1
|
Piper KN, Pankow J, Wood JD. Juvenile probation staff perceptions of engaging families in substance use services. FAMILY RELATIONS 2024; 73:2079-2102. [PMID: 38881821 PMCID: PMC11175584 DOI: 10.1111/fare.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 09/08/2023] [Indexed: 06/18/2024]
Abstract
Objectives Study objectives were to (a) understand juvenile justice staff members' experiences with engaging families in youth substance use services and (b) identify staff-perceived barriers to family engagement across steps of substance use service provision. Background Lack of family involvement in juvenile justice system substance use (SU) services is a key barrier to successful treatment of justice-involved youth. Method From June through November 2015, 33 focus groups were conducted at juvenile justice system probation sites across seven states. There were 263 participants, which included juvenile justice probation and behavioral health staff. Results Strategies to engage families in services were highly variable across the 33 juvenile justice sites. Juvenile justice staff members identified barriers to family engagement in SU services including family discomfort, distrust of juvenile justice staff, lack of family service compliance, difficulties accessing SU services, lack of transportation, insurance and cost barriers, low perceived need for treatment, lack of SU education, and SU treatment stigma. Conclusion and Implications Barriers to family engagement directly impact the success of SU service provision in juvenile justice settings. Implementation of strategies to engage families of justice-involved youth (e.g., providing tangible, informational, and emotional support to families, and involving families in juvenile justice policy and care decisions) are critical to improving SU outcomes among this vulnerable population.
Collapse
Affiliation(s)
- Kaitlin N Piper
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jennifer Pankow
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX
| | - Jennifer D Wood
- Department of Criminal Justice, Temple University, Philadelphia, PA
| |
Collapse
|
2
|
Stanley JN, DeLucca SC, Perron L, Belenko S. The impact of co-occurring mental health problems on referral to and initiation of treatment among youth under probation supervision: Findings from a cluster randomized trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 160:209279. [PMID: 38135122 DOI: 10.1016/j.josat.2023.209279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/20/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Many youth under community supervision have substance use and co-occurring mental health issues. Yet, access to treatment is limited, and many programs cannot address co-occurring disorders. This study examines how co-occurring symptoms among youth on probation affect referral to and initiation of treatment. We hypothesize that both referral and initiation rates will be lower for youth with any co-occurring indicators. METHODS This study collected administrative data from 14 sites in three states between March 2014 and November 2017 using JJ-TRIALS, a cluster randomized trial. Among 8552 youth in need of treatment (screened as having a substance use problem, drug possession arrest, positive drug test, etc.), 2069 received a referral to treatment and 1630 initiated treatment among those referred. A co-occurring indicator (n = 2828) was based on symptoms of an internalizing and/or externalizing issue. Descriptive analyses compared referral and initiation by behavioral health status. Two-level mixed effects logistic regression models estimated effects of site-level variables. RESULTS Among youth in need with co-occurring internal, external, or both indicators, only 16 %, 18 %, and 20 % were referred to treatment and of those referred, 63 %, 69 %, and 57 % initiated treatment, respectively. Comparatively, 27 % and 83 % of youth with a substance use only indicator were referred and initiated treatment respectively. Multi-level multivariate models found that, contrary to our hypothesis, co-occurring-both (p = 0.00, OR 1.44) and co-occurring-internal indicators (p = 0.06, OR 1.25) predicted higher referral but there were no differences in initiation rates. However, there was substantial site-level variation. CONCLUSIONS Youth on probation in need of substance use treatment with co-occurring issues have low referral rates. Behavioral health status may influence youth referral to treatment depending on where a youth is located. Depending on the site, there may be a lack of community programs that can adequately treat youth with co-occurring issues and reduce unmet service needs.
Collapse
Affiliation(s)
- Jennifer N Stanley
- Temple University, Department of Criminal Justice, 1115 Polett Walk, Philadelphia, PA 19122, United States.
| | - Sarah C DeLucca
- Temple University, Department of Criminal Justice, 1115 Polett Walk, Philadelphia, PA 19122, United States
| | - Lauren Perron
- Temple University, Department of Criminal Justice, 1115 Polett Walk, Philadelphia, PA 19122, United States
| | - Steven Belenko
- Temple University, Department of Criminal Justice, 1115 Polett Walk, Philadelphia, PA 19122, United States
| |
Collapse
|
3
|
Holloway ED, Irgens M, McPhee J, Folk JB, Tolou-Shams M. Youth recidivism: youth self-report matters. Front Psychol 2024; 14:1208317. [PMID: 38239481 PMCID: PMC10794774 DOI: 10.3389/fpsyg.2023.1208317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/13/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction "Recidivism" is used ubiquitously in juvenile justice research and typically describes repeat legal contact; however, researchers, policymakers, and clinicians operationalize it in various ways. Despite assuming each measure is a proxy for continued delinquent behavior leading to further legal contact, few have examined the association between youth delinquent behavior and self-reported and official records of legal contact. Furthermore, systemic bias against ethnoracial and gender minoritized youth often results in more harsh treatment by the legal system, which could influence recidivism measurement. Latent variable modeling of legal contact is understudied; thus, it is important to examine the feasibility of measuring this construct as a latent variable, including measurement invariance by gender. Methods Among 401 youth ages 12-18 years at first ever court contact, we examined three metrics of legal contact over a 2-year follow-up period: youth-report of arrest, caregiver-report of their adolescent's arrest, and official records of the number of new court charges. We examined between-group differences on each metric based on gender and ethnoracial identity. We then measured: (1) the association between youths' self-reported delinquency and each metric, (2) gender-specific associations between self-reported delinquency and each metric, and (3) gender-based measurement invariance for a latent recidivism variable using confirmatory factor analysis. Results Youth were consistent reporters of their own delinquent behavior and prospective legal contact measured by arrests. There were no between-group differences based on gender or ethnoracial identity for any legal contact measures. Delinquency and all legal contact variables were positively intercorrelated for the overall sample and the male subsample. For females, delinquency was not associated with caregiver-reported youth arrest or number of new charges. The latent legal contact variable had unique factor structures for male and female subsamples, suggesting no measurement invariance. Discussion Youth-reported delinquency at first ever legal contact was most strongly associated with youth-reported arrest during a 2-year follow-up period, followed by caregiver-reported arrest, and the number of new charges. Unique latent variable factor structures for male and female subsamples suggests the inter-relation between legal contact variables is gender-specific. Stakeholders should consider prioritizing youth-reported delinquency since it is most strongly related to prospective youth-reported arrest.
