Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley).
Psychiatr Serv. 2021 May 1;72(5):546-554. doi: 10.1176/appi.ps.202000163. Epub 2021 Mar 26.
Youths in the juvenile justice system often do not access needed behavioral health services. The behavioral health services cascade model was used to examine rates of substance use screening, identification of substance use treatment needs, and referral to and initiation of treatment among youths undergoing juvenile justice system intake and to identify when treatment access is most challenged. Characteristics associated with identification of behavioral health needs and linkage to community services were also examined.
Data were drawn from administrative records of 33 community justice agencies in seven states participating in Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System, funded by the National Institute on Drug Abuse (N=8,307 youths). Contributions of youth, staff, agency, and county characteristics to identification of behavioral health needs and linkage to community services were examined.
More than 70% (5,942 of 8,307) of youths were screened for substance use problems, and more than half needed treatment. Among those in need, only about one-fifth were referred to treatment, and among those referred, 67.5% initiated treatment. Overall, <10% of youths with identified needs initiated services. Multivariable multilevel regression analyses revealed several contributors to service-related outcomes, with youths' level of supervision being among the strongest predictors of treatment referral.
Community justice agencies appear to follow an approach that focuses identification and linkage practices on concerns other than youths' behavioral health needs, although such needs contribute to reoffending. Local agencies should coordinate efforts to support interagency communication in the referral and cross-system linkage process.
青少年司法系统中的青少年往往无法获得所需的行为健康服务。本研究采用行为健康服务级联模型，调查了在接受青少年司法系统受理的青少年中进行物质使用筛查、识别物质使用治疗需求以及转介和开始治疗的比例，并确定了治疗机会最受挑战的时机。还检查了与识别行为健康需求和与社区服务联系相关的特征。
数据来自参与国家药物滥用研究所（NIDA）资助的青少年司法系统法律干预中的青少年转化研究的七个州的 33 个社区司法机构的行政记录（N=8,307 名青少年）。检查了青少年、工作人员、机构和县级特征对识别行为健康需求和与社区服务联系的贡献。
超过 70%（8,307 名青少年中的 5,942 名）接受了物质使用问题筛查，超过一半的青少年需要治疗。在需要治疗的青少年中，只有约五分之一被转介到治疗中，在被转介的青少年中，有 67.5%开始接受治疗。总体而言，<10%有需求的青少年开始接受服务。多变量多层回归分析显示了与服务相关的结果的几个贡献者，其中青少年的监管级别是治疗转介的最强预测因素之一。
社区司法机构似乎遵循一种方法，该方法侧重于识别和联系实践，而不是关注青少年的行为健康需求，尽管这些需求会导致再次犯罪。地方机构应协调努力，支持转介和跨系统联系过程中的机构间沟通。
