Center for Mississippi Health Policy

Written by Omkar Ghodke, University of Mississippi Winner of the Terence Downer Scholarship

Executive Summary

Mississippi is facing a serious youth mental health crisis that contributes to rising juvenile incarceration rates and suicides. Youth in rural areas, in particular, struggle to access timely mental health services. To address this, we propose a Mental Health First Responder Training Program for school staff, police officers, and community workers, supported by telehealth services. Schools and community centers should act as hubs for immediate mental health support, helping de-escalate crises before they turn into legal problems. Similar approaches in other states have successfully reduced youth incarceration and improved overall mental health outcomes.

Background

A large number of Mississippi’s youth are facing mental health crises that contribute to high rates of juvenile detention, particularly for non-violent offenses, and a concerning rise in suicides. Nationally, 70% of detained youth have a diagnosed mental health condition¹, and Mississippi is in line with these trends. The state has poor access to mental health services, with only 3.86 mental health providers per 100,000 people in health professional shortage area². Additionally, just 42 psychiatrists serve 59 of rural counties and 6 rural counties have no mental health providers³, leaving many without local access to essential services. This lack of support places vulnerable youth at greater risk of entering the juvenile justice system or suffering from untreated mental health conditions, often resulting in tragic outcomes like suicide.

Geographic barriers worsen the issue. Youth in rural areas, where mental health services are scarce, are more likely to end up in the juvenile justice system instead of receiving the care they need⁴. The report from Center for Healthcare Quality and Payment Reform notes that half of rural hospitals are at risk of closing⁵, leaving significant parts of the state without access to critical mental health care. Those with mental health disorders are more likely to be arrested for non-violent offenses⁴. Annually, 800 people in Mississippi are detained, primarily because of untreated or undiagnosed mental health conditions⁶.

The state has also seen a sharp rise in youth suicide rates. The Centers for Disease Control reports a 38% increase in suicides among people aged 10-24 between 2001 and 2021⁷. Many young people, struggling with depression, anxiety, and trauma, feel isolated and overwhelmed, leading to suicidal thoughts when they lack adequate mental health support.

Although Mississippi has expanded telehealth services through the University of Mississippi Medical Center’s telehealth network, these services remain underused. The Mississippi Division of Medicaid found that only 2% of youth on Medicaid used telehealth services in 2018⁸, highlighting the gap in reaching at-risk youth, particularly in rural areas⁸. The connection between untreated mental health conditions and incarceration is clear, and the costs of housing detained youth with mental health needs are high.

Targeted interventions using existing telehealth infrastructure could reduce youth incarceration significantly by providing timely care before crises escalate into criminal behavior. This model has proven successful in other states, showing similar potential in Mississippi.

Key Findings

Mississippi continues to struggle with high youth incarceration rates, with 65% of detained youth diagnosed with a mental health disorder. The state’s shortage of providers—3.86 per 100,000 people—makes accessing mental health care difficult, especially in rural areas. Rural youth are more likely to be incarcerated due to limited mental health services, as almost half of rural hospitals are at risk of closure. Although telehealth services are available, only 2% of youth on Medicaid used them in 2018.

States have successfully reduced youth incarceration by integrating telehealth⁹ into schools and community centers. Implementing similar programs in Mississippi could greatly reduce juvenile incarceration rates, particularly for non-violent offenses driven by untreated mental health conditions.

Recommendation

To address the youth mental health crisis and lower incarceration rates, we propose a Mental Health First Responder Training Program for school staff, police officers, and community workers. Supported by telehealth services, this program would allow trained personnel to quickly connect youth to mental health professionals. Training would focus on recognizing early signs of mental health crises, de-escalation techniques, and early intervention strategies.

Schools and community centers should serve as hubs for these interventions, offering immediate access to mental health professionals via telehealth. This model ensures youth receive timely care, preventing crises from escalating into legal problems.