Collapse
Affiliation(s)
- Evan D. Holloway
- Juvenile Justice Behavioral Health Lab, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States
| | | | | | | | | |
Collapse
|
4
|
Sheerin KM, Williamson-Butler S, Vieira A, Grant M, Kemp KA. The association between caregiver psychiatric distress and perceived barriers to behavioral health treatment participation for youth in the juvenile legal system. JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:218-232. [PMID: 37986105 PMCID: PMC10842162 DOI: 10.1111/jmft.12682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
Youth in the juvenile legal system (JLS) evidence high rates of behavioral health concerns but struggle to access services. Given that caregivers are often tasked with helping their child to initiate and persist with services, it seems important to understand how their own well-being impacts their experiences of barriers to treatment participation for their child. The present study examined the link between caregiver (N = 196; 89% female) psychiatric concerns and experiences of treatment barriers among a sample of youth involved in the JLS. A cluster analysis revealed a cluster of caregivers with clinically significant levels of psychiatric distress and a cluster with low levels of psychiatric distress. Hierarchical regression analyses revealed that belonging to the high-distress cluster was predictive of experiencing certain types of barriers to treatment participation. These findings have implications for interventions for addressing barriers to treatment participation for caregivers of legally involved youth.
Collapse
Affiliation(s)
- Kaitlin M Sheerin
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, Rhode Island, USA
| | | | - Alyssa Vieira
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Miyah Grant
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Kathleen A Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, Rhode Island, USA
| |
Collapse
|
5
|
Meza JI, Folk J, Hoskins D, Kemp K, Tolou-Shams M. Risk and Protective Factors Associated with Self-Cutting Behavior Among Adolescents at First Contact with the Juvenile Court. J Youth Adolesc 2023; 52:2494-2508. [PMID: 37592194 PMCID: PMC10522515 DOI: 10.1007/s10964-023-01839-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023]
Abstract
Adolescents involved in juvenile legal system are at increased risk for self-cutting behavior, however, correlates associated with elevated risk remain underresearched, particularly among youth with first involvement with the court. This study utilized an epidemiological two-year longitudinal study involving 401 adolescents at first contact with the court (Mage = 14.47; SDage = 1.94 years; 43% female; 42% Latinx/Hispanic) and an involved caregiver. Study aims examined key prospective psychosocial correlates of self-cutting behavior. Baseline assessments captured individual and family level risk and protective factors; self-cutting behavior was assessed longitudinally every four months post-baseline for 24 months. Psychosocial correlates of self-cutting behavior included adolescent affect dysregulation, post-traumatic stress disorder symptoms, impulsive decision making, anxiety and depression symptoms. Significant protective factors included positive communication with caregiver and family, higher self-esteem, and having a caring and supportive family. These findings suggest that internalizing symptoms as well as difficulties with emotion regulation and impulsive decision making are correlated with heightened risk for self-cutting behavior among adolescents involved in the juvenile legal system. The findings also suggest that individual and family level protective factors, like positive communication and a supportive family, are associated with decreased risk for self-cutting behavior among adolescents at first contact with the court.
Collapse
Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
| | - Johanna Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - David Hoskins
- Pediatric Psychology Program, UCSF Benioff Children's Hospital, San Francisco, USA
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, Brown University, Warren Alpert Medical School, Providence, USA
- Department of Child and Adolescent Psychiatry and Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| |
Collapse
|
6
|
Folk JB, Ramaiya M, Holloway E, Ramos L, Marshall BDL, Kemp K, Li Y, Bath E, Mitchell DK, Tolou-Shams M. The Association Between Expanded ACEs and Behavioral Health Outcomes Among Youth at First Time Legal System Contact. Res Child Adolesc Psychopathol 2023; 51:1857-1870. [PMID: 36565372 PMCID: PMC10290175 DOI: 10.1007/s10802-022-01009-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/25/2022]
Abstract
A growing body of literature has documented high rates of adverse childhood experiences (ACEs) and their effects on behavioral health among adolescents impacted by the juvenile legal system. Most research with justice-impacted youth assesses the ten standard ACEs, encompassing abuse, neglect, and household dysfunction. This body of work has largely ignored the five expanded ACEs which assess social and community level adversity. Justice-impacted youth commonly experience expanded ACEs (racial discrimination, placement in foster care, living in a disadvantaged neighborhood, witnessing violence, bullying), and inclusion of these adversities may enhance predictive utility of the commonly used ACEs score. The current study examined the prospective impact of total ACEs (standard and expanded) on alcohol and cannabis use, substance-related consequences, and psychiatric symptoms during the year following first ever contact with the juvenile court. Results indicate justice-impacted youth experience multiple expanded ACEs prior to first court contact. The expanded ACEs did not predict any of the behavioral health outcomes assessed, over and above the standard ACEs. Inclusion of expanded ACEs in the standard ACEs score may not increase utility in identifying prospective behavioral health outcomes among youth in first time contact with the juvenile legal system.
Collapse
Affiliation(s)
- Johanna B Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Megan Ramaiya
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Evan Holloway
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lili Ramos
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Yu Li
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Daphne Koinis Mitchell
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Brown University, Providence, RI, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
7
|
Ahrens K, Blackburn N, Aalsma M, Haggerty K, Kelleher K, Knight DK, Joseph E, Mulford C, Ryle T, Tolou-Shams M. Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:99-110. [PMID: 37393415 PMCID: PMC10961647 DOI: 10.1007/s11121-023-01566-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2023] [Indexed: 07/03/2023]
Abstract
Youth involved in the legal system (YILS) experience rates of opioid and substance use disorders (OUD/SUDs) and overdose that is well above those in the general population. Despite the dire need, and the existing programs that focus on treatment of these problems in YILS, research on opioid initiation, and OUD prevention, including feasibility and sustainability, are severely limited. We present four studies testing interventions that, while not necessarily novel as SUD treatments, test novel structural and interpersonal strategies to prevent opioid initiation/OUD precursors: (1) ADAPT (Clinical Trial No. NCT04499079) provides real-time feedback using community-based treatment information system data to create a more effective mental health and SUD treatment cascade to prevent opioid use; (2) HOME (Clinical Trial No. NCT04135703) provides youth experiencing homelessness, including YILS, with direct access to shelter in independent living without prerequisites as an opioid initiation prevention strategy; (3) LeSA (Clinical Trial No. NCT04678960) uses the Trust-Based Relational Intervention® to equip YILS and their caregivers with self-regulatory and communication skills during the transition from secure confinement to reduce opioid initiation/re-initiation; and (4) POST (Clinical Trial No. NCT04901312) tests two interventions integrating interpersonal/drinking and drug refusal skills, case management, and goal setting among YILS in transitioning out of secure detention as opioid initiation prevention strategies. We discuss early implementation barriers and facilitators, including complexities of prevention research with YILS and adaptations due to COVID-19. We conclude by describing anticipated end products, including implementation of effective prevention interventions and integration of data from multiple projects to address larger, multi-site research questions.
