Does Mental Health Service Use Prevent Child Welfare and Juvenile Justice Systems Involvement?

Introduction: Nearly 50% of teens alleged to have been victims of abuse report at least one mental health (MH) problem (Heneghan et al., 2013), and upwards of 70 percent of juvenile detainees are diagnosed with a psychiatric disorder (Abram et al., 2015). While patterns of MH service use to address negative developmental outcomes are well documented among teens in child welfare (CW) or juvenile justice (JJ) systems, limited efforts focus on whether access to MH services prevents dual system involvement. To that end, the current study addressed the following aims: 1) What is the prevalence of mental health service use among youth involved in CWJJ systems?, 2) Does mental health service use prevent dual involvement in CWJJ systems?, and 3) Given differences in single system involvement and patterns of MH service use by age, gender, and race/ethnicity, to what extent is dual system involvement moderated by these characteristics?

Methods: This study relied on administrative data collected from the Data Management Office (DMO) in a large mid-Atlantic City. DMO mined data from several systems of care to develop one integrated dataset of system involved youth in 2003-05 (Cohort 1; n=10,170) and 2012-14 (Cohort 2, n=5,787), with the overall objective to examine patterns of system involvement now and 2003 when the Keeping Children and Families Safe Act of 2003 was passed to enhance linkages between systems. For each cohort, the following data were provided: demographics, placement types, number of placement spells, and receipt of delinquency and MH services. Of the 15,957 youth (µ=15.4), 35 % were female. Most of the sample included African Americans (76%), followed by Latinos (13%) and Caucasians (10%). Logistic regression was conducted to examine the likelihood of dual involvement in CWJJ systems.

Results: Eighteen percent of the sample was estimated to be involved in both systems. Among those who experienced dual involvement, 29% received MH services prior to CWJJ involvement, while 52% of youth involved in either CW or JJ received MH services. Findings showed that males, younger youth, and youth in the 2^nd cohort (versus the 1^st cohort) were more likely to experience dual involvement. Compared to African Americans, Caucasians were less likely to experience dual involvement. Utilization of MH services decreased the odds of dual involvement. Furthermore, such effects of MH service were particularly salient among Latinos, older youth, and those in cohort II.

Discussion: Results underscore the salience of providing mental health services to prevent dual involvement. Receipt of mental health services may also play a role in disrupting disparities in system involvement between Latinos and Caucasians and between older and younger youth. Future research is needed to validate findings and to understand how and under what conditions MH systems are effective in preventing dual involvement.