Racial/ethnic disparities in prior mental health service use among incarcerated adolescents

Research on racial and ethnic disparities in mental health and substance abuse service use among incarcerated youth in the U.S. is inconclusive. This cross-sectional study adds to our understanding of racial and ethnic disparities by examining the prior use of mental health and substance abuse services among incarcerated juveniles. Guided by Andersen's behavioral model of health service utilization, a series of logistic regression analyses were conducted on a non-probability sample of 13–19 year-old youth in two residential facilities for juvenile offenders in Western Pennsylvania (N = 181). Black and Hispanic youth were less likely than White youth to have used mental health and substance abuse services, even when controlling for predisposing, enabling, and need factors. Additional analyses revealed that these differences did not hold across all service types, specifically with regards to outpatient service use. Significant differences did exist, however, in the prior use of inpatient mental health and substance abuse services. This suggests that White youth are often funneled into the mental health system, while youth of color enter the justice system. Implications for racial/ethnic disproportionality in service use and justice system involvement are discussed.     

The development and evolution of Reclaiming Futures at the ten-year mark: Reflections and recommendations

Reclaiming Futures has been a successful national demonstration project, initially funded by the Robert Wood Johnson Foundation, which seeks to improve a system-wide response to young people in the juvenile justice system with substance abuse issues. The initiative is a multiyear effort that has included complex simultaneous community and cross-system planned change efforts. The intention of the initiative is to develop, test, and disseminate a response to unmet needs and to extensive gaps and fragmentation in the availability and quality of services and opportunities that would have a positive impact not only on the lives of individual youth, but on community capacity to engage and encourage youth success as well. This article summarizes the developmental trajectory of the initiative, with a focus on elements of the planned change process. How change efforts were conceptualized, sequenced, executed, and evaluated are discussed and their implications explored. Now adopted in 29 communities around the nation, this article describes two federal and state dissemination efforts as examples of its continued expansion.     

The legal rights of LGBT youth in state custody: what child welfare and juvenile justice professionals need to know

Youth in state custody, regardless of their sexual orientation or gender identity, have federal and state constitutional and statutory rights. These rights guarantee a young person safety in their placement as well as freedom from deprivation of their liberty interest. Many lesbian, gay, bisexual, and transgender (LGBT) youth have these rights violated on a regular basis. Many cases in both the child welfare and juvenile justice contexts have resulted in extensive and time-consuming consent decrees as well as sizable damages awards. Knowledge of a youth's legal rights can help providers avoid legal liability while creating a safer and healthier environment for LGBT youth. This article provides a general overview of the successful federal legal claims that youth in the child welfare and juvenile justice systems have made, discussion of the rights generated as a result, particle application of these rights to the experiences of LGBT youth with hypothetical scenarios, a focus on specific rights that emanate from certain state laws, and a focus on specific concerns of transgender youth.     

Race,Substance Abuse,and Mental Health Disorders as Predictors of Juvenile Court Outcomes: Do They Vary By Gender?

Predicting juvenile court outcomes based on youthful offenders’ delinquency risk factors is important for the adolescent social work field as well as the juvenile justice system. Using a random sample of 341 delinquent youth from one Midwestern urban county, this study extends previous research by examining if race, substance abuse, and mental health disorders influence important delinquency outcomes (number of court offenses, felony conviction(s), probation supervision length, detention length, and number of probation services) differently for male and female juvenile offenders. Multivariate analysis findings revealed that race was significant only for males, and having a substance use disorder was a stronger predictor of delinquency outcomes for males; whereas, having a mental health disorder was a stronger predictor of delinquency outcomes for females. Implications for this research include the importance of early disorder identification and subsequent availability of gender-focused treatment.     

Examining the link between child maltreatment and delinquency for youth with emotional and behavioral disorders

This study examined service delivery and risk factors for 93 youth with emotional and behavioral disorders who were served by one jurisdiction's child welfare, juvenile justice, and special education agencies. The researchers collected data through an archival review of agency records. The article discusses findings as they relate to the link between maltreatment and delinquency for youth with emotional and behavioral disorders and includes recommendations for integrating early intervention efforts.     

