“Mostly under health education we think of ‘body,’” says Kathleen Hofvendahl-Clark, a health educator with the Santa Cruz County Probation Department, “but I don’t think we can separate physical from mental health.”

As part of a new, multidisciplinary team, Kathleen works with some 50 teenagers a month at the Juvenile Hall in Felton near Santa Cruz, providing potentially lifesaving information and health and mental health interventions. Her position is funded by a four-year grant from The California Endowment’s Healthy Returns Initiative; Santa Cruz is one of five California county probation departments selected to participate in the initiative.

The youth that Kathleen sees are, as a population, among those most at-risk with the least access to services. When youth arrive at the Juvenile Hall, they receive a physical exam by a nurse—in some cases their first physical exam ever—as well as a mental health screening. These standardized screenings help identify conditions that may have been previously undiagnosed or untreated, and that may even have been a contributing factor in the behavior that led to the child’s arrest.

“The nurse might discover that one needs glasses or that another has impacted wisdom teeth,” explains Kathleen. “The mental health screening might reveal underlying depression or anxiety. Addressing these kinds of issues can make a big difference for that child. For example, research shows that girls who receive medical and dental care have a lower recidivism rate.”

Kathleen follows up with the child’s parents to provide a list of resources like free clinics and specialists that accept MediCal so that they can get the care they need. She often refers families to a partner organization, La Manzana Community Resource Center, whose eligibility specialist can assist them in navigating the system to receive the benefits and services they are entitled to, from health insurance and food stamps to housing and immigration assistance. The eligibility specialist’s position—half time at the Center and half time at Juvenile Hall—was also created through the Healthy Returns Initiative and is critical to overcoming barriers to obtaining medical coverage, not only for the juvenile but for the entire family.

Laura Garnette, Division Director for the Juvenile Unit at the Santa Cruz Probation Department, has been overseeing the Healthy Returns Initiative at her site and is passionate about its impact. “The fact that a kid has touched our system means they’re now targeted for resources,” she says. This greatly increases their chances for success upon release, aided by a Youth Reentry Team that includes four local community-based organizations.

Providing Help Where It’s Needed
Because most juveniles move quickly in and out of the facility, Kathleen may not have much time to work with them. “So I facilitate stand-alone workshops where the kids can get everything they need in one session,” she says. The topics she teaches include personal hygiene, parenting, STD prevention, nutrition and coping with stress. “These kinds of curricula—aimed at behavior change once the kids return to their neighborhoods—are ultimately about mental health and preventing violence.”

It was at one of her workshops where Kathleen first connected with 17-year-old Carlos*, who has struggled with his weight for years. He was pre-diabetic, with high blood pressure and an enlarged heart. Kathleen found Carlos receptive to making changes that could dramatically improve his health.

Carlos continued to receive services from the team after he returned to the community. In his opinion, “This is good attention, not bad attention.”

Laura Garnette believes this is one of the real breakthroughs achieved by the Healthy Returns Initiative. “Being able to focus on physical and mental health needs separated from criminality, and addressing those needs through community-based intervention, is a complete transformation of how we do things.”

*Name has been changed for privacy.