AuthorAntoinette Kavanaugh
Antoinette Kavanaugh
If you are representing a youth, you are not simply representing a small adult.
As this chapter by Dr. Antoinette Kavanaugh explains, the adolescent brain
is still developing, and relative to adults in the criminal justice system, youth
have a higher rate of mental disabilities. The chapter further explains how
these factors impact representation and can shape litigation strategies such
as suppression, competency, and mitigation.
• • •
As a normal developmental process, adolescence is a time of remarkable
change and growth. The brain goes through changes that contribute to
adolescents thinking and acting differently than their adult counterparts.
Unfortunately, not all changes associated with adolescence are positive.
Factors that make youth a vulnerable population from a developmental
perspective include mental illness, cognitive abilities, and psychosocial
maturity. Often these factors present differently in the juvenile justice sys-
tem population than they do in youth who are not in the justice system.
Mental Illness and Substance Abuse in the
General Population
From a mental health perspective, a youth has a serious emotional distur-
bance (SED) when he or she has a mental health disorder that results in
functional impairment in different domains of the adolescent’s life (e.g.,
school, family, or community).
126 Representing People with Mental Disabilities
One in ten adolescents ages twelve to fourteen and almost half of kids
ages seventeen and eighteen, consume alcohol regularly. Ethnic and gender
differences also contribute to teenage drinking patterns. Males consume
alcohol at higher rates than females and white and Hispanic adolescents
consume alcohol at higher rates than African-American adolescents or
teens from other ethnic groups. As is the case with alcohol, there is a lin-
ear age trend regarding the use of illicit drugs. Nearly 40 percent of youth
ages thirteen and fourteen use drugs and the rate doubles for those ages
seventeen and eighteen. Again, males were more likely to use illicit drugs
and the gender disparity was greatest among older adolescents.
That said, not all adolescents who use drugs or alcohol will meet the
criteria for a substance use disorder (SUD). Results from a 2014 national
survey of drug and alcohol use sponsored by the Substance Abuse and
Mental Health Services Administration (SAMHSA) found that 5 percent
of youth between ages twelve and seventeen had an SUD in the past year.
Put another way, one in twenty of those youths abused or were dependent
on some type of illicit substance.1
From a clinician’s perspective, kids use substances and although not all
use rises to the level of a disorder, substance abuse disorders are a mental
health problem. A criminal defense lawyer should know that many kids
in the criminal justice system will have that diagnosis. In other words, a
lawyer should be aware not only about serious mental disorders, but also
to the entire constellation of mental health and psychosocial issues con-
fronting adolescent clients.
Service Utilization
Many adolescents with mental health needs do not receive treatment. For
adolescents, mental health service utilization varies by type and number
of disorders. Those with attention-deficit/hyperactivity disorder, conduct
disorder, or oppositional-defiant disorder are more likely to receive services
than those with an anxiety or substance use disorder. Adolescents depend
on the adults in their life in a myriad of ways to seek and access treatment
(e.g., transportation, financially, and insurance coverage). Perhaps the rea-
son the percentage of those who utilize services is greater when there is
more than one disorder present is that adolescents with more than one
disorder have greater functional impairments, which makes it harder for
1 SAMHSA 2014.

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