Robst John, Armstrong Mary, Dollard Norin
Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA.
Department of Child and Family Studies, University of South Florida, Tampa, FL, USA.
Crim Behav Ment Health. 2017 Dec;27(5):501-513. doi: 10.1002/cbm.2024. Epub 2017 Mar 9.
High rates of mental health disorders and exposure to trauma among the juvenile justice population highlight the importance of understanding whether and how mental health services can help prevent further justice system involvement as well as provide treatment.
We had two principal questions: Is out-of-home mental health treatment after arrest associated with reduced recidivism among young people who have been exposed to trauma? Are particular types of out-of-home treatment associated with better outcomes? We hypothesised that type of residential setting would affect outcomes among those with histories of serious trauma.
Primary data sources included Florida Juvenile Justice, Child Welfare and Medicaid data from July 2002 through June 2008. We identified all Florida Juvenile Justice cases with a record of 'severe emotional disturbance'. Two groups were identified - one for whom an arrest was followed within 90 days by out-of-home placement for mental health treatment and the other for whom there was some other out-of-home placement. Generalised estimating equations (GEE) were used to calculate associations with likelihood of re-arrest during a 12 month at risk period.
Young people who had experienced severe trauma and were sent to out-of-home treatment settings after conviction for a criminal offence had lower recidivism rates when receiving treatment in foster care than other out-of-home placements, while those with less severe or no trauma histories had lower recidivism rates with any out-of-home placement.
We believe that this is the first study to have considered how trauma histories may mediate outcomes for young people in out-of-home placements after arrest or conviction for a criminal offence. Findings suggest that case managers and clinicians should consider the trauma histories when making decisions about the appropriate treatment setting in these circumstances. Copyright © 2017 John Wiley & Sons, Ltd.
青少年司法系统中的人群心理健康障碍发生率高且易遭受创伤，这凸显了了解心理健康服务能否以及如何有助于预防再次卷入司法系统并提供治疗的重要性。
我们有两个主要问题：被捕后接受家庭外心理健康治疗与遭受创伤的年轻人再犯罪率降低是否相关？特定类型的家庭外治疗是否与更好的结果相关？我们假设居住环境类型会影响有严重创伤史者的治疗结果。
主要数据来源包括2002年7月至2008年6月期间佛罗里达州青少年司法、儿童福利和医疗补助数据。我们识别出所有有“严重情绪障碍”记录的佛罗里达州青少年司法案件。确定了两组——一组在被捕后90天内被安置到家庭外接受心理健康治疗，另一组则有其他家庭外安置情况。使用广义估计方程（GEE）来计算在12个月风险期内与再次被捕可能性的关联。
因刑事犯罪被定罪后经历严重创伤并被送往家庭外治疗机构的年轻人，在寄养机构接受治疗时的再犯罪率低于其他家庭外安置情况，而创伤史较轻或无创伤史的年轻人在任何家庭外安置情况下再犯罪率都较低。
我们认为这是第一项考虑创伤史如何影响被捕或因刑事犯罪被定罪的年轻人在家庭外安置治疗结果的研究。研究结果表明，个案管理员和临床医生在这些情况下决定合适的治疗环境时应考虑创伤史。版权所有© 2017约翰·威利父子有限公司。