Collapse
Affiliation(s)
- Kym Ahrens
- Seattle Children's Hospital and Research Institute, Seattle, WA, USA.
| | | | - Matthew Aalsma
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kevin Haggerty
- University of Washington Social Development Research Group, Seattle, WA, USA
| | | | - Danica K Knight
- Texas Christian University Karyn Purvis Institute of Child Development, Fort Worth, TX, USA
| | - Elizabeth Joseph
- Texas Christian University Institute of Behavioral Research, Fort Worth, TX, USA
| | | | - Ted Ryle
- Washington State Dept. of Children, Youth and Families/Juvenile Rehabilitation, Olympia, WA, USA
| | - Marina Tolou-Shams
- University of California San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| |
Collapse
|
8
|
Olsen EM, Whiteley LB, Giorlando KK, Beausoleil N, Tolou-Shams M, Esposito-Smythers C, Brown LK. The Role of Family Factors in the Outcomes of Court-Involved Youth. YOUTH VIOLENCE AND JUVENILE JUSTICE 2023; 21:309-324. [PMID: 38274153 PMCID: PMC10809991 DOI: 10.1177/15412040231179110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Court-involved youth (CIY) comprise a significant portion of the U.S. population and have a high prevalence of psychiatric illness and substance use. Youth delinquency has also been associated with family variables and parenting practices. However, it is not known which family factors are most relevant to behavioral outcomes in CIY mandated to outpatient mental health treatment. Self-report measures from 163 CIY (M = 15.19 years; 58.3% male) starting psychiatric care in two U.S. cities were utilized in a cross-sectional analysis to examine the association of parental monitoring and family functioning with the severity and variety of delinquent acts. Results demonstrate that parental monitoring is significantly associated with the delinquent behavior of CIY in mental health treatment, beyond that of psychiatric symptoms and substance use. Improved understanding of influential family factors can enhance tailoring of existing interventions to ensure that they are relevant to the needs of CIY, especially those in psychiatric treatment.
Collapse
Affiliation(s)
- Elizabeth M. Olsen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
- Department of Child and Adolescent Psychiatry, Bradley Hospital, East Providence, RI
| | - Laura B. Whiteley
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
| | - Kayla K. Giorlando
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI
| | - Nancy Beausoleil
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA
| | | | - Larry K. Brown
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
- Department of Child and Adolescent Psychiatry, Bradley Hospital, East Providence, RI
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI
| |
Collapse
|
9
|
Hoskins D, Meza JI, Del Cid MV, Kemp K, Koinis-Mitchell D, Webb M, Tolou-Shams M. Impact of Family, Neighborhood, and Schools on Behavioral Health Needs of Justice-Involved Latinx Adolescents. COUPLE & FAMILY PSYCHOLOGY 2023; 12:168-189. [PMID: 37705892 PMCID: PMC10499485 DOI: 10.1037/cfp0000204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Latinx adolescents are overrepresented in the justice system and have high untreated behavioral health needs. We examined the family as well as promotive and inhibitive environments (i.e., neighborhood and school) and their associations on behavioral health among 181 first-time justice-involved Latinx adolescents. Results showed that more optimal caregiver-adolescent attachment was associated with fewer behavioral health needs; more negative caregiver-adolescent communication with greater behavioral health needs. Increased neighborhood disadvantage and negative school interactions served as inhibitive environments and were associated with greater behavioral health needs. Moderation analyses indicated that negative communication was associated with greater behavioral health needs among dyads with large acculturation differences but not for dyads close in acculturation. Findings underscore the need to assess the family relationships and communication, promotive/inhibitive environments, and acculturation differences when determining how to meet behavioral health needs among justice-involved Latinx adolescents.
Collapse
Affiliation(s)
- David Hoskins
- UCSF Benioff, Children's Hospital, Oakland, California, United States
| | | | | | - Kathleen Kemp
- UCSF Benioff, Children's Hospital, Oakland, California, United States
| | | | - Margaret Webb
- UCSF Benioff, Children's Hospital, Oakland, California, United States
| | | |
Collapse
|
10
|
Kemp K, Micalizzi L, Becker SJ, Cheaito A, Suazo NC, Fox K, Hernandez L, Spirito A. Intervention for marijuana using, court-involved non-incarcerated youth. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209100. [PMID: 37315797 PMCID: PMC10529931 DOI: 10.1016/j.josat.2023.209100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/22/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Justice-involved youth (JIY) are at elevated risk for substance use and for substance use-related harm compared to non-JIY. Marijuana use is of significant concern in this population, as it is tied to reoffending. Motivational enhancement therapy (MET) and electronic interventions show promise in reducing youth substance use; the degree to which these findings extend to JIY requires additional research attention. Thus, the purpose of this study was to test the preliminary feasibility and effectiveness of a combined brief electronic parenting intervention plus a brief MET-based electronic intervention for JIY adolescents, followed by feedback and development of a change plan with a court worker, on marijuana use. METHODS Participants were 83 parent-youth dyads recruited from a diversionary family court program who screened positive for past-year marijuana use. At baseline and 3- and 6-month follow-ups, youth self-reported on their substance use, parental monitoring, peer substance use, and dyads completed a discussion task querying parental monitoring, limit setting, and substance use. The study randomized dyads to psychoeducation or the experimental intervention condition post-baseline. The MET-based intervention involved the self-administered e-TOKE (an electronic, marijuana-specific assessment and feedback tool) and a brief follow-up meeting with court staff counselors to review feedback and create a marijuana use change plan. Caregivers completed a computer program aimed at improving parenting and communication with their adolescents. The study administered feasibility and acceptability measures for both conditions. RESULTS Feasibility of study procedures was demonstrated through recruitment and retention (∼75 % success). Acceptability ratings from youth, parents, and court staff were high and positive. While levels of parental monitoring, as assessed by an observational task, improved over the course of the study, the intervention did not result in a significant change in any of the outcomes tested. CONCLUSIONS Despite high acceptability and feasibility ratings for the use of an electronic plus in-person MET intervention, reduction of marijuana and other substances was limited for most youth. This suggests that a more intensive intervention, such as stepped care, may be necessary for JIY who are not specifically referred for court proceedings due to marijuana use or those with already well-established use patterns.
