Barrett James G, Flores Michael, Lee Esther, Mullin Brian, Greenbaum Chloe, Pruett Erika A, Cook Benjamin Lê
Department of Psychiatry, Health Equity Research Lab, Cambridge Health Alliance/Harvard Medical School.
Psychol Public Policy Law. 2022 May;28(2):179-187. doi: 10.1037/law0000325. Epub 2021 Sep 13.
Despite the high rates of mental illness among youth in the juvenile justice system, many justice-involved youth do not receive adequate behavioral health services. We examined differences in health service utilization outcomes between youth who were diverted through a community-based, precomplaint program (Safety Net; = 41), and youth with juvenile justice involvement in neighboring cities ( = 154). Individual arrest and health care records were combined to evaluate the rate of health care service utilization before and after initial police contact. A difference-in-differences approach with propensity score weighting was used to evaluate the impact of Safety Net on health service use, including inpatient, outpatient, emergency department (ED), and primary care visits. Compared to their nondiverted counterparts, Safety Net youth had a significant increase in psychiatric outpatient visits (average treatment effect [ATE] of 26%; < .05) and psychiatric outpatient and primary care visits among those with a diagnosed mental illness (ATE of 19% and 12%, respectively); < .05). There were no significant differences in ED or hospitalization outcomes. Results suggest that precomplaint diversion through Safety Net fosters access to outpatient behavioral health and primary care services that address the underlying issues that put youth in contact with police.
尽管青少年司法系统中的青少年精神疾病发病率很高，但许多涉及司法的青少年并未获得足够的行为健康服务。我们研究了通过基于社区的投诉前项目（安全网；n = 41）被分流的青少年与邻近城市中涉及青少年司法的青少年（n = 154）在医疗服务利用结果方面的差异。将个人逮捕记录和医疗记录相结合，以评估初次与警方接触前后的医疗服务利用率。采用倾向得分加权的差异-in-差异方法来评估安全网对医疗服务使用的影响，包括住院、门诊、急诊科（ED）和初级保健就诊。与未被分流的青少年相比，安全网项目的青少年在精神科门诊就诊方面有显著增加（平均治疗效果[ATE]为26%；P <.05），在被诊断患有精神疾病的青少年中，精神科门诊和初级保健就诊也有增加（ATE分别为19%和12%；P <.05）。在急诊科就诊或住院结果方面没有显著差异。结果表明，通过安全网进行投诉前分流有助于获得门诊行为健康和初级保健服务，这些服务可以解决导致青少年与警方接触的潜在问题。
