 

American Academy of Child and Adolescent 

Psychiatry 34:599–611. 

Safer, D.J. 1997. Self-reported suicide attempts 

by adolescents. Annals of Clinical Psychiatry 

9:263–269. 

Sedlak, A.J., and Bruce, C. Forthcoming. Youth’s 

Characteristics and Backgrounds: Findings from 

the Survey of Youth in Residential Placement: 

Washington, DC: U.S. Department of Justice, 

Office of Justice Programs, Office of Juvenile 

Justice and Delinquency Prevention. 

Shaffer, D., Vieland, V., Garland, A., Rojas, M., 

Underwood, M., and Busner, C. 1990. Adolescent suicide attempters: Response to suicideprevention programs. Journal of the American 

Medical Association 264(24): 3151–3155. 

Skowyra, K., and Cocozza, J.J. 2006. A Blueprint 

for Change: Improving the System Response to 

Youth with Mental Health Needs Involved with 

the Juvenile Justice System. Delmar, NY: National 

Center for Mental Health and Juvenile Justice. 

Skowyra, K., and Cocozza, J.J. 2007. Blueprint for 

Change: A Comprehensive Model for the Identification and Treatment of Youth with Mental Health 

Needs in Contact with the Juvenile Justice System. 

Delmar, NY: Policy Research Associates, Inc. 

Teplin, L.A., Abram, K.M., McLelland, G.M., 

Dulcan, M.K., and Mericle, A.A. 2002. Psychiatric disorders in youth in juvenile detention. 

Archives of General Psychiatry 59:1133–1143. 

U.S. Census Bureau. 2005. Single grade of enrollment and high school graduation status for people 3 years old and over, by age (single years 

for 3 to 24 years), race, and Hispanic origin: 

October 2003 (table 2 at school enrollment— 

social and economic characteristics of students: 

October 2003, detailed tables). Washington, DC: 

U.S. Census Bureau, Population Division, Education and Social Stratification Branch. 

U.S. Department of Education. 2003. The 

Educational System in the United States: Case 

Study Findings. Washington, DC: U.S. Department of Education; National Institute on Student 

Achievement, Curriculum, and Assessment; Office of Educational Research and Improvement. 

U.S. Department of Education. 2005. 26th Annual 

(2004) Report to Congress on the Implementation 

of the Individuals with Disabilities Education Act, 

vol. 1. Washington, DC: U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education 

Programs. 

U.S. Department of Education, Office for Civil 

Rights. 2007. Civil rights data collection: 2004. 

Digest of Education Statistics, 2007. Washington, 

DC: U.S. Department of Education. 

Velez, C.N., and Cohen, P. 1988. Suicidal behavior and ideation in a community sample of 

children: Maternal and youth reports. Journal 

of American Academy of Child and Adolescent 

Psychiatry 27:349–356. 

Wasserman, G.A., Keenan, K., Tremblay, R.E., 

Coie, J.D., Herrenkohl, T.I., Loeber, R., and 

Petechuk, D. 2003. Risk and Protective Factors 

of Child Delinquency. Bulletin. Washington, DC: 

U.S. Department of Justice, Office of Justice 

Programs, Office of Juvenile Justice and Delinquency Prevention. 

White, A.M. 2003. What happened? Alcohol, 

memory blackouts and the brain. Alcohol 

Research and Health 27:186–196. 

Wintersteen, M.B., Diamond, G.S., and Fein, J.A. 

2007. Screening for suicide risk in the pediatric 

emergency and acute care setting. Current Opinion in Pediatrics 19:398–404. 
PRESORTED PRESORTED STANDARD STANDARD 

POSTAGE POSTAGE & FEES PAID 

DOJ/OJJDP DOJ/OJJDP

PERMIT NO. G–91

 

U.S. Department Department of Justice 

Office of Justice Justice Programs Programs

Office of Juvenile Juvenile Justice Justice and Delinquency Delinquency PreventionPrevention 

Washington, Washington, DC 20531 

Official Official BusinessBusiness 

Penalty Penalty for Private Private Use $300 

Bulletin Bulletin NCJ XXXXXX NCJ 227728

*NCJ~227728*

Acknowledgments 

Andrea J. Sedlak, Ph.D., Vice President and Associate Director of Human Services 

Research at Westat, is Project Director of the Survey of Youth in Residential Placement (SYRP). Karla S. McPherson, Ph.D., is a Senior Study Director at Westat and 

SYRP Analyst. Other Westat staff who made key contributions to the study included David Cantor, Ph.D., John Hartge, John Brown, Alfred Bishop, Gary Shapiro, 

Sheila Krawchuk, Carol Bruce, Ph.D., Monica Basena, Kristen Madden, and Ying 

Long, as well as many other dedicated Westat staff, too numerous to name here. 

The National Council on Crime and Delinquency (NCCD) assisted during the SYRP 

design and preliminary analyses under a subcontract to Westat. Contributing 

NCCD staff included Madeline Wordes, Ph.D., Eileen Poe-Yamagata, and Christopher J. Hartney. 

Several OJJDP program managers provided support and guidance over the course 

of the project: Joseph Moone, Barbara Allen-Hagen, and Janet Chiancone. Many 

members of the SYRP Advisory Board offered constructive advice at critical points. 

Finally, this study would not have been possible without the generous cooperation 

of the many state directors and hundreds of local facility administrators who provided the information, space, and staff support needed to conduct the survey and 

the thousands of youth who agreed to participate and contributed their time and the 

details of their lives and experiences in answering the SYRP questions. 

This bulletin was prepared under grant number 

2001–JR–BX–K001 from the Office of Juvenile 

Justice and Delinquency Prevention (OJJDP), 

U.S. Department of Justice. 

Points of view or opinions expressed in this 

document are those of the authors and do 

not necessarily represent the official position 

or policies of OJJDP or the U.S. Department 

of Justice. 

The Office of Juvenile Justice and Delinquency 

Prevention is a component of the Office of 

Justice Programs, which also includes the 

Bureau of Justice Assistance; the Bureau of 

Justice Statistics; the Community Capacity 

Development Office; the National Institute 

of Justice; the Office for Victims of Crime; 

and the Office of Sex Offender Sentencing, 

Monitoring, Apprehending, Registering, and 

Tracking (SMART).