Collapse
Affiliation(s)
- Kathleen Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States; Rhode Island Family Court Mental Health Clinic, 1 Dorrance Street, Providence, RI 02903, United States
| | - Lauren Micalizzi
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Department of Behavioral and Social Sciences, Box G-S121-5, Providence, RI 02903, United States
| | - Sara J Becker
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Department of Behavioral and Social Sciences, Box G-S121-5, Providence, RI 02903, United States
| | - Aya Cheaito
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States
| | - Nazaret C Suazo
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States
| | - Kara Fox
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States
| | - Lynn Hernandez
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States; UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA 01655, United States
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States.
| |
Collapse
|
11
|
Sheerin KM, Brodell R, Huey SJ, Kemp KA. Applying ecological systems theory to juvenile legal system interventions outcomes research: a measurement framework. Front Psychol 2023; 14:1177568. [PMID: 37425162 PMCID: PMC10327555 DOI: 10.3389/fpsyg.2023.1177568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Intervention research and development for youth in the juvenile legal system (JLS) has often focused on recidivism as the primary outcome of interest. Although recidivism is an important outcome, it is ultimately a downstream marker of success and is affected by changes in other domains of youths' lives (e.g., family and peer relations, neighborhood safety, local and state-level policies). Thus, the present manuscript proposes the application of ecological systems theory to selecting outcomes to assess intervention effects in JLS intervention research to better capture proximal and distal influences on youth behavior. To that end, we first provide an overview of the strengths and limitations of using recidivism as an outcome measure. Next, the current application of social ecology theory to existing research on both risk and protective factors of JLS involvement is discussed, as well as existing work on assessing social-ecological domains within intervention studies. Then, a measurement framework is introduced for selecting pertinent domains of youths' social ecologies to assess as intervention outcomes, moderators, and mediators. To facilitate this, we provide examples of concrete constructs and measures that researchers may select. We conclude with potential new avenues of research to which our proposed framework could lead, as well as potential limitations of implementing our framework.
Collapse
Affiliation(s)
- Kaitlin M. Sheerin
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, RI, United States
- Bradley-Hasbro Children’s Research Center, Rhode Island Hospital, Providence, RI, United States
| | - Regina Brodell
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Stanley J. Huey
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Kathleen A. Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, RI, United States
- Bradley-Hasbro Children’s Research Center, Rhode Island Hospital, Providence, RI, United States
| |
Collapse
|
12
|
Meza JI, Godoy SM, Nguyen PT, Perris GE, Barnert ES, Bath EP. Risk profiles of suicide attempts among girls with histories of commercial sexual exploitation: A latent class analysis. CHILD ABUSE & NEGLECT 2023; 137:106036. [PMID: 36680963 PMCID: PMC10226678 DOI: 10.1016/j.chiabu.2023.106036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Girls impacted by commercial sexual exploitation (CSE) in the juvenile legal system are three times more likely to have suicide attempts than girls without histories of exploitation. Yet, research on risk profiles and correlates that contribute to elevated suicide risk among girls with CSE histories remains scant. OBJECTIVE We sought to examine suicide attempts profiles among CSE-impacted girls in the juvenile legal system. PARTICIPANTS AND SETTING We partnered with a specialty court for CSE-impacted youth in Los Angeles County. METHODS Data were collected from case files of the 360 girls participating in the court from 2012 to 2016. Latent class analysis was used to identify their profiles of risk indicators. RESULTS Four risk profiles for suicide attempts emerged: (1) Parental Incarceration (PI; 30 %), (2) Child Welfare Contact (CWC; 25 %), (3) Disruptive Behavior and Sleep Problems (DBS; 25 %), and (4) Pervasive Risk (PR; 22 %). Among youth in the PI group, 5 % had a suicide attempt; however, contrary to our hypothesis, no youth in the CWC group had a suicide attempt. Rates of suicide attempt were significantly higher among youth in the DBS group, as 14 % had a suicide attempt. As hypothesized, youth in the PR were associated with higher risk of suicide attempts, with 28 % reporting a prior suicide attempt. CONCLUSIONS Findings underscore the need for standardized suicide screenings and treatment referrals for girls with CSE histories and suggest an important opportunity for multidisciplinary collaboration with courts to improve suicide prevention strategies. The present study also supports the importance of examining risk across the socioecological context.
Collapse
Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 300 Medical Plaza Driveway, Room 3308, Los Angeles, CA 90095, United States.
| | - Sarah M Godoy
- School of Social Work, University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building, 325 Pittsboro Street, Room 400-I, Chapel Hill, NC 27599, United States.
| | - Phuc T Nguyen
- Department of Psychology, UC Berkeley, Berkeley Way West Building, 2121 Berkeley Way, Berkeley, CA 94720, United States.
| | - Georgia E Perris
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, UCLA Semel Neuropsychiatric Institute, 760 Westwood Plaza, Room A8-232, Los Angeles, CA 90024, United States.
| | - Elizabeth S Barnert
- Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, UCLA Pediatrics BOX 951752, 12-467 MDCC, Los Angeles, CA 90095, United States.
| | - Eraka P Bath
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, UCLA Semel Neuropsychiatric Institute, 760 Westwood Plaza, Room A8-228, Los Angeles, CA 90024, United States.
| |
Collapse
|
13
|
Tolou-Shams M, Folk JB, Holloway ED, Ordorica CM, Dauria EF, Kemp K, Marshall BDL. Psychiatric and Substance-Related Problems Predict Recidivism for First-Time Justice-Involved Youth. THE JOURNAL OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW 2023; 51:35-46. [PMID: 36646452 PMCID: PMC10019581 DOI: 10.29158/jaapl.220028-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Justice-involved youth with clinically significant co-occurring psychiatric and substance-related problems are at increased risk for recidivism. Less is known about how psychiatric symptoms (i.e., internalizing and externalizing) and substance-related problems (i.e., alcohol and cannabis) interact to predict recidivism, especially at first court contact. Among 361 first-time justice-involved youth aged 12 to 18, we used nested multivariate negative binomial regression models to examine the association between psychiatric symptoms, substance-related problems and 24-month recidivism while accounting for demographic and legal covariates. Clinically significant externalizing symptoms and alcohol-related problems predicted recidivism. Moderation analyses revealed that alcohol-related problems drove recidivism for youth without clinically significant psychiatric symptoms and externalizing symptoms predicted recidivism, regardless of alcohol-related problems. After accounting for other predictors, Latinx, Black non-Latinx, and multiracial non-Latinx youth were more likely to recidivate at follow-up than White non-Latinx youth. Systematic screening, referral, and linkage to treatment for psychiatric and substance-related problems are needed to reduce recidivism risk among first-time justice-involved youth. Differences in recidivism rates by race/ethnicity not attributable to behavioral health needs suggest it is imperative to concurrently deploy large-scale structural interventions designed to combat systemic racial bias and overrepresentation of ethnoracial minoritized youth within the juvenile justice system.
