By Iris Smith, Ph.D.
Youth involved in the justice system are known to be at high risk for alcohol and drug use, and mental and physical health problems. However, most juvenile justice systems do not screen for substance use or mental health disorders, provide substance use or behavioral health services, or have policies that link youth to community resources once released.
In 2021, courts with juvenile jurisdiction handled an estimated 437,300 delinquency cases. Of those, 46,300 youth were presented with drug law violations, 2,100 presented with liquor law violations and 24,894 youth were either detained or committed to a residential youth placement facility. The largest increase in case rates for youth between 13 and 17 was for drug offenses.1,2 That same year, more than 32 million youth between 10 and 16 years old were under juvenile court jurisdiction.2 Between 2005 and 2021, delinquency case rates declined for youth of all racial groups. However, case rates (per 1000 youth) were highest for American Indian (14.8) and Black youth (31.7) compared to cases involving White or Hispanic youth (11.4 and 9.5 respectively), and lowest for Asian youth (2.5).1
In 2023 Black youth were almost 10 times more likely to be detained compared to White youth and remain in detention longer.3 Over the past decade, young women have become the fastest growing cohort in the juvenile justice system, however only 4% of available programs offer gender-specific services.4
Post-incarceration youth are ill prepared for successful re-integration into their communities. These youth have a higher prevalence of mental health and substance use disorders (SUDs), continuing delinquency, and low academic achievement and unemployment. They are more likely to have experienced neglect, abuse, and dysfunctional family environments. Youth involved in the juvenile justice system are more likely to have a history of multiple adverse childhood experiences (ACEs) compared to non-involved youth, and those with a history of ACEs have a higher rate of recidivism.5 In the United States 75% of youth leaving forensic institutions are arrested within three years of reentering the community.6
Youth who are, or have been, involved with the juvenile justice system are at higher risk for multiple poor outcomes including, SUDs, behavioral and physical health problems, criminal activity, and homelessness, yet there are few evidence-based interventions for this interest group. The Juvenile Justice Behavioral Health Services Cascade (Cascade) is a promising framework for addressing disparities and deficiencies of state Juvenile Justice systems. Cascade, developed by a research cooperative funded by the National Institute of Drug Abuse (NIDA), is experimentally testing a multi-site implementation intervention protocol to reduce unmet substance use treatment needs among delinquent youth under community supervision and increase evidence-based interventions for them. Cascade is a multi-component service model that engages Juvenile Justice agencies, behavioral health providers, and other partners and builds capacity through staff training and technical assistance resources. The ultimate goal of Cascade is to maximize the number who are identified, referred, initiated, and retained in substance use treatment for a sufficient period of time to achieve clinically meaningful effects.7
Resources
Aalsma, M. C., Aarons, G. A., Adams, Z. W., Alton, M. D., Boustani, M., Dir, A. L., Embi, P. J., Grannis, S., Hulvershorn, L. A., Huntsinger, D., Lewis, C. C., Monahan, P., Saldana, L., Schwartz, K., Simon, K. I., Terry, N., Wiehe, S. E., & Zapolski, T. C. B. (2021). Alliances to Disseminate Addiction Prevention and Treatment (ADAPT): A Statewide Learning Health System to Reduce Substance Use Among Justice-Involved Youth in Rural Communities. Journal of Substance Abuse Treatment, 128, 108368. https://doi.org/10.1016/j.jsat.2021.108368
Annie E. Casey Foundation (2023). Changing Course in Youth Detention: Reversing Widening Gaps by Race and Place. Annie E. Casey Foundation; Baltimore, MD.
Belenko S, Knight D, Wasserman GA, Dennis ML, Wiley T, Taxman FS, Oser C, Dembo R, Robertson AA, Sales J. (2017) The Juvenile Justice Behavioral Health Services Cascade: A New Framework for Measuring Unmet Substance Use Treatment Services Need Among Adolescent Offenders. Journal of Substance Abuse Treatment 74; pg.80-91.
Hockenberry S, Puzzanchera C (2024). Juvenile Court Statistics 2021. National Center for Juvenile Justice; Pittsburgh, PA.
Thomann A, Keyes Latocia, Ryan A, Graaf G (2020). Intervention Response to the Trauma-Exposed, Justice-Involved Female Youth: A Narrative Review of Effectiveness in Reducing Recidivism. International Journal Environmental Research in Public Health 17(20); pg. 7402. PMCID: 33053618
Voisin, D. R., Kim, D. H., Bassett, S. M., & Marotta, P. L. (2020). Pathways linking family stress to youth delinquency and substance use: Exploring the Mediating Roles of Self-efficacy and Future Orientation. Journal of health psychology, 25(2), 139–151. https://doi.org/10.1177/1359105318763992
Yohros A (2023) Examining the Relationship between Adverse Childhood Experiences and Juvenile Recidivism: A Systematic Review and Meta-Analysis. Trauma Violence Abuse 24(3); pg. 1640-1655.