The program would be cost-effective by utilizing existing personnel and telehealth infrastructure. Training could be delivered online, supplemented with workshops to build crisis management skills. With schools and community centers already in place, minimal investment is required to integrate telehealth equipment. By preventing escalation, Mississippi can avoid costly interventions, such as emergency room visits or detention, which place significant financial strain on the state’s healthcare and juvenile justice systems.

Conclusion

Mississippi’s youth mental health crisis is directly linked to its high juvenile incarceration and suicide rates. The state’s limited access to mental health providers, particularly in rural areas, combined with underused telehealth services, leaves many at-risk youths without support. A Mental Health First Responder Training Program, backed by telehealth, offers a cost-effective and practical solution. Schools and community centers should serve as hubs for these interventions, providing timely care and preventing legal issues. By leveraging existing infrastructure and focusing on early intervention, Mississippi can reduce youth incarceration, avoid costly interventions, and improve mental health outcomes for its most vulnerable youth.

References

1. Model Programs Guide Literature Review: Intersection Between Mental Health and the Juvenile Justice System | Office of Juvenile Justice and Delinquency Prevention. Accessed September 9, 2024. https://ojjdp.ojp.gov/library/publications/model-programs-guide-literature-review-intersection-between-mental-health-and
2. Mental Health Care Health Professional Shortage Areas (HPSAs). KFF. Accessed September 9, 2024. https://www.kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas-hpsas/
3. Mississippi – 2024 – III.B. Overview of the State. Accessed September 9, 2024. https://mchb.tvisdata.hrsa.gov/Narratives/Overview/df43de25-ef21-42ab-89a3-53210e20d7d8
4. Ghiasi N, Azhar Y, Singh J. Psychiatric Illness and Criminality. In: StatPearls. StatPearls Publishing; 2024. Accessed September 9, 2024. http://www.ncbi.nlm.nih.gov/books/NBK537064/
5. Bose D. Nearly half of rural hospitals at risk of closure in Mississippi, new data shows. Mississippi Today. July 24, 2023. Accessed September 9, 2024. http://mississippitoday.org/2023/07/24/mississippi-rural-hospitals-new-report/
6. Taft I. Mississippi jailed more than 800 people awaiting psychiatric treatment in a year. Just one jail meets state standards. Mississippi Today. November 13, 2023. Accessed September 9, 2024. http://mississippitoday.org/2023/11/13/mississippi-jailed-more-than-800-people-awaiting-psychiatric-treatment-in-a-year-just-one-jail-meets-state-standards/
7. Products – Data Briefs – Number 471 – June 2023. doi:10.15620/cdc:128423
8. Jonk Y, O’Connor H, Talbot JA. Pre-Pandemic Telehealth Use among Children in Medicaid Managed Care and Fee-for-Service Programs. Published online 2018.
9. Telemedicine can improve the health of youths in detention – PubMed. Accessed September 9, 2024. https://pubmed-ncbi-nlm-nih-gov.umiss.idm.oclc.org/18776069/

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Omkar Ghodke completed his Bachelor’s in Pharmacy in 2020 from H.K College of Pharmacy, India, and is currently a third-year PhD student in the Department of Pharmacy Administration and is pursuing an Interdisciplinary Graduate Minor in Applied Statistics at the University of Mississippi. His current research interests include health economics, healthcare utilization, and outcomes research, with a focus on opioid use, rheumatoid arthritis, and chronic pain management. He is particularly interested in evaluating how policy interventions and health education initiatives impact healthcare access and patient outcomes. The Department of Pharmacy Administration at the University of Mississippi School of Pharmacy is home to 7 faculty members and 18 graduate students. The department draws upon its over 60-year history with work in health care outcomes, pharmacoeconomics, pharmacoepidemiology, health-related quality of life, pharmaceutical policy, and community-based research, among other areas. The Department of Pharmacy Administration maintains strategic partnerships with several external stakeholders such as Mississippi Medicaid, Pharmacy Quality Alliance, and the National Community Pharmacists Association.

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