Collapse
Affiliation(s)
- Marina Tolou-Shams
- Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI.
| | - Johanna B Folk
- Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI
| | - Evan D Holloway
- Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI
| | - Catalina M Ordorica
- Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI
| | - Emily F Dauria
- Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI
| | - Kathleen Kemp
- Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI
| | - Brandon D L Marshall
- Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI
| |
Collapse
|
14
|
Knight DK, Belenko S, Dennis ML, Wasserman GA, Joe GW, Aarons GA, Bartkowski JP, Becan JE, Elkington KS, Hogue A, McReynolds LS, Robertson AA, Yang Y, Wiley TRA. The comparative effectiveness of Core versus Core+Enhanced implementation strategies in a randomized controlled trial to improve substance use treatment receipt among justice-involved youth. BMC Health Serv Res 2022; 22:1535. [PMID: 36527067 PMCID: PMC9758864 DOI: 10.1186/s12913-022-08902-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Most justice-involved youth are supervised in community settings, where assessment and linkage to substance use (SU) treatment services are inconsistent and fragmented. Only 1/3 of youth with an identified SU need receive a treatment referral and even fewer initiate services. Thus, improving identification and linkage to treatment requires coordination across juvenile justice (JJ) and behavioral health (BH) agencies. The current study examines the comparative effectiveness of two bundled implementation intervention strategies for improving SU treatment initiation, engagement, and continuing care among justice-involved youth supervised in community settings. Exploration, Preparation, Implementation, Sustainment (EPIS) served as the conceptual framework for study design and selection/timing of implementation intervention components, and the BH Services Cascade served as the conceptual and measurement framework for identifying and addressing gaps in service receipt. METHODS Part of a larger Juvenile-Justice Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) Cooperative, this study involved a multisite, cluster-randomized control trial where sites were paired then randomly assigned to receive Core (training teams on the BH Services Cascade and data-driven decision making; supporting goal selection) or Core+Enhanced (external facilitation of implementation teams) intervention components. Youth service records were collected from 20 JJ community supervision agencies (in five states) across five study phases (baseline, pre-randomization, early experiment, late experiment, maintenance). Implementation teams comprised of JJ and BH staff collaboratively identified goals along the BH Cascade and used data-driven decision-making to implement change. RESULTS Results suggest that Core intervention components were effective at increasing service receipt over time relative to baseline, but differences between Core and Core+Enhanced conditions were non-significant. Time to service initiation was shorter among Core+Enhanced sites, and deeper Cascade penetration occurred when external facilitation (of implementation teams) was provided. Wide variation existed in the degree and nature of change across service systems. CONCLUSIONS Findings demonstrate the criticality of early EPIS phases, demonstrating that strategies provided during the formative exploration and preparation phases produced some improvement in service receipt, whereas implementation-focused activities produced incremental improvement in moving youth farther along the Cascade.
Collapse
Affiliation(s)
- Danica K. Knight
- grid.264766.70000 0001 2289 1930Karyn Purvis Institute of Child Development, Texas Christian University, Fort Worth, USA
| | - Steven Belenko
- grid.264727.20000 0001 2248 3398Department of Criminal Justice, Temple University, Philadelphia, USA
| | | | - Gail A. Wasserman
- grid.21729.3f0000000419368729Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA
| | - George W. Joe
- grid.264766.70000 0001 2289 1930Institute of Behavioral Research, Texas Christian University, Fort Worth, USA
| | - Gregory A. Aarons
- grid.266100.30000 0001 2107 4242Child and Adolescent Services Research Center, University of California, San Diego, USA
| | - John P. Bartkowski
- grid.215352.20000000121845633Department of Sociology, University of Texas at San Antonio, San Antonio, USA
| | - Jennifer E. Becan
- grid.264766.70000 0001 2289 1930Institute of Behavioral Research, Texas Christian University, Fort Worth, USA
| | - Katherine S. Elkington
- grid.21729.3f0000000419368729Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA
| | - Aaron Hogue
- grid.475801.fPartnership to End Addiction, New York, USA
| | - Larkin S. McReynolds
- grid.239585.00000 0001 2285 2675Mailman School of Public Health, Columbia University, NYS Psychiatric Institute, New York, USA
| | - Angela A. Robertson
- grid.260120.70000 0001 0816 8287Social Science Research Center, Mississippi State University, Starkville, USA
| | - Yang Yang
- grid.264766.70000 0001 2289 1930Institute of Behavioral Research, Texas Christian University, Fort Worth, USA
| | - Tisha R. A. Wiley
- grid.420090.f0000 0004 0533 7147Service Research Branch, National Institute on Drug Abuse, Bethesda, USA
| |
Collapse
|
15
|
Rosen B, Dauria E, Shumway M, Smith JD, Koinis-Mitchell D, Tolou-Shams M. Association of pregnancy attitudes and intentions with sexual activity and psychiatric symptoms in justice-involved youth. CHILDREN AND YOUTH SERVICES REVIEW 2022; 138:106510. [PMID: 38107676 PMCID: PMC10723635 DOI: 10.1016/j.childyouth.2022.106510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Context With over one-third of detained girls experiencing teenage pregnancy, it is critical that the juvenile justice system better addresses the sexual and reproductive health (SRH) needs of youth. Although pregnancy attitudes and intentions (PAI) are associated with pregnancy outcomes among the general adolescent population, this relationship has not been examined among justice-involved youth. Methods Participants were drawn from a longitudinal study characterizing trajectories of behavioral and reproductive health and recidivism among newly justice-involved youth in a Northeast family court. Baseline and four-month follow-up data from 288 justice-involved youth (JIY) were analyzed to characterize PAI; examine associations between pregnancy intentions and unprotected sexual activity (i.e., no hormonal, intrauterine, or barrier protection against pregnancy); and explore the relationship between pregnancy intentions and psychiatric symptoms. Results At baseline, 39% of JIY youth were sexually active, 44% of these youth reported inconsistent condom use and 14% had not used birth control at last sexual intercourse. Nearly half of sexually active youth reported some intent around pregnancy and those with any pregnancy intentions were more likely to report depression, low self-esteem, substance use, and trauma history. Pregnancy intentions at baseline predicted higher rates of unprotected sexual activity at four months (OR: 16.9, CI = 2.48-115.7). Conclusions This study highlights the importance of developing and implementing more comprehensive SRH assessments and brief interventions for youth entering the justice system.
