Browsing by Subject "juvenile justice system"

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    Detained Adolescents: Mental Health Needs, Treatment Use, and Recidivism
    (AAPL, 2016-06) White, Laura M.; Lau, Katherine S. L.; Aalsma, Matthew C.; Department of Pediatrics, IU School of Medicine
    Objective: Although approximately 60%-70% of detained adolescents meet criteria for a mental disorder, few receive treatment upon community reentry. Given that mental health treatment can potentially reduce recidivism, the study examined detained adolescents’ mental health needs and their post-detention mental health treatment and recidivism. Method: Altogether, 1574 adolescents (<18 years) completed a mental health screener at a detention center. Scores on the screener, mental health treatment utilization (60-days post-detention), and recidivism (6-months post-detention) were measured. Results: About 82.2% of adolescents earned elevated scores on the mental health screener, but only 16.4% utilized treatment and 37.2% recidivated. Logistic regression models revealed adolescents with insurance and higher Angry-Irritable scores were significantly more likely to obtain treatment, whereas males, Black adolescents, older adolescents, and adolescents endorsing a trauma history were less likely. Black adolescents, insured adolescents, and adolescents with higher Alcohol/Drug Use scores were significantly more likely to recidivate. Mental health treatment increased the likelihood of recidivism. Discussion: The prevalence of mental health needs among DAs was high, but treatment utilization was low, with notable treatment disparities across race, gender, and age. The use of mental health treatment predicted recidivism, suggesting treatment may act as a proxy measure of mental health problems. Future research should assess the impact of timely and continuous mental health services on recidivism.
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    Preventive Care Use Among Justice-Involved and Non–Justice-Involved Youth
    (AAP, 2017-11) Aalsma, Matthew C.; Anderson, Valerie R.; Schwartz, Katherine; Ouyang, Fangqian; Tu, Wanzhu; Rosenman, Marc B.; Wiehe, Sarah E.; Pediatrics, School of Medicine
    BACKGROUND AND OBJECTIVES: Youth involved in the juvenile justice system (ie, arrested youth) are at risk for health problems. Although increasing preventive care use by justice-involved youth (JIY) is 1 approach to improving their well-being, little is known about their access to and use of care. The objective of this study was to determine how rates of well-child (WC) and emergency department visits, as well as public insurance enrollment continuity, differed between youth involved in the justice system and youth who have never been in the system. We hypothesized that JIY would exhibit less frequent WC and more frequent emergency service use than non–justice-involved youth (NJIY). METHODS: This was a retrospective cohort study of administrative medical and criminal records of all youth (ages 12–18) enrolled in Medicaid in Marion County, Indiana, between January 1, 2004, and December 31, 2011. RESULTS: The sample included 88 647 youth; 20 668 (23%) were involved in the justice system. JIY had lower use rates of WC visits and higher use rates of emergency services in comparison with NJIY. JIY had more and longer gaps in Medicaid coverage compared with NJIY. For all youth sampled, both preventive and emergency services use varied significantly by Medicaid enrollment continuity. CONCLUSIONS: JIY experience more and longer gaps in Medicaid coverage, and rely more on emergency services than NJIY. Medicaid enrollment continuity was associated with differences in WC and emergency service use among JIY, with policy implications for improving preventive care for these vulnerable youth.