Disparate Juvenile Court Outcomes for Disabled Delinquent Youth: A Social Work Call to Action

Current service delivery for at-risk youth is through four separate systems: special education; mental health and substance abuse; juvenile justice; and child welfare. Many youth (and their families) are involved with more than one of these systems, making early disability identification and subsequent systems coordination paramount in leading to more successful juvenile court outcomes. This coordination is an important and prioritized public policy concern because a majority of youth (disproportionately minority) within juvenile justice populations has been identified with mental health disorders, special education disabilities, or maltreatment histories. This study of a unique sample of probation-supervised delinquent youths (n = 397) identifies these disabilities and their corresponding court supervision, detention, and incarceration outcomes for a 48-month period in Cuyahoga County, Ohio (greater Cleveland). Within this youth sample over 32% had a special education disability, over 39% had a mental health disorder, over 32% had a substance abuse disorder, and over 56% were victims of maltreatment. Even higher disability rates were found for those youth who were subsequently detained or incarcerated. Many of these youth had multiple disabilities (and subsequently poorer juvenile court outcomes) and were concurrently involved in more than one disability service system. Policy and client services implications are reviewed and discussed.

Collaboration Between Community Mental Health and Juvenile Justice Systems: Barriers and Facilitators

Recent studies have confirmed a high prevalence of youth with diagnosable mental health disorders within the juvenile justice system, as well as the vulnerability of youth in the mental health system who enter the juvenile justice system. This high prevalence of dual system involvement has spawned challenges of collaboration between the mental health and juvenile justice systems to provide needed services to youth and their families. Seventy-two in-depth interviews were conducted with 18 youth and their parents/guardians, mental health professionals from five different community mental health centers, and juvenile justice professionals in urban and rural communities in a Midwest state in the United States. Professionals, youth and parents identified several important factors that facilitated collaboration, as well as a myriad of barriers that needed to be overcome. Findings suggest ways to improve partnerships between the two systems and the development of supportive policies and procedures.     

The role of interagency collaboration in facilitating receipt of behavioral health services for youth involved with child welfare and juvenile justice

Unmet need for behavioral health care is a serious problem for crossover youth, or those simultaneously involved with the child welfare and juvenile justice systems. Although a large percentage of crossover youth are serious emotionally disturbed, relatively few receive necessary behavioral health services. Few studies have examined the role of interagency collaboration in facilitating behavioral health service access for crossover youth. This study examined associations for three dimensions of collaboration between local child welfare and juvenile justice agencies - jurisdiction, shared information systems, and overall connectivity - and youths' odds of receiving behavioral health services. Data were drawn from the National Survey of Child and Adolescent Well-Being, a national survey of families engaged with the child welfare system. Having a single agency accountable for youth care increased youth odds of receiving outpatient and inpatient behavioral health services. Inter-agency sharing of administrative data increased youth odds of inpatient behavioral health service receipt. Clarifying agency accountability and linking databases across sectors may improve service access for youth involved with both the child welfare and juvenile justice systems.     

Programa shortstop: a culturally focused juvenile intervention for Hispanic youth

Culturally sensitive juvenile delinquency and substance abuse interventions are relatively limited and unavailable to many first-time Hispanic juvenile offenders. The purpose of this study was to test the effectiveness of a culturally focused juvenile and substance abuse intervention program for first time Hispanic youth offenders. The intent of the program was to decrease juvenile recidivism and increase substance abuse resistance. Programa Shortstop is a family based intervention designed for Hispanic youth ages 9-17. The intervention was delivered to 352 youth and at least one parent/caregiver over the 5-year study period. For intervention youth, the results of the recidivism study (n = 321) indicated that 89% of youth participating in Programa Shortstop between 1995 to 1997 were not rearrested within one year of completing Programa Shortstop. Additionally, statistical paired t-test analysis found that the intervention model had a positive effect on legal knowledge and school related factors associated with substance abuse and delinquency. Parent participants demonstrated significant increases in knowledge related to substance abuse and the legal system.     

Parental Divorce: A Protection from Later Delinquency for Maltreated Children

Family structure and maltreatment (abuse and neglect) have been identified as predictors of youth delinquency, although the relationship is not clear. This article furthers this research by studying a sample of maltreated children (n = 250) in one Midwest county, and through a multiple regression analysis of many risk factors, the study identified only one significant delinquency variable that made delinquency less likely—children who experience parental divorce. Some established risk factors were surprisingly found not to be predictive of later delinquency: minority race, one-parent families, youth substance abuse, recurrent maltreatment, and youth behind in academic grade level. Implications for the family studies and juvenile justice fields are set forth.     

