Bridging mental health and juvenile justice: Adolescents’ and parents’ experiences of intersectoral collaboration

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Although intersectoral collaboration is increasingly promoted as best practice, little is known about the perspectives of the adolescents and their parents concerning the involvement and coordination of judicial and mental health services in the context of rehabilitation and reintegration. Since they are the ones navigating these complex systems, this study used in-depth interviews with 13 adolescents during or after their stay in a juvenile correctional facility and 10 parents. Using thematic analyses, four main themes were constructed: (1) customised support that transcends sectoral divisions and organisational silos, (2) collaboration between organisations and sectors, (3) client-centred relationships and (4) care with a long-term perspective. Our findings reinforce emerging evidence that relational continuity and a single coordinating role are pivotal determinants of sustainable youth mental health outcomes during and after detention. juvenile offender mental health intersectoral collaboration vulnerable youth families Introduction Various studies have examined the prevalence of psychopathology among detained adolescents, such as psychotic illness, major depression, attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD), with significant numbers as a result (Beaudry et al., 2021 ; Livanou et al., 2019 ). In addition, most of the incarcerated youth have experienced a history of traumatic events (Abram et al., 2004 ; Carrion & Steiner, 2000 ). Furthermore, in Flanders (Belgium), research showed that 82.9% of male and 94.9% of female incarcerated adolescents had at least one psychiatric disorder, with numbers for internalising disorders (such as major depressive disorder and PTSD) ranging from 20.4% for males to 56.4% for females and externalising disorders (such as ADHD and conduct disorder) up to 81.2% for males and 86.7% for females (Van Damme et al., 2014 ). Given that the expertise of a juvenile correctional facility (JCF) is mainly behavioural and crime-oriented combined with the high prevalence of mental health (MH) disorders among the inhabitants, the Flemish JCFs collaborate with MH organisations located nearby. By means of outreaching, several adolescents are followed up by a MH team for treatment, (crisis) intervention and/or medication consultation. This way their right to treatment (Assembly, 1989 ) is being met, their quality of life can be improved (de Ruigh et al., 2019 ) and the likelihood of reoffending reduced (Hoeve et al., 2013 ; Zeola et al., 2017 ). Despite these high rates of MH difficulties and current efforts in the workplace, access to timely and continuous treatment remains inconsistent. Although intersectoral collaboration is increasingly promoted as best practice (Reeves et al., 2011 ; Strype et al., 2014 ; Stutsky & Laschinger, 2014 ), most studies focus on structures and professional perceptions (Blanken et al., 2022 ; Kaasbøll et al., 2022 ; Schwalbe & Maschi, 2012 ), whereas the voices of adolescents and their families — who ultimately navigate these complex systems — are largely absent. Studies concerning the collaboration between JCFs and MH services primarily focus on evidence-based practices and practical applications, such as appropriate screening and assessment during detention (Swank & Gagnon, 2017 ; Underwood & Washington, 2016 ), effective clinical interventions (Clair-Michaud et al., 2016 ; O'Hara et al., 2019 ; Pullmann, 2010 ) or access to healthcare during community re-entry (Barnert et al., 2020 ). Other research described feelings of frustration and helplessness among professionals because of their perception of poor intersectoral collaboration (McElvaney & Tatlow-Golden, 2016 ) and pointed to the need for MH training for JCF-staff on topics such as adolescent development and trauma (Gagnon & Swank, 2021 ). Studies that examine the perspectives of incarcerated adolescents or their parents tend to focus on how they perceive their situation or trajectory, rather than on their view of the broader context within which the care is provided by different sectors. Studies looked at, for example, experiences of detained adolescents from racial and ethnic minorities (Shelton, 2004 ), adolescents’ perceptions of substance use (Jackson-Roe et al., 2015 ) or family relations (Ginner Hau & Azad, 2022 ). Studies concerning the parental perspective, for example, examined facilitators and barriers for participation (Simons, van der Vaart, et al., 2019 ) or constructed a model for parent involvement during detention (Burke et al., 2014 ). Yet to meet the complex needs of these adolescents and their parents, we believe it is vital to better understand their experiences with different services providing support. Therefore, the following research question guides this study: How do adolescents in juvenile correctional facilities and their parents experience the involvement and coordination of judicial and MH services? By answering this question, we aim to contribute to practical improvements and policy-making decisions at the level of the JCFs, MH services and their partnership. Methods This study was part of a comprehensive qualitative study to optimise the collaboration between JCFs and MH care providers. To answer the research question, a qualitative approach by means of semi-structured interviews both with adolescents and parents was chosen. This study was approved by the Antwerp University’s Ethical Committee of Social and Humane Sciences (SHW_2022_82_2 and SHW_2024_18). Participants (and guardians of minors) provided informed consent. Participants During 2023–2024, youth and parents were purposively recruited for in-depth interviews. First, all long-term cohabitation units of all five JCFs in Flanders (Belgium) were visited by first author. There, the adolescents present were informed about the study and invited to consider voluntary participation. In total, 107 adolescents (88 male, 19 female) were approached. 39 of them (33 male, 6 female) showed interest. Additionally, two adolescents who had previously left the JCF and were known to the researchers from earlier research activities were contacted via their parents, and one expressed interest. In total, 40 adolescents expressed interest in an individual interview. For those aged 18 + and minors with parental consent, JCF staff scheduled an interview at a convenient time. Communication regarding the adolescent who had already left the facility occurred directly between the parent and EC. Common reasons not to plan an interview were: difficulties in contacting a parent/guardian, no consent, fugue or change of residence of the adolescent. The final sample consisted of 13 adolescents (10 male, 3 female). Most of the interviews (n = 11) took place within the walls of the JCF, one in a connecting care facility and one at home. The participating adolescents were 13 to 19 years old, with an average of 16. Their length of stay varied between one to over nine months. Eight of them received support from the outreaching MH team. With this sample, we intended to interview a diverse population of adolescents with varying residential experience (i.e. gender, age, duration of stay, (not) receiving MH support) so that a broad impression can be formed about their experiences. To approach parents/guardians, we asked JCF staff to contact them. Ten parental figures (7 biological, 2 foster, 1 stepparent; all hereafter referred to as parent) were willing to participate voluntarily. Seven interviews were conducted, including four individual and three partner interviews. At the time of the interview, their children (4 males, 3 females) resided in a JCF (n = 3), at home (n = 2) or in a youth facility (n = 2) after leaving a JCF. The age of their child ranged from 13 to 18 years, with an average of 15. Data collection In-depth interviews were conducted by a doctoral researcher (EC) using an interview guide. This guide was applied flexibly to accommodate participants’ needs, language use and concerns regarding the predefined topics. Sample questions for parents were: In what way are you involved in your child’s MH care during their stay in a JCF? and What would a quality MH offer look like to you? For adolescents, four customizable interview techniques were used (Teachman & Gibson, 2013 ): (1) a short get-to-know-each-other activity, (2) visual metaphors, (3) vignettes about made-up detained adolescents, (4) sentence starters. Sample questions were: Think of a moment during your stay when you felt bad. Which image best matches your emotions and why? What could help this fictional character in distress? and Complete this sentence: ‘What’s good/bad about my MH counselling is … ’ All interviews were audio-recorded and transcribed verbatim, with all information that could identify them removed. Interviews with youth lasted 20 to 69 minutes (average of 49min), with parents 1 to 2,5 hours (average of 1h28min). Participants were not compensated for participation. Each interview started with explaining the research goals, obtaining consent, and reminding participants they could stop anytime, skip questions and that anonymity was assured. Data analysis Reflexive thematic analysis (TA) (Braun & Clarke, 2021 ) was used to identify shared themes. TA offers the possibility of an inductively-developed critical analysis with which we aim to capture and explore perspectives of youths and parents concerning the involvement of different service providers. Although we operated without a pre-defined coding frame, our background as criminologist (first author), clinical psychologist (second author) and child and adolescent psychiatrist (third author) and associated theoretical frameworks will likely have had an influence. The analysis was led by a single researcher (first author), beginning with a manual pen-and-paper approach. A fellow PhD researcher independently coded 15% of the youth transcripts as part of the analysis. Codes and themes were then revised and discussed within the research team through which a deeper understanding of the data was achieved. Afterwards, first author independently coded all 20 transcripts with NVivo 14. Next, the authors discussed to establish themes per respondent type. A member-checking phase followed: participants received an information poster with thematic patterns related to their role and could provide feedback, which was integrated into the final analysis. All quotes are translated into English and labelled with a pseudonym, for adolescents with indication of their age, for adults with indication of their role. Results From adolescents’ and parents’ perspectives on the involvement and coordination of different service providers, four main themes were constructed: (1) customised support that transcends sectoral divisions and organisational silos, (2) collaboration between organisations and sectors, (3) client-centred relationships and (4) care with a long-term perspective. Customised support that transcends sectoral divisions and organisational silos Adolescents and parents often face a complex care system where providers specialize in certain domains, have waiting lists or impose conditions for support. Since these youth often have complex needs, such factors limit both accessibility and continuity of care. Hence, some respondents feel they are being passed from one provider to another or that no service meets their needs, which can lead to frustration, powerlessness or isolation. “It’s just beyond words. [A child psychiatric hospital], in the context of voluntary care: a three-year waiting list. That’s just not normal, right? By then, she would’ve already hanged herself, so to speak.” (parent Yasmin) “She spent um, a year in [a child psychiatric hospital]. And something definitely went wrong there in terms of… um, care. It was like… yeah… for them, after a year it was basically, ‘okay, we actually can’t do anything more, so yeah… she’s going home.’ It kind of felt like she was just shown the way out – that’s how it felt to us, sort of like… […]And there, yeah… there was just, there was nothing else available for us anymore.” (parent Jolanda) Throughout the interview, parent Karin lists all the steps she has taken with her child. Due to MH workers relocating, unavailable outpatient service, limited period of crisis care and organisations refusing her child, the search for appropriate care went on endlessly. Yet the psychiatric conclusion always came down to: “[Your child] is in need for stability.” As a result, crisis admission and collocation were no longer carried out. “And then,” says Karin, “the JCF comes in. That’s what they call the solution. ” Like Karin, other parents and some adolescents feel as if some are staying in a JCF due to a lack of alternatives. “Yeah, that’s why I’m in the JCF now. Because they can’t… Because they don’t have a spot anywhere else for me. Somewhere that suits my needs.” (Robby, 18 yrs) “I get that this place is meant for punishment. But… there are young people here who shouldn’t be punished. And… they just need help. And that should be taken into account too.” (Walt, 13 yrs) Parents identify opportunities to improve service provision. Firstly, a cross-sectoral coordinating agency could facilitate access to appropriate care and intervene when parents cannot cope or navigate the system. Secondly, MH care could be organised more effectively across organisational boundaries to avoid the constant turnover of professionals and ensure care follows adolescent’s needs rather than institutional constraints. “Well, I think… a coordinator who guides you along – I think that’s a really beautiful word, coordinator – that’s what you need, because you can’t see the wood for the trees anymore, with all those rules.” (parent Adam) “And thát is the big problem. There’s no continuity. And that a psychologist belongs to an institution and speaks very much from the institution’s perspective. From their capacity and their rules.” – “And hardly from the child’s perspective, right?” – “Not from the child’s needs.” (parents Karin and Martin) “But if you’ve got someone different every time!” – “A new face and it always creates a kind of barrier.” (parents Jolanda and Peter) Ilya (18 yrs) struggles with this lack of continuity of MH care during his stay. “I’ve had 20 psychologists in my life already and all that. I’m not going to tell my life story to someone again,” he exclaims. Collaboration between organisations and sectors Even with less compartmentalised and coordinated support, combining different areas of expertise remains essential to address the complex needs of those involved. Therefore, high-quality collaboration and cross-sector exchange are crucial. Our respondents offer several recommendations on shaping such collaboration and key elements to consider. Firstly, for adolescents on the intersection between challenging behaviour and MH problems, the focus of care must be directed at both aspects simultaneously. Professionals with diverse backgrounds and expertise can mutually reinforce their work. “No, they really need intensive support from the right people in the right place. People who are trained to work with children like that.” (parent Mary) “If I could turn back time, I’d just really like to talk to a psychologist. Someone who understands trauma. Someone who truly gets how you feel, someone who’s actually studied that. (Diego, 18 yrs) “No, with the JCF, well yeah… I’ll keep saying it: it is what it is and it will always be a JCF. But inside, it does function.” – “But there’s a real need for something that brings safety, predictability and psychiatric know-how.” – “That’s really missing, you know. That psychiatric know-how… really, in an institution like the JCF – or at least in some of them – you should have a psychiatrist employed full-time, someone who’s constantly involved.” (parents Karin and Martin) Secondly, despite calls for effective integration of JCF and MH services, it remains crucial for adolescents to be able to confide in a MH professional who is independent of the criminal justice system and bound by professional confidentiality. “[The MH worker] would always say: ‘We’re not writing anything down for your file,’ so to speak. So you could really tell them anything.” (Kai, 16 yrs) Although parents recognise the need for confidentiality to allow their child to express themselves fully, some struggle with limited insight into their child’s problems or feel their parental perspective is overlooked. So, thirdly, clear communication and information sharing on both judicial and MH process can facilitate this, ideally as a two-way exchange. “You want information! How’s your child doing? You don’t want [the MH care hiding] behind patient confidentiality. […] Feedback to parents? Zero! And what’s essential – and I get it, the whole patient relationship and ethics and blah blah, sure, that’s valid. But legally: until they’re eighteen, I’m their guardian. Then they should change the law.” (parent Adam) “I would’ve really liked to speak to that psychiatrist. […] But that was the only moment I actually felt like, ‘wait a minute… what exactly are we doing here?’ Um, and then towards the end, he suddenly decided to stop her [medication]. Because [my child] said, ‘I don’t feel anything from it. For falling asleep.’ While I was thinking: […] if you’d just communicated that with me beforehand, or checked in with me like, ‘how do you experience it?’ then maybe it wouldn’t have been stopped.” (parent Yasmin) Lastly and subsequently, another important anchor point is knowing the MH diagnosis and its implications. This is crucial for the adolescent, future organisations, and parents. For the latter, such psychoeducation can strengthen the connection with their child and clarify certain behavioural patterns. “So from there, things could move forward in the other institutions, because they started to see… And for us, it was really a kind of revelation too – we recognised certain situations, and then they said things like, ‘look, that’s because of the autism.’” (Parent Peter) “We actually learned a great deal from that explanation of how a child with attachment issues functions – the theory really taught us a lot.” (parent Karin) Some adolescents also seek greater insight into their psychological functioning. For instance, Walt (13 yrs) expresses a desire for professionals to “explain, like, explain things or something. What, what that is… brain stuff or something. […] How that, sometimes, works differently for other people.” Client-centred relationships Regardless of which organisation or sector is providing care, adolescents and parents emphasise the importance of high-quality relationships with individual caretakers. A focus on client-centred care demands investment in connectedness and understanding of needs. In view of this, adolescents want to be seen for who they are, beyond their behaviour or the juvenile crime they’ve committed. “People who come into contact with the police and all that… that doesn’t automatically make someone a bad person,” describes Salma (15 yrs). Like her, other youngsters want their personality and strengths to be at the heart of interactions with service providers. “Well, I am just a boy who needs a lot of attention, and when I’m, um, how should I put it, hyperactive, I seek even more attention. I’m someone who really demands a lot of attention. […] I’m a bit different from other young people.” (Robby, 18 yrs) “I’ve known [the residential workers] for a long time, you know. So I’ve been through things with some of them, well, actually, with all of them. Good times, bad times. And what I mean by that is… I trust them. […] I know they’ve got my back. Because when I’m going through a tough time or when I’m not feeling great, we talk sometimes and stuff…” (Yarah, 16 yrs) Not only the adolescents, but also parents are looking for individual attention and predictability for their child. Humanity and a strong relationship with the care worker remain crucial. “[My son] actually needs one-on-one support.” (parent Omar) “But I think… especially if young people are given the feeling of ‘we’re listening, we hear you’ – that’s really important. Not just listening, but actually hearing them and doing something. And that goes for wat the youngsters say and also what the parents say…” (parent Jolanda) “Warm spaces for young people, with structure, a sense of safety and where parents can truly catch their breath.” (parent Aicha) Jolanda and Aicha already allude to their own needs as parents. Although parental respondents emphasise that the adolescent should be at the centre of the rehabilitative care pathway, they also require support. “Yeah, because sometimes they don’t really think like… okay, the youngster has been placed there [in the JCF], and that’s not pleasant – it’s confronting for a child. But that child also has a family. You know what I mean?” (parent Yasmin) “Yeah, maybe the parents also need support, you know? It’s not just about the youngster. Of course, the young person is really important, because they’re the ones who… But, yeah, the parents too…” (parent Jolanda) Parents identify a variety of support needs for themselves, ranging from MH to financial support or help in (re)building the bond with their child. “Well, you do need quite a bit of support, don’t you. […] Yeah, it’s like you can’t switch off your mind anymore, right? So yeah, you don’t get any mental rest during all that time.” (parent Peter) “And you’re breaking up a family, right. I mean, staying together as a couple through this wasn’t easy. […] It has… such an impact.” (parent Aicha) Given this significant impact, having someone to listen, provide updates on their child’s trajectory or someone who walks alongside them during the difficult process can make an important difference. If I have any problems, they always say: ‘You can call us, you can call the residential group.’ They really do try to help us.” (parent Omar) “And that there [in the JCF] are people who actually dó offer guidance and information. Who say: ‘Ah, we don’t know either, but we’ll help you look for answers.’ And I really appreciate that! Just admitting that. That kind of contact. That’s honestly so nice!” (parent Adam) “Just, you know, well… being able to get things off your chest, right? That’s it… ‘cause honestly, I can’t talk to anyone about it, except maybe my partner and my parents.” (parent Mary) Likewise, adolescents highlight the significance of a trusting relationship with their care provider, including both JCF and MH professionals. They want the opportunity to talk when needed and to rely on someone who can ease insecurities and help express feelings. “Then [me and the outreach MH worker] also talk a bit. Just about, yeah, what’s still going to happen and stuff. Or about what’s coming next. Or if I have questions, that they can answer them.” (Hassan, 19 yrs) “We sometimes have a laugh. So I just feel comfortable with [the child and youth psychiatrist], really.” (Yarah, 16 yrs) “Sometimes I just talk to [the MH worker]. And… just do fun activities and stuff. Crafts, drawing, things like that.” (Tim, 16 yrs) Care with a long-term perspective Related to the need for continuity, adolescents and parents value clarity about the remaining trajectory and future support. The possibility of losing this support causes anxiety for some parents. “Yeah, a follow-up… I don’t know if that even exists, a follow-up service after the [forensic child and adolescent psychiatry-unit]. That would be good. But I think once all the sentences have been served, yeah, then he’s really free and there’s nothing left anymore, right? […] If you come from psychia… or from the [forensic child and adolescent psychiatry-unit], it’s a sign that there’s… eh, and they pass on signals like: ‘look, listen, keep an eye on him because… yeah… that boy really does have problems.’ That there would be some kind of follow-up, that he’d have to talk to those people every now and then, like, ‘how are things, how’s it going?’” (parent Harold) In a different context, Diego (18 yrs) expresses a similar wish of having someone “who could come to my place every week or something. See how things are going at home.” For some youngsters, it is reassuring that this kind of continuing service can be provided by a MH professional they already know. “Because when I’m outta here [the JCF], I’ll probably carry on working with [the outreaching MH worker].” (Kenzo, 17 yrs) Nico (14 yrs) shares his view on whether aftercare should be provided by the same person as during his JCF stay: “actually ye… actually no. You know, actually yes. Because I know mrs [outreach psychologist] well. I don’t know the other support workers that well.” On the other hand, says Salma (15 yrs), the connection takes precedence: “ To know them for a while, that doesn’t matter. It’s just that the person has to click with you.” Which leads back to the importance of the individual relationship that is built up between care recipient and provider. Respondents stress that sustainability requires introducing the next step at their own pace. “Because from the way she talked sometimes, I could tell she wasn’t really ready to come back yet. And I kind of knew she wouldn’t handle that [the transition from a closed to an open environment] very well. They’d told me at the JCF that it would be more gradual. That they’d work with test moments and gradually build it up. And I thought… I think that’ll be better. For her. And for our peace of mind too.” (parent Yasmin) “Well, she was still in that defensive mode and that… and we felt that, if at that moment you just put her back into society, at home with us, that… that it would immediately go wrong again. You could feel it, well, you could see it in the way she acted too, right. […] So we thought, ‘yeah, no, it’s not going to work like this, right.’ If it’s going to have a real chance, there needs to be another step in between, yeah.” (parent Peter) That “other step” could be another care facility, a gradual build-up of freedoms, close follow-up during the transition or a visit to the new environment and preparation for what to expect there. “I’m actually glad to be out of here [the JCF]. Out of the closed institution. Because there, you have a bit more freedom than here. And um… also, yeah, well… scared… I’m actually a bit afraid, like, imagine if things go wrong, then… then… then do you come back here? And that’s what I want to avoid, you know?” (Yarah, 16 yrs) Discussion By means of in-depth interviews with 13 detained adolescents and 10 parents, we focused on their perceptions of the involvement and coordination of both judicial and MH services. Due to (the need for) the simultaneous action of both sectors, providing support can become more complicated. Our findings reinforce emerging evidence that relational continuity and a single coordinating role are pivotal determinants of sustainable youth MH outcomes during and after detention. At the macro level, the complex care landscape and its perceived impenetrability leave our respondents with a sense of powerlessness. Nearly all our respondents are open to help but it seems impossible to get appropriate and timely support. In their Blueprint for Change, Skowyra and Cocozza (Skowyra & Cocozza, 2007 ) argue that MH, juvenile justice and other sectors share responsibility for these youth, making collaboration a cornerstone. Effective collaboration requires a shared goal, clear objectives and strategies to achieve them (Skowyra & Cocozza, 2007 ), while accountability may shift between organisations depending on the phase of the trajectory (Chuang & Wells, 2010 ; Skowyra & Cocozza, 2007 ). Due to the need for combining multiple areas of expertise, at the meso level, our respondents benefit from high-quality collaboration among professionals. Key concepts in a context in which simultaneous efforts are made to address (criminal) behaviour and MH are professional confidentiality, clear communication, information sharing and psychoeducation. In this regard, it is important to allocate time and resources for professionals to shape and maintain the collaboration. This way, a common language can develop and a lasting appreciation for each other’s contributions is fostered (Dickerson et al., 2012 ). The third, micro level of the findings comprises both our respondents’ immediate, present-day interactions, and their reflections on continuation of support. In the here and now, adolescents and parents highlight the importance of connecting relationships, aligning with relation-centred care that views relationships as therapeutic and interactions as outcome-shaping (Soklaridis PhD et al., 2016 ). Collaboration should therefore extend beyond service providers to include families (Simons, Mulder, et al., 2019 ), for example by supporting the restoration of parent-child bonds or offering MH care to parents. Regarding the long-term aspect, having a follow-up perspective and insight into possible future support, motivates and reassures people. Underwood et al. (Underwood PsyD et al., 2014 ) recommend intensive and specialized aftercare for juveniles with serious MH problems (Underwood PsyD et al., 2014 ). Re-entry and aftercare programs, aimed at continuing and coordinating services, are best to be initiated as soon as possible, either during the JCF trajectory or soon after (Zajac et al., 2015 ). Strengths and limitations Most respondents were recruited through purposive sampling, ensuring variation in adolescent and parent profiles. Still, participation bias cannot be ruled out. It is possible that mainly youth and parents who are more empowered and naturally more talkative participated in the interviews. Although parents concerned about their child’s MH were not specifically targeted, they may have been overrepresented in our study. Barriers (e.g. less involvement with the trajectory, not sufficiently proficient in Dutch) are likely to have had an influence in taking part. This may mean that the perspectives of youth and parents who struggle most to navigate the social service landscape and to express themselves verbally are underrepresented in this study. Implications for research and practice The research findings are consistent with the literature on intersectoral collaboration in rehabilitation services (Haight et al., 2014 ; McElvaney & Tatlow-Golden, 2016 ; Saia et al., 2020 ). Focusing on adolescents’ and parents’ perspectives provides valuable insights for policymakers and professionals seeking to develop more coordinated, responsive and relation-centred rehabilitation strategies. Moreover, it can help optimise intersectoral collaboration through reflection and identification of areas for improvement. In this way, it can serve as a good practice to inspire other forms of intersectoral collaboration, such as the operation of other closed or (semi-)open residential care programs for adolescents with MH problems. At their core, collaborative processes require the systematic identification of challenges and achievements, the cultivation of shared understanding and the maintenance of personal distinctiveness (van Hille, 2022 ). Declarations FUNDING: This work received funding. Specific details have been removed to preserve author anonymity during peer review. Author Contribution Conceptualisation and methodology: E.C., I.G.; Data analysis: E.C.; Writing – original draft: E.C., I.G.; Writing – review & editing: E.C., I.G., D.v.W.; Funding acquisition: I.G. All authors contributed to writing the manuscript and provided approval for the submitted version. Acknowledgement We highly appreciate the study participants, the members of the steering committee and researcher Iulia Andreea Vescan for their contribution. We acknowledge the use of Copilot for language editing. Data Availability The data underlying this study are not publicly accessible due to ethical and legal constraints aimed at protecting participant confidentiality. References Abram, K. M., Teplin, L. A., Charles, D. R., Longworth, S. L., McClelland, G. M., & Dulcan, M. K. (2004). Posttraumatic Stress Disorder and Trauma in Youth in Juvenile Detention. Archives of General Psychiatry , 61 (4), 403–410. https://doi.org/10.1001/archpsyc.61.4.403 Assembly, U. N. G. (1989). Convention on the Rights of the Child, 20 November 1989. Annual review of population law , 16 , 95–501. Barnert, E. S., Abrams, L. S., Lopez, N., Sun, A., Tran, J., Zima, B., & Chung, P. J. (2020). Parent and provider perspectives on recently incarcerated youths’ access to healthcare during community reentry. Children and Youth Services Review , 110 , 104804. https://doi.org/https://doi.org/10.1016/j.childyouth.2020.104804 Beaudry, G., Yu, R., Långström, N., & Fazel, S. (2021). An Updated Systematic Review and Meta-regression Analysis: Mental Disorders Among Adolescents in Juvenile Detention and Correctional Facilities. Journal of the American Academy of Child & Adolescent Psychiatry , 60 (1), 46–60. https://doi.org/https://doi.org/10.1016/j.jaac.2020.01.015 Blanken, M., Mathijssen, J., van Nieuwenhuizen, C., Raab, J., & van Oers, H. (2022). Intersectoral collaboration at a decentralized level: information flows in child welfare and healthcare networks. BMC Health Services Research , 22 (1), 449. https://doi.org/10.1186/s12913-022-07810-z Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide . SAGE Publications Ltd. Burke, J. D., Mulvey, E. P., Schubert, C. A., & Garbin, S. R. (2014). The challenge and opportunity of parental involvement in juvenile justice services. Children and Youth Services Review , 39 , 39–47. https://doi.org/https://doi.org/10.1016/j.childyouth.2014.01.007 Carrion, V. G., & Steiner, H. (2000). Trauma and Dissociation in Delinquent Adolescents. Journal of the American Academy of Child & Adolescent Psychiatry , 39 (3), 353–359. https://doi.org/https://doi.org/10.1097/00004583-200003000-00018 Chuang, E., & Wells, R. (2010). The role of interagency collaboration in facilitating receipt of behavioral health services for youth involved with child welfare and juvenile justice. Children And Youth Services Review , 32 (12), 1814–1822. https://doi.org/10.1016/j.childyouth.2010.08.002 Clair-Michaud, M., Martin, R. A., Stein, L. A. R., Bassett, S., Lebeau, R., & Golembeske, C. (2016). The Impact of Motivational Interviewing on Delinquent Behaviors in Incarcerated Adolescents. Journal of Substance Abuse Treatment , 65 , 13–19. https://doi.org/https://doi.org/10.1016/j.jsat.2015.09.003 de Ruigh, E. L., Popma, A., Twisk, J. W. R., Wiers, R. W., van der Baan, H. S., Vermeiren, R. R., J. M., & Jansen, L. M. C. (2019). Predicting quality of life during and post detention in incarcerated juveniles. Quality of Life Research , 28 (7), 1813–1823. https://doi.org/10.1007/s11136-019-02160-6 Dickerson, J. G., Collins-Camargo, C., & Martin‐Galijatovic, R. (2012). How collaborative the collaboration? Assessing interagency collaboration within a juvenile court diversion program. Juvenile and Family Court Journal , 63 (3), 21–35. https://doi.org/https://doi.org/10.1111/j.1755-6988.2012.01078.x Gagnon, J. C., & Swank, J. M. (2021). A National Survey on Mental Health Professional Development in Juvenile Justice Facilities: Implications for Youth Reentry. Behavioral Disorders , 46 (3), 149–162. https://doi.org/10.1177/0198742920911183 Ginner Hau, H., & Azad, A. (2022). Swedish Adolescent Female Offenders with Limited Delinquency: Exploring Family-Related Narratives from a Developmental Perspective. Child and Adolescent Social Work Journal , 39 (2), 219–232. https://doi.org/10.1007/s10560-020-00719-8 Haight, W. L., Bidwell, L. N., Marshall, J. M., & Khatiwoda, P. (2014). Implementing the Crossover Youth Practice Model in diverse contexts: Child welfare and juvenile justice professionals' experiences of multisystem collaborations. Children and Youth Services Review , 39 , 91–100. https://doi.org/https://doi.org/10.1016/j.childyouth.2014.02.001 Hoeve, M., McReynolds, L. S., & Wasserman, G. A. (2013). The Influence of Adolescent Psychiatric Disorder on Young Adult Recidivism. Criminal Justice and Behavior , 40 (12), 1368–1382. https://doi.org/10.1177/0093854813488106 Jackson-Roe, K., Murray, C., & Brown, G. (2015). Understanding young offenders' experiences of drinking alcohol: An interpretative phenomenological analysis. Drugs: Education Prevention & Policy , 22 (1), 77–85. https://doi.org/10.3109/09687637.2014.973371 Kaasbøll, J., Ådnanes, M., Paulsen, V., & Melby, L. (2022). Interagency collaboration for early identification and follow-up of mental health problems in residential youth care: evaluation of a collaboration model. Nordic Social Work Research , 12 (4), 592–607. https://doi.org/10.1080/2156857X.2020.1833964 Livanou, M., Furtado, V., Winsper, C., Silvester, A., & Singh, S. P. (2019). Prevalence of Mental Disorders and Symptoms Among Incarcerated Youth: A Meta-Analysis of 30 Studies. International Journal of Forensic Mental Health , 18 (4), 400–414. https://doi.org/10.1080/14999013.2019.1619636 McElvaney, R., & Tatlow-Golden, M. (2016). A traumatised and traumatising system: Professionals' experiences in meeting the mental health needs of young people in the care and youth justice systems in Ireland. Children and Youth Services Review , 65 , 62–69. https://doi.org/https://doi.org/10.1016/j.childyouth.2016.03.017 O'Hara, K. L., Duchschere, J. E., Shanholtz, C. E., Reznik, S. J., Beck, C. J., & Lawrence, E. (2019). Multidisciplinary partnership: Targeting aggression and mental health problems of adolescents in detention. American Psychologist , 74 (3), 329–342. https://doi.org/10.1037/amp0000439 Pullmann, M. D. (2010). Predictors of Criminal Charges for Youth in Public Mental Health during the Transition to Adulthood. J Child Fam Stud , 19 (4), 483–491. https://doi.org/10.1007/s10826-009-9320-8 Reeves, S., Lewin, S., Espin, S., & Zwarenstein, M. (2011). Interprofessional teamwork for health and social care . Wiley. Saia, K., Toros, K., & DiNitto, D. M. (2020). Interprofessional collaboration in social rehabilitation services for dually-involved Estonian youth: Perceptions of youth, parents, and professionals. Children and Youth Services Review , 113 , 104945. https://doi.org/https://doi.org/10.1016/j.childyouth.2020.104945 Schwalbe, C. S., & Maschi, T. M. (2012). Probation Officers’ Perspectives on Interagency Collaboration for Juvenile Offenders With Mental Health Problems. Psychiatric Services , 63 (8), 830–833. https://doi.org/10.1176/appi.ps.201100166%M 22854729 Shelton, D. (2004). Experiences of detained young offenders in need of mental health care. Journal Of Nursing Scholarship , 36 (2), 129–133. https://doi.org/10.1111/j.1547-5069.2004.04025.x Simons, I., Mulder, E., Breuk, R., Rigter, H., van Domburgh, L., & Vermeiren, R. (2019). Determinants of parental participation in Family-centered Care in Juvenile Justice Institutions. Child & Family Social Work , 24 (1), 59–68. https://doi.org/https://doi.org/10.1111/cfs.12581 Simons, I., van