Mental Health Access Before Children End Up in the Juvenile Justice System

Author: The Tower Foundation

In the face of long waitlists, insurance hurdles, and unresponsive providers, Boston-based Health Law Advocates (HLA) made connecting young people with timely and appropriate mental health services a top priority. HLA’s attorneys, equipped with deep expertise navigating the complex behavioral health system, began helping families access this essential care for their children—an effort the Tower Foundation has supported for over a decade.

94% of families in the Mental Health Advocacy Program for Kids reported facing barriers to mental health care like bureaucratic delays and insufficient transportation options.

“The kids’ mental health system is complex,” said Matt Selig, JD, executive director of HLA. “There are many different parts of the system that are supposed to help kids, whether it’s a school system, a state agency, or their insurance plan. Each has a different legal framework, which can be very confusing. Fortunately, our lawyers have a very specialized expertise to help families navigate the systems.”

HLA launched the first iteration of its Mental Health Advocacy Program for Kids (MHAP for Kids) in 2012, ensuring that youth in the juvenile justice system had access to appropriate care, such as individualized education plans or appropriate mental health treatment. Eighty percent of children involved in juvenile courts meet the criteria for a mental health diagnosis, often ending up in the system because these needs have not been addressed. MHAP for Kids attorneys worked with youth and their families and collaborated with state agencies to secure comprehensive mental health services within the home and in-school settings.

In 2014, after two years in the juvenile justice system, with funding from the Tower Foundation, HLA contracted with the Boston University School of Public Health to thoroughly evaluate the court-based program and gain a deeper understanding of the mental health needs of the community’s youth.

The study, published in 2017, found the program to be highly effective in connecting children and adolescents with timely and appropriate mental health care, while also preventing a subset of them from further court involvement. Survey responses also revealed a greater need to find help for children who were not in the juvenile system but were still struggling to find much-needed care.

“We heard from the community that our services needed to be expanded,” said Marisol Garcia, JD, HLA’s deputy director and director of MHAP for Kids. “People wanted to know why we were only based in the juvenile justice system and why kids had to fail before they could access our services.”

40% of children in the Mental Health Advocacy Program for Kids have been hospitalized for psychiatric challenges, and 39% have been seen by a crisis team.

Answering the community’s call for additional access, HLA began working in 2017 with the Massachusetts Department of Children & Families to place attorneys in family resource centers throughout the state, providing legal services to all children needing access to mental health care.

For children like Amiyah, a girl with autism spectrum disorder who faced denial after denial for services like functional behavioral assessments and an individualized education plan, MHAP for Kids’ advocacy proved critical. In Amiyah’s case, and many others like it, MHAP for Kids’ legal efforts connected her with the support she needed, improving her mental health and academic performance.


The Tower Foundation continued to support MHAP for Kids as it grew, helping with multi-year planning, partnerships, and funding for additional data to illustrate the program’s impact in the state. The evidence showing the program’s impact resulted in the state funding MHAP for Kids’ expansion.

MHAP for Kids started with two attorneys serving just two counties. The program now has 17 attorneys providing support to families across Massachusetts. In the future, MHAP for Kids plans to consult with other states to help launch similar programs for families.

“The Tower Foundation has supported us every step of the way,” said Garcia. “The way they’ve helped us grow and establish this program has made it clear they support us every step of the way.”