Relationships of sexual, physical, and emotional abuse to emotional and behavioral problems among incarcerated adolescents

This study examined the relationships of sexual, physical and emotional abuse to emotional (internalizing) and behavioral (externalizing) problems among incarcerated girls and boys. Participants were youth who were remanded to the correctional facilities within a statewide juvenile correctional system in a southern state in the United States of America. Each participant completed a structured interview regarding abuse history, emotional and behavioral difficulties, and demographic characteristics. Multiple regression analyses indicated that girls were more likely than boys to internalize their problems. The only abuse variable that was positively and significantly associated with emotional problems was emotional abuse. Greater behavioral problems were significantly related to youths being younger in age, white ethnicity, history of sexual abuse, and history of physical abuse. There were overall gender differences for internalizing problems, but not for externalizing problems among incarcerated adolescents. Furthermore, physical and sexual abuses were related to externalizing problems but not to internalizing problems. Thus, different types of abuse appear to have different effects on adolescent behavior. Implications for future research and practice are discussed.     

Latina and African‐American Girls in the Juvenile Justice System: Needs,Problems, and Solutions

This review focuses on Latina and African‐American girls in the juvenile justice system with a special emphasis on their mental health, substance abuse, and treatment needs. Like many young women in the juvenile justice system, Latina and African‐American girls often have histories of neglect, abuse, and trauma, which contribute to later mental health and substance abuse issues. Despite these histories, juvenile justice professionals sometimes rely on stereotypes rooted in cultural deficit thinking to explain Latina and African‐American girls' delinquency. Relying on gendered, racialized, and classed stereotypes and assumptions can result in decisions that negatively impact Latina and African‐American girls' access to mental health, substance abuse, and other types of treatment. Policy and practice implications for better addressing the needs of Latina and African‐American girls are discussed.     

Relationships of Sexual,Physical, and Emotional Abuse to Emotional and Behavioral Problems Among Incarcerated Adolescents

ABSTRACT

This study examined the relationships of sexual, physical and emotional abuse to emotional (internalizing) and behavioral (externalizing) problems among incarcerated girls and boys. Participants were youth who were remanded to the correctional facilities within a statewide juvenile correctional system in a southern state in the United States of America. Each participant completed a structured interview regarding abuse history, emotional and behavioral difficulties, and demographic characteristics. Multiple regression analyses indicated that girls were more likely than boys to internalize their problems. The only abuse variable that was positively and significantly associated with emotional problems was emotional abuse. Greater behavioral problems were significantly related to youths being younger in age, white ethnicity, history of sexual abuse, and history of physical abuse. There were overall gender differences for internalizing problems, but not for externalizing problems among incarcerated adolescents. Furthermore, physical and sexual abuses were related to externalizing problems but not to internalizing problems. Thus, different types of abuse appear to have different effects on adolescent behavior. Implications for future research and practice are discussed.     

Behavioral health correlates of exposure to community violence among African-American adolescents in Chicago

AimsThough public health researchers are more aware of behavioral health concerns among African American youth, few studies have explored how exposure to community violence may be related to adverse youth concerns. This study examines the relationship between exposure to community violence and mental health problems, substance use, school engagement, juvenile justice involvement, and STI risk behaviors.MethodsA total of 638 African American adolescents living in predominantly low-income, urban communities participated in the study by completing self-report measures on exposure to community violence, mental health, school engagement proxies, substance use, delinquency markers and sexual risk behaviors.ResultsAdolescents who reported higher rates of exposure to community violence were significantly more likely to report poorer mental health, delinquent behaviors, a history of juvenile justice involvement, lower school bonding and student-teacher connectedness. These youth were also significantly more likely to use alcohol, cigarettes, and illicit substances, and engage in sexual risk behaviors.ConclusionsFindings suggest that there is a critical need for culturally relevant prevention and intervention efforts for African American adolescents who are frequently exposed to community violence.     

