The missing link (age): Multilevel contributors to service uptake failure among youths on community justice supervision

Gail A. Wasserman, Larkin S. McReynolds, Faye S. Taxman, Steven Belenko, Katherine S. Elkington, Angela A. Robertson, Michael L. Dennis, Danica K. Knight, Hannah K. Knudsen, Richard Dembo, Adam Ciarleglio, Tisha R.A. Wiley

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)546-554
Number of pages9
JournalPsychiatric Services
Volume72
Issue number5
DOIs
StatePublished - May 2021

Bibliographical note

Funding Information:
Methods: 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.

Funding Information:
This study was conducted under the Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) project cooperative agreement, funded by the National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH). The authors acknowledge support from the following NIDA grant awards: U01 DA-036221 (to Chestnut Health Systems), U01 DA-036226 (Columbia University), U01 DA-036233 (Emory University), U01 DA-036176 (Mississippi State University), U01 DA-036225 (Temple University), U01 DA-036224 (Texas Christian University), and U01 DA-036158 (University of Kentucky). The authors thank Corey Smith for his assistance in assembling and preparing the analytical files for these analyses and the staff and youths participating across the 33 sites and six research centers. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of NIDA, NIH, or the participating universities or juvenile justice systems. The authors report no financial relationships with commercial interests. Received March 13, 2020; revisions received May 5, June 30, and August 4, 2020; accepted August 21, 2020; published online March 26, 2021.

Funding Information:
The Juvenile Justice–Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) co-operative agreement, which was funded by the National Institute on Drug Abuse, includes six research centers, each working with four to six local justice agencies providing community justice supervision (e.g., probation) in Florida, Georgia, Kentucky, Mississippi, New York, Pennsylvania, and Texas. Its primary aim was to test the effectiveness of a locally customized intervention to improve delivery of services addressing substance use needs for justice-involved youths by working with justice agencies and their community-based behavioral health partners. We analyzed data from youths and staff in 33 county-level sites during the baseline study phase, before researchers implemented a systems-level intervention to improve interagency service delivery. Research centers received study approval from their institutional review boards (21). Justice staff provided informed consent for surveys, and a waiver of consent was granted to review deidentified youth records. By design, justice sites (27 intake settings and six youth courts) provided community-based justice services to juveniles whose behavioral health needs were typically addressed by other local providers. Sites varied in sociodemographic characteristics and service availability.

Publisher Copyright:
© 2021 American Psychiatric Association. All rights reserved.

ASJC Scopus subject areas

  • Psychiatry and Mental health

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