Collapse
Affiliation(s)
- Brooke Rosen
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195, United States
| | - Emily Dauria
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, United States
- Department of Community and Behavioral Health Sciences, Graduate School of Public Health, University of Pittsburgh, United States
- Department of Psychiatry and Behavioral Sciences, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Avenue, Building 5, Room 7M18, San Francisco, CA, 94110, United States
| | - Martha Shumway
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, United States
| | - Jaime Dumoit Smith
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, United States
- Department of Psychiatry and Behavioral Sciences, 1001 Potrero Avenue, Building 20, Suite 2100, San Francisco, CA 94110, United States
| | - Daphne Koinis-Mitchell
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Rhode Island Hospital Department of Psychiatry, 1 Hoppin St. Coro West, 2nd Floor, Providence, RI 02903, United States
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, United States
- Department of Psychiatry and Behavioral Sciences, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Avenue, Building 5, Room 7M18, San Francisco, CA, 94110, United States
| |
Collapse
|
16
|
Kemp K, Poindexter B, Ng MY, Correia V, Marshall BDL, Koinis-Mitchell D, Tolou-Shams M. EARLY IDENTIFICATION OF SUICIDE RISK FACTORS AMONG JUSTICE-INVOLVED YOUTH. CRIMINAL JUSTICE AND BEHAVIOR 2022; 49:730-744. [PMID: 35754948 PMCID: PMC9221642 DOI: 10.1177/00938548211059504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Suicidal thoughts and behaviors among juvenile justice populations are elevated. However, the characteristics of justice-involved youth who consider and attempt suicide are not well understood. This study examined suicidal ideation and attempt with first-time, preadjudicated diverted youth, and the relationship with commonly associated risk factors. The sample included 135 youth (50% male, M age = 14.48) that provided complete responses to self-reported lifetime suicidal ideation and attempt items. Analyses examined relationships between suicidal ideation/attempt and mental health, child welfare involvement, delinquency, self-cutting, and substance use. First time, preadjudicated diverted youth reported high rates of lifetime suicidal ideation (27%) and attempt (17%). Suicidal ideation and attempt were associated with sexually minoritized status and self-cutting, while child welfare involvement was only associated with suicidal ideation. This high-risk population would benefit from refined suicide screening and prevention services not always available to justice-involved youth living in the community.
Collapse
|
17
|
Porche MV, Fortuna LR, Tolou-Shams M. Unpacking the Layers: Dismantling Inequities in Substance Use Services and Outcomes for Racially Minoritized Adolescents. Child Adolesc Psychiatr Clin N Am 2022; 31:223-236. [PMID: 35361361 PMCID: PMC10662943 DOI: 10.1016/j.chc.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Minoritized youth have lower prevalence rates of substance use disorders (SUD) compared with White peers, but proportionally those that are diagnosed are less likely to engage in specialized care and there are few culturally responsive treatments or programs available. We examine social determinants of SUD, with emphasis on the impact of trauma, including racial trauma, and include an intersectional approach incorporating race, ethnicity, and gender. This review of the literature highlights evidence-based effective clinical practice as examples for the field in developing therapeutic approaches to SUD for this population.
Collapse
Affiliation(s)
- Michelle V Porche
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco (UCSF), 1001 Potrero Avenue, Building 5, Room 7M, San Francisco, CA, USA.
| | - Lisa R Fortuna
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, 1001 Potrero Avenue, Building 5, Room 7M16, San Francisco, CA, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, 1001 Potrero Avenue, Building 5, Room 7M18, San Francisco, CA 94110, USA
| |
Collapse
|
18
|
Abstract
Methods to prevent substance use disorders (SUDs) act on the individual risk factors for addiction. Most adults with SUD initiated substance use during their teenage years, so preventive interventions during adolescence are critical. Antisubstance use messaging, routine screening, and pathways for referral to treatment can be extended into all settings whereby trusted adults interact with adolescents such as sports, mentoring programs, child protective services, and juvenile justice settings. Pediatric primary care is an ideal place to incorporate preventive counseling and screening for substance use. Evidence-based technologic interventions for primary, secondary, and tertiary prevention are needed.
Collapse
Affiliation(s)
- Leah F Nelson
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Elissa R Weitzman
- Harvard Medical School, Boston, MA 02115, USA; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Computational Health Informatics Program, Boston Children's Hospital, Boston, MA 02115, USA
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA.
| |
Collapse
|
19
|
Tolou-Shams M, Holloway ED, Ordorica C, Yonek J, Folk JB, Dauria EF, Lehn K, Ezimora I, Wiley HMF. Leveraging Technology to Increase Behavioral Health Services Access for Youth in the Juvenile Justice and Child Welfare Systems: a Cross-systems Collaboration Model. J Behav Health Serv Res 2022; 49:422-435. [PMID: 35835953 PMCID: PMC9282614 DOI: 10.1007/s11414-022-09808-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 01/07/2023]
Abstract
Behavioral health services access for justice- and child welfare-involved youth is limited despite significant need. Structural interventions to address limited access are nascent. Technology can advance access, but few interventions focus on system-impacted youth and their mental health needs and challenges. This article describes the development, process, and initial outcomes of the Youth Justice and Family Well-Being Technology Collaborative (JTC) that was formed to leverage technology within and across public health and justice-related systems to promote increased behavioral health services access. Cross-system considerations are identified for public health, court, and other key stakeholders to successfully integrate technology into practice to expand access to these critical services.
Collapse
Affiliation(s)
- Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General, University of California, 1001 Potrero Ave, Bldg. 5, 7M, San Francisco, CA, 94110, USA.
| | - Evan D. Holloway
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General, University of California, 1001 Potrero Ave, Bldg. 5, 7M, San Francisco, CA 94110 USA
| | - Catalina Ordorica
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General, University of California, 1001 Potrero Ave, Bldg. 5, 7M, San Francisco, CA 94110 USA
| | - Juliet Yonek
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General, University of California, 1001 Potrero Ave, Bldg. 5, 7M, San Francisco, CA 94110 USA
| | - Johanna B. Folk
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General, University of California, 1001 Potrero Ave, Bldg. 5, 7M, San Francisco, CA 94110 USA
| | - Emily F. Dauria
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA USA
| | - Kristiana Lehn
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General, University of California, 1001 Potrero Ave, Bldg. 5, 7M, San Francisco, CA 94110 USA
| | - Ifunanya Ezimora
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General, University of California, 1001 Potrero Ave, Bldg. 5, 7M, San Francisco, CA 94110 USA
| | | |
Collapse
|
20
|
Ng MY, Harrison A, Bath E, Kemp K, Galbraith K, Brown LK, Tolou-Shams M. Sexting and Behavioral Health in First-time Justice-Involved Adolescents. CHILDREN AND YOUTH SERVICES REVIEW 2022; 132:106298. [PMID: 37745773 PMCID: PMC10516529 DOI: 10.1016/j.childyouth.2021.106298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Objectives We examined the prevalence of sexting, related motivations, demographics, and association with behavioral health problems among justice-involved adolescents. Hypotheses We hypothesized positive associations between sexting and sexual risk, substance use, delinquency, and mental health problems. Methods Participants were 307 community-supervised justice-involved adolescents with a first-time offense (Mage =14.50 years, 44.6% female) and their caregivers. Adolescents answered questions on technology use and sexting by sending, receiving, or forwarding sexually suggestive text messages and images (pictures or videos). They also completed measures of recent (past 4-month) sexual activity, unprotected sex, cigarette, alcohol, marijuana, and other drug use, and delinquency; current trauma symptoms, internalizing problems, and adaptive functioning. Results Prevalence of sexting were 37.7% (lifetime overall; 17.0% sent texts; 17.4% sent images) and 29.5% (past-year overall; 12.8% sent texts; 13.6% sent images). Sexts were commonly sent as presents to partners, in response to sexts received, or to have fun. "Sexters" were older than "non-sexters" and more likely to identify as lesbian, gay, bisexual, or questioning. Past-year sexting was significantly associated with recent sexual activity; unprotected sex; alcohol use and days of use; marijuana and other drug use; delinquency and variety of delinquent acts; and elevated trauma symptoms and internalizing problems. Conclusions Sexting is prevalent among adolescents with a first-time offense and co-occurs with multiple behavioral health needs. Intervention for this population may be informed by routinely assessing sexting in community settings. Familiarity with local reporting laws could help clinicians navigate the legal implications of sexting among adolescents with existing justice-system involvement.
