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Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI.
Published: March 2023
AI Article Synopsis
Article Abstract
Justice-involved youth with clinically significant co-occurring psychiatric and substance-related problems are at increased risk for recidivism. Less is known about how psychiatric symptoms (i.e., internalizing and externalizing) and substance-related problems (i.e., alcohol and cannabis) interact to predict recidivism, especially at first court contact. Among 361 first-time justice-involved youth aged 12 to 18, we used nested multivariate negative binomial regression models to examine the association between psychiatric symptoms, substance-related problems and 24-month recidivism while accounting for demographic and legal covariates. Clinically significant externalizing symptoms and alcohol-related problems predicted recidivism. Moderation analyses revealed that alcohol-related problems drove recidivism for youth without clinically significant psychiatric symptoms and externalizing symptoms predicted recidivism, regardless of alcohol-related problems. After accounting for other predictors, Latinx, Black non-Latinx, and multiracial non-Latinx youth were more likely to recidivate at follow-up than White non-Latinx youth. Systematic screening, referral, and linkage to treatment for psychiatric and substance-related problems are needed to reduce recidivism risk among first-time justice-involved youth. Differences in recidivism rates by race/ethnicity not attributable to behavioral health needs suggest it is imperative to concurrently deploy large-scale structural interventions designed to combat systemic racial bias and overrepresentation of ethnoracial minoritized youth within the juvenile justice system.
