Abstract
This study is aimed at exploring the relationship between mental health and alcohol or other drug use (AOD) and recidivism with juvenile delinquents in Texas. A recent study states that substance use disorders and comorbidity of substance use with mental health problems were directly related and demonstrated an increased likelihood of recidivism. Detained juveniles have vast mental health needs, with a large portion meeting the diagnostic criteria for a mental health disorder(s). More so, about 60 to 80 percent of detained juveniles have at least 1 mental disorder in comparison to the general juvenile population reporting only 15 to 20 percent. Even with all that is known, the role of detention based mental health care on recidivism has been generally unexplored.
Introduction
Over the past fifteen years, researchers have made extensive progress in treating adolescents with AOD use and mental health disorders. In the year 2009, approximately 70% of juveniles in the justice system were diagnosed with mental health disorders. Recidivism, or rearrests for juveniles, though declining can be as high as 52%. (2017 Annual Review of treatment Effectiveness) Yet, researchers have left unexplored how impactful these mental health disorders, along with substance abuse, are by way of recidivism. When compared to those with no history of arrest, juvenile detainees are generally about three times more inclined to disclose abuse of AOD (Substance Abuse and Mental Health Services Administration, 2003). In addition, most adolescents in the juvenile justice system meet diagnostic criteria for substance use disorders (Neighbors, Kempton, and Forehand, 1992; Robertson, Dill, Husain, and Undesser, 2004; Teplin, Abram, McClelland, Dulcan, and Mericle, 2002). Prior studies show that youth involved with the juvenile justice system are more likely than the general population youth to be diagnosed with at least one mental health issue (Abram et al., 2004). The use of multiple substances is common among juvenile offenders. Within the last ten years there has been a huge dependence on the juvenile justice system to meet the ever-growing needs of juvenile offenders with mental health concerns. The “comorbidity of substance use and mental health issues are known to be greater in youth in the justice system” (Abrantes, Hoffman, & Anton, 2005; Shufelt & Cocozza, 2006; Teplin, Abram, McClellenand, Dulcan, & Mericle, 2002). An additional factor of this study is to assess the impact of TJJD on recidivism. To do so, the connection between the length of first incarceration and number of following offenses will be explored.
Research Question
1. Do juveniles that are treated for mental illness and alcohol or other drug use disorders recidivate at a higher rate when compared to the general population of incarcerated juveniles in Harris County at 6 months, 12 months and 24 months post- release?
Literature review
The critical health hazards of drug abuse compound the necessity to get a juvenile who is misusing drugs into treatment as swiftly as possible. Furthermore, adolescents found abusing drugs are probable to have further struggles such as: mental health concerns complementing and potentially influencing their substance use. These issues also need to be dealt with. Disappointingly, fewer than one third of adolescents allowed into substance abuse treatment who suffer from added mental health issues receive any support for their illnesses (National Institute on Drug Abuse). Mental health is commonly associated with weakened judgment, which affects the ability to make sound decisions and increases the potential of “risky behavior” (Silver et al., 2008) Substance use is prevalent among those incarcerated. Prior studies have explored the links between mental health and offending (Silver, Felson, & Vaneseltine, 2008; Silver, Piquero, Jennings, Piquero, & Leiber, 2011; Teplin et al., 2006) Yet, there are gaps that exist in literature regarding the launch and retention treatment for juveniles in the justice setting. Research states that youth with mental disorders comprise a large subgroup of those who appear in juvenile court due to their increased risk for engaging in aggressive and impulsive behavior. Almost 66 percent of youth in correctional settings today meet criteria for one or multiple mental disorders. Comprehending the roles of these issues is essential to help improve treatment strategies for juveniles. Though the commonality of mental health and substance use concerns between offenders has been confirmed (Aarons et al., 2001; Fox et al., 2014; Hodgon, 2008; NIMH, 2016), minimal consideration has been given to how substance use and mental health interrelate in regards to recidivism. (Craig et al., 2017) Mental health issues when combined with substance abuse are described by Zajac, Sheidow, and Davis (2015) as the “perfect storm” when mentioning adolescents. With the Juvenile Justice system and the Mental Health System having two separate but equally important purposes, researchers and policy writers are faced with a vital question, what is the appropriate response for these youth?
Mental Health
Dating back to the early 1990’s, there is data that implicitly states “83% of youth that exhibited serious delinquent behaviors also had a clinical level of mental disorder.” Studies suggest that juvenile offenders with mental illness are at a noticeably higher risk of recidivating when compared to their peers without mental illness (Prins & Draper, 2009; Skeem, Winter, Kennealy, Louden, & Tatar, 2013). Youth with mental illnesses are more inclined to abuse substances than their non-mentally ill counterparts. (Craig, Wilson, Baglivio, Wolff, Piquero, Epps, 2017) 43% of youth getting services for mental illness are diagnosed with co-existing substance use disorders (SUDs; Fox et al., 2014). Juveniles in need of SUD treatment are an inadequately served population (Lyons, Baerer, Quiegley, Erich, & Griffin, 2001) that have a history of greater likeliness to recidivate (Cottle, Lee, & Heilbrun, 2001). The commonness of mental disorders are noticeably higher in juvenile justice settings than in youth in the U.S general population, which is noted to be between 15 and 20%. Research indicates that approximately 66% of juveniles in detention centers meet criteria for at least one mental disorder or more. (Grisso, 2008). A neglected area of research is the relationship between mental health, substance use and rearrests. A study in Cook County, Illinois discovered that excluding conduct disorder 60 percent of males & 68 percent of females in juvenile detention met the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev) criteria and had disorder specific impairment for one or multiple disorders (Teplin et al., 2002). There is also research that found about 83% of youth displaying delinquent behaviors to have a diagnosable mental disorder (Brenda, 1995). Youth with mental disorders have a greater chance of offending as well as reoffending and when adjudicated, dispositions should have mandated aftercare and be a combined effort between both mental health and the juvenile justice system (Grisso, 2008).
