Arrested Youth: Epidemiological, Mental Health Care, and Cost-Effectiveness Research to Guide Public Health Partnerships
Grantee: Indiana University
Principal Investigator: Matthew Aalsma
Project Number: R40MC21514
Project Date: 2/1/2011
Final Report
Age group(s)
- Adolescence (12-18 years)
Abstract
Incarcerated youth are at high risk for physical and mental health morbidity and mortality, but represent a small subsample of all youth involved in juvenile justice. Approximately two million juveniles were arrested in 2008 (Office of Juvenile Justice Delinquency Prevention, 2009). Of youth arrested, over 350,000 (17%) were placed in detention (short-term, local secure placement prior to court), and over 90,000 (4%) were incarcerated in a juvenile prison (longer-term incarceration at state facility) (FBI Uniform Crime Reports, 2009). Thus, the arrested youth are the largest proportion of juvenile justice involved youth. The overall mortality rate for detained youth is over 4 times that of the general population.(Teplin, 2005) Detained and incarcerated youth disproportionately exhibit acute and chronic health problems (Clark & Gehshan, 2006) and the majority met criteria for a mental health diagnosis (Fazel, Doll, & Langstom, 2008). This increased health care need among detained youth has led to extensive programming focused on mental health screening(Grisso, 2007), as well as specific recommendations regarding the medical care(American Academy of Pediatrics, 2001). A similar public health / health care planning and intervention effort does not exist for arrested youth, the largest group of youth in the juvenile justice system. Through this research proposal, we will build upon already established relationships with the Marion County Superior Court Juvenile Division, Marion County Jail, Indiana Department of Corrections, Indiana Family and Social Services Administration (which includes Indiana Office of Medicaid Policy and Planning and Department of Mental Health and Addictions), and the informatics center which houses the majority of clinical data in Indianapolis, Indiana. Given the research team's experience and community and statewide partnerships, we are uniquely positioned to systematically study a 10-year cohort of juvenile justice-involved youth (arrested, detained, and incarcerated), to examine physical and mental health and care, with an emphasis on cost-effectiveness. Specific aims include the following: Aim 1. Evaluate the health care needs and utilization rates of arrested youth. Aim 2. Assess how mental health diagnosis and care relates to initial involvement in and recidivism with the juvenile justice system. . Aim 3. Evaluate the cost-effectiveness of continuous, timely mental health care from the perspective of both the justice and health care systems. Our interdisciplinary team of researchers with expertise in medicine, mental health, epidemiology, economics, informatics, and criminology will assess the physical and mental health care needs and utilization patterns of youth involved in the juvenile justice system. Additionally, we will evaluate how mental health care connection can affect recidivism as well as economic costs to the justice and health care systems. The expected outcomes of this study will contribute to Healthy People 2010 (given the focus on eliminating health disparities) as well as MCHB's strategic plan by improving care for youth in juvenile justice (Strategic area #1), limiting health disparity (Strategic area #2), improving the quality of care by assessing connection to mental health care (Strategic area #3), and by studying the physical and mental health of vulnerable youth (Strategic area #4). With the increased understanding from this study, we will be better able to target resources and establish novel programs to populations in need prior to arrest, detention, or incarceration.Publications
Listed is descending order by year published.
Aalsma MC, Anderson VR, Schwartz K, et al. Preventative care use among justice-involved and non-justice-involved youth. Pediatrics. 2017;140(5). doi:10.1542/peds.2017-1107
Aalsma MC, Brown JR, Holloway ED, Ott MA. Connection to mental health care upon community reentry for detained youth: a qualitative study. BMC Public Health. 2014;14:117.
Brown JR, Holloway ED, Akakpo TF, Aalsma MC. "Straight up": enhancing rapport and therapeutic alliance with previously-detained youth in the delivery of mental health services. Community Ment Health J. 2014;50(2):193-203.
Neff MR, Aalsma MC, Rosenman MB, Wiehe SE. Psychiatric medication refill practices of juvenile detainees. Child Psychiatry Hum Dev. 2013 Dec;44(6):717-26.
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