RESUMEN
Poor sleep during adolescence is a public health concern that may be especially important to address among youth in juvenile correctional facilities, who tend to experience greater mental health challenges, substance use disorders, and traumatic stress exposure. However, evidence for addressing sleep in correctional settings is limited. Using de-identified composite clinical cases, this paper describes challenges and opportunities for addressing sleep disorders (i.e. insomnia) and promoting sleep health (i.e. improving duration, regularity, and behaviors) among adolescents in long-term juvenile correctional facilities. These clinical cases highlight common presenting problems and underscore the need for integrated sleep and mental health interventions as well as adaptations to enhance feasibility and efficacy of behavioral sleep treatment and sleep health promotion in juvenile correctional contexts. We conclude by summarizing clinical, research, and policy implications for addressing adolescent sleep problems and promoting sleep health and well-being in these contexts.
RESUMEN
This column describes a civil rights lawsuit over the conditions in the Monterey County, California, jail that resulted in a court order to make substantial reforms. The remarkable feature of the case was the parties' willingness to use neutral experts to assess the facility's deficiencies in general medical and mental health care, safety, and disability access. The authors outline areas in which the 2015 settlement affects matters such as drug abuse and withdrawal screening, suicide assessment, continuation of medications, and psychic harm caused by isolation. The elements of the court order could serve as a template for improvements in other jurisdictions.