Joshua Beasley Jr. entered the Texas juvenile justice system in 2018, when he was 11, after a series of misdemeanor offenses, including kicking a school safety officer and spitting on a police officer. What began as a low-level juvenile case became five years in secure custody as his behavior deteriorated and new charges accumulated. Joshua engaged in serious self-harm, made repeated suicidal gestures and attempts, and was eventually transferred to adult prison, where he died by suicide in 2023, at 16.
For many, Joshua’s story points to failures in the Texas Juvenile Justice Department (TJJD). But it also illustrates a different failure now common in many states: the disappearance of intensive residential psychiatric treatment for children whose needs extend far beyond what outpatient care can provide.
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Joshua’s mother, Amnisty Freelen, said in an interview with City Journal that she recognized long before his incarceration that her son needed a higher level of psychiatric care. She sought help through the mental-health system, but the options were limited: a brief psychiatric hospitalization, outpatient counseling, and medication. Joshua would not engage with outpatient treatment, and she felt that he needed a structured inpatient setting.
Instead, she says, officials assured her he would receive the mental-health care he needed in TJJD. “He needed more of an inpatient treatment, but people never offered that,” she said. “The only thing they were offering was TJJD.”
After Joshua engaged in repeated self-harm and suffered psychiatric crises in custody, TJJD transferred him to Vernon State Hospital, a state psychiatric facility that serves youth involved with the justice system. There, his mother says, he stabilized. “When TJJD sent Josh to the Vernon State Hospital, he immediately started excelling and doing great there,” she said. He stopped repeatedly harming himself, attended school, participated in treatment, and said that hospital staff cared about him and listened to him.
But after roughly two months, Joshua was returned to TJJD. Within 24 hours, his mother said, he was harming himself again. Later that year, after he turned 16, TJJD transferred him to the Texas Department of Criminal Justice, the state’s adult prison system. On March 24, 2023, he was found unresponsive in his cell at the Wayne Scott Unit with a sheet tied around his neck.
Joshua’s experience reflects a problem common in many states: an ongoing lack of residential psychiatric care. Most children with mental-health needs can be treated through outpatient and community-based services, but a smaller group requires a higher level of care. Federal surveys dating back to the early 1990s have consistently identified a durable population of kids with serious emotional disturbance—generally around 5 percent to 6 percent of the overall child population.
Residential treatment forms part of the more intensive end of the continuum of care: 24-hour treatment for youth whose psychiatric and behavioral needs cannot be safely or effectively managed at home. Programs vary widely in quality, structure, security, clinical intensity, and length of stay. Psychiatric residential treatment facilities are among the most intensive options, providing inpatient-level psychiatric treatment for children outside a hospital.
Care at that level has steadily contracted. Since 2010, the number of youth residential mental-health treatment programs has declined by more than 60 percent nationwide. Residential beds have fallen by about two-thirds, and the number of children served has dropped nearly 78 percent. According to the Substance Abuse and Mental Health Services Administration, 94 percent of states experienced reductions in youth served in psychiatric residential treatment facilities between 2010 and 2022.
The kids who once would have been helped by those programs did not disappear. Instead, they increasingly entered other public systems, particularly the juvenile criminal-justice system.
Some are detained simply because no appropriate treatment bed is available. A bipartisan investigation released in February by Georgia Senator Jon Ossoff and Virginia Representative Jen Kiggans found that juvenile detention centers in 25 states were holding young people who could have been released to residential mental-health programs if spaces were available. More than half of juvenile detention centers reported holding youth for at least a month while they waited. Some reported delays lasting as long as a year.
Others arrive by a different path. Restrictive policy changes have made it tougher for residential programs to serve youth with severe behavioral needs, leading some children to be discharged or rejected once their behavior escalates beyond what programs are allowed or able to manage. Some cycle through outpatient care, crisis services, and short-term placements until their psychiatric distress manifests as assault or other violent offenses (like robbery, sexual assault, or homicide) that brings them into juvenile detention.
Texas officials increasingly acknowledge both realities. Earlier this year, the TJJD and the Meadows Mental Health Policy Institute completed a statewide assessment of the state’s juvenile-justice continuum of care. Across all seven regions, probation chiefs described detention becoming the default response when intensive psychiatric treatment was unavailable. “We’ve had kids wait in detention for 40-plus days because there was nowhere else to go,” said one official. The report concludes that probation departments have become “the default service system” because of “the widening gap between what youth need, what counties are expected to manage, [and] what options actually exist.”
