The Catalan model of mental health care in the field of juvenile justice
The population served by mental health services within the juvenile justice system presents a high degree of complexity at the clinical, familial, and social levels. In Catalonia, an intervention model with highly specialized services has been developed to address their specific needs.
Currently in Catalonia, there are various services that provide highly specialized care to adolescents with mental health problems and/or addictions who are serving a court-ordered sentence . In this regard, during their detention, and therefore deprivation of liberty, we have the Therapeutic Unit at the Els Til.lers Educational Center , managed by the Sant Joan de Déu Health Park , which is an inpatient unit for young people requiring intensive mental health intervention. We also have the Mental Health and Addictions Team (ESMIA), which offers outpatient care in juvenile justice centers throughout the region. For young people serving an open-environment measure, the Sant Pere Claver Hospital Foundation manages the Child Care Team (EAM) , a community program of high therapeutic intensity for adolescents serving supervised release measures and minors under 14 years of age who are not criminally responsible and are cared for by the General Directorate of Child and Adolescent Care (DGAIA).
The adolescent with mental health problems in the juvenile justice system
This has been made possible by the development of the legal framework for juvenile justice. This includes Organic Law 5/2000 of January 12, regulating the criminal liability of minors (LORPM), and its amendments, Law 27/2001 on Juvenile Justice, and Royal Decree 1774/2004 of July 30, which approves the regulations implementing the LORPM. This law emphasizes the importance of guaranteeing mental health and addiction services to individuals deprived of their liberty in juvenile justice centers, within the framework of their right to receive comprehensive healthcare, regardless of whether they are in a detention center or in the community.
In 2005, an agreement was signed between the Department of Justice and the Department of Health, outlining the comprehensive mental health and addiction treatment program for young people exhibiting delinquent behavior. In 2006, the Therapeutic Unit at the Els Til·lers Educational Center in Mollet del Vallès was inaugurated, offering 12 inpatient beds for intensive rehabilitation and community reintegration for individuals with mental health issues.
On July 17, 2017, a new care agreement was signed between the Department of Justice and the Department of Health, highlighting the importance of collaboration between primary care and mental health teams. Priority is given to promoting prevention, treatment adherence, and psychosocial rehabilitation to ensure continuity of care in a community setting once the criminal justice system has completed its intervention.
The Comprehensive Plan for the Care of People with Mental Disorders and Addictions (2017-2019) of the Government of Catalonia dedicates strategic line 7 to improving mental health care within the judicial system. The Department of Health prioritizes mental health and addiction care to effectively implement a community-based care model that takes into account the needs of the most vulnerable groups.
As a result of these agreements, the Therapeutic Unit at the Els Til.lers Educational Center was expanded, reaching a total of 20 beds in September 2019. Simultaneously, with the aim of strengthening and supporting the transition to a community environment, the role of liaison nurse was created. This nurse provides support and guidance to young people and their families, in coordination with the various professionals involved, to facilitate their access to community mental health services and ensure continuity of treatment adherence and mental health support that had been established during the period of the court-ordered measure.
Multidisciplinary biopsychosocial care model in juvenile justice
The main objective of the Therapeutic Unit at the Els Til.lers Educational Center is to offer comprehensive and intensive therapeutic care to achieve psychopathological stability and consolidate the clinical improvement of the adolescents served. They are provided with extensive support to develop a life plan that will allow them to live freely within the community.
Spiritual care in mental health in juvenile justice
Often, the first symptoms of mental disorders begin to appear during adolescence. This is why early intensive intervention is especially important, as it strengthens the prevention, treatment, and recovery of individuals at risk of developing a serious mental disorder. Warning signs related to some type of mental illness, substance abuse, or maladaptive personality traits are detected, which could potentially lead to a personality disorder. Early intervention prevents the consolidation of the disorder and reverses the course of symptoms, thus preventing the development of a disorder.
In this crucial stage of adolescence, the family 's influence remains highly significant, and families often encounter complex situations such as their children's delinquent behavior, the emergence of mental health symptoms, or a previously undiagnosed child. Furthermore, adolescents are often unreceptive to their parents. Therefore, parents or guardians require close support when their children engage in behaviors that necessitate intervention from the legal system. They need not only to understand what their children are experiencing but also to receive guidance and strategies for interacting with them, more appropriate parenting models to foster prosocial behavior, and psychoeducation about the symptoms. They also frequently need to alleviate their guilt over their children's transgressions, gain understanding of their role as parents, and learn how to support and understand their children's needs. Finally, families require guidance on community resources that can provide support during these challenging times.
The role of families in the recovery of people with mental disorders who are deprived of their liberty
Addressing cases of mental health problems or addictions admitted to a therapeutic unit within the juvenile justice system requires a multidisciplinary team comprised of specialists in psychiatry, psychology, social education, social integration, social work, substance abuse, occupational therapy, and nursing. These diverse disciplines allow for a response to the specific needs of each individual admitted and the implementation of a comprehensive and personalized treatment plan for each adolescent. In this regard, the Juvenile Justice Therapeutic Unit at CE Els Til.lers prioritizes a relationship-based model, where professionals provide positive role models, fostering conflict resolution and corrective emotional experiences that lead to positive changes in the young people's relationships with themselves and their surroundings. The educational intervention techniques employed are based on positive discipline and restorative practices, enabling young people to develop greater responsibility, empowerment, and a sense of belonging—elements that are often limited within traditional educational models.
Community engagement program for incarcerated youth
The intervention approach, although framed within a closed, private facility, has a community-based perspective . During their stay, individuals are prepared to live in the community, working intensively on emotional identification and management, conflict resolution, and psychoeducation—all with the aim of supporting them in developing an identity and a life plan that these adolescents have often lost. Objectives are established, tailored to each individual's personal, social, clinical, legal, and family circumstances. These objectives are shared with the individual through a collaborative decision-making model, where each young person can experience the goals as their own and integrate them with their own desires and aspirations for the future. Furthermore, during their stay, outings to the community are possible, which is one of the main objectives and motivations for these young men and women. Through coordinated educational and family support, they can reintegrate into community life, thus reducing the risk of clinical relapse and recidivism.
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