der Vaart, W., Vermeiren, R., Rigter, H., Breuk, R., van Domburgh, L., & Mulder, E. (2019). Parental Participation in Juvenile Justice Institutions: Parents’ Perspectives on Facilitating and Hindering Factors. International Journal of Forensic Mental Health , 18 (2), 124–137. https://doi.org/10.1080/14999013.2018.1526231 Skowyra, K. R., & Cocozza, J. J. (2007). Blueprint for change: A comprehensive model for the identification and treatment of youth with mental health needs in contact with the juvenile justice system . Policy Research Associates, Inc. Soklaridis PhD, S., Adler Nevo, M. D., FRCPC, G., & PRCPC, L. M. (2016). Relationship-centred care in health: A 20-year scoping review. Patient Experience Journal , 3 (1), 130–145. https://doi.org/10.35680/2372-0247.1111 Strype, J., Gundhus, H. I., Egge, M., & Ødegård, A. (2014). Perceptions of Interprofessional Collaboration. Professions and Professionalism , 4 (3). https://doi.org/10.7577/pp.806 Stutsky, B. J., & Laschinger, H. K. S. (2014). Development and testing of a conceptual framework for interprofessional collaborative practice. Health Interprofessional Practice and Education , 2 (2), eP1066. https://doi.org/10.7710/2159-1253.1066 Swank, J. M., & Gagnon, J. C. (2017). A National Survey of Mental Health Screening and Assessment Practices in Juvenile Correctional Facilities. Child & Youth Care Forum , 46 (3), 379–393. https://doi.org/10.1007/s10566-016-9379-5 Teachman, G., & Gibson, B. E. (2013). Children and Youth With Disabilities:Innovative Methods for Single Qualitative Interviews. Qualitative Health Research , 23 (2), 264–274. https://doi.org/10.1177/1049732312468063 Underwood, L. A., & Washington, A. (2016). Mental Illness and Juvenile Offenders. International Journal of Environmental Research and Public Health , 13 (2), 228. https://doi.org/10.3390/ijerph13020228 Underwood PsyD, L. A., Warren PsyD, K. M., Talbott PsyD, L., Jackson PhD, L., & Dailey Ma, F. L. L. (2014). Mental Health Treatment in Juvenile Justice Secure Care Facilities: Practice and Policy Recommendations. Journal of Forensic Psychology Practice , 14 (1), 55–85. https://doi.org/10.1080/15228932.2014.865398 Van Damme, L., Colins, O. F., & Vanderplasschen, W. (2014). Gender differences in psychiatric disorders and clusters of self-esteem among detained adolescents. Psychiatry Research , 220 (3), 991–997. https://doi.org/https://doi.org/10.1016/j.psychres.2014.10.012 van Hille, I. (2022). Omgaan met paradoxen in sector-overschrijdende samenwerking: Op zoek naar de balans tussen resultaat en ‘baggerwerk’. Beleid en Maatschappij , 49 (1), 82–85. Zajac, K., Sheidow, A. J., & Davis, M. (2015). Juvenile Justice, Mental Health, and the Transition to Adulthood: A Review of Service System Involvement and Unmet Needs in the U.S. Children And Youth Services Review , 56 , 139–148. https://doi.org/10.1016/j.childyouth.2015.07.014 Zeola, M. P., Guina, J., & Nahhas, R. W. (2017). Mental Health Referrals Reduce Recidivism in First-Time Juvenile Offenders, But How Do We Determine Who is Referred? Psychiatric Quarterly , 88 (1), 167–183. https://doi.org/10.1007/s11126-016-9445-z Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8658295","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":581426101,"identity":"9fc28d6a-780e-4ae1-9206-f78ad5aaa5f7","order_by":0,"name":"Elien Craenhals","email":"data:image/png;base64,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","orcid":"","institution":"University of Antwerp","correspondingAuthor":true,"prefix":"","firstName":"Elien","middleName":"","lastName":"Craenhals","suffix":""},{"id":581426105,"identity":"5e4532a9-b0a4-4f7f-8e31-bdb3fcf71276","order_by":1,"name":"Inge Glazemakers","email":"","orcid":"","institution":"University of Antwerp","correspondingAuthor":false,"prefix":"","firstName":"Inge","middleName":"","lastName":"Glazemakers","suffix":""},{"id":581426111,"identity":"5a5fbaa0-1b6e-49ac-8272-941904554a16","order_by":2,"name":"Dirk van West","email":"","orcid":"","institution":"University of Antwerp","correspondingAuthor":false,"prefix":"","firstName":"Dirk","middleName":"van","lastName":"West","suffix":""}],"badges":[],"createdAt":"2026-01-21 10:27:02","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8658295/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8658295/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106404672,"identity":"ae926179-0aef-4501-b3fc-3e75f6fd652a","added_by":"auto","created_at":"2026-04-08 09:16:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":412723,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8658295/v1/51078a7d-6f84-423c-8e1c-d3866671bf90.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Bridging mental health and juvenile justice: Adolescents’ and parents’ experiences of intersectoral collaboration","fulltext":[{"header":"Introduction","content":"\u003cp\u003eVarious studies have examined the prevalence of psychopathology among detained adolescents, such as psychotic illness, major depression, attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD), with significant numbers as a result (Beaudry et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Livanou et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). In addition, most of the incarcerated youth have experienced a history of traumatic events (Abram et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Carrion \u0026amp; Steiner, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). Furthermore, in Flanders (Belgium), research showed that 82.9% of male and 94.9% of female incarcerated adolescents had at least one psychiatric disorder, with numbers for internalising disorders (such as major depressive disorder and PTSD) ranging from 20.4% for males to 56.4% for females and externalising disorders (such as ADHD and conduct disorder) up to 81.2% for males and 86.7% for females (Van Damme et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGiven that the expertise of a juvenile correctional facility (JCF) is mainly behavioural and crime-oriented combined with the high prevalence of mental health (MH) disorders among the inhabitants, the Flemish JCFs collaborate with MH organisations located nearby. By means of outreaching, several adolescents are followed up by a MH team for treatment, (crisis) intervention and/or medication consultation. This way their right to treatment (Assembly, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e1989\u003c/span\u003e) is being met, their quality of life can be improved (de Ruigh et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) and the likelihood of reoffending reduced (Hoeve et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Zeola et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDespite these high rates of MH difficulties and current efforts in the workplace, access to timely and continuous treatment remains inconsistent. Although intersectoral collaboration is increasingly promoted as best practice (Reeves et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Strype et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Stutsky \u0026amp; Laschinger, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2014\u003c/span\u003e), most studies focus on structures and professional perceptions (Blanken et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Kaasbøll et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Schwalbe \u0026amp; Maschi, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2012\u003c/span\u003e), whereas the voices of adolescents and their families — who ultimately navigate these complex systems — are largely absent. Studies concerning the collaboration between JCFs and MH services primarily focus on evidence-based practices and practical applications, such as appropriate screening and assessment during detention (Swank \u0026amp; Gagnon, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Underwood \u0026amp; Washington, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), effective clinical interventions (Clair-Michaud et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; O'Hara et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Pullmann, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) or access to healthcare during community re-entry (Barnert et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Other research described feelings of frustration and helplessness among professionals because of their perception of poor intersectoral collaboration (McElvaney \u0026amp; Tatlow-Golden, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) and pointed to the need for MH training for JCF-staff on topics such as adolescent development and trauma (Gagnon \u0026amp; Swank, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudies that examine the perspectives of incarcerated adolescents or their parents tend to focus on how they perceive their situation or trajectory, rather than on their view of the broader context within which the care is provided by different sectors. Studies looked at, for example, experiences of detained adolescents from racial and ethnic minorities (Shelton, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2004\u003c/span\u003e), adolescents’ perceptions of substance use (Jackson-Roe et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) or family relations (Ginner Hau \u0026amp; Azad, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Studies concerning the parental perspective, for example, examined facilitators and barriers for participation (Simons, van der Vaart, et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) or constructed a model for parent involvement during detention (Burke et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e Yet to meet the complex needs of these adolescents and their parents, we believe it is vital to better understand their experiences with different services providing support. Therefore, the following research question guides this study: How do adolescents in juvenile correctional facilities and their parents experience the involvement and coordination of judicial and MH services? By answering this question, we aim to contribute to practical improvements and policy-making decisions at the level of the JCFs, MH services and their partnership.\u003c/p\u003e "},{"header":"Methods","content":"\u003cp\u003eThis study was part of a comprehensive qualitative study to optimise the collaboration between JCFs and MH care providers. To answer the research question, a qualitative approach by means of semi-structured interviews both with adolescents and parents was chosen. This study was approved by the Antwerp University’s Ethical Committee of Social and Humane Sciences (SHW_2022_82_2 and SHW_2024_18). Participants (and guardians of minors) provided informed consent.\u003c/p\u003e\u003cp\u003eParticipants\u003c/p\u003e\u003cp\u003eDuring 2023–2024, youth and parents were purposively recruited for in-depth interviews. First, all long-term cohabitation units of all five JCFs in Flanders (Belgium) were visited by first author. There, the adolescents present were informed about the study and invited to consider voluntary participation. In total, 107 adolescents (88 male, 19 female) were approached. 39 of them (33 male, 6 female) showed interest. Additionally, two adolescents who had previously left the JCF and were known to the researchers from earlier research activities were contacted via their parents, and one expressed interest. In total, 40 adolescents expressed interest in an individual interview. For those aged 18 + and minors with parental consent, JCF staff scheduled an interview at a convenient time. Communication regarding the adolescent who had already left the facility occurred directly between the parent and EC. Common reasons not to plan an interview were: difficulties in contacting a parent/guardian, no consent, fugue or change of residence of the adolescent. The final sample consisted of 13 adolescents (10 male, 3 female). Most of the interviews (n = 11) took place within the walls of the JCF, one in a connecting care facility and one at home. The participating adolescents were 13 to 19 years old, with an average of 16. Their length of stay varied between one to over nine months. Eight of them received support from the outreaching MH team. With this sample, we intended to interview a diverse population of adolescents with varying residential experience (i.e. gender, age, duration of stay, (not) receiving MH support) so that a broad impression can be formed about their experiences.\u003c/p\u003e\u003cp\u003eTo approach parents/guardians, we asked JCF staff to contact them. Ten parental figures (7 biological, 2 foster, 1 stepparent; all hereafter referred to as parent) were willing to participate voluntarily. Seven interviews were conducted, including four individual and three partner interviews. At the time of the interview, their children (4 males, 3 females) resided in a JCF (n = 3), at home (n = 2) or in a youth facility (n = 2) after leaving a JCF. The age of their child ranged from 13 to 18 years, with an average of 15.