By Jennifer Clifton, DNP, FNP-BC, CCHP-CP, CCHP-A
The National Commission on Correctional Health Care (NCCHC) has adopted a new position statement, Optimizing Health and Education Outcomes for Youth in Confinement. At its heart is a simple but powerful premise: youth in juvenile detention cannot succeed—inside or after release—unless their health and educational needs are addressed together. For incarcerated youth, the health and educational systems are deeply intertwined. Multidisciplinary teams of health professionals, educators and custody staff need to collaborate to improve outcomes during confinement and beyond.
The position statement calls for juvenile correctional providers to ensure all youth receive appropriate screening, diagnostic services, health treatment, and referral for educational services as needed to meet their educational needs.
Youth in confinement experience disproportionately high rates of chronic medical conditions, behavioral health disorders, trauma exposure, and learning disabilities, as described in the statement. At the same time, many have had fragmented or inadequate access to adequate education services prior to detention. The Juvenile Health Committee saw a clear gap in policy guidance addressing how correctional health systems should work collaboratively with facility-based schools to meet these overlapping needs. This position statement was developed to fill that gap and to align correctional practices with evidence-based pediatric and educational standards, with pediatric providers actively working to ensure youths’ educational needs are met as a vital part of health care delivery.
A central highlight of the statement is the emphasis on early, comprehensive screening. The committee underscored that vision problems, hearing deficits, ADHD, dyslexia, depression, anxiety, substance use disorders, and trauma can all undermine educational engagement if left unrecognized. Identifying both medical and nonmedical contributors to learning challenges or poor educational engagement among youth at intake allows facilities to intervene early and coordinate care across disciplines
Also important is the statement’s focus on bidirectional care: managing health issues that affect education and addressing educational challenges that impact health. Health problems like ADHD, asthma, depression, and traumatic brain injuries must be treated in ways that support educational participation and success. Likewise, educational struggles must be understood as potential indicators of unmet health needs.
The position statement also highlights the need for interdisciplinary collaboration. Health care professionals, educators, custody staff, and community partners all play a role in developing and supporting individualized education plans (IEPs) and 504 Plans. Regular communication and shared planning help ensure that medical, mental health, and educational needs are addressed in a coordinated and legally compliant manner and recognized as a key responsibility of youth correctional health systems.
Another key pillar is trauma-informed care. Many detained youth have experienced significant trauma that interferes with learning, behavior, and engagement. The statement calls for trauma-informed approaches across health care, education, and custody to create environments that are safe, supportive, and conducive to learning
Finally, the statement emphasizes reentry planning and continuity of care. Education and health gains made during confinement are easily lost without robust discharge planning, including insurance enrollment, transfer of educational records, medication continuity, school enrollment support, and family engagement. These efforts are essential to reducing recidivism and supporting long-term well-being
The Juvenile Health Committee felt this position statement was urgently needed to reinforce that education is not ancillary to health care in juvenile facilities—it is a core component of rehabilitation. Several factors made such guidance urgent: High rates of undiagnosed or untreated conditions, fragmented services, legal and ethical mandates, and growing evidence linking education, health, and recidivism
Ultimately, the position statement reflects a shift away from treating detained youth as “offenders” and toward developing young people whose health, learning, and life trajectories can be reshaped with the right support. By aligning health and education systems, NCCHC hopes to create pathways that lead not only out of confinement—but toward opportunity, stability, and long-term wellness.
Jennifer Clifton, DNP, FNP-BC, CCHP-CP, CCHP-A, is the American Association of Nurse Practitioners liaison on the NCCHC Board of Representatives and co-chair of the Juvenile Health Committee. She is a clinical professor and associate dean of Practice and Community Collaboration at the University of Utah College of Nursing.
