Abstract
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, a longitudinal study of 1,829 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 422-432 |
| Number of pages | 11 |
| Journal | Journal of the American Academy of Child and Adolescent Psychiatry |
| Volume | 63 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2024 |
Funding
This work was supported by the National Institute on Drug Abuse grants R01DA042082 , R01DA042082-S1 , R01DA019380 , R01DA022953 , and R01DA028763 ; the Eunice Kennedy Shriver National Institute of Child Health and Human Development grant R01HD093935 ; the National Institute of Mental Health grants R01MH54197 and R01MH59463 (Division of Services and Intervention Research and Center for Mental Health Research on AIDS); the National Institute on Minority Health and Health Disparities grant R01MD014020; the Office of Juvenile Justice and Delinquency Prevention, US Department of Justice grants 2013-JF-FX-0057, 2012-JR-FX-0005, 2008-JF-FX-0068, 2005-JL-FX-0288, and 1999-JE-FX-1001; the National Institute of Justice, US Department of Justice grants 2020-MU-MU-0001, 2017-IJ-CX-0019, and 2016-R2-CX-0039; and the Centers for Disease Control and Prevention grant R01CE003271 (National Center for Injury Prevention and Control and National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention). Major funding was also provided by the National Institute on Alcohol Abuse and Alcoholism; the National Institutes of Health Office of Behavioral and Social Sciences Research; the Substance Abuse and Mental Health Services Administration (Center for Mental Health Services, Center for Substance Abuse Prevention, and Center for Substance Abuse Treatment); the National Institutes of Health Office of Research on Women's Health; the National Institutes of Health Office of Rare Disease Research; the US Department of Labor; the US Department of Housing and Urban Development; The William T. Grant Foundation; and The Robert Wood Johnson Foundation. Additional funds were provided by The John D. and Catherine T. MacArthur Foundation, The Owen L. Coon Foundation, The Open Society Foundations, and The Chicago Community Trust. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Keywords
- criminal justice
- health disparities
- health inequities
- juvenile justice
- mental health services
ASJC Scopus subject areas
- Developmental and Educational Psychology
- Psychiatry and Mental health
