Juvenile justice systems of care: results of a national survey of community supervision agencies and behavioral health providers on services provision and cross-system interactions.

BACKGROUND: Youth involved in the juvenile justice (JJ) system have high needs for behavioral health services, especially related to substance use and mental disorders. This study aimed to understand the extent to which elements in the cascade model of behavioral health services for JJ-involved youth are provided to youth by Community Supervision (CS) and/or Behavioral Health (BH) providers. In order to understand interactions across CS and BH systems, this study used a multistage probabilistic survey design to sample CS agencies and their primary BH service providers of substance use and mental health treatment in the United States. Parallel surveys were administered to both CS and BH providers regarding: characteristics of youth served, BH services available, whether services were provided directly and/or by referral, use of evidence-based practices (EBPs), and methods of collaboration, referral, and information exchange across CS and BH providers. RESULTS: The findings from weighted national estimates demonstrate that youth referred from CS to the BH programs represent a more severe sub-group of youth under CS supervision. There are established cross-system relationships for assessment and referral for substance use and mental health treatment, but less so for prevention services. Most CS programs refer youth to BH providers for these services, which typically utilize more highly trained staff to provide EBPs to a majority of the youth served. More intensive substance use and mental health treatment, aftercare, and recovery support services were limited in availability. CONCLUSIONS: The findings suggest that although many elements in a cascade model of BH services for JJ-involved youth have been implemented within local systems of care through collaboration between CS and BH providers, there are several underdeveloped areas and potential for attrition across the service cascade. Greater attention to providing services to youth with higher levels of severity, aftercare services, and recovery support is warranted within a multi-systemic framework.

Judges' Perceptions of Screening, Assessment, Prevention, and Treatment for Substance Use, Mental Health, and HIV among Juveniles on Community Supervision: Results of a National Survey.

Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) National Survey was funded in part to describe the current status of screening, assessment, prevention and treatment for substance use, mental health, and HIV for youth on community supervision within the US juvenile justice system. Surveys were administered to community supervision agencies and their primary behavioral healthcare providers, as well as the juvenile or family court judge with the largest caseload of youth on community supervision. This article presents the findings from the judges' survey. Survey results indicated juvenile and family court judges were open to innovations for improving the court's performance, rated their relationships with collaborators highly, and appreciated the impact of screening, assessment, prevention, and treatment on judicial practices.

Eugene Cullen Kennedy (1928-2015).

Presents an obituary for Eugene Cullen Kennedy, who died at age 86 on June 3, 2015, from heart and lung failure. Kennedy was trained as a counseling psychologist, but his impact went far beyond psychology, spanning 50 years and satisfying the intellectual tastes of a diversity of enthusiasts. (PsycINFO Database Record

Trauma and Morbidities Among Female Detainees in a Large Urban Jail.

Using data from 810 women entering the Department of Women's Justice Services in the Cook County Jail (Chicago) from 2010 to 2013, this study examines patterns of trauma exposure and the relationship between trauma exposure and mental disorders. Female detainees averaged 6.1 (SD = 4.90) types of trauma in their lifetimes, with greater trauma exposure associated with earlier age of trauma onset, more recent trauma exposure, and higher rates of fear for life or injury. Higher rates of trauma exposure were also correlated with higher rates of past-year symptoms of posttraumatic stress disorder as well as other internalizing, externalizing, and substance use disorders. Behavioral health programming for female detainees in jail settings should include more trauma-sensitive mental health and substance use disorder treatments.

Co-occurring substance use and mental disorders in the criminal justice system: a new frontier of clinical practice and research.

This editorial introduces this special section of the Psychiatric Rehabilitation Journal, which focuses on justice-involved persons with co-occurring mental and substance use disorders (CODs). It contains seven original articles examining CODs among justice-involved populations that vary by gender, age, setting (e.g., community/ court, jail, prison), environment (urban, rural), geographic region, and nationality. (PsycINFO Database Record

Comorbidity among female detainees in drug treatment: an exploration of internalizing and externalizing disorders.

OBJECTIVE: The current study explored the prevalence and comorbidity of major internalizing and externalizing psychiatric disorders in a sample of female detainees participating in drug treatment programs in the nation's largest single-site jail, the Cook County (Chicago) Department of Corrections. METHODS: A total of 253 women participated in a Needs Inventory. The study incorporated an extensive combination of measures, which captured the women's demographic characteristics and psychological problems as well as their substance use and drug treatment histories and their criminal thinking tendencies. For the purpose of analyses, women were combined into 3 groups: women with substance use problems but no comorbid psychiatric disorders, women with 1 comorbid psychiatric disorder (either internalizing or externalizing), and women with both internalizing and externalizing disorders. RESULTS: More than 3/4 of the women were comorbid for another psychiatric (an internalizing or externalizing) disorder. Comorbid disorders were related to lower self-esteem, greater drug use severity, and higher levels of criminal thinking. For example, measures of reported histories of criminal activities and trauma exposure increased with comorbidity. The most critical variables in differentiating between female detainees with no and both internalizing and externalizing disorders were criminal thinking and exposure to trauma. CONCLUSIONS: The women in the present investigation and other female detainees in drug treatment programs require interventions that focus on both criminal and psychiatric recidivism. These interventions are most effectively delivered in a person-focused recovery framework that provides integrated modules of services. (PsycINFO Database Record

Probable posttraumatic stress disorder in a sample of urban jail detainees.

This study examined the nature and extent of probable posttraumatic stress disorder (PTSD) among men in a substance abuse treatment program in a large urban jail. Specifically, it explored the prevalence of probable PTSD and other psychiatric problems among jail detainees, the types of trauma detainees experienced during different phases of their lives, and how those experiences might have contributed to the development of probable PTSD. Results showed that psychiatric problems were quite serious; nearly one-quarter of the sample reported previous psychiatric hospitalization, and nearly 10% were being currently treated with psychiatric medication. In addition, 21% of the sample met the criteria for probable PTSD, a rate five times greater than that in the general population. The current study suggests that the presence of probable PTSD among male detainees should be incorporated into the creation and implementation of jail-based behavioral healthcare services, including screening, assessment, and clinical interventions. Furthermore, in-custody drug treatment programs should adopt trauma-informed strategies for all program participants as the expected standard of care.

The effects of self-control, gang membership, and parental attachment/identification on police contacts among Latino and African American youths.

This study assessed the correlates of self-control and police contact in a sample of Chicago public high school students. The investigation examined the effects of parental attachment/identification, family structure, and peer association on self-control and the effects of parental attachment/identification, family structure, peer association, and self-control on police contact. Differences between African American and Latino youth on the predictors of the two dependent measures were tested in separate regression models. Weak parental attachment/identification and gang affiliation (peer association) predicted low self-control among all students. Among African American youth, only weak maternal attachment/identification predicted low self-control; both weak maternal attachment/identification and gang affiliation predicted low self-control among Latino youth. Gang affiliation predicted police stops (delinquency) among African Americans but not among Latinos. However, both African American and Latino students with lower self-control were more likely to be stopped by the police than those with higher self-control.

Recovery-oriented care for drug-abusing offenders.

As described by the authors, a recovery-oriented system of care for drug-abusing criminal offenders is one that provides for continuity of treatment, using evidence-based interventions at every stage as clients progress through the justice system. Treatment Alternatives for Safe Communities of Illinois has partnered with criminal justice and treatment programs to establish a basic recovery-oriented system, with programs that span pre-adjudication, probation or incarceration, and parole.

Screening for serious mental illness in populations with co-occurring substance use disorders: Performance of the K6 scale.

Serious mental illnesses (SMIs) such as schizophrenia, bipolar disorder, and major depression are prevalent among individuals with substance use disorders, particularly those in drug treatment programs. No screening tool has yet become the gold standard for identifying SMI among individuals with substance use disorders. One candidate instrument, the K6 screening scale, is brief, easy to administer and score, and has performed well, detecting SMI in studies using general population samples. We used data from the National Survey on Drug Use and Health to examine the K6's psychometric properties in a subsample of persons with substance use disorders and found that the K6 accurately screened for severe psychological distress associated with SMI among individuals with substance use disorders and across different psychiatric disorders.

Standardized assessment of substance-related, other psychiatric, and comorbid disorders among probationers.

This study examined the prevalence of alcohol- and substance-related disorders in a random sample of 627 adult probationers in Illinois. The investigation also explored the prevalence of major psychiatric disorders and their co-occurrences with alcohol and substance use disorders. To detect the presence of psychiatric disorders, researchers employed standardized assessment tools based on Diagnostic and Statistical Manual of Mental Disorders criteria. Overall, results showed that probationers had significantly higher rates of psychiatric disorders, substance use disorders, and co-occurring disorders compared with persons in the general population. In light of these findings, probation administrators are urged to invest more resources in treating drug use, mental illness, and codisorders, the latter of which is associated with a higher risk of violent behaviors.