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Symposia

Dissemination & Implementation Science

Socio-Ecological Perspectives on Assessing and Intervening on Barriers to Psychological Treatment Among Diverse Adolescents and Young Adults

3 - (SYM 71) Identifying Access and Engagement Barriers to Trauma Informed Care Faced by Incarcerated Youth: A Community-based Participatory Research Approach

Sunday, November 23, 2025

2:32 PM - 2:46 PM CST

Location: Empire C, Level 2

Keywords: Adolescents, College Students, Mental Health Disparities
Recommended Readings: Mongelli, F., Georgakopoulos, P., & Pato, M. T. (2020). Challenges and opportunities to meet the mental health needs of underserved and disenfranchised populations in the United States. Focus (American Psychiatric Publishing), 18(1), 16–24. https://doi.org/10.1176/appi.focus.20190028, Garney, W., Wilson, K., Ajayi, K. V., Panjwani, S., Love, S. M., Flores, S., Garcia, K., & Esquivel, C. (2021). Social-ecological barriers to access to healthcare for adolescents: A scoping review. International Journal of Environmental Research and Public Health, 18(8), 4138. https://doi.org/10.3390/ijerph18084138, Benton, T.D., Boyd, R.C., Njoroge, W.F. (2021). Addressing the global crisis of child and adolescent mental health. JAMA Pediatrics,175(11),1108–1110. doi:10.1001/jamapediatrics.2021.2479, ,

Speaker(s)

GB

Gray Bowers, M.A. (they/them/theirs)

University of California, Los Angeles
Los Angeles, CA, United States

Co-author(s)

GB

Gray Bowers, M.A. (they/them/theirs)

University of California, Los Angeles
Los Angeles, CA, United States
LN

Lauren Ng, Ph.D.

Assistant Professor
University of California, Los Angeles
Los Angeles, CA, United States

Abstract Body
There is a high unmet need for trauma informed interventions for incarcerated youth, with over 90% of legal system-involved youth reporting trauma exposure and over 30% meeting PTSD diagnostic criteria. The current study aimed to identify factors that may increase the implementation of, and engagement in, trauma informed interventions within secure detention facilities for incarcerated youth. Methods. Healing Dialogue & Action (HDA), an organization of Credible Messengers (CM; i.e., people with legal system lived experience) that deliver services to incarcerated youth in LA County, participated in a 3-day workshop (N = 21) with researchers to elucidate intervention barriers including presentations on socio-ecological model, facilitated large and small group discussions, and individual free response surveys. Results. Thematic analysis of qualitative data identified barriers to accessing and engaging in trauma informed care across socio-ecological levels, including: low self-esteem, trauma history, gang membership, facility culture, staff attitudes, system mistrust, and policy restrictions. Individual level barriers reduced initial acceptability of engaging in services while structural level barriers prevented effective implementation efforts. Discussion. Findings highlighted that using CMs as intervention providers is a promising avenue to circumvent barriers to care by more easily building trust and rapport between legal system-involved youth and providers, thereby increasing youth buy-in. Specifically, CMs lived experience and self-disclosures promoted engagement by normalizing youths' experiences while de-stigmatizing mental health symptoms and treatment. Conclusion. Partnering with CMs offers unique perspectives on factors that may increase the successful implementation of interventions within secure detention facilities due to their extensive dual experience living and working in these settings .This research provides insight into current barriers to trauma informed treatment access and engagement faced by incarcerated youth and the utility of community-based implementation of a Credible Messenger model to effectively reduce individual, facility, and system level barriers to care.