The Development of Theory and Treatment with Substance Abusing Female Juvenile Offenders

Little is known regarding the specific treatment needs of those female juvenile offenders with a history of substance abuse. While social scientists have advanced distinct theories regarding adolescent substance use and juvenile delinquency, minimal work has been conducted to integrate or link these two. In attempting to further explore their interrelationships, this article will review and incorporate the relevant theoretical and practice milestones in three areas: (1) substance abuse and women, (2) substance abuse and adolescents, and (3) substance abuse and juvenile delinquency, leading to the development of new theory and practice relevant to the female substance abusing juvenile offender population. The authors propose some practice considerations for current interventions with this population and discuss implications for future research and exploration.     

Mental Disorders,Comorbidity, and Postrunaway Arrests Among Homeless and Runaway Adolescents

This study examined the associations between lifetime mental disorder, comorbidity, and self‐reported postrunaway arrests among 428 (187 males, 241 females) homeless and runaway youth. The analysis examined the pattern of arrests across five lifetime mental disorders (alcohol abuse, drug abuse, conduct disorder, major depressive episode, and posttraumatic stress disorder). The adolescents, ranging from 16 to 19 years old, were interviewed directly on the streets and in shelters in four Midwestern states using computer‐assisted personal interviewing. Extensive self‐reports of early life history, behaviors since running away from home, and diagnostic interviewing (UM‐CIDI and DISC‐R) were used to estimate possible disorders. There was a high level of postrunaway arrests reported by the youth; more than half were arrested at least once after the initial runaway, with the average of 4.4 times. Consistent with the hypotheses, there were differential associations between individual mental disorders and involvement with the criminal justice system. Only externalizing disorders such as substance abuse and conduct disorder were related to arrest. Street youth with multiple externalizing and internalizing disorders were more likely to be arrested than nondisordered youths.     

Adolescents in residential treatment: The prevalence of ACEs,substance use and justice involvement

Abstract

Although associations between developmental trauma, juvenile justice involvement and youth substance use have been previously reported in the published literature, the interconnection among these three factors has not been adequately studied. This article describes the interconnection among these three factors and calls for greater attention to the role of adverse childhood experiences (ACEs) in the diagnosis and treatment of youth who present with histories of substance use and/or offending behavior. Pilot data are presented that show high rates of self-reported trauma exposure, substance use history, justice involvement, and mental health problems in a sample of adolescents in residential treatment. The data point to the need for residential treatment centers to consider trauma histories in developing treatment plans for youth with current and prior substance use and offending behavior.     

Comorbid Substance Use and Mental Disorders Among Offending Youth

ABSTRACT

This study examines the offense, substance use, and mental illness characteristics for a subset of adolescent juvenile detainees receiving services through a federally funded system of care initiative. Findings indicate that 65% of these youth were comorbid for both mental and substance use disorders. Female detainees were at greater risk on almost every measure of mental health impairment and dual substance use and mental disorders. Study results highlight the need for effective, integrated treatment models that can serve youth involved in multiple child-serving systems, and address the challenging constellation of comorbid conditions faced by many juvenile offenders.     

The Evolution of Substance Abuse Treatment in Juvenile Justice

ABSTRACT

This paper discusses the scope of substance abuse and related problems among juvenile offenders, and describes three models of addressing the problem based on a review of current approaches, ranging from Treatment Alternatives to Street Crimes programs (TASC), to juvenile drug courts, to an integrated treatment network model. The relevant strengths and weaknesses of each in supporting lasting change in substance-abusing juvenile offenders and their families are presented, and a call to action is offered for communities wishing to aim their interventions innovatively and precisely in the direction of substance abuse among their delinquent youth.     

Judging childhood

This article brings ethnohistorical inquiry to bear in exploring the certainties of Progressive Era reformers regarding the role of the state, the meaning of childhood, and the power of intervention in the lives of children, youth, and families in Butte, Montana. The author draws on the key themes of the Just Practice perspective (Finn & Jacobson, 2008)—as an organizing frame to explore assumptions and contestations regarding childhood, well-being, trouble, and intervention as expressed through primary source documents and reports of juvenile court proceedings in Butte from 1900 to 1914. Butte, a site of rapid industrialization at the turn of the last century, provides a local context in which to examine ways these certainties were asserted, negotiated, embedded, and resisted in the making of a nascent system of child welfare and juvenile justice. The historical analysis offers a foundation for critical reflection on the certainties embedded in contemporary practice with children and youth.