Collapse
Affiliation(s)
- Mei Yi Ng
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, and Department of Psychology and Center for Children and Families, Florida International University
- Florida International University, Anna Harrison is now at the San Francisco VA Healthcare System, and Katharine Galbraith is now at the University of Southern California
| | - Anna Harrison
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, and Suicide Prevention Program, San Francisco VA Healthcare System
| | - Eraka Bath
- Department of Psychiatry and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and Rhode Island Hospital
| | - Katharine Galbraith
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, and Zuckerberg San Francisco General Hospital
| | - Larry K Brown
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and Rhode Island Hospital
| | - Marina Tolou-Shams
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, and Zuckerberg San Francisco General Hospital
| |
Collapse
|
21
|
Tolou-Shams M, Dauria EF, Folk J, Shumway M, Marshall BDL, Rizzo CJ, Messina N, Covington S, Haack LM, Chaffee T, Brown LK. VOICES: An efficacious trauma-informed, gender-responsive cannabis use intervention for justice and school-referred girls with lifetime substance use history. Drug Alcohol Depend 2021; 228:108934. [PMID: 34530316 PMCID: PMC8717799 DOI: 10.1016/j.drugalcdep.2021.108934] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/04/2021] [Accepted: 06/19/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Girls have unique developmental pathways to substance use and justice system involvement, warranting gender-responsive intervention. We tested the efficacy of VOICES (a 12-session, weekly trauma-informed, gender-responsive substance use intervention) in reducing substance use and HIV/STI risk behaviors among justice- and school-referred girls. METHODS Participants were 113 girls (Mage = 15.7 years, SD = 1.4; 12 % White, 19 % Black, 15 % multi-racial; 42 % Latinx) with a history of substance use referred from juvenile justice (29 %) and school systems (71 %). Study assessments were completed at baseline, 3-, 6- and 9-months follow-up. Primary outcomes included substance use and HIV/STI risk behaviors; secondary outcomes included psychiatric symptoms (including posttraumatic stress) and delinquent acts. We hypothesized that girls randomized to the VOICES (n = 51) versus GirlHealth (attention control; n = 62) condition would report reduced alcohol, cannabis and other substance use, HIV/STI risk behaviors, psychiatric symptoms, and delinquent acts. RESULTS Girls randomized to VOICES reported significantly less cannabis use over 9-month follow-up relative to the control condition (time by intervention, p < .01), but there were no between group differences over time in HIV/STI risk behavior. Girls in both conditions reported fewer psychiatric symptoms and delinquent acts over time. CONCLUSIONS Data support the use of a trauma-informed, gender-responsive intervention to reduce cannabis use among girls with a substance use history and legal involvement; reducing cannabis use in this population has implications for preventing future justice involvement and improving public health outcomes for girls and young women, who are at disproportionate health and legal risk relative to their male counterparts.
Collapse
Affiliation(s)
- Marina Tolou-Shams
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, United States.
| | - Emily F. Dauria
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, United States
| | - Johanna Folk
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, United States.
| | - Martha Shumway
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, United States.
| | - Brandon D. L. Marshall
- Brown University School of Public Health, Department of Epidemiology, 121 South Main Street, Providence, RI, 02912, United States
| | - Christie J. Rizzo
- Department of Applied Psychology, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, United States
| | - Nena Messina
- UCLA Integrated Substance Abuse Programs, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA, 90025, United States.
| | | | - Lauren M. Haack
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, United States
| | - Tonya Chaffee
- University of California, San Francisco, Department of Pediatrics, 1001 Potrero Ave, San Francisco, CA, 94110, United States.
| | - Larry K Brown
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI, 02903, United States.
| |
Collapse
|
22
|
Hirschtritt ME, Folk JB, Marshall BDL, Li Y, Tolou-Shams M. Cannabis Use Among Court-Involved Minority Sexual Orientation and Gender Identity Adolescents. THE JOURNAL OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW 2021; 49:350-360. [PMID: 34001670 PMCID: PMC8429183 DOI: 10.29158/jaapl.200104-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We examined the effects of family functioning and beliefs regarding peers' cannabis use among minority (n = 112) and non-minority (n = 275) sexual orientation and gender identity (SOGI), first-time court-involved adolescents. We examined longitudinally the effects of baseline general family functioning and peer cannabis use beliefs on self-reported cannabis use and cannabis-related consequences after 12 months. At baseline, 39.2 percent of adolescents reported using cannabis. Minority SOGI adolescents reported worse family functioning (p = .017) and higher peer cannabis use beliefs (p = .047). Higher peer cannabis use beliefs at baseline predicted recent cannabis use at the 12-month assessment for both minority and non-minority SOGI adolescents. Better family functioning predicted a lower likelihood of recent cannabis use at 12 months for non-minority SOGI adolescents, but not for minority SOGI adolescents. Baseline peer cannabis use beliefs and family functioning predicted cannabis-related consequences for both cohorts at 12 months when accounting for intermediate (i.e., four-month and eight-month) data. Among all first-time court-involved adolescents, those who believed greater cannabis use among their peers reported more subsequent cannabis use themselves. Conversely, higher general family functioning may be less of a protective factor for minority SOGI adolescents. These results suggest the utility of feedback interventions to modify peer norm beliefs among first-time court-involved adolescents.
Collapse
Affiliation(s)
- Matthew E Hirschtritt
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA.
| | - Johanna B Folk
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Brandon D L Marshall
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Yu Li
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Marina Tolou-Shams
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| |
Collapse
|
23
|
Tolou-Shams M, Folk JB, Marshall BD, Dauria EF, Kemp K, Li Y, Koinis-Mitchell D, Brown LK. Predictors of cannabis use among first-time justice-involved youth: A cohort study. Drug Alcohol Depend 2021; 225:108754. [PMID: 34051549 PMCID: PMC8282753 DOI: 10.1016/j.drugalcdep.2021.108754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/04/2021] [Accepted: 04/09/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Justice-involved youth use cannabis at higher rates than their same-aged peers increasing likelihood of adverse behavioral health consequences and continued legal involvement. This study examined individual level predictors of early onset use cannabis use (<13 years of age) and cannabis use initiation in the 12 months following first court contact. METHODS Participants were 391 first-time justice-involved youth (56.9 % male; Mage = 14.6 years; 32.1 % White, 11.1 % Black, 14.7 % Other/Multi-racial, 42.2 % Latinx) and an involved caregiver (87.2 % female; Mage = 41.0 years). Baseline assessments captured individual level factors; cannabis use was assessed every four months post-baseline for 12 months. Primary analyses involved multivariable modified Poisson regressions and survival analysis. RESULTS In multivariable models, youth who reported lifetime cannabis use (n = 188, 48.1 %) were older, reported alcohol use and positive cannabis use expectancies. Greater self-control and self-concept were associated with lower likelihood of lifetime cannabis use. Youth who initiated cannabis during the 12-month follow-up (n = 30, 14.8 %) tended to be older, White/non-Latinx, and to report more psychiatric symptoms (posttraumatic stress, externalizing, internalizing, and affect dysregulation), delinquent behavior, lower levels of self-control, poorer self-concept, greater drug use intentions and positive cannabis expectancies. In the multivariable survival analysis, affect dysregulation, internalizing symptoms, and more positive cannabis expectancies remained independently and positively associated with cannabis initiation. CONCLUSIONS There is a critical and unique window of opportunity to prevent cannabis use initiation among first-time justice-involved youth. Research is needed to determine whether brief interventions that aim to modify expectancies about cannabis use reduce rates of cannabis initiation in this underserved population.
Collapse
Affiliation(s)
- Marina Tolou-Shams
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, USA.
| | - Johanna B. Folk
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, USA
| | - Brandon D.L. Marshall
- Brown University School of Public Health, Department of Epidemiology, 121 South Main Street, Providence, RI, 02903, USA
| | - Emily F. Dauria
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, USA
| | - Kathleen Kemp
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI, 02903, USA.
| | - Yu Li
- Brown University School of Public Health, Department of Epidemiology, 121 South Main Street, Providence, RI, 02903, USA.
| | - Daphne Koinis-Mitchell
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI, 02903, USA; The Warren Alpert Medical School of Brown University, Department of Pediatrics, 222 Richmond St, Providence, RI, 02903, USA; Rhode Island Hospital, Division of Child and Adolescent Psychiatry, Coro West, 1 Hoppin Street, Providence, RI 02903.
| | - Larry K. Brown
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI, 02903, USA,Rhode Island Hospital, Division of Child and Adolescent Psychiatry, Coro West, 1 Hoppin Street, Providence, RI 02903
| |
Collapse
|
24
|
Folk JB, Ramos LM, Bath EP, Rosen B, Marshall BD, Kemp K, Brown L, Conrad S, Tolou-Shams M. The prospective impact of adverse childhood experiences on justice-involved youth's psychiatric symptoms and substance use. J Consult Clin Psychol 2021; 89:483-498. [PMID: 34264697 PMCID: PMC8754104 DOI: 10.1037/ccp0000655] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Justice-involved youth report high rates of adverse childhood experiences (ACEs; abuse, neglect, household dysfunction) and are at high risk for elevated behavioral health needs (i.e., substance use, psychiatric symptoms). Research with broad samples of adolescents shows ACEs predict behavioral health outcomes, yet most research on the impact of ACEs among justice-involved youth focuses on recidivism. The present study addresses this gap by examining the prospective association between ACEs and psychiatric symptoms, substance use, and substance-related problems (i.e., consequences of use) among first-time justice-involved youth. METHOD First-time justice-involved youth (n = 271; 54.3% male; M age = 14.5 years; 43.5% Latinx; non-Latinx: 34.2% White, 8.6% Black, 7.1% Other, 6.7% Multiracial) and their caregivers were assessed at youth's first court contact and 4- and 12-month follow-ups. Youth and caregivers reported youth's exposure to ACEs through a series of instruments at baseline and 4-months (e.g., Childhood Trauma Questionnaire Short-Form; Traumatic Life Events Inventory). Primary outcomes included youth alcohol and cannabis use (Adolescent Risk Behavior Assessment), consequences of use (Brief Young Adult Alcohol Consequences Questionnaire; Brief Marijuana Consequences Scale), and psychiatric symptoms (Behavior Assessment System for Children; National Stressful Events Survey PTSD Short Scale). RESULTS Youth were exposed to three ACEs, on average, prior to first justice contact (M = 3). Exposure to more ACEs, particularly abuse, predicted substance use and psychiatric outcomes. Gender differences emerged for cannabis use and internalizing symptoms. CONCLUSIONS Implications for trauma-responsive juvenile justice reform are discussed, including screening for ACEs and their sequelae at first court contact and considering the role of masculine norms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Johanna B. Folk
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA 94110
| | - Lili M.C. Ramos
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA 94110
| | - Eraka P. Bath
- University of California, Los Angeles, Department of Psychiatry, 150 UCLA, Medical Plaza Driveway, Los Angeles, CA 90095
| | - Brooke Rosen
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA 94110
| | - Brandon D.L. Marshall
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI 02903
| | - Kathleen Kemp
- The Warren Alpert Medical School of Brown University, School of Public Health, 222 Richmond St, Providence, RI 02903
| | - Larry Brown
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI 02903
| | - Selby Conrad
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI 02903
| | - Marina Tolou-Shams
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA 94110
| |
Collapse
|
25
|
Abstract
Justice-involved youth have a number of risk factors for HIV infection, including high rates of substance use, psychiatric comorbidities, and risky sexual behaviors. Although detained youth are likely to receive health care-which may include HIV testing-court-involved, non-incarcerated (CINI) youth may be unlikely to receive HIV testing services either before or during their justice involvement. However, the relationship between risk factors and HIV testing among CINI youth is largely unknown. We explored the association between HIV testing and factors commonly associated with both HIV testing and HIV risk among 173 CINI youth with identified behaviors that put them at risk for HIV acquisition. Only 15.6% of participants reported a lifetime history of HIV testing, despite high rates of sexual and substance use risk behaviors. Age (older), gender (female), sexual orientation (non-heterosexual), recent marijuana use, lifetime use of other drugs, history of a sexually transmitted infection, pap smear in the past year and history of mental health/substance use treatment were all significantly associated with lifetime HIV testing. The extremely low testing rates in this sample emphasize that the juvenile justice system outside of detention is not adequately addressing youths' needs related to HIV testing or ensuring access to testing services for youth at risk of contracting HIV. Results suggest that additional efforts are needed to connect justice-involved youth to healthcare more broadly and HIV testing in particular.
Collapse
Affiliation(s)
- Emily Haney-Caron
- Department of Psychology, John Jay College of Criminal Justice and the Graduate Center, City University of New York, 524 West 59th Street, New York, NY, 10019, USA.
| | - Larry K Brown
- Department of Psychiatry and Human Behavior, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Marina Tolou-Shams
- UCSF Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| |
Collapse
|