Tedeschi Frank, Horwitz Sarah McCue, Surko Michael, Weinberger Emily, Bart Amanda, Baetz Carly, Guo Fei, Alexander Ava, Havens Jennifer F
Dr. Tedeschi, Dr. Surko, and Dr. Baetz are Clinical Assistant Professors; Dr. Horwitz is a Professor; Mr. Guo is a research scientist; and Dr. Havens is Department Chair, Department of Child & Adolescent Psychiatry (DCAP), New York University Grossman School of Medicine, New York, New York. Dr. Weinberger is a psychology resident, Denver Health Medical Center, Denver, Colorado. Ms. Bart is an executive assistant, Brennan Center for Justice at NYU School of Law, New York, New York. Ms. Alexander is a doctoral student, Department of Psychology, University of Utah, Salt Lake City, Utah.
J Am Acad Psychiatry Law. 2024 Dec 12;52(4):460-469. doi: 10.29158/JAAPL.240082-24.
Numerous recommendations have been made to address the high rates of mental health disorders among justice-involved youth. Few data are available on the use, quality, appropriateness, or availability of services to address these needs. This study examined the relationship between trauma-informed mental health screening, other referral pathways for diagnostic evaluation, subsequent DSM-5 diagnoses, and treatments for evaluated youth. Eligible participants were all youth admitted to New York City secure juvenile detention facilities from September 17, 2015 to October 30, 2016 who remained in the facility for at least five days ( = 786). Of those, 581 (73.9%) were voluntarily screened and 309 (53.2%) later received a diagnostic evaluation. Youth who screened positive for depression, posttraumatic stress disorder, and problematic substance use were more likely to be evaluated. Treatment received was related to diagnosis rather than reason for referral. For youth who were referred for behavioral or emotional concerns, 99.1 percent (114 of 115) of those diagnosed with a neurodevelopmental disorder had attention-deficit/hyperactivity disorder (ADHD). These data are among the first to describe DSM-5 diagnoses and treatment among youth detainees. They highlight the prevalence of ADHD in detained youth and argue for the coordination of universal trauma-informed mental health screening and a structured referral system for this population.
针对涉司法青少年心理健康障碍高发的问题，人们已经提出了许多建议。但关于满足这些需求的服务的使用情况、质量、适宜性或可获得性的数据却很少。本研究考察了创伤知情心理健康筛查、其他诊断评估转诊途径、后续的《精神疾病诊断与统计手册》（第五版）（DSM - 5）诊断以及接受评估青少年的治疗之间的关系。符合条件的参与者为2015年9月17日至2016年10月30日期间入住纽约市安全少年拘留设施且在该设施停留至少五天的所有青少年（n = 786）。其中，581名（73.9%）青少年接受了自愿筛查，309名（53.2%）随后接受了诊断评估。在抑郁症、创伤后应激障碍和物质使用问题筛查呈阳性的青少年更有可能接受评估。接受的治疗与诊断有关，而非转诊原因。对于因行为或情绪问题被转诊的青少年，被诊断患有神经发育障碍的青少年中，99.1%（115名中的114名）患有注意力缺陷多动障碍（ADHD）。这些数据是首批描述青少年被拘留者中DSM - 5诊断和治疗情况的数据之一。它们凸显了ADHD在被拘留青少年中的患病率，并主张对该人群进行普遍的创伤知情心理健康筛查以及构建一个结构化的转诊系统。