Anxiety
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines anxiety as a disorder in which people worry to the point of fearfulness and or nervousness. These feelings cause distress and impact daily life. People suffering from anxiety disorder are two to three times more likely to have an alcohol or other substance abuse disorder at some point in their lives than the general population. Approximately 20 percent of Americans with an anxiety or mood disorder such as depression have an alcohol or other substance use disorder, and about 20 percent of those with an alcohol or substance use disorder also have anxiety (American Anxiety Association, 2018). SAMHSA states that anxiety disorders are one of the most prevalent forms of mental disorders among children and adolescents, but they frequently are uncharted and or untreated. Research suggest that AOD usage is directly linked to depression as well as anxiety. (SAMHSA, 2018)
How anxiety can influence juvenile recidivism, pull studies about.
Depression
SAMHSA says depression is one of the most prevalent mental disorders. Approximately 7% of the United States population has some form of depression in any given year. Depression can impact how a person thinks, behaves, interacts. Those suffering from depression often struggle with daily activities, such as sleeping, eating, and working. People with depression may share common feelings of sadness, hopelessness, anger, irritability, and tiredness. Alcohol and other substance use disorders frequently go hand in hand with depression.
How mental health can influence juvenile recidivism, pull studies about.
Alcohol and Other Drugs Use Disorder
In this study AOD acts as an umbrella and encompasses all substance use disorders. The correlation among offending and substance use is heavily investigated and recorded (Aarons, Brown, Hough, Garland, & Wood, 2001; D’Amico et al., 2015; Feldstein Ewing, Filbey, Loughran, Chassin & Piquero, 2015; Putins, 2010). In the 2010 study, Putin’s investigated “reasons to offend” finding that substance use was one of the most common. Substance use is associated with recidivism. Drug-Crime cycle is a word utilized to depict a substance using juvenile who was in recurrent interaction with the juvenile justice system. (White & Gorman, 2000).
How alcohol and drug use can influence juvenile recidivism, pull studies about.
Comorbidity
Comorbidity, or the occurrence of multiple mental disorders is common among adolescents. An increase in and impulsiveness and aggression are linked to comorbidity and creates a greater likelihood of contact with the juvenile justice system. Research emphasizes the significance of comorbidity for understanding the connection between adolescents’ mental disorders and their behaviors. Juvenile depression and or anxiety in conjunction with AOD disorders are great predictors of reoffending. Research substantiates the idea that mental disorders and their comorbidity increase the chance that a juvenile will be arrested and have continued justice system contact (Grisso, 2008).
Recidivism of Adolescents
Participation in the drug-crime cycle is a known forecaster of recidivism (Cottle et al., 2001). One of the immediate goals of the juvenile justice system is to minimize recidivism. This study defines recidivism as rearrests. According to the 2017 Annual Review of Treatment Effectiveness, 51.5 percent of youth that participated in specialized AOD treatment programs provided by Texas Department of Juvenile Justice (TDDJ) were rearrested within one year and 44.9 percent of youth that participated in specialized mental health treatment programs provided by TDJJ were rearrested within one year. It is important to mention that one year re-arrest for all youth was 51.8%. Does this mean that the evidence based strategies that TDJJ are currently using aren’t as effective as we are led believe?
How depression can influence juvenile recidivism, pull studies about.
Hypothesis
H1: Juveniles with mental health disorders are most likely to recidivate.
H2: Juveniles that suffer from AOD issues are likely to recidivate.
Proposed Method
Data for juveniles convicted of criminal offenses during their juvenile years. The sample will be gathered from all juveniles that reached age 18 within the 2 years before the first day of data collection. From the population, those that have mental health and probation files, and remained in juvenile jurisdiction until they reached 18 compose the sample for this study.
Participants
The sample will be acquired from all youth that reach age 18 within 2 years prior to the first day of data collection. From the designated population, only those with both mental health and probation files, and remained in juvenile jurisdiction until 18 are the sample. Participants are projected to be mostly minority males and females based on the population of youth offenders and minority overrepresentation in the justice system.
Design
This is a secondary, quantitative investigation.
Measures
Behavioral variables consist of the following: (diagnosis based on DSM)
Predictor Variables
Anxiety
Depression
Alcohol or other Drug Use Disorder
Outcome Variable
Recidivism, defined in this study as the number of reconvictions after first arrest prior to 18 years old.
Procedure
Information is to be obtained from the probation department. Variables will be measured utilizing two institutional case files on each participant. One source is the probation file, designed to give an exhaustive review of the juvenile. The next source is the mental health file, which includes a psychological assessment that encloses clinical diagnosis’s and important historical data. Data gathered will be coded using checklist designed to evaluate all variables.
Planned Analysis
Linear regression because predictor variables are categorical and continuous and our outcome variable is continuous as well.
Limitations
Did not look at all disorders related to juvenile delinquency
Did not investigate gender
Did not investigate age
Did not investigate socio-economic differences
Did not investigate race differences
What we did not add in the study