September 22, 2022
As King County seeks to achieve its objective of “zero youth detention” — in the end eliminating the follow of juvenile detention within the county —College of Washington researchers are working to assist handle main systemic challenges in how younger folks interact with well being care.
With a strategic plan to shut the juvenile detention heart by 2025, King County wants an more and more sturdy system to make sure youth are getting constant and accessible providers, together with well being care. That is very true upon launch from juvenile detention, the researchers say.
“For many youth involved in the criminal legal system, their first health care experience as an adolescent is in a setting of confinement and trauma,” mentioned Sarah Gimbel, a professor of kid, household and inhabitants well being nursing within the UW Faculty of Nursing. “So, while juvenile detention is a less than ideal setting for getting physical and mental health care, it is also critical that we are meeting kids where they are today, addressing their needs, and improving the chances that they will continue to engage in health care services in the community.”
Whereas King County guides investments and creates insurance policies that help households and stop youth involvement within the authorized system, Gimbel explains, enhancing help for youth who’re already detained is essential, particularly as they reenter their communities from detention.
“You think about the resources and money that we put into incarcerating kids, and yet so little is put on the back end to help them move back into their communities,” Gimbel mentioned. “We’ve been working for over a year in the juvenile detention clinic with some really amazing frontline health workers, but they are struggling in a system that is scheduled to close down without a concrete plan for what that looks like.”
Gimbel has been co-leading a staff of UW specialists in an implementation science project to construct a system for managing well being look after youth who’re detained. The staff, which incorporates advisers and specialists from the native organizations CHOOSE180 and Community Passageways, along with Harborview Medical Heart, are enhancing the standard of care within the clinic on the King County Kids and Household Justice Heart to higher serve and monitor the well being wants of younger folks.
“Prior to young people engaging with the criminal legal system, they’re often coming from neighborhoods that are under-resourced and under-supported,” mentioned Sean Goode, govt director of CHOOSE180. “The data tells us that a large percentage of the children who are living incarcerated are coming from neighborhoods that are farthest away from economic justice, health justice, educational justice, and so the sheer amount of disproportionate injustices they’ve experienced prior to walking into a courtroom are extraordinary. Then they end up incarcerated, living in these facilities, and for likely the first or second time in their lives, they begin to be asked questions about their health and well-being.”
The UW staff’s systems-building effort has funding from varied state and basis sources, however within the spring Gimbel made a pitch on the UW Faculty of Nursing’s “Dawg Tank” grant competitors. She gained the $15,000 award with a plan to reinforce the programs method with the creation of a nurse navigation place to assist younger folks handle their healthcare that might be exterior of the justice heart’s clinic. The nurse will work intently with CHOOSE180.
“Navigating our health care system is very difficult,” mentioned Addy Borges, a UW graduate scholar engaged on the programs challenge. “When a young person is involved in the criminal legal system, there are usually many other competing priorities and stressors facing them and their families, so navigating health care can be particularly challenging.”
The concept to attempt the nurse-navigation challenge got here from conversations with group members and repair suppliers in regards to the results of detention and how you can make well being care accessible for youth and households who’ve been marginalized by the present programs.
“Our hope is that this nurse navigation pilot can be part of the movement toward a community-based system that does not involve detention,” Borges mentioned. “It is an evolving concept that will be guided by community organizations that have deep experience in this space.”
Goode provides that these youth are confronted with a confluence of challenges, together with that once they depart incarceration, they’re additionally leaving the care plans which will have been launched for the primary time inside these partitions.
“And for the young people who have been forced to live incarcerated inside those facilities, we have to figure out how we make sure they have care when they exit back into the community,” Goode mentioned. “That’s where this conversation around nurse navigation comes into play. It’s an opportunity to imagine a world where young people more immediately have access to a continuation of care that allows them to continue their journey toward wellness and wholeness.”
The UW group has discovered that inefficiencies in well being care providers in juvenile detention facilities, exacerbated by communication and coordination limitations, end in missed alternatives to handle the person well being wants of youth. The group goals to interrupt down partitions between siloed providers with a view to enhance communication and make suppliers work synergistically.
“My work sits at the intersection of nursing (and health care in general) and systems engineering,” Gimbel mentioned. “I focus on helping frontline health workers do their work better with whatever resources they have. And right now, addressing the complex health needs of youth engaged in the criminal legal system has the potential to improve their well-being, as well as prevent recidivism and support King County’s goal of zero youth detention.”
“We know with certainty that young people, when they’re engaged in their healing journey, are far less likely to cause harm,” mentioned Goode, “which allows us all to live in the community we dream of, a community where all young people have the opportunity to thrive, live and love.”
For extra data, contact Sarah Gimbel at [email protected].