\u003c/p\u003e\u003cp\u003eData collection\u003c/p\u003e\u003cp\u003eIn-depth interviews were conducted by a doctoral researcher (EC) using an interview guide. This guide was applied flexibly to accommodate participants’ needs, language use and concerns regarding the predefined topics. Sample questions for parents were: \u003cem\u003eIn what way are you involved in your child’s MH care during their stay in a JCF?\u003c/em\u003e and \u003cem\u003eWhat would a quality MH offer look like to you?\u003c/em\u003e For adolescents, four customizable interview techniques were used (Teachman \u0026amp; Gibson, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2013\u003c/span\u003e): (1) a short get-to-know-each-other activity, (2) visual metaphors, (3) vignettes about made-up detained adolescents, (4) sentence starters. Sample questions were: \u003cem\u003eThink of a moment during your stay when you felt bad. Which image best matches your emotions and why? What could help this fictional character in distress?\u003c/em\u003e and \u003cem\u003eComplete this sentence: ‘What’s good/bad about my MH counselling is …\u003c/em\u003e’\u003c/p\u003e\u003cp\u003eAll interviews were audio-recorded and transcribed verbatim, with all information that could identify them removed. Interviews with youth lasted 20 to 69 minutes (average of 49min), with parents 1 to 2,5 hours (average of 1h28min). Participants were not compensated for participation. Each interview started with explaining the research goals, obtaining consent, and reminding participants they could stop anytime, skip questions and that anonymity was assured.\u003c/p\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eReflexive thematic analysis (TA) (Braun \u0026amp; Clarke, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) was used to identify shared themes. TA offers the possibility of an inductively-developed critical analysis with which we aim to capture and explore perspectives of youths and parents concerning the involvement of different service providers. Although we operated without a pre-defined coding frame, our background as criminologist (first author), clinical psychologist (second author) and child and adolescent psychiatrist (third author) and associated theoretical frameworks will likely have had an influence.\u003c/p\u003e\u003cp\u003eThe analysis was led by a single researcher (first author), beginning with a manual pen-and-paper approach. A fellow PhD researcher independently coded 15% of the youth transcripts as part of the analysis. Codes and themes were then revised and discussed within the research team through which a deeper understanding of the data was achieved. Afterwards, first author independently coded all 20 transcripts with NVivo 14. Next, the authors discussed to establish themes per respondent type. A member-checking phase followed: participants received an information poster with thematic patterns related to their role and could provide feedback, which was integrated into the final analysis.\u003c/p\u003e\u003cp\u003eAll quotes are translated into English and labelled with a pseudonym, for adolescents with indication of their age, for adults with indication of their role.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eFrom adolescents\u0026rsquo; and parents\u0026rsquo; perspectives on the involvement and coordination of different service providers, four main themes were constructed: (1) customised support that transcends sectoral divisions and organisational silos, (2) collaboration between organisations and sectors, (3) client-centred relationships and (4) care with a long-term perspective.\u003c/p\u003e \u003cp\u003eCustomised support that transcends sectoral divisions and organisational silos\u003c/p\u003e \u003cp\u003e Adolescents and parents often face a complex care system where providers specialize in certain domains, have waiting lists or impose conditions for support. Since these youth often have complex needs, such factors limit both accessibility and continuity of care. Hence, some respondents feel they are being passed from one provider to another or that no service meets their needs, which can lead to frustration, powerlessness or isolation.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;It\u0026rsquo;s just beyond words. [A child psychiatric hospital], in the context of voluntary care: a three-year waiting list. That\u0026rsquo;s just not normal, right? By then, she would\u0026rsquo;ve already hanged herself, so to speak.\u0026rdquo; (parent Yasmin)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;She spent um, a year in [a child psychiatric hospital]. And something definitely went wrong there in terms of\u0026hellip; um, care. It was like\u0026hellip; yeah\u0026hellip; for them, after a year it was basically, \u0026lsquo;okay, we actually can\u0026rsquo;t do anything more, so yeah\u0026hellip; she\u0026rsquo;s going home.\u0026rsquo; It kind of felt like she was just shown the way out \u0026ndash; that\u0026rsquo;s how it felt to us, sort of like\u0026hellip; [\u0026hellip;]And there, yeah\u0026hellip; there was just, there was nothing else available for us anymore.\u0026rdquo; (parent Jolanda)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThroughout the interview, parent Karin lists all the steps she has taken with her child. Due to MH workers relocating, unavailable outpatient service, limited period of crisis care and organisations refusing her child, the search for appropriate care went on endlessly. Yet the psychiatric conclusion always came down to: \u003cem\u003e\u0026ldquo;[Your child] is in need for stability.\u0026rdquo;\u003c/em\u003e As a result, crisis admission and collocation were no longer carried out. \u003cem\u003e\u0026ldquo;And then,\u0026rdquo;\u003c/em\u003e says Karin, \u003cem\u003e\u0026ldquo;the JCF comes in. That\u0026rsquo;s what they call the solution.\u003c/em\u003e\u0026rdquo; Like Karin, other parents and some adolescents feel as if some are staying in a JCF due to a lack of alternatives.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Yeah, that\u0026rsquo;s why I\u0026rsquo;m in the JCF now. Because they can\u0026rsquo;t\u0026hellip; Because they don\u0026rsquo;t have a spot anywhere else for me. Somewhere that suits my needs.\u0026rdquo; (Robby, 18 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I get that this place is meant for punishment. But\u0026hellip; there are young people here who shouldn\u0026rsquo;t be punished. And\u0026hellip; they just need help. And that should be taken into account too.\u0026rdquo; (Walt, 13 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e Parents identify opportunities to improve service provision. Firstly, a cross-sectoral coordinating agency could facilitate access to appropriate care and intervene when parents cannot cope or navigate the system. Secondly, MH care could be organised more effectively across organisational boundaries to avoid the constant turnover of professionals and ensure care follows adolescent\u0026rsquo;s needs rather than institutional constraints.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Well, I think\u0026hellip; a coordinator who guides you along \u0026ndash; I think that\u0026rsquo;s a really beautiful word, coordinator \u0026ndash; that\u0026rsquo;s what you need, because you can\u0026rsquo;t see the wood for the trees anymore, with all those rules.\u0026rdquo; (parent Adam)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;And th\u0026aacute;t is the big problem. There\u0026rsquo;s no continuity. And that a psychologist belongs to an institution and speaks very much from the institution\u0026rsquo;s perspective. From their capacity and their rules.\u0026rdquo; \u0026ndash; \u0026ldquo;And hardly from the child\u0026rsquo;s perspective, right?\u0026rdquo; \u0026ndash; \u0026ldquo;Not from the child\u0026rsquo;s needs.\u0026rdquo; (parents Karin and Martin)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;But if you\u0026rsquo;ve got someone different every time!\u0026rdquo; \u0026ndash; \u0026ldquo;A new face and it always creates a kind of barrier.\u0026rdquo; (parents Jolanda and Peter)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eIlya (18 yrs) struggles with this lack of continuity of MH care during his stay. \u003cem\u003e\u0026ldquo;I\u0026rsquo;ve had 20 psychologists in my life already and all that. I\u0026rsquo;m not going to tell my life story to someone again,\u0026rdquo;\u003c/em\u003e he exclaims.\u003c/p\u003e \u003cp\u003eCollaboration between organisations and sectors\u003c/p\u003e \u003cp\u003eEven with less compartmentalised and coordinated support, combining different areas of expertise remains essential to address the complex needs of those involved. Therefore, high-quality collaboration and cross-sector exchange are crucial. Our respondents offer several recommendations on shaping such collaboration and key elements to consider.\u003c/p\u003e \u003cp\u003eFirstly, for adolescents on the intersection between challenging behaviour and MH problems, the focus of care must be directed at both aspects simultaneously. Professionals with diverse backgrounds and expertise can mutually reinforce their work.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;No, they really need intensive support from the right people in the right place. People who are trained to work with children like that.\u0026rdquo; (parent Mary)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;If I could turn back time, I\u0026rsquo;d just really like to talk to a psychologist. Someone who understands trauma. Someone who truly gets how you feel, someone who\u0026rsquo;s actually studied that. (Diego, 18 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;No, with the JCF, well yeah\u0026hellip; I\u0026rsquo;ll keep saying it: it is what it is and it will always be a JCF. But inside, it does function.\u0026rdquo; \u0026ndash; \u0026ldquo;But there\u0026rsquo;s a real need for something that brings safety, predictability and psychiatric know-how.\u0026rdquo; \u0026ndash; \u0026ldquo;That\u0026rsquo;s really missing, you know. That psychiatric know-how\u0026hellip; really, in an institution like the JCF \u0026ndash; or at least in some of them \u0026ndash; you should have a psychiatrist employed full-time, someone who\u0026rsquo;s constantly involved.\u0026rdquo; (parents Karin and Martin)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eSecondly, despite calls for effective integration of JCF and MH services, it remains crucial for adolescents to be able to confide in a MH professional who is independent of the criminal justice system and bound by professional confidentiality.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;[The MH worker] would always say: \u0026lsquo;We\u0026rsquo;re not writing anything down for your file,\u0026rsquo; so to speak. So you could really tell them anything.\u0026rdquo; (Kai, 16 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e Although parents recognise the need for confidentiality to allow their child to express themselves fully, some struggle with limited insight into their child\u0026rsquo;s problems or feel their parental perspective is overlooked. So, thirdly, clear communication and information sharing on both judicial and MH process can facilitate this, ideally as a two-way exchange.\u003c/p\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;You want information! How\u0026rsquo;s your child doing? You don\u0026rsquo;t want [the MH care hiding] behind patient confidentiality. [\u0026hellip;] Feedback to parents? Zero! And what\u0026rsquo;s essential \u0026ndash; and I get it, the whole patient relationship and ethics and blah blah, sure, that\u0026rsquo;s valid. But legally: until they\u0026rsquo;re eighteen, I\u0026rsquo;m their guardian. Then they should change the law.\u0026rdquo; (parent Adam)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I would\u0026rsquo;ve really liked to speak to that psychiatrist. [\u0026hellip;] But that was the only moment I actually felt like, \u0026lsquo;wait a minute\u0026hellip; what exactly are we doing here?\u0026rsquo; Um, and then towards the end, he suddenly decided to stop her [medication]. Because [my child] said, \u0026lsquo;I don\u0026rsquo;t feel anything from it. For falling asleep.\u0026rsquo; While I was thinking: [\u0026hellip;] if you\u0026rsquo;d just communicated that with me beforehand, or checked in with me like, \u0026lsquo;how do you experience it?\u0026rsquo; then maybe it wouldn\u0026rsquo;t have been stopped.\u0026rdquo; (parent Yasmin)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eLastly and subsequently, another important anchor point is knowing the MH diagnosis and its implications. This is crucial for the adolescent, future organisations, and parents. For the latter, such psychoeducation can strengthen the connection with their child and clarify certain behavioural patterns.