Inequities in Mental Health Services: A 16-Year Longitudinal Study of Youth in the Justice System

Details

• Alternative Title:
  J Am Acad Child Adolesc Psychiatry
• Personal Author:
  Luna, María José ; Abram, Karen M. ; Aaby, David ; Welty, Leah J. ; Teplin, Linda A.
• Description:
  Objective:
  
  To examine: (1) if youth who have mental health disorders receive needed services after they leave detention—and as they age; and (2) inequities in service use, focusing on demographic characteristics and type of disorder.
  
  Method:
  
  We used data from the Northwestern Juvenile Project, our longitudinal study of 1829 youth randomly sampled from detention in Chicago, Illinois in 1995. Participants were re-interviewed up to 13 times through 2015. Interviewers assessed disorders using structured diagnostic interviews and assessed service use using the Child and Adolescent Service Assessment and the Services Assessment for Children and Adolescents.
  
  Results:
  
  Less than 20% of youth who needed services received them, up to median age 32 years. Female participants with any disorder had nearly twice the odds of receiving services compared with male participants (OR: 1.82; 95% CI: 1.41, 2.35). Compared with Black participants with any disorder, non-Hispanic White and Hispanic participants had 2.14 (95% CI 1.57, 2.90) and 1.50 (95% CI: 1.04, 2.15) times the odds of receiving services. People with a disorder were more likely to receive services during childhood (< age 18) than during adulthood (OR: 2.29; 95% CI: 1.32, 3.95). Disorder mattered: participants with an internalizing disorder had 2.26 times and 2.43 times the odds of receiving services compared with those with a substance use disorder (respectively, 95% CI: 1.26, 4.04; 95% CI: 1.49, 3.97).
  
  Conclusion:
  
  Few youth who need services receive them as they age; inequities persist over time. We must implement evidence-based strategies to reduce barriers to services.
  
  
• Subjects:
  Adolescent Adult Child Female Humans Juvenile Delinquency Longitudinal Studies Male Mental Disorders Mental Health Services Substance-Related Disorders Young Adult

  More +
• Keywords:
  Criminal Justice Health Disparities Health Inequities Juvenile Justice Mental Health Services
• Source:
  J Am Acad Child Adolesc Psychiatry. 63(4):422-432
• Pubmed ID:
  37516236
• Pubmed Central ID:
  PMC10818024
• Document Type:
  Journal Article
• Funding:
  R01 DA019380/DA/NIDA NIH HHSUnited States/ ; R01 DA028763/DA/NIDA NIH HHSUnited States/ ; R01 HD093935/HD/NICHD NIH HHSUnited States/ ; R01 DA042082/DA/NIDA NIH HHSUnited States/ ; R01 MH059463/MH/NIMH NIH HHSUnited States/ ; R01 CE003271/CE/NCIPC CDC HHSUnited States/ ; R01 MD014020/MD/NIMHD NIH HHSUnited States/ ; R01CE003271/ACL/ACL HHSUnited States/ ; R01 DA022953/DA/NIDA NIH HHSUnited States/
• Volume:
  63
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:725ba00be6bf809e3abde2fe7789b4af8f6ce9f69430bffd6dfb0648b8b584012baf5a4f0791cb7c80a0ada36de38cea9d9cd4208c8b5c84f7a6efc830ea0fbb
• Download URL:
  https://stacks.cdc.gov/view/cdc/147654/cdc_147654_DS1.pdf
• File Type:
  [PDF - 466.96 KB ]