Psychiatric and Substance-Related Problems Predict Recidivism for First-Time Justice-Involved Youth.

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.

Youth recidivism: youth self-report matters.

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.

Leveraging Technology to Increase Behavioral Health Services Access for Youth in the Juvenile Justice and Child Welfare Systems: a Cross-systems Collaboration Model.

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.

An Ecodevelopmental Framework for Engaging Diverse Youth in Foster Care and Their Families Into Technology-Based Family Intervention Research Trials.

Family-based interventions delivered via telehealth are a promising mode for overcoming barriers to behavioral health treatment among youth in foster care and their families. There is a dearth of research, however, regarding effectiveness of these interventions for youth in foster care, who commonly exhibit complex behavioral health treatment needs. Clinical research in this area directly relates to equity in service access and quality for these youth and families, with numerous barriers and enabling factors to consider in order to improve engagement in clinical trials and bolster the evidence base. We present a framework to better understand the multi-systemic factors impacting youth and family engagement in clinical research on family-based telehealth interventions, drawing on relevant theory, including the bioecological model and ecodevelopmental theory. We also draw on our experiences conducting technology-based clinical research through the Family Telehealth Project, an evaluation of a brief family-based affect management intervention designed specifically for youth in foster care and their families, as a case example. Recommendations for promoting engagement in clinical research on family-based telehealth interventions with diverse youth in foster care and their families are provided.

Peer, substance use, and race-related factors associated with recidivism among first-time justice-involved youth.

OBJECTIVES: Peer deviancy and substance-related consequences are dynamic criminogenic needs associated with increased risk of recidivism for justice-involved youth. Most prior research in this area, however, is based on samples of primarily male youth charged with delinquent offenses. Because identification of dynamic criminogenic needs is essential to delinquency risk reduction efforts, the purpose of this study was to examine the role of peer deviancy and substance-related consequences in a sample of youth at first contact with the juvenile justice system, with relatively equal representation of males and females and youth charged with delinquent and status offenses. HYPOTHESES: We hypothesized that higher levels of peer deviancy and more severe alcohol- and cannabis-related consequences would predict recidivism. We also hypothesized that Black and brown youth would be more likely to recidivate than non-Latinx White participants. METHOD: First-time justice-involved youth (N = 401) aged 12-18 and their caregivers reported independent variables at baseline (demographic, legal, psychiatric, and peer factors). Official records of recidivism (i.e., number of new charges 2 years later) was the dependent variable for nested multivariate negative binomial regression models. RESULTS: Peer deviancy reported by caregivers, but not by youth, predicted recidivism 2 years later. Consequences related to alcohol, but not cannabis, increased recidivism risk. Finally, participants who were younger, male, charged with a delinquent offense, and Black, multiracial, and/or Latinx were more likely to recidivate than non-Latinx White participants after controlling for covariates. CONCLUSIONS: Results highlight the influence of institutionalized racism on later court involvement for youth of color at first court contact, regardless of individual risk. Deviant peers and consequences of alcohol are salient intervention targets for this population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Juvenile probation officers' evaluation of traumatic event exposures and traumatic stress symptoms as responsivity factors in risk assessment and case planning.

Juvenile probation officers (JPOs) are increasingly using risk/needs assessments to evaluate delinquency risk, identify criminogenic needs and specific responsivity factors, and use this information in case planning. Justice-involved youth are exposed to traumatic events and experience traumatic stress symptoms at a high rate; such information warrants attention during the case planning process. The extent to which JPOs identify specific responsivity factors, in general, and trauma history, specifically, when scoring risk/need assessments is understudied. In the current study, 147 JPOs reviewed case vignettes that varied by the adolescents' gender (male vs. female), traumatic event exposure (present vs. absent), and traumatic stress symptoms (present vs. absent), and then scored the YLS/CMI and developed case plans based on that information. JPOs who received a vignette that included trauma information identified a higher number of trauma-specific responsivity factors on the YLS/CMI. Despite an overall high needs match ratio (57.2%), few JPOs prioritized trauma as a target on case plans. The findings underscore the importance of incorporating trauma screening into risk/needs assessment and case planning. (PsycINFO Database Record

Juvenile Probation Officer Self-Assessed Mental Health Competency as a Predictor of Case Management Practices.

Justice-involved youth endorse high rates of mental health problems. Juvenile probation is the most common disposition in the justice system and juvenile probation officers (JPOs) are crucial for connecting justice-involved youth with appropriate care. We examined the role of mental health competency on the use of self-report case management strategy types (deterrence, restorative justice, and treatment) by JPOs and whether jurisdiction-level differences were relevant. Results suggest that mental health competency predicted use of restorative justice and treatment strategies and all three strategy types varied at the county level. The role of mental health competency in use of treatment strategies is relevant to connecting justice-involved youth to mental health care. Furthermore, a substantial amount of the variance predicting the use of all three strategies was accounted for at the county level.

The effects of racial heterogeneity on mental health: A study of detained youth across multiple counties.

A majority of detained adolescents experience mental health and substance use problems. Limited research has examined the interaction between the race/ethnicity of an individual youth and county-level racial heterogeneity on adolescent mental health outcomes. Participants were identified through a statewide mental health screening project that took place in detention centers across 11 different counties in a Midwestern state during January 1, 2008, to May 10, 2010. A total of 23,831 detained youth (ages 11-18 years), identified as non-Hispanic White (46.6%), Black (43.5%), or Hispanic (9.8%), completed a mental health screener that assessed problems in alcohol/drug use, depression-anxiety, anger-irritability, trauma, somatic complaints, and suicide ideation. Census data were gathered to determine the racial heterogeneity of each county and other county-level variables. Hierarchical linear regression analyses were used to test the independent and interactive effects of youth race/ethnicity and county-level variables (including racial heterogeneity of the county) on adolescent mental health. Independent of other community characteristics, as county-level racial heterogeneity increased, mental health problems among detained youth decreased. In future research on the development and persistence of mental health problems in detained youth, both community and individual-level factors should be considered.

Job-related burnout among juvenile probation officers: Implications for mental health stigma and competency.

The high demands and responsibilities of probation work, particularly with juvenile clients, may lead to burnout, which can negatively impact how probation officers work with clients, particularly individuals with behavioral health concerns. Yet, research examining burnout and related outcomes among juvenile probation officers (JPOs) is limited. We surveyed 246 JPOs in a Midwestern state to identify the prevalence, predictors, and potential outcomes of burnout. JPOs reported moderate levels of burnout; about 30% of the sample scored in the high range for emotional exhaustion and cynicism. Contrary to study hypotheses, there were no group-level differences in burnout scores across gender, race/ethnicity, age, or education. In regression models, burnout was predicted by being White (vs. minority), serving in an urban (vs. rural) county, dissatisfaction with department guidelines, job dissatisfaction, viewing job role as more treatment-oriented along the enforcement-treatment continuum, and turnover intention. JPOs with burnout were more likely to endorse mental health stigma and lack of mental health competency to address juvenile clients with behavioral health concerns. Findings suggest burnout prevention and intervention programs should be considered for JPOs to increase job satisfaction, limit job turnover, reduce burnout, and possibly increase effective practices for managing juvenile clients with behavioral health needs.

Connection to mental health care upon community reentry for detained youth: a qualitative study.

BACKGROUND: Although detained youth evidence increased rates of mental illness, relatively few adolescents utilize mental health care upon release from detention. Thus, the goal of this study is to understand the process of mental health care engagement upon community reentry for mentally-ill detained youth. METHODS: Qualitative interviews were conducted with 19 youth and caregiver dyads (39 participants) recruited from four Midwest counties affiliated with a state-wide mental health screening project. Previously detained youth (ages 11-17), who had elevated scores on a validated mental health screening measure, and a caregiver were interviewed 30 days post release. A critical realist perspective was used to identify themes on the detention and reentry experiences that impacted youth mental health care acquisition. RESULTS: Youth perceived detention as a crisis event and having detention-based mental health care increased their motivation to seek mental health care at reentry. Caregivers described receiving very little information regarding their child during detention and felt "out of the loop," which resulted in mental health care utilization difficulty. Upon community reentry, long wait periods between detention release and initial contact with court or probation officers were associated with decreased motivation for youth to seek care. However, systemic coordination between the family, court and mental health system facilitated mental health care connection. CONCLUSIONS: Utilizing mental health care services can be a daunting process, particularly for youth upon community reentry from detention. The current study illustrates that individual, family-specific and systemic issues interact to facilitate or impair mental health care utilization. As such, in order to aid youth in accessing mental health care at detention release, systemic coordination efforts are necessary. The systematic coordination among caregivers, youth, and individuals within the justice system are needed to reduce barriers given that utilization of mental health care is a complex process.

"Straight up": enhancing rapport and therapeutic alliance with previously-detained youth in the delivery of mental health services.

A strong therapeutic alliance has been shown to improve mental health treatment outcomes in adults, but this topic has not been fully explored with youth. Adolescents, particularly justice-involved youth, stand to benefit greatly from an improved treatment experience. One quality which can improve treatment is mental health providers' interpersonal skills when attempting to build a therapeutic rapport with adolescent clients. Semi-structured interviews were conducted with 19 youth who screened positive for mental health concerns while in juvenile detention. Four themes were identified as important to improving the therapeutic alliance: Empathy, client-directed care, sequencing, and positive rapport. Suggestions for strengthening a therapeutic alliance are provided.

An exploration of community reentry needs and services for prisoners: a focus on care to limit return to high-risk behavior.

Prisoner reentry is a stressful process and many prisoners return to behaviors that led to incarceration upon community reentry. We assess how individual-level vulnerabilities interact with system-level barriers that impact the community reentry process. An additional area explored was the impact of reentry services on risk behavior (i.e., sexual risk and substance use). Fifty-one (22 men, 29 women) primarily minority adults returning from the county jail or state prison participated in 4 focus groups in Febuary 2010. Participants took part in tape-recorded focus groups facilitated by research staff trained in qualitative research methodology. Participants reported that a lack of discharge planning led to poor community reentry (basic needs such as stable housing and employment were not met). As a result of a difficulty in accessing services to meet basic needs, many participants used drugs or engaged in sex for drugs, money, or transportation early in the community reentry process. Given the individual-level vulnerabilities of prisoners, they are more likely to reengage in risk behavior, which increases the risk of acquiring and transmitting HIV, reengaging in substance use, and recidivism. In summary, discharge planning should focus not only on sexual and substance use risk reduction, but also confirm that basic needs are met soon, if not immediately, upon release and subsequent community reentry.