A County-Level Case Study of Early Psychosis in the Context of a Hybrid Juvenile Competency Restoration and Mental Health Problem-Solving Court and Linkage to Coordinated Specialty Care Services.

An important and unresolved question in the context of the implementation of coordinated specialty care (CSC) for early psychosis in the United States is the extent to which youth and young adults from marginalized backgrounds are able to equitably access CSC services. In this brief report, we describe pathways between a county hybrid juvenile competency restoration and mental health problem-solving court ('Court'), serving youth with high rates of psychosis and multiple risk factors for poor long-term outcomes, and local CSC services. We found that the Court was overall successful in linking youth with psychosis to care, but in the majority of cases this was not CSC programming more specifically. Drawing on Court and CSC records as well as family interviews, we report on factors contributing to low linkage to CSC, including family-side barriers (lack of transportation, preference for lower intensity / lower demand services) and provider-side barriers, including eligibility criteria such as duration of psychosis, that ultimately exclude otherwise eligible Court-involved youth.

A criação de institutos disciplinares: uma análise histórica / Creation of juvenile detention facilities: a historical analysis / La creación de institutos disciplinares: un análisis Histórico

Neste estudo objetivamos compreender as origens do Instituto Disciplinar de São Paulo, estabelecimento criado no início do período republicano, que atendia adolescentes ditos "delinquentes". Para isso, analisamos documentos históricos e as obras Classificação dos criminosos: introdução ao estudo do direito penal (1925) e Os menores delinquentes e o seu tratamento no Estado de São Paulo (1909), ambas de autoria de Candido Naziazeno Nogueira da Motta (1870-1942), jurista que apresentou o projeto de criação do primeiro Instituto Disciplinar do estado de São Paulo. Concluímos que a Escola Positiva de Direito Penal, exerceu grande influência na criação de Institutos Disciplinares no Brasil e que a predileção histórica do Estado brasileiro, em geral, pelo isolamento social ou aprisionamento como solução para o problema da delinquência juvenil demonstra que o ideário da higiene social ainda permanece na execução das políticas públicas voltadas aos jovens que atualmente denominamos em conflito com a lei. (AU)

This study aimed to understand the origins of Juvenile Detention Center of São Paulo, establishment created at the beginning of the republican period, which served so-called "delinquent" teenagers. For this, we analyzed historical documents and the works Classificação dos criminosos: introdução ao estudo do direito penal (1925) and Os menores delinquentes e o seu tratamento no Estado de São Paulo (1909), both by Candido Naziazeno Nogueira da Motta (1870-1942), jurist who presented the project to create the first Juvenile Detention Center in the state of São Paulo. We conclude that the Positive School of Criminal Law had a great influence on the creation of Juvenile Detention Centers in Brazil and that the historical predilection of the Brazilian State, in general, for social isolation or imprisonment as a solution to juvenile delinquency demonstrates that the ideal of social hygiene still remains in the execution of public policies aimed at young people that are currently in conflict with the law. (AU)

En este estudio se tuvo por objetivo comprender los orígenes de lo Instituto Disciplinar de São Paulo, establecimiento creado en el inicio del período republicano, que atendía adolescentes dichos "delincuentes". Para eso, analizamos documentos históricos y las obras Classificação dos criminosos: introdução ao estudo do direito penal (Clasificación de los criminales: introducción al estudio del derecho penal ) y Os menores delinquentes e o seu tratamento no Estado de São Paulo (1909), (Los menores delincuentes y su tratamiento en el Estado de São Paulo) (1925) ambas de autoría de Candido Naziazeno Nogueira da Motta (1870-1942), jurista que presentó el proyecto de creación del primer Instituto Disciplinar del estado de São Paulo. Concluimos que la Escola Positiva de Derecho Penal, ejerció gran influencia en la creación de Institutos Disciplinares en Brasil y que la predilección histórica del Estado brasileño, en general, por el aislamiento social o aprisionamiento como solución para el problema de la delincuencia juvenil apunta que el ideario de la higiene social aún permanece en la ejecución de las políticas públicas volcadas a los jóvenes que actualmente se denomina en conflicto con la ley. (AU)

Facilitators of Practitioner Adherence to a Risk/Need Assessment Tool: Hypothesis Testing on a Survey of Juvenile Probation Officers.

