3P
Delinquency Placement and Inpatient Mental Health Treatment Among Youth in Substitute Care
Evidence shows the close link between child welfare services and juvenile justice involvement. Youth in the child welfare and juvenile justice systems have notably high rates of mental health issues. This study follows an entry cohort of youth placed in substitute care to examine the degree to which delinquency placement and inpatient mental health treatment occur both before and after youth’ placement in substitute care. Such investigation can provide useful information that allows us to develop improved strategies to prevent youth from cycling in and out of multiple public service systems.
Methods:
This study used administrative records for child welfare, delinquency, and publicly-funded mental health services in a large metropolitan area. The sample is consisted of 752 youth in grades 7 through 9 who were placed in substitute care from 2004 through 2007. Each individual in the sample was tracked for 6 years in the juvenile justice and child welfare system prior and subsequent to their initial placement in substitute care. Descriptive analyses were conducted to report the prevalence of delinquency placement and inpatient mental health treatment before and after youth’ placemen in substitute care. Cox regression was used to examine the role of the selected variables on the risk of delinquency placement and inpatient mental health treatment.
Results:
Approximately 20% of the youth in the sample had a history of delinquent care in the 3 years before their initial substitute care placement. The rate increased to 31% during the 3 years after the placement. While 5% of the youth had a history of inpatient or residential mental health treatment before their substitute care placement, the rate went up to 21% during the post placement period. Overall, half of the youth in substitute care were involved with either delinquent care or inpatient mental health treatment.
The risk of subsequent delinquency placement for African Americans and Latinas was 2.7 and 2.0 times the risk for other racial and ethnic groups. Males were 2.1 times greater at risk for subsequent delinquent care compared to females. Having a history of group home placement was associated with 53% increase in the risk of delinquent care. Youth with a history of previous delinquent care were 5.4 times more at risk for receiving delinquent care than those without.
Implications for Practice or Policy:
Nearly half of the youth were concurrently or sequentially placed in delinquent care and/or received inpatient mental health treatment during the study period. This finding confirms that youth coming into substitute care at old age is a high risk group for subsequent entries into juvenile justice and mental health systems.
This study points out the challenges of the youth moving across service systems and a myriad of needs to be addressed before they make the transition to adulthood. Some transfers between service systems are intentional and appropriate. Nevertheless, multiple systems involvement reported in this study reveals a complexity to these intersecting problems and opportunities for leveraging more investments to facilitate collaborations across service agencies to better serve these vulnerable youth.