Texas has far more capacity to detain young people than to treat them. As of February, it had approximately 165 public youth mental-health beds, compared with 5,718 juvenile-justice beds. That imbalance has become more consequential because the youth entering juvenile justice today have increasingly severe psychiatric needs. By 2022, approximately 85 percent of youth committed to TJJD had moderate or high mental-health needs, up from 21 percent in 2014. The agency recorded more than 6,500 suicide alerts in secure facilities during fiscal year 2021.
Joshua entered TJJD at the worst possible time. By 2022, Executive Director Shandra Carter described the agency as experiencing “the worst staffing crisis” in its history. Secure facilities were averaging about half of the staffing levels needed to operate safely. Chronic vacancies meant fewer staff members supervising youth, fewer clinicians available to provide treatment, and increasing reliance on lockdowns that confined kids to their rooms for much of the day, limiting school, therapy, recreation, and other programming. Mental-health staffing was similarly depleted. By September 2023, only 52 percent of mental-health positions were filled.
Texas was not alone. The Council of State Governments Justice Center has described juvenile-justice systems nationwide as being in crisis because agencies cannot recruit and retain enough front-line staff. Nearly 90 percent of corrections agencies reported moderate or severe staffing shortages following the Covid-19 pandemic.
None of this excuses the failures of juvenile justice. But it helps explain why detention facilities increasingly struggle to care for kids with profound psychiatric illness. A system designed to supervise delinquent youth has become responsible for managing some of the most psychiatrically complex children in the country.
Why are so many of these young people in prison in the first place? The answer begins outside the juvenile-justice system, in the contraction of residential psychiatric treatment. These programs were designed for children whose needs exceeded the capacities of outpatient services, brief hospitalization, or family supervision. Some of these patients posed serious risks to themselves or others, but their primary problem was psychiatric illness, not criminality.
Residential treatment was not in decline because it had become obsolete, but because of a long-standing ideological and policy preference among progressive policymakers and advocates for community-based care, often based on the assumption that outpatient services could replace more intensive commitments for nearly all youth. In recent years, that inclination has hardened into outright hostility to residential treatment. The celebrity anti-treatment campaign led by Paris Hilton and the media coverage surrounding it recast residential care as abusive and illegitimate, accelerating political pressure against the very settings needed for youth whose problems cannot be safely managed at home.
Texas is now trying to expand its capacity for children’s psychiatric treatment. In June, the state opened a new psychiatric hospital in Dallas with 292 beds, including 92 for children and adolescents, and has invested in several other state hospital projects. But psychiatric hospitals are designed to stabilize patients during an acute crisis, not provide the weeks or months of structured treatment that some kids need before they can safely return home.
Until recently, Texas had no certification framework for Psychiatric Residential Youth Treatment Facilities, or PRYTFs. That changed in 2024, when the Texas Health and Human Services Commission created its first certification program. The state is now planning at least one publicly funded PRYTF in Jefferson County, which the commission expects to open in spring 2027. Those are important first steps, but they also underscore how recently Texas began rebuilding a level of care for youth that the state has long lacked.
For years, families seeking intensive psychiatric residential treatment faced limited in-state options, while juvenile probation departments increasingly found themselves supervising youth whose psychiatric needs exceeded the services available in their communities.
Joshua Beasley’s mother believes his brief transfer to Vernon State Hospital showed what her son needed all along: a secure psychiatric setting focused on treatment rather than detention. At Vernon, she said, “he was Josh again,” because he was receiving adequate psychiatric care. “If they would’ve kept him there like I requested,” she said, “he would still be alive today.”
Detention plays a necessary role for youth who commit crimes, but it is not designed to serve as the state’s primary placement for children with severe mental illness, suicidality, and self-harm.
If we want fewer high-need youth entering juvenile detention, we must rebuild the intensive residential treatment continuum that has quietly disappeared over the past decade. Only then will detention stop functioning as the default answer for young people whose needs exceed what families, schools, probation departments, and outpatient services can provide.