Organizational structure, climate, and collaboration between juvenile justice and community mental health centers: implications for evidence-based practice implementation for adolescent substance use disorder treatment

A Johnson-Kwochka,M P Salyers,M C Aalsma,A Dir

doi:10.1186/s12913-020-05777-3

A Johnson-Kwochka, M P Salyers + Show 2 more

Open Access

https://doi.org/10.1186/s12913-020-05777-3

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Abstract

BackgroundSubstance use disorders are prevