Ohio's Behavioral Health Juvenile Justice (BHJJ) Initiative: Promoting Resilience in Juvenile Justice-Involved Youth with Behavioral Health and Trauma Concerns

Background: The majority of juvenile justice-involved (JJI) youth have a history of mental health or substance use problems.  Multiple studies estimate that between 65% to 75% of JJI youth have at least one behavioral health disorder.  Along with behavioral health disorders, JJI youth also experience significantly elevated rates of trauma and childhood exposure to violence.  Unfortunately, many JJI youth do not receive treatment until they enter the justice system.  Further, local jurisdictions are often ill-equipped to accurately assess youth for behavioral health problems and provide appropriate treatment.  Ohio’s Behavioral Health/Juvenile Justice (BHJJ) program is a diversion program for juvenile justice-involved youth between the ages of 10-18 with behavioral health issues.  In lieu of detention, the youth are diverted into more comprehensive, community and evidence-based behavioral health treatment.  Participating counties were able to select their own evidence-based treatment models.  Examples of models used include Multisystemic Therapy, Functional Family Therapy, and Trauma-Focused Cognitive Behavioral Therapy. The current study was designed to 1) examine the overall impact of the BHJJ program on youth outcomes and 2) examine whether the presence of physical or sexual abuse, or exposure to domestic violence, impacted success in the program. 

Methods: The sample consisted of 2,325 JJI youth (61.4% male, 52% nonwhite) who participated in the BHJJ program between 2006-2015.  As part of a program evaluation, participants completed several surveys and assessments throughout the project, including the Ohio Scales, the Trauma Symptom Checklist for Children, and the Substance Use Survey.  In addition, participating juvenile courts provided information on court charges prior to, during, and after program participation. Bivariate and multivariate analytic methods were used to evaluate the overall success of the program. Logistic regression were utilized to examine the extent to which abuse or exposure to domestic violence was associated with successful treatment completion and new adjudications (i.e., delinquency).

Results: Overall, 67% of the sample completed treatment successfully.  Using bivariate and multivariate analytical methods, results indicated significant improvements in youth functioning and problem severity and significant decreases in substance use and trauma symptoms from enrollment to termination. Logistic regression was used, controlling for gender, race, and age, to examine the impact of exposure to abuse or domestic violence on program outcomes.  Results indicated that exposure to abuse or domestic violence was not associated with successful treatment completion or future adjudications. 

Conclusions: Overall, the BHJJ program produced significant improvements in behavioral health functioning and trauma symptomatology for the majority of youth who participated.  Despite significant histories of exposure to violence and trauma, youth demonstrated program success, both in terms of treatment and juvenile justice outcomes.  In particular, youth who were physically or sexually abused, or those who witnessed domestic violence, were equally likely to complete treatment successfully and refrain from future delinquency as youth who had no abuse history.  JJI youth, even those who have experienced abuse or domestic violence, responded positively to behavioral health treatment and demonstrated resiliency.