Care planning needs for youth in custody, inpatient and outpatient settings

Background Despite comparable rates of mental health problems, youth in custody, in- and outpatient groups typically differ with respect to experiences of trauma and expression of internalizing and externalizing behaviours. While comparisons between these groups have been made, an exploration of specific care planning needs have yet to be investigated. Objectives To compare the care planning needs identified for youth in custody and those within inpatient (e.g., mental health hospital admissions) and outpatient treatment (e.g., community mental health agencies), while controlling for age and sex differences. Methods The sample consisted of 755 youth aged 16–19 recruited from youth justice and mental health facilities in Ontario, Canada. Semi-structured interviews using the interRAI child and youth suite of instruments were completed. Items that signify imminent risk, as well as the accompanying Collaborative Action Plans among samples of youth were compared. Results Male youth in custody were more likely to require care planning related to substance/tobacco/nicotine use and withdrawal symptoms than both in- and outpatient youth. They also were more likely to report harm to others, while inpatient females were most likely to report self-harm. Irrespective of case type, males were more likely to require care planning related to educational needs and communication. Youth in custody were more likely to trigger Collaborative Action Plans related to transition planning compared to patient groups. Conclusions Evidence suggests that youth involved within the justice system present with a unique and complex set of needs. This research supports the need for tailored services and evidence-based intervention that may transgress the boundaries of the youth justicesetting to the community.