As Mental Health Awareness Month draws to a close, the Division of Juvenile Justice and Delinquency Prevention is highlighting the mental health needs of our juvenile population and looking forward to the opening of a new unit that will provide crisis mental health services to youth in juvenile detention and youth development centers.
DJJDP Youth Carry Significant Mental Health Needs
Each December, DJJDP conducts a point-in-time survey at all youth development centers and contractual residential programs focusing on the mental health needs of the youth in those settings.
The 2025 point-in-time survey revealed that 99.4% of juveniles in North Carolina’s YDCs caried at least one mental health diagnosis. The YDC population carried an average of 4.7 distinct mental health and/or substance use disorder diagnoses, and in some cases as many as 12. Of the youth surveyed, 58% were taking prescribed psychotropic medication, and 43% had co-occurring mental health and substance use diagnoses.
In contractual residential settings, including group homes, short-term residential facilities, transitional living homes, and crisis and assessment centers, 79% of youth carried at least one mental health diagnosis. Of those surveyed, 22% of youth in these settings were taking prescribed psychotropic medication, and 22% had co-occurring mental health and substance use diagnoses.
While juvenile detention centers are not included in the point-in-time survey as they are short term and do not complete comprehensive assessments on all youth, youth in North Carolina’s JDCs carry significant mental health needs. One example is that from Nov. 1, 2024 through Oct. 31, 2025, 210 youth in North Carolina’s juvenile detention centers were placed on suicide watch, representing 8.43% of the total detention population during that time. Of those youth, only four were admitted to psychiatric inpatient hospitalization.
Barriers to Care
Unfortunately, involvement in the juvenile justice system can create barriers for youth who might be better served through a residential mental health placement. JJ-involved youth may be rejected from such placements for a variety of reasons, ranging from aggressive or sexualized behavior to gang involvement or a history of running away. In some cases, the label of being JJ-involved is enough to keep youth out of a residential mental health setting and in juvenile detention or a youth development center.
In an anecdotal sample of 425 detention admissions from 2021-2025, youth awaiting behavioral health placement remained in detention for 71 days on average, nearly three times longer than the average length of stay in detention for a youth under juvenile jurisdiction (25 days in 2025). 116 of those admissions lasted longer than 90 days.
Of the 425 admissions, 168 were recommended for placement at a psychiatric residential treatment facility, but only 70 ended up in PRTF placement. 103 of those admissions resulted in youth returning to the community with no additional placement, and a total of 33 youth waiting for behavioral health placements ended up in a JJ youth development center. All told, only 59% of detention admissions in that sample concluded with a youth entering the recommended level of care afterward.
Mental Health Care in JJ Facilities
With residential mental health placements sometimes not being an option, or taking some time to come to fruition, DJJDP ends up working to provide the best mental health services available while in JJ facilities. However, these youth are recognized as needing services from behavioral health type facilities.
At every juvenile detention center, a contract mental health clinician is available on a part-time basis each day. In youth development centers, where youth are committed for an average of 14 months, full-time clinicians work hand in hand with contractors to provide more robust, mental health services as part of an overarching service plan for each youth. Every facility has designated locations where youth can receive counseling in a confidential setting.
In addition to these clinical resources, all direct care staff in JJ facilities receive trauma-informed training to understand how negative childhood experiences can contribute to a child’s behavior, relationship challenges and involvement with the juvenile justice system. Many direct care staff also receive training in Mental Health First Aid, a program to help non-clinical staff assist youth in times of mental health crisis until they can connect with a licensed mental health clinician.
A New Resource for Youth in Crisis
Despite these services and resources, youth in juvenile justice facilities sometimes require significant crisis mental health support beyond the capacity of a detention center or youth development center. In some instances, these youth may be experiencing serious emotional disturbances, substance use withdrawal, psychosis and/or be on suicide watch.
In years past, these circumstances have resulted in frequent transportation to outside behavioral health facilities, straining staff resources as youth remain in unsecure facilities, sometimes for a week or longer.
This summer, thanks to a $3.5 million investment from the NC Department of Health and Human Services, DJJDP is partnering with New Hope Treatment Centers and Alliance Health to open a new enhanced mental health services unit to support youth in crisis at C.A. Dillon Juvenile Detention Center in Butner. With a capacity of 8-10 youth, this new unit will provide a secure setting where youth in juvenile justice facilities can receive crisis and stabilization services and work to send youth either back to their facility of origin or other options based on the student’s community-based plan.
In collaboration with DJJDP direct care and behavioral health staff, clinicians from New Hope Treatment Center will provide crisis intervention and support for youth, conduct assessments, provide clinical interventions and provide whole-person care, engaging with each youth’s service planning team and family partners.
This is not a placement alternative, but rather a resource that should help youth make progress toward their goals in their original facilities or wherever the plan is for the youth upon release. The net result of this new unit will be better mental health support for youth in DJJDP facilities, decreased reliance on external behavioral health facilities for youth who must be in detention and youth development centers, and better connections to community-based services.