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;So from there, things could move forward in the other institutions, because they started to see\u0026hellip; And for us, it was really a kind of revelation too \u0026ndash; we recognised certain situations, and then they said things like, \u0026lsquo;look, that\u0026rsquo;s because of the autism.\u0026rsquo;\u0026rdquo; (Parent Peter)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;We actually learned a great deal from that explanation of how a child with attachment issues functions \u0026ndash; the theory really taught us a lot.\u0026rdquo; (parent Karin)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eSome adolescents also seek greater insight into their psychological functioning. For instance, Walt (13 yrs) expresses a desire for professionals to \u003cem\u003e\u0026ldquo;explain, like, explain things or something. What, what that is\u0026hellip; brain stuff or something. [\u0026hellip;] How that, sometimes, works differently for other people.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003eClient-centred relationships\u003c/p\u003e \u003cp\u003e Regardless of which organisation or sector is providing care, adolescents and parents emphasise the importance of high-quality relationships with individual caretakers. A focus on client-centred care demands investment in connectedness and understanding of needs. In view of this, adolescents want to be seen for who they are, beyond their behaviour or the juvenile crime they\u0026rsquo;ve committed. \u003cem\u003e\u0026ldquo;People who come into contact with the police and all that\u0026hellip; that doesn\u0026rsquo;t automatically make someone a bad person,\u0026rdquo;\u003c/em\u003e describes Salma (15 yrs). Like her, other youngsters want their personality and strengths to be at the heart of interactions with service providers.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Well, I am just a boy who needs a lot of attention, and when I\u0026rsquo;m, um, how should I put it, hyperactive, I seek even more attention. I\u0026rsquo;m someone who really demands a lot of attention. [\u0026hellip;] I\u0026rsquo;m a bit different from other young people.\u0026rdquo; (Robby, 18 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I\u0026rsquo;ve known [the residential workers] for a long time, you know. So I\u0026rsquo;ve been through things with some of them, well, actually, with all of them. Good times, bad times. And what I mean by that is\u0026hellip; I trust them. [\u0026hellip;] I know they\u0026rsquo;ve got my back. Because when I\u0026rsquo;m going through a tough time or when I\u0026rsquo;m not feeling great, we talk sometimes and stuff\u0026hellip;\u0026rdquo; (Yarah, 16 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e Not only the adolescents, but also parents are looking for individual attention and predictability for their child. Humanity and a strong relationship with the care worker remain crucial.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;[My son] actually needs one-on-one support.\u0026rdquo; (parent Omar)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;But I think\u0026hellip; especially if young people are given the feeling of \u0026lsquo;we\u0026rsquo;re listening, we hear you\u0026rsquo; \u0026ndash; that\u0026rsquo;s really important. Not just listening, but actually hearing them and doing something. And that goes for wat the youngsters say and also what the parents say\u0026hellip;\u0026rdquo; (parent Jolanda)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Warm spaces for young people, with structure, a sense of safety and where parents can truly catch their breath.\u0026rdquo; (parent Aicha)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e Jolanda and Aicha already allude to their own needs as parents. Although parental respondents emphasise that the adolescent should be at the centre of the rehabilitative care pathway, they also require support.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Yeah, because sometimes they don\u0026rsquo;t really think like\u0026hellip; okay, the youngster has been placed there [in the JCF], and that\u0026rsquo;s not pleasant \u0026ndash; it\u0026rsquo;s confronting for a child. But that child also has a family. You know what I mean?\u0026rdquo; (parent Yasmin)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e\u003cem\u003e \u0026ldquo;Yeah, maybe the parents also need support, you know? It\u0026rsquo;s not just about the youngster. Of course, the young person is really important, because they\u0026rsquo;re the ones who\u0026hellip; But, yeah, the parents too\u0026hellip;\u0026rdquo; (parent Jolanda)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e Parents identify a variety of support needs for themselves, ranging from MH to financial support or help in (re)building the bond with their child.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Well, you do need quite a bit of support, don\u0026rsquo;t you. [\u0026hellip;] Yeah, it\u0026rsquo;s like you can\u0026rsquo;t switch off your mind anymore, right? So yeah, you don\u0026rsquo;t get any mental rest during all that time.\u0026rdquo; (parent Peter)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;And you\u0026rsquo;re breaking up a family, right. I mean, staying together as a couple through this wasn\u0026rsquo;t easy. [\u0026hellip;] It has\u0026hellip; such an impact.\u0026rdquo; (parent Aicha)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eGiven this significant impact, having someone to listen, provide updates on their child\u0026rsquo;s trajectory or someone who walks alongside them during the difficult process can make an important difference.\u003c/p\u003e \u003cp\u003e \u003cem\u003eIf I have any problems, they always say: \u0026lsquo;You can call us, you can call the residential group.\u0026rsquo; They really do try to help us.\u0026rdquo; (parent Omar)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;And that there [in the JCF] are people who actually d\u0026oacute; offer guidance and information. Who say: \u0026lsquo;Ah, we don\u0026rsquo;t know either, but we\u0026rsquo;ll help you look for answers.\u0026rsquo; And I really appreciate that! Just admitting that. That kind of contact. That\u0026rsquo;s honestly so nice!\u0026rdquo; (parent Adam)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Just, you know, well\u0026hellip; being able to get things off your chest, right? That\u0026rsquo;s it\u0026hellip; \u0026lsquo;cause honestly, I can\u0026rsquo;t talk to anyone about it, except maybe my partner and my parents.\u0026rdquo; (parent Mary)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eLikewise, adolescents highlight the significance of a trusting relationship with their care provider, including both JCF and MH professionals. They want the opportunity to talk when needed and to rely on someone who can ease insecurities and help express feelings.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Then [me and the outreach MH worker] also talk a bit. Just about, yeah, what\u0026rsquo;s still going to happen and stuff. Or about what\u0026rsquo;s coming next. Or if I have questions, that they can answer them.\u0026rdquo; (Hassan, 19 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;We sometimes have a laugh. So I just feel comfortable with [the child and youth psychiatrist], really.\u0026rdquo; (Yarah, 16 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Sometimes I just talk to [the MH worker]. And\u0026hellip; just do fun activities and stuff. Crafts, drawing, things like that.\u0026rdquo; (Tim, 16 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eCare with a long-term perspective\u003c/p\u003e \u003cp\u003e Related to the need for continuity, adolescents and parents value clarity about the remaining trajectory and future support. The possibility of losing this support causes anxiety for some parents.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Yeah, a follow-up\u0026hellip; I don\u0026rsquo;t know if that even exists, a follow-up service after the [forensic child and adolescent psychiatry-unit]. That would be good. But I think once all the sentences have been served, yeah, then he\u0026rsquo;s really free and there\u0026rsquo;s nothing left anymore, right? [\u0026hellip;] If you come from psychia\u0026hellip; or from the [forensic child and adolescent psychiatry-unit], it\u0026rsquo;s a sign that there\u0026rsquo;s\u0026hellip; eh, and they pass on signals like: \u0026lsquo;look, listen, keep an eye on him because\u0026hellip; yeah\u0026hellip; that boy really does have problems.\u0026rsquo; That there would be some kind of follow-up, that he\u0026rsquo;d have to talk to those people every now and then, like, \u0026lsquo;how are things, how\u0026rsquo;s it going?\u0026rsquo;\u0026rdquo; (parent Harold)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eIn a different context, Diego (18 yrs) expresses a similar wish of having someone \u003cem\u003e\u0026ldquo;who could come to my place every week or something. See how things are going at home.\u0026rdquo;\u003c/em\u003e For some youngsters, it is reassuring that this kind of continuing service can be provided by a MH professional they already know.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Because when I\u0026rsquo;m outta here [the JCF], I\u0026rsquo;ll probably carry on working with [the outreaching MH worker].\u0026rdquo; (Kenzo, 17 yrs)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eNico (14 yrs) shares his view on whether aftercare should be provided by the same person as during his JCF stay: \u003cem\u003e\u0026ldquo;actually ye\u0026hellip; actually no. You know, actually yes. Because I know mrs [outreach psychologist] well. I don\u0026rsquo;t know the other support workers that well.\u0026rdquo;\u003c/em\u003e On the other hand, says Salma (15 yrs), the connection takes precedence: \u0026ldquo;\u003cem\u003eTo know them for a while, that doesn\u0026rsquo;t matter. It\u0026rsquo;s just that the person has to click with you.\u0026rdquo;\u003c/em\u003e Which leads back to the importance of the individual relationship that is built up between care recipient and provider.\u003c/p\u003e \u003cp\u003eRespondents stress that sustainability requires introducing the next step at their own pace.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Because from the way she talked sometimes, I could tell she wasn\u0026rsquo;t really ready to come back yet. And I kind of knew she wouldn\u0026rsquo;t handle that [the transition from a closed to an open environment] very well. They\u0026rsquo;d told me at the JCF that it would be more gradual. That they\u0026rsquo;d work with test moments and gradually build it up. And I thought\u0026hellip; I think that\u0026rsquo;ll be better. For her. And for our peace of mind too.\u0026rdquo; (parent Yasmin)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Well, she was still in that defensive mode and that\u0026hellip; and we felt that, if at that moment you just put her back into society, at home with us, that\u0026hellip; that it would immediately go wrong again. You could feel it, well, you could see it in the way she acted too, right. [\u0026hellip;] So we thought, \u0026lsquo;yeah, no, it\u0026rsquo;s not going to work like this, right.\u0026rsquo; If it\u0026rsquo;s going to have a real chance, there needs to be another step in between, yeah.\u0026rdquo; (parent Peter)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThat \u0026ldquo;other step\u0026rdquo; could be another care facility, a gradual build-up of freedoms, close follow-up during the transition or a visit to the new environment and preparation for what to expect there.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I\u0026rsquo;m actually glad to be out of here [the JCF]. Out of the closed institution. Because there, you have a bit more freedom than here. And um\u0026hellip; also, yeah, well\u0026hellip; scared\u0026hellip; I\u0026rsquo;m actually a bit afraid, like, imagine if things go wrong, then\u0026hellip; then\u0026hellip; then do you come back here? And that\u0026rsquo;s what I want to avoid, you know?\u0026rdquo; (Yarah, 16 yrs)\u003c/em\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eBy means of in-depth interviews with 13 detained adolescents and 10 parents, we focused on their perceptions of the involvement and coordination of both judicial and MH services. Due to (the need for) the simultaneous action of both sectors, providing support can become more complicated. Our findings reinforce emerging evidence that relational continuity and a single coordinating role are pivotal determinants of sustainable youth MH outcomes during and after detention.\u003c/p\u003e \u003cp\u003eAt the macro level, the complex care landscape and its perceived impenetrability leave our respondents with a sense of powerlessness. Nearly all our respondents are open to help but it seems impossible to get appropriate and timely support. In their Blueprint for Change, Skowyra and Cocozza (Skowyra \u0026amp; Cocozza, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) argue that MH, juvenile justice and other sectors share responsibility for these youth, making collaboration a cornerstone. Effective collaboration requires a shared goal, clear objectives and strategies to achieve them (Skowyra \u0026amp; Cocozza, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2007\u003c/span\u003e), while accountability may shift between organisations depending on the phase of the trajectory (Chuang \u0026amp; Wells, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Skowyra \u0026amp; Cocozza, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDue to the need for combining multiple areas of expertise, at the meso level, our respondents benefit from high-quality collaboration among professionals. Key concepts in a context in which simultaneous efforts are made to address (criminal) behaviour and MH are professional confidentiality, clear communication, information sharing and psychoeducation. In this regard, it is important to allocate time and resources for professionals to shape and maintain the collaboration. This way, a common language can develop and a lasting appreciation for each other\u0026rsquo;s contributions is fostered (Dickerson et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe third, micro level of the findings comprises both our respondents\u0026rsquo; immediate, present-day interactions, and their reflections on continuation of support. In the here and now, adolescents and parents highlight the importance of connecting relationships, aligning with relation-centred care that views relationships as therapeutic and interactions as outcome-shaping (Soklaridis PhD et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Collaboration should therefore extend beyond service providers to include families (Simons, Mulder, et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), for example by supporting the restoration of parent-child bonds or offering MH care to parents. Regarding the long-term aspect, having a follow-up perspective and insight into possible future support, motivates and reassures people. Underwood et al. (Underwood PsyD et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2014\u003c/span\u003e) recommend intensive and specialized aftercare for juveniles with serious MH problems (Underwood PsyD et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Re-entry and aftercare programs, aimed at continuing and coordinating services, are best to be initiated as soon as possible, either during the JCF trajectory or soon after (Zajac et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStrengths and limitations\u003c/p\u003e \u003cp\u003eMost respondents were recruited through purposive sampling, ensuring variation in adolescent and parent profiles. Still, participation bias cannot be ruled out. It is possible that mainly youth and parents who are more empowered and naturally more talkative participated in the interviews. Although parents concerned about their child\u0026rsquo;s MH were not specifically targeted, they may have been overrepresented in our study. Barriers (e.g. less involvement with the trajectory, not sufficiently proficient in Dutch) are likely to have had an influence in taking part. This may mean that the perspectives of youth and parents who struggle most to navigate the social service landscape and to express themselves verbally are underrepresented in this study.\u003c/p\u003e \u003cp\u003eImplications for research and practice\u003c/p\u003e \u003cp\u003eThe research findings are consistent with the literature on intersectoral collaboration in rehabilitation services (Haight et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; McElvaney \u0026amp; Tatlow-Golden, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Saia et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Focusing on adolescents\u0026rsquo; and parents\u0026rsquo; perspectives provides valuable insights for policymakers and professionals seeking to develop more coordinated, responsive and relation-centred rehabilitation strategies. Moreover, it can help optimise intersectoral collaboration through reflection and identification of areas for improvement. In this way, it can serve as a good practice to inspire other forms of intersectoral collaboration, such as the operation of other closed or (semi-)open residential care programs for adolescents with MH problems. At their core, collaborative processes require the systematic identification of challenges and achievements, the cultivation of shared understanding and the maintenance of personal distinctiveness (van Hille, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFUNDING:\u003c/h2\u003e \u003cp\u003eThis work received funding. Specific details have been removed to preserve author anonymity during peer review.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConceptualisation and methodology: E.C., I.G.; Data analysis: E.C.; Writing \u0026ndash; original draft: E.C., I.G.; Writing \u0026ndash; review \u0026amp; editing: E.C., I.G., D.v.W.; Funding acquisition: I.G. All authors contributed to writing the manuscript and provided approval for the submitted version.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe highly appreciate the study participants, the members of the steering committee and researcher Iulia Andreea Vescan for their contribution. We acknowledge the use of Copilot for language editing.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data underlying this study are not publicly accessible due to ethical and legal constraints aimed at protecting participant confidentiality.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbram, K. M., Teplin, L. A., Charles, D. R., Longworth, S. L., McClelland, G. M., \u0026amp; Dulcan, M. K. (2004). Posttraumatic Stress Disorder and Trauma in Youth in Juvenile Detention. \u003cem\u003eArchives of General Psychiatry\u003c/em\u003e, \u003cem\u003e61\u003c/em\u003e(4), 403\u0026ndash;410. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1001/archpsyc.61.4.403\u003c/span\u003e\u003cspan address=\"10.1001/archpsyc.61.4.403\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAssembly, U. N. G. (1989). Convention on the Rights of the Child, 20 November 1989. \u003cem\u003eAnnual review of population law\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e, 95\u0026ndash;501.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarnert, E. S., Abrams, L. S., Lopez, N., Sun, A., Tran, J., Zima, B., \u0026amp; Chung, P. J. (2020). Parent and provider perspectives on recently incarcerated youths\u0026rsquo; access to healthcare during community reentry. \u003cem\u003eChildren and Youth Services Review\u003c/em\u003e, \u003cem\u003e110\u003c/em\u003e, 104804. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1016/j.childyouth.2020.104804\u003c/span\u003e\u003cspan address=\"10.1016/j.childyouth.2020.104804\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBeaudry, G., Yu, R., L\u0026aring;ngstr\u0026ouml;m, N., \u0026amp; Fazel, S. (2021). An Updated Systematic Review and Meta-regression Analysis: Mental Disorders Among Adolescents in Juvenile Detention and Correctional Facilities. \u003cem\u003eJournal of the American Academy of Child \u0026amp; Adolescent Psychiatry\u003c/em\u003e, \u003cem\u003e60\u003c/em\u003e(1), 46\u0026ndash;60. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1016/j.jaac.2020.01.015\u003c/span\u003e\u003cspan address=\"10.1016/j.jaac.2020.01.015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBlanken, M., Mathijssen, J., van Nieuwenhuizen, C., Raab, J., \u0026amp; van Oers, H. (2022). Intersectoral collaboration at a decentralized level: information flows in child welfare and healthcare networks. \u003cem\u003eBMC Health Services Research\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(1), 449. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12913-022-07810-z\u003c/span\u003e\u003cspan address=\"10.1186/s12913-022-07810-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraun, V., \u0026amp; Clarke, V. (2021). \u003cem\u003eThematic analysis: A practical guide\u003c/em\u003e. SAGE Publications Ltd.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBurke, J. D., Mulvey, E. P., Schubert, C. A., \u0026amp; Garbin, S. R. (2014). The challenge and opportunity of parental involvement in juvenile justice services. \u003cem\u003eChildren and Youth Services Review\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e, 39\u0026ndash;47. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1016/j.childyouth.2014.01.007\u003c/span\u003e\u003cspan address=\"10.1016/j.childyouth.2014.01.007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCarrion, V. G., \u0026amp; Steiner, H. (2000). Trauma and Dissociation in Delinquent Adolescents. \u003cem\u003eJournal of the American Academy of Child \u0026amp; Adolescent Psychiatry\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e(3), 353\u0026ndash;359. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1097/00004583-200003000-00018\u003c/span\u003e\u003cspan address=\"10.1097/00004583-200003000-00018\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChuang, E., \u0026amp; Wells, R. (2010). The role of interagency collaboration in facilitating receipt of behavioral health services for youth involved with child welfare and juvenile justice. \u003cem\u003eChildren And Youth Services Review\u003c/em\u003e, \u003cem\u003e32\u003c/em\u003e(12), 1814\u0026ndash;1822. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.childyouth.2010.08.002\u003c/span\u003e\u003cspan address=\"10.1016/j.childyouth.2010.08.002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eClair-Michaud, M., Martin, R. A., Stein, L. A. R., Bassett, S., Lebeau, R., \u0026amp; Golembeske, C. (2016). The Impact of Motivational Interviewing on Delinquent Behaviors in Incarcerated Adolescents. \u003cem\u003eJournal of Substance Abuse Treatment\u003c/em\u003e, \u003cem\u003e65\u003c/em\u003e, 13\u0026ndash;19. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1016/j.jsat.2015.09.003\u003c/span\u003e\u003cspan address=\"10.1016/j.jsat.2015.09.003\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ede Ruigh, E. L., Popma, A., Twisk, J. W. R., Wiers, R. W., van der Baan, H. S., Vermeiren, R. R., J. M., \u0026amp; Jansen, L. M. C. (2019). Predicting quality of life during and post detention in incarcerated juveniles. \u003cem\u003eQuality of Life Research\u003c/em\u003e, \u003cem\u003e28\u003c/em\u003e(7), 1813\u0026ndash;1823. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s11136-019-02160-6\u003c/span\u003e\u003cspan address=\"10.1007/s11136-019-02160-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDickerson, J. G., Collins-Camargo, C., \u0026amp; Martin‐Galijatovic, R. (2012). How collaborative the collaboration? Assessing interagency collaboration within a juvenile court diversion program. \u003cem\u003eJuvenile and Family Court Journal\u003c/em\u003e, \u003cem\u003e63\u003c/em\u003e(3), 21\u0026ndash;35. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1111/j.1755-6988.2012.01078.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1755-6988.2012.01078.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGagnon, J. C., \u0026amp; Swank, J. M. (2021). A National Survey on Mental Health Professional Development in Juvenile Justice Facilities: Implications for Youth Reentry. \u003cem\u003eBehavioral Disorders\u003c/em\u003e, \u003cem\u003e46\u003c/em\u003e(3), 149\u0026ndash;162. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/0198742920911183\u003c/span\u003e\u003cspan address=\"10.1177/0198742920911183\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGinner Hau, H., \u0026amp; Azad, A. (2022). Swedish Adolescent Female Offenders with Limited Delinquency: Exploring Family-Related Narratives from a Developmental Perspective. \u003cem\u003eChild and Adolescent Social Work Journal\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e(2), 219\u0026ndash;232. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s10560-020-00719-8\u003c/span\u003e\u003cspan address=\"10.1007/s10560-020-00719-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaight, W. L., Bidwell, L. N., Marshall, J. M., \u0026amp; Khatiwoda, P. (2014). Implementing the Crossover Youth Practice Model in diverse contexts: Child welfare and juvenile justice professionals' experiences of multisystem collaborations. \u003cem\u003eChildren and Youth Services Review\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e, 91\u0026ndash;100. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1016/j.childyouth.2014.02.001\u003c/span\u003e\u003cspan address=\"10.1016/j.childyouth.2014.02.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoeve, M., McReynolds, L. S., \u0026amp; Wasserman, G. A. (2013). The Influence of Adolescent Psychiatric Disorder on Young Adult Recidivism. \u003cem\u003eCriminal Justice and Behavior\u003c/em\u003e, \u003cem\u003e40\u003c/em\u003e(12), 1368\u0026ndash;1382. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/0093854813488106\u003c/span\u003e\u003cspan address=\"10.1177/0093854813488106\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJackson-Roe, K., Murray, C., \u0026amp; Brown, G. (2015). Understanding young offenders' experiences of drinking alcohol: An interpretative phenomenological analysis. \u003cem\u003eDrugs: Education Prevention \u0026amp; Policy\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(1), 77\u0026ndash;85. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3109/09687637.2014.973371\u003c/span\u003e\u003cspan address=\"10.3109/09687637.2014.973371\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKaasb\u0026oslash;ll, J., \u0026Aring;dnanes, M., Paulsen, V., \u0026amp; Melby, L. (2022). Interagency collaboration for early identification and follow-up of mental health problems in residential youth care: evaluation of a collaboration model. \u003cem\u003eNordic Social Work Research\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(4), 592\u0026ndash;607. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/2156857X.2020.1833964\u003c/span\u003e\u003cspan address=\"10.1080/2156857X.2020.1833964\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLivanou, M., Furtado, V., Winsper, C., Silvester, A., \u0026amp; Singh, S. P. (2019). Prevalence of Mental Disorders and Symptoms Among Incarcerated Youth: A Meta-Analysis of 30 Studies. \u003cem\u003eInternational Journal of Forensic Mental Health\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e(4), 400\u0026ndash;414. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/14999013.2019.1619636\u003c/span\u003e\u003cspan address=\"10.1080/14999013.2019.1619636\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcElvaney, R., \u0026amp; Tatlow-Golden, M. (2016). A traumatised and traumatising system: Professionals' experiences in meeting the mental health needs of young people in the care and youth justice systems in Ireland. \u003cem\u003eChildren and Youth Services Review\u003c/em\u003e, \u003cem\u003e65\u003c/em\u003e, 62\u0026ndash;69. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1016/j.childyouth.2016.03.017\u003c/span\u003e\u003cspan address=\"10.1016/j.childyouth.2016.03.017\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eO'Hara, K. L., Duchschere, J. E., Shanholtz, C. E., Reznik, S. J., Beck, C. J., \u0026amp; Lawrence, E. (2019). Multidisciplinary partnership: Targeting aggression and mental health problems of adolescents in detention. \u003cem\u003eAmerican Psychologist\u003c/em\u003e, \u003cem\u003e74\u003c/em\u003e(3), 329\u0026ndash;342. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/amp0000439\u003c/span\u003e\u003cspan address=\"10.1037/amp0000439\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePullmann, M. D. (2010). Predictors of Criminal Charges for Youth in Public Mental Health during the Transition to Adulthood. \u003cem\u003eJ Child Fam Stud\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(4), 483\u0026ndash;491. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s10826-009-9320-8\u003c/span\u003e\u003cspan address=\"10.1007/s10826-009-9320-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReeves, S., Lewin, S., Espin, S., \u0026amp; Zwarenstein, M. (2011). \u003cem\u003eInterprofessional teamwork for health and social care\u003c/em\u003e. Wiley.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaia, K., Toros, K., \u0026amp; DiNitto, D. M. (2020). Interprofessional collaboration in social rehabilitation services for dually-involved Estonian youth: Perceptions of youth, parents, and professionals. \u003cem\u003eChildren and Youth Services Review\u003c/em\u003e, \u003cem\u003e113\u003c/em\u003e, 104945. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1016/j.childyouth.2020.104945\u003c/span\u003e\u003cspan address=\"10.1016/j.childyouth.2020.104945\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchwalbe, C. S., \u0026amp; Maschi, T. M. (2012). Probation Officers\u0026rsquo; Perspectives on Interagency Collaboration for Juvenile Offenders With Mental Health Problems. \u003cem\u003ePsychiatric Services\u003c/em\u003e, \u003cem\u003e63\u003c/em\u003e(8), 830\u0026ndash;833. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1176/appi.ps.201100166%M 22854729\u003c/span\u003e\u003cspan address=\"10.1176/appi.ps.201100166%M 22854729\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShelton, D. (2004). Experiences of detained young offenders in need of mental health care. \u003cem\u003eJournal Of Nursing Scholarship\u003c/em\u003e, \u003cem\u003e36\u003c/em\u003e(2), 129\u0026ndash;133. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/j.1547-5069.2004.04025.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1547-5069.2004.04025.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSimons, I., Mulder, E., Breuk, R., Rigter, H., van Domburgh, L., \u0026amp; Vermeiren, R. (2019). Determinants of parental participation in Family-centered Care in Juvenile Justice Institutions. \u003cem\u003eChild \u0026amp; Family Social Work\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(1), 59\u0026ndash;68. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1111/cfs.12581\u003c/span\u003e\u003cspan address=\"10.1111/cfs.12581\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSimons, I., van der Vaart, W., Vermeiren, R., Rigter, H., Breuk, R., van Domburgh, L., \u0026amp; Mulder, E. (2019). Parental Participation in Juvenile Justice Institutions: Parents\u0026rsquo; Perspectives on Facilitating and Hindering Factors. \u003cem\u003eInternational Journal of Forensic Mental Health\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e(2), 124\u0026ndash;137. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/14999013.2018.1526231\u003c/span\u003e\u003cspan address=\"10.1080/14999013.2018.1526231\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSkowyra, K. R., \u0026amp; Cocozza, J. J. (2007). \u003cem\u003eBlueprint for change: A comprehensive model for the identification and treatment of youth with mental health needs in contact with the juvenile justice system\u003c/em\u003e. Policy Research Associates, Inc.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSoklaridis PhD, S., Adler Nevo, M. D., FRCPC, G., \u0026amp; PRCPC, L. M. (2016). Relationship-centred care in health: A 20-year scoping review. \u003cem\u003ePatient Experience Journal\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e(1), 130\u0026ndash;145. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.35680/2372-0247.1111\u003c/span\u003e\u003cspan address=\"10.35680/2372-0247.1111\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStrype, J., Gundhus, H. I., Egge, M., \u0026amp; \u0026Oslash;deg\u0026aring;rd, A. (2014). Perceptions of Interprofessional Collaboration. \u003cem\u003eProfessions and Professionalism\u003c/em\u003e, \u003cem\u003e4\u003c/em\u003e(3). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.7577/pp.806\u003c/span\u003e\u003cspan address=\"10.7577/pp.806\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStutsky, B. J., \u0026amp; Laschinger, H. K. S. (2014). Development and testing of a conceptual framework for interprofessional collaborative practice. \u003cem\u003eHealth Interprofessional Practice and Education\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e(2), eP1066. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.7710/2159-1253.1066\u003c/span\u003e\u003cspan address=\"10.7710/2159-1253.1066\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSwank, J. M., \u0026amp; Gagnon, J. C. (2017). A National Survey of Mental Health Screening and Assessment Practices in Juvenile Correctional Facilities. \u003cem\u003eChild \u0026amp; Youth Care Forum\u003c/em\u003e, \u003cem\u003e46\u003c/em\u003e(3), 379\u0026ndash;393. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s10566-016-9379-5\u003c/span\u003e\u003cspan address=\"10.1007/s10566-016-9379-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTeachman, G., \u0026amp; Gibson, B. E. (2013). Children and Youth With Disabilities:Innovative Methods for Single Qualitative Interviews. \u003cem\u003eQualitative Health Research\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(2), 264\u0026ndash;274. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/1049732312468063\u003c/span\u003e\u003cspan address=\"10.1177/1049732312468063\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnderwood, L. A., \u0026amp; Washington, A. (2016). Mental Illness and Juvenile Offenders. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(2), 228. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/ijerph13020228\u003c/span\u003e\u003cspan address=\"10.3390/ijerph13020228\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnderwood PsyD, L. A., Warren PsyD, K. M., Talbott PsyD, L., Jackson PhD, L., \u0026amp; Dailey Ma, F. L. L. (2014). Mental Health Treatment in Juvenile Justice Secure Care Facilities: Practice and Policy Recommendations. \u003cem\u003eJournal of Forensic Psychology Practice\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(1), 55\u0026ndash;85. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/15228932.2014.865398\u003c/span\u003e\u003cspan address=\"10.1080/15228932.2014.865398\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVan Damme, L., Colins, O. F., \u0026amp; Vanderplasschen, W. (2014). Gender differences in psychiatric disorders and clusters of self-esteem among detained adolescents. \u003cem\u003ePsychiatry Research\u003c/em\u003e, \u003cem\u003e220\u003c/em\u003e(3), 991\u0026ndash;997. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.1016/j.psychres.2014.10.012\u003c/span\u003e\u003cspan address=\"10.1016/j.psychres.2014.10.012\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003evan Hille, I. (2022). Omgaan met paradoxen in sector-overschrijdende samenwerking: Op zoek naar de balans tussen resultaat en \u0026lsquo;baggerwerk\u0026rsquo;. \u003cem\u003eBeleid en Maatschappij\u003c/em\u003e, \u003cem\u003e49\u003c/em\u003e(1), 82\u0026ndash;85.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZajac, K., Sheidow, A. J., \u0026amp; Davis, M. (2015). Juvenile Justice, Mental Health, and the Transition to Adulthood: A Review of Service System Involvement and Unmet Needs in the U.S. \u003cem\u003eChildren And Youth Services Review\u003c/em\u003e, \u003cem\u003e56\u003c/em\u003e, 139\u0026ndash;148. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.childyouth.2015.07.014\u003c/span\u003e\u003cspan address=\"10.1016/j.childyouth.2015.07.014\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZeola, M. P., Guina, J., \u0026amp; Nahhas, R. W. (2017). Mental Health Referrals Reduce Recidivism in First-Time Juvenile Offenders, But How Do We Determine Who is Referred? \u003cem\u003ePsychiatric Quarterly\u003c/em\u003e, \u003cem\u003e88\u003c/em\u003e(1), 167\u0026ndash;183. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s11126-016-9445-z\u003c/span\u003e\u003cspan address=\"10.1007/s11126-016-9445-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"juvenile offender, mental health, intersectoral collaboration, vulnerable youth, families","lastPublishedDoi":"10.21203/rs.3.rs-8658295/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8658295/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eDespite high rates of mental health problems among justice-involved adolescents, access to timely and continuous treatment remains inconsistent. Although intersectoral collaboration is increasingly promoted as best practice, little is known about the perspectives of the adolescents and their parents concerning the involvement and coordination of judicial and mental health services in the context of rehabilitation and reintegration. Since they are the ones navigating these complex systems, this study used in-depth interviews with 13 adolescents during or after their stay in a juvenile correctional facility and 10 parents. Using thematic analyses, four main themes were constructed: (1) customised support that transcends sectoral divisions and organisational silos, (2) collaboration between organisations and sectors, (3) client-centred relationships and (4) care with a long-term perspective. Our findings reinforce emerging evidence that relational continuity and a single coordinating role are pivotal determinants of sustainable youth mental health outcomes during and after detention.\u003c/p\u003e","manuscriptTitle":"Bridging mental health and juvenile justice: Adolescents’ and parents’ experiences of intersectoral collaboration","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-29 22:58:56","doi":"10.21203/rs.3.rs-8658295/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e4df2e89-d66b-40ec-bce9-1c9487b9764e","owner":[],"postedDate":"January 29th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-07T22:39:01+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-29 22:58:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8658295","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8658295","identity":"rs-8658295","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}