Untreated behavioral health conditions and unaddressed exposures to childhood trauma both have significant negative effects on lifetime well-being. In the long run, they may cause many different bad outcomes. These include increased challenges in school and at home; increased risk of suicide, homelessness, and victimization; and increased substance use and abuse, comorbid physical health problems, decreased mental wellbeing, delayed or disrupted cognitive development, and premature death (Cromer & Villodas, 2017; Flannery, Singer, & Wester, 2001; Yates, Dodds, Sroufe, & Egeland, 2003).

But nearly half of adolescents that need services do not receive them. Among those that do, significant differences in access are apparent across racial and ethnic groups (Alegria, Vallas, & Pumariega, 2011; Kirk & Sampson, 2013).

Youth with these conditions are disproportionately excluded from school. They are also over-represented in the child welfare and juvenile justice systems (Abram, et al., 2013; Arroyo, 2001; Shufelt & Cocozza, 2006; Teplin, Abram, McCelland, Dulcan, & Mericle, 2002). Just getting involved with the justice system can have negative results in the short and long term. These include decreased mental well-being, life-long barriers to education and employment, and harsher legal penalties for future crimes (Hobbs, Wulf-Ludden, & Strawhun, 2013; Holman & Ziedenberg, 2006; Mendel, 2011; Ryzin & Dishion, 2013). Plus, spending time in detention disrupts health care during adolescence, a key developmental period. Research shows that this may make existing health disparities between white adults and adults of color worse (Kirk & Sampson, 2013).