The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #55460

E. Michael Foster, PhD, Health Policy and Administration, Pennsylvania State University, 116 Henderson Building, University Park, PA 16802 and Amir Qaseem, MD, MHA, Department of Health Policy & Administration, The Pennsylvania State University, 1846 Park Forest Avenue, State College, PA 16803, (814) 861-6397, aqaseem@psu.edu.

This study examines how improved mental health services in general or a system of care in particular affects juvenile justice involvement. This quasi-experimental longitudinal study matches and compares a system-of-care community with a similar community. Data sources included interviews with care givers and their children and management information systems (MIS) for the Stark and Mahoning County (Ohio) Juvenile Courts for the period of 1997 to 2000. A sample of 449 children and adolescents ages 6 to 17 with serious emotional and behavioral problems who were using mental health services were recruited for this longitudinal study. Cox proportional hazard modeling is used to estimate the risks of juvenile court involvement and the impact of the system of care. In the models, study entry was treated as a time-varying covariate. This allowed for the adjustment of pre-existing between-site differences to better capture the effect of the system of care. An initial analysis of first offense (regardless of severity) revealed that the hazard (or risk) of first juvenile justice involvement was 42% lower under the system of care. A second analysis that included only serious offenses indicated the system of care was associated with a 55% reduction. We also examined recidivism or the risk of subsequent offenses. The effect for the system of care was a 40% reduction for all offenses and a 36% reduction for serious offenses. The findings suggest that improved mental health services reduce the risk of juvenile justice involvement for children and adolescents.

Learning Objectives:

• Determine whether improved mental health services affect juvenile justice involvement.
• Illustrate use of hazard modeling.

Keywords: Mental Health, Criminal Justice

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.