Wisconsin at Intersection of Public Health and Youth Justice

June 06, 2023 | Caitlin Langhorne Griffith, Meghan Auer, Allison Budzinski

Despite the decline in the number of people arrested and incarcerated over the past decade, youth—especially youth of color and those exposed to adverse childhood experiences (ACEs) are still criminalized at alarming rates. ACEs are potentially traumatic events that occur in childhood that impact a child's well-being and overall development. This can range from experiences of violence, abuse, and neglect to substance use, mental health problems, and growing up with an incarcerated parent.

When children's ACEs remain unaddressed, they become more vulnerable to falling into patterns they learned and were exposed to throughout their childhoods, fostering intergenerational concerns and trauma. Preventing trauma and parental separation in these formative years can ultimately prevent justice involvement in later years. However, by the time any child encounters law enforcement and the judicial system, it is likely they have already experienced trauma and adversity in their lives.

Health agencies play a critical role in strengthening supports for children and youth with incarcerated parents and justice-involved youth to stop the cycle of incarceration. By partnering across sectors and systems (e.g., youth justice, mental health, education, healthcare groups, community organizations), health agencies can (1) integrate a public health approach, (2) move prevention upstream to address factors such as socioeconomic status, housing, access to education and healthcare, and (3) break the intergenerational cycle. By working upstream, health agencies can better address the shared root causes of harmful behaviors.

Wisconsin Youth Justice Partnerships

Data from the Wisconsin Behavioral Risk Factor Surveillance System from 2017 to 2020 show that people of color in the state of Wisconsin experience ACEs at disproportionate rates. While 59% of Wisconsinites who identify as white report at least one ACE, others experience ACEs at higher rates, including those who identify as Black (77%), Hispanic (73%), Asian (65%), and American Indian (64%).

Furthermore, 60% of Wisconsin adults experienced at least one ACE before age 18, and 16% of Wisconsin adults have an ACE score of four or higher. An ACE score is based on 10 questions about common traumatic childhood experiences (before 18 years old); each “yes” response receives one point with the sum being the total number of ACEs. Wisconsin recognizes four or more ACEs as a critical "tipping point" for elevated health risks later in life. Therefore, justice-involved youth who report an ACE score of four or more must receive services and support to buffer potential negative impacts and intergenerational trauma.

Wisconsin Black youth represent about 10% of the youth population in Wisconsin, yet they account for more than 16% of youth arrests. In Wisconsin, youth of color are simultaneously represented at disproportionate rates across the five contact points of the youth justice system: arrest, diversion, pre-trial detention, disposition commitments, and adult transfer. This data drives state agency collaboration and the prioritization of upstream prevention.

Multiple Wisconsin state agencies, including the Department of Corrections, Department of Justice, Department of Children and Families, Department of Public Instruction, and Department of Health Services, formed partnerships to better support youth in the justice system. These agencies work together to shift the focus from unnecessarily bringing youth into the system to more of a prevention and diversion approach, ensuring youth and their families have what they need to thrive.

In late January, Wisconsin’s governor issued a press release declaring 2023 the Year of Mental Health and backed the proclamation by announcing approximately $500 million dollars in new funding allocated to expanding mental health and substance use services across the state. What's more, the Wisconsin 2023-2025 biennium budget includes proposals to support community-based services and expand independent living services to youth.

These measures will support new linkages and access to care without confinement or formal youth justice system involvement. In addition, Wisconsin has a fully funded Medicaid benefit known as Comprehensive Community Service, a behavioral health program focused on meeting individual needs across the lifespan, and is accessible in 70 of the state's 72 counties, as well as through three of the 11 federally recognized tribal nations with members in Wisconsin.</p

These state agencies are also working together to meet children where they are, connect them with care, and integrate their voices into all initiatives. They anchor themselves with input from their communities and use the Wisconsin State Health Improvement Plan as a roadmap in their push to reduce the risk of additional ACEs among youth in the justice system, mitigate intergenerational trauma, and prevent ACEs among future youth. Furthermore, the state of Wisconsin is leveraging the Resilient Wisconsin initiative to break down silos across state agencies, recognizing ACEs as a public health crisis that demands a comprehensive public health response.

Considerations for Building Partnerships in the Youth Justice System

Diverting youth from the justice system through upstream prevention requires cross-system partnerships. Public health agencies can play a critical role in helping state partners prevent and divert youth from becoming involved in the justice system, specifically by championing upstream primary prevention health policies. By collaborating with the youth justice system, public health agencies are better positioned to prevent youth from ever engaging with the system. Other considerations include:

• Connect with State Advisory Group (SAG) contacts and inquire about ways public health staff can partner with them. Inquire about openings within the SAG or the appointment process in your state and work to acquire a public health representation. SAGs were established under the federal Juvenile Justice and Delinquency Prevention Act and are integral in ensuring state compliance and utilization of federal funding. SAGs also play an influential role in directing funds toward upstream prevention initiatives through grants and technical assistance.
• Take inventory of grassroots organizations supporting youth justice diversion to explore opportunities for ACEs prevention. Identify concurrent primary prevention programs underway at local health departments that complement the youth justice diversion strategies. Once these relationships are established, present braided and layering funding or grant opportunities that dually address ACEs prevention and youth justice diversion.
• Invite youth justice staff and youth with lived experience to statewide or local public health meetings, Communities of Practice, or other gatherings to include a variety of voices in planning public health initiatives or programs that could align with current efforts.
• Invest in routine ACEs screening programs for early ACEs detection, as well as for preventing accumulation of additional ACEs. For example, public health agencies can champion medical providers using the Pediatric ACEs and Related Life-Events Screener to support early and consistent screening.
• Share public health data with youth justice partners to strengthen their ability to dedicate resources toward upstream prevention and diversion strategies. Youth justice partners may also be willing to share data and trends promoting cross-collaboration and strengthening funding proposals.
• Use upstream policy strategies (e.g., increasing economic supports for families, supporting safe and stable housing, supporting caregiver health) to prevent ACEs and, in turn, help prevent youth justice system involvement.

ASTHO thanks Wisconsin's Department of Corrections, Department of Justice, Department of Children and Families, Department of Public Instruction, and Department of Health Services for contributing to this blog. The State of Wisconsin typically utilizes the terms “youth” and youth justice” rather than “juvenile.” The Wisconsin Department of Health Services prefers the use of the term “Indigenous peoples.” However, the Wisconsin Behavioral Risk Factor Surveillance System survey uses “American Indian.”