We used a statewide survey to test hypotheses about the predictors of juvenile probation officers' adherence to the Youth Level of Service/Case Management Inventory (YLS/CMI) risk/need assessment (RNA) tool, focusing on (1) the consistency and quality with which officers completed the tool, and (2) the extent to which they used it in decisions. While some hypotheses had been tested in prior quantitative studies, others were based on insights from case studies. Results showed that leadership and climate variables were consistently important in predicting adherence, though these tended to operate indirectly through their effects on other facilitators. Probation officer attitudes, either toward the YLS/CMI or to evidence-based practices, were also important across adherence measures. Although inconsistent in their effects across dependent variables, quality assurance of officer decision-making, external office relationships, and county YLS/CMI policies also predicted adherence.

Health determinants of adolescent criminalisation.

Several conditions related to health and development in adolescence can increase the risk that a young person will be exposed to the criminal justice system. Such determinants include neurodevelopmental disability, poor mental health, trauma, and experiences of maltreatment. Furthermore, the risk of exposure to the criminal justice system seems to be amplified by social marginalisation and inequality, such that young people are made susceptible to criminal behaviour and criminalisation by a combination of health difficulties and social disadvantages. This Review presents evidence on the health determinants of criminalisation among adolescents, providing a persuasive case for policy and practice reform, including for investment in approaches to prevent criminalisation on the basis of health and developmental difficulties, and to better address related needs once within a criminal justice system.

Implementation of risk-need-responsivity principles into probation case planning.

OBJECTIVE: Research indicates moderate-to-limited integration of the risk-need-responsivity (RNR) principles in probation case planning. Efforts to improve implementation are important targets for research, policy, and practice. This study examined the ability of two juvenile probation departments to implement RNR principles with fidelity following a comprehensive implementation protocol that included RNR-related policies, creation of a service matrix for criminogenic need-to-service matching, and extensive staff training. HYPOTHESES: The researchers anticipated fidelity to the risk and need principles would be stronger than previous studies. METHOD: This implementation study involved secondary data analysis of services received over 10 months for 254 adolescent offenders (76.80% male, 72.40% White, M age = 16.13 years) from two probation departments following adoption of the Youth Level of Service/Case Management Inventory. RESULTS: Probation departments evidenced strong fidelity to the risk principle, such that higher risk youth were assigned more services with higher intensity. Fidelity to the need principle was moderate at best (an average 24.61% to 29.38% need-to-service match) and varied by criminogenic need, overall risk level, and the operational definition of criminogenic need. CONCLUSIONS: Comprehensive implementation practices are associated with strong fidelity to the risk principle, but it may take longer for probation departments to achieve strong fidelity to the need principle. Researchers should identify more feasible methods for implementing the need principle and strive for a consensus on methods for measuring need-to-service match that are also consistent with probation policies. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Unit Costs of Delinquent Acts for Use in Economic Evaluations.

BACKGROUND: Youth mental health interventions aimed at reducing substance use and delinquency in adolescents compete with other types of interventions for reimbursement from public funding. Within the youth mental health domain, delinquent acts impose high costs on society. These costs should be included in economic evaluations conducted from a societal perspective. Although the relevance of these costs is recognized, they are often left out because the unit costs of delinquent acts are unknown. AIMS OF THE STUDY: This study aims to provide a method for estimating the unit costs per perpetrator of 14 delinquent acts common in the Netherlands and included in self reported delinquency questionnaires: robbery/theft with violence, simple theft/pickpocketing, receiving stolen goods, destruction/vandalism of private or public property, disorderly conduct/discrimination, arson, cybercrime, simple and aggravated assault, threat, forced sexual contact, unauthorised driving, driving under the influence, dealing in soft drugs, and dealing in hard drugs. METHODS: Information on government expenditures and the incidence of crimes, number of perpetrators, and the percentage of solved and reported crimes was obtained from the national database on crime and justice of the Research and Documentation Centre of the Ministry of Justice and Security, Statistics Netherlands, and the Council for the Judiciary in the Netherlands. We applied a top-down micro costing approach to calculate the point estimate of the unit costs for each of the delinquent acts and, subsequently, estimated the mean (SD) unit costs for each of the delinquent acts by taking random draws from a triangular distribution while taking into account a 10% uncertainty associated with the associated point estimate. RESULTS: The mean (SD) unit costs per delinquent act per perpetrator ranged between EUR495 (EUR1.30) for "Driving under the influence" and EUR33,813 (EUR78.30) for a "Cybercrime". These unit costs may be considered as outliers as most unit costs ranged between EUR 2,600 and EUR 13,500 per delinquent act per perpetrator. DISCUSSION: This study is the first to estimate the unit costs per delinquent act per perpetrator in the Netherlands. The results of this study enable the inclusion of government expenditures associated with crime and justice in economic evaluations conducted from a societal perspective. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Youth mental health interventions aimed at reducing substance use and delinquency in adolescents are increasingly subjected to economic evaluations. These evaluations are used to inform decisions concerning the allocation of scarce healthcare resources and should cover all the costs and benefits for society, including those associated with delinquent acts. IMPLICATIONS FOR HEALTH POLICIES: The results of this study facilitate economic evaluations of youth mental health interventions aimed at reducing substance use and delinquency in adolescents, conducted from a societal perspective. IMPLICATIONS FOR FURTHER RESEARCH: Based on health-economic evaluations conducted in the field of youth mental health and the results of the current study, we recommend including the estimated unit costs in guidelines for health-economic evaluations conducted from a societal perspective. Future research could aim at examining whether these unit costs require regular updating. The methodology applied in this study allows for this.

The Potential of Pay-for-Success as a Financing Strategy for Evidence-Based Practices: An Illustration with Multisystemic Therapy.

There is a critical need to identify strategies for financing the implementation of evidence-based practices. We illustrate the potential of pay-for-success financing (PFS)-a strategy in which private investors fund implementation and receive a return on investment from a government payer-using multisystemic therapy as an example. We argue that standard multisystemic therapy (for serious juvenile offenders) and several of its adaptations (for other complex behavioral problems in youth) would be good candidates for PFS in the right contexts. Despite some challenges for policymakers and administrators, PFS has significant potential as a financing strategy for evidence-based practices.

Community-Based Implementation of a Paraprofessional-Delivered Cognitive Behavioral Therapy Program for Youth Involved with the Criminal Justice System.

Psychosocial interventions for common emotional and behavioral difficulties have been developed for use in correctional facilities, yet these programs are largely unavailable upon community re-entry due to a shortage of trained mental health specialists. In this study, we developed and piloted a youth worker-delivered cognitive behavioral therapy (CBT) program for young men at high risk for incarceration receiving services at a youth development organization. We formed a community-academic partnership to support the conduct of research across all phases of this project (2014-2016). We analyzed data gathered through focus groups and individual interviews with program staff, administrators, and young men. This study reports on implementation process and outcomes across phases. Main findings indicate the preliminary feasibility and acceptability of the youth worker-delivered CBT curriculum. We discuss strengths and limitations of our approach and provide suggestions for future studies that aim to implement paraprofessional-delivered CBT programs within community-based organizations.

Critical issues for youth involved in the juvenile justice system: Innovations in prevention, intervention, and policy.

This introduction to the themed issue presents a targeted review of historical and contemporary trends in the prevention, intervention, and policy response to juvenile justice system-involved youth. These trends underscore often overlooked ideological assumptions that implicate individual-level problem definitions, a pattern of victim blaming tendencies despite having a workforce increasingly trained in assessing context, and a system whose rehabilitative mandate is at odds with the social demand to maintain itself and its structures through keeping youth system-involved. Further, contemporary trends point to efforts that redirect blame from individual youth to families, and which ultimately ignore the broader sociopolitical context of mass incarceration that has selectively disenfranchized those same families. These and other critical paradoxes are underscored, with particular attention to the dilemmas raised by the invited articles within this issue - which push interdisciplinary frameworks in a direction that concretizes and advances solutions for critical issues in youth justice prevention and intervention.

Use of Manifest Injustice in the Washington State Juvenile Rehabilitation Administration.

In the Washington State Juvenile Code, the Manifest Injustice (MI) provision allows judges to sentence youth outside of the standard guidelines. We compared rates of Juvenile Rehabilitation Administration (JRA) involvement and MI between racial minority youth and Caucasian youth. Although not statistically significant, there was a trend toward African American and multiracial youth having MI used to decrease their sentence less frequently than Caucasian youth. African American youth were about half as likely to have MI used to intensify their sentence compared with Caucasian youth (rate ratio = .49, p = .002), whereas multiracial youth were 42 percent less likely (rate ratio = .58, p = .04). More African American youth reside in urban and liberal parts of the state where judges may be more progressive and less likely to use MI to intensify sentences. More diversion programs targeting minority youth exist in urban areas of Washington, and more African American youth are transferred to adult court; both reduce the likelihood of minority youth receiving MI. Judges in rural areas of the state, which have fewer treatment resources, may be using MI to access services only available to court-involved youth. It is imperative that community behavioral health services are available so that youth and families can be justly served.

Organizational Context and Individual Adaptability in Promoting Perceived Importance and Use of Best Practices for Substance Use.

This study examines associations among organizational context, staff attributes, perceived importance, and use of best practices among staff in community-based, juvenile justice (JJ) agencies. As part of the National Institute on Drug Abuse's Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, 492 staff from 36 JJ agencies were surveyed about the perceived importance and use of best practices within their organization in five substance use practice domains: screening, assessment, standard referral, active referral, and treatment support. Structural equation models indicated that supervisory encouragement and organizational innovation/flexibility were associated with greater individual adaptability. Adaptability (willingness to try new ideas, use new procedures, adjust quickly to change), was positively correlated with importance ratings. Importance ratings were positively associated with reported use of best practices. Organizational climates that support innovation likely affect use of practices through staff attributes and perceptions of the importance of such services.

Restorative Justice Conferencing: Not a Panacea for the Overrepresentation of Australia's Indigenous Youth in the Criminal Justice System.

Restorative justice conferencing is a police diversionary strategy used extensively in Australian jurisdictions to channel young offenders away from formal court processing. Advocates view conferencing as culturally appropriate and a means to reduce the overrepresentation of Indigenous young people because it is rooted in Indigenous justice traditions. However, whether conferencing is effective at reducing recidivism by Indigenous young people compared with non-Indigenous young people remains unknown. We examine this using a longitudinal cohort of youth offenders from Australia. Propensity score matching was used to match Indigenous and non-Indigenous young people at their first conference and examined reoffending outcomes to explore its efficacy at reducing recidivism ( n = 394). Results indicate that, despite statistically controlling for factors related to reoffending, recidivism levels postconference were significantly higher for Indigenous young people. These results suggest that conferencing is unlikely to address the problem of Indigenous overrepresentation within Australia's youth justice system.

Juvenile Corrections in the Era of Reform: A Meta-Synthesis of Qualitative Studies.

In this article, the authors synthesize knowledge from select qualitative studies examining rehabilitation-oriented juvenile residential corrections and aftercare programs. Using meta-synthesis methodology, the authors extracted and coded content from 10 research studies conducted by five authors across criminology, sociology, and social welfare disciplines. The total number of published works based on those studies analyzed was 18. Collectively, these studies offer insight into three major components of the juvenile correctional experience: therapeutic treatment and evidence-based practices, the shaping of identities and masculinities, and preparation for reentry. This analysis is particularly important as the United States is currently in an era of reform during which policymakers are increasingly espousing the benefits of rehabilitation for youth offenders over punishment. These studies took place before, during, and after this era of reform, and yet, the findings are surprisingly consistent over time, raising key questions about the effectiveness of the reform strategies.

A multimodal day treatment program for multi-problem young adults: study protocol for a randomized controlled trial.

BACKGROUND: Effective interventions for young adults with severe, multiple problems - such as psychosocial and psychiatric problems, delinquency, unemployment and substance use - are scarce but urgently needed in order to support an adequate transition to adulthood. A multimodal day treatment program called "New Opportunities" (in Dutch: "De Nieuwe Kans"; DNK) was specifically developed to target multi-problem young adults in The Netherlands. The aim of this study protocol is to describe the design of a randomized controlled trial (RCT) in clinical practice to examine the effectiveness of DNK in comparison with care as usual (CAU). METHODS/DESIGN: Multi-problem young adults in Rotterdam, The Netherlands, will be assigned randomly to DNK (expected N = 150) and CAU (expected N = 150). Primary outcome measures are recidivism and self-sufficiency. Secondary outcome measures include quality of life, attending school/work, psychological functioning, cognitive distortions and substance use. Participant and program characteristics will be examined as potential moderators of effectiveness. Additionally, cost-effectiveness will be measured. During 14 months, data from multiple resources will be collected at four time points. DISCUSSION: This study is one of the first RCTs on the effectiveness of interventions developed for multi-problem young adults. The results will contribute to the currently scant knowledge about what works for various multi-problem young adults in their transition to adulthood. In addition, the study protocol will provide insight into implementing an RCT in a dynamic setting of clinical practice. TRIAL REGISTRATION: Dutch Trial Register, identifier: NTR5163 . Registered on 17 April 2015; retrospectively registered during the recruitment phase.

Risk and Outcomes: Are Adolescents Charged with Sex Offenses Different from Other Adolescent Offenders?

Juveniles who have committed sexual offenses are subject to specialized treatment and policies based on their assumed unique dangerousness, despite contradictory evidence. Limited information is available regarding risk factors and their relationships to outcomes in this population. The comparative frequency and predictive utility of empirically supported risk factors for general delinquency were examined using data from the Pathways to Desistance study. Adolescent males who committed sexual offenses (n = 127) were compared to adolescent males who committed non-sexual offenses (n = 1021). At the start of the study, the sample ranged in age from 14 to 18 (M = 16.00, SD = 1.12) and self-identified as primarily African American (44 %), Latino (29 %), or White (25 %). Outcomes were measured over 7 years and included general and sexual recidivism, involvement in school and work, and positive relationships with peers and adults. The results indicated a few small differences in the presence of risk factors and their relationship to outcomes, with many similarities. Juveniles who have committed sexual offenses had equivalent general recidivism but higher sexual recidivism, though this rate was low (7.87 %, or 10 of the 127 adolescents who had committed sexual offenses). New clinical and policy approaches may be needed given the similarities between groups.

Sex and Racial/Ethnic Differences in Positive Outcomes in Delinquent Youth After Detention: A 12-Year Longitudinal Study.

Importance: Longitudinal studies of delinquent youth have focused on criminal recidivism, not on psychosocial outcomes in adulthood. This omission is critical because after detention most youth return to the community, where they become the responsibility of pediatric health care professionals. Objective: To investigate 8 positive outcomes among delinquent youth 5 and 12 years after detention, focusing on sex and racial/ethnic differences. Design, Setting, and Participants: In the Northwestern Juvenile Project, a longitudinal US study of long-term outcomes of delinquent youth after detention, participants were interviewed in detention between November 20, 1995, and June 14, 1998, and reinterviewed up to 9 times during the 12-year study period, through May 12, 2011. Data analysis was conducted between November 18, 2013, and July 25, 2016. Exposures: Juvenile detention. Main Outcomes and Measures: Achievement of positive outcomes in 8 domains: educational attainment, residential independence, gainful activity, desistance from criminal activity, mental health, abstaining from substance abuse, interpersonal functioning, and parenting responsibility. Outcomes were assessed with widely used measures supplemented by correctional records. Results: The study included 1829 youth at baseline (1172 males and 657 females; mean [SD] age, 14.9 [1.4] years). At the end of the study, 1520 (83.1%) of the original sample remained (944 males and 576 females; mean [SD] age, 27.6 [1.4] years). Twelve years after detention, females were more likely than males to have positive outcomes for gainful activity (odds ratio [OR], 2.53; 95% CI, 1.86-3.44), desistance from criminal activity (OR, 5.89; 95% CI, 4.38-7.92), residential independence (OR, 3.41; 95% CI, 2.57-4.52), parenting responsibility (OR, 18.65; 95% CI, 12.29-28.30), and mental health (OR, 1.48; 95% CI, 1.13-1.92). Twelve years after detention, only 21.9% of males and 54.7% of females had achieved more than half of the outcomes. As youth aged, the number of positive outcomes increased only modestly (mean increase for males, 0.37; 95% CI, 0.13-0.62; for females, 0.29; 95% CI, 0.13-0.45). Among males, non-Hispanic white individuals were significantly more likely to achieve most positive outcomes compared with minorities, but less likely to abstain from substance abuse. For example, 12 years after detention, non-Hispanic white males had nearly 3 times the odds of educational attainment compared with African American (OR, 2.82; 95% CI, 1.77-4.50) and Hispanic males (OR, 2.91; 95% CI, 1.75-4.82), and 2 to 5 times the odds of gainful activity compared with African American (OR, 5.17; 95% CI, 3.16-8.45) and Hispanic males (OR, 2.58; 95% CI, 1.56-4.26). Latent class analysis shows that African American males fared the worst, with lives characterized by incarceration, criminal activity, and few positive outcomes. Conclusions and Relevance: Our findings highlight racial/ethnic disparities among youth in achieving positive outcomes after detention. To improve outcomes, pediatric health care professionals should recognize the importance of psychosocial health, partner with on-site psychosocial services in their practices, and facilitate access to services in the community.

The Mobility of Youth in the Justice System: Implications for Recidivism.

Both residential mobility and community disadvantage have been shown to be associated with negative outcomes for adolescents generally and juvenile offenders specifically. The current study examines the effects of moving among a large sample (n = 13,096) of previously adjudicated youth (31.6 % female, 41.2 % Black, 16.5 % Hispanic). Additionally, we examine whether moving upward to a more affluent neighborhood, moving downward to an area of greater disadvantage, or moving laterally to a similar neighborhood tempers the effects of residential mobility. We use a combination of analytical techniques, including propensity score matching to untangle the effects of mobility sans pre-existing conditions between movers and non-movers. Results show relocation increases recidivism, irrespective of the direction of the move with regard to socioeconomic context. Moving upward has the most detrimental impact for adjudicated male adolescents, while downward relocations evidenced the largest effect for female youth. Implications for policy and future research needs are discussed.

Racial/Ethnic Disproportionality in Psychiatric Diagnoses and Treatment in a Sample of Serious Juvenile Offenders.

Psychiatric disorder prevalence has been shown demonstrably higher among justice-involved adolescents than youth in the general population. Yet, among arrested juveniles, little is known regarding racial/ethnic differences in disorder prevalence, the role of trauma exposure in the diagnosis of behavioral disorders, or subsequent psychiatric treatment provided to adolescents with such diagnoses. The current study examines racial/ethnic disparity in psychiatric diagnoses and treatment of behavioral disorders associated with delinquency, controlling for traumatic experiences, behavioral indicators, and prior offending among serious juvenile offenders. Logistic regression is employed to explore the racial/ethnic disproportionality in behavioral disorder diagnoses and psychiatric treatment provision among 8763 males (57.7 % Black, 11.8 % Hispanic) and 1,347 females (53.7 % Black, 7.6 % Hispanic) admitted to long-term juvenile justice residential placements in Florida. The results indicate Black males are 40 % more likely, and Black females 54 % more likely to be diagnosed with conduct disorder than Whites, even upon considerations of trauma, behavioral indicators, and criminal offending. Black and Hispanic males are approximately 40 % less likely to be diagnosed with ADHD than White males, with no racial/ethnic differences for females. Importantly, Black males are 32 % less likely to receive psychiatric treatment than White males, with no differences between White and Hispanic males, or any female subgroups. Traumatic exposures increased the odds of oppositional defiant disorder and ADHD, but not conduct disorder for males, though adverse childhood experiences were unrelated to behavioral disorder diagnoses among females.