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Wasserman GA, McReynolds LS, Taxman FS, Belenko S, Elkington KS, Robertson AA, Dennis ML, Knight DK, Knudsen HK, Dembo R, Ciarleglio A, Wiley TRA. The Missing Link(age): Multilevel Contributors to Service Uptake Failure Among Youths on Community Justice Supervision. Psychiatr Serv 2021; 72:546-554. [PMID: 33765861 PMCID: PMC8288447 DOI: 10.1176/appi.ps.202000163] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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.
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Affiliation(s)
- Gail A Wasserman
- 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)
| | - Larkin S McReynolds
- 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)
| | - Faye S Taxman
- 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)
| | - Steven Belenko
- 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)
| | - Katherine S Elkington
- 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)
| | - Angela A Robertson
- 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)
| | - Michael L Dennis
- 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)
| | - Danica K Knight
- 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)
| | - Hannah K Knudsen
- 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)
| | - Richard Dembo
- 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)
| | - Adam Ciarleglio
- 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)
| | - Tisha R A Wiley
- 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)
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Yonek JC, Dauria EF, Kemp K, Koinis-Mitchell D, Marshall BDL, Tolou-Shams M. Factors Associated With Use of Mental Health and Substance Use Treatment Services by Justice-Involved Youths. Psychiatr Serv 2019; 70:586-595. [PMID: 31138054 PMCID: PMC6713457 DOI: 10.1176/appi.ps.201800322] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Nonincarcerated (community-supervised) youths who are first-time offenders have high rates of mental and substance use disorders. However, little is known about their use of psychiatric services (mental health and substance use) or factors associated with service use. This study examined the prevalence, determinants, and barriers to service use among community-supervised youths. METHODS Data were from a longitudinal study of mental health and substance use outcomes among adolescents ages 12-18 from a northeastern family court in which caregivers and youths completed assessments (N=423 dyads). The Behavior Assessment System for Children, Second Edition, assessed youths' psychiatric symptoms. The Child and Adolescent Services Assessment assessed service use and barriers. Family functioning and caregiver-adolescent communication were assessed with the McMaster Family Assessment Device and the Parent-Adolescent General Communication Scale, respectively. Multivariable regression analyses examined the cross-sectional relationship between youths' service use and determinants of use at baseline. RESULTS Of the 423 youths, 49% experienced psychiatric symptoms and 36% used psychiatric services in the past 4 months. The highest adjusted odds of service use were associated with youths' psychiatric symptoms and caregivers' history of a psychiatric diagnosis. The lowest odds were associated with caregivers' identifying as being from racial and ethnic minority groups. Caregiver-reported barriers to service use differed according to prior service use and by caregiver race-ethnicity. CONCLUSIONS Results suggest a need for interventions to increase access to and engagement in psychiatric services for community-supervised youths and the importance of caregiver factors in designing such interventions.
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Affiliation(s)
- Juliet C Yonek
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Emily F Dauria
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Kathleen Kemp
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Daphne Koinis-Mitchell
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Brandon D L Marshall
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Marina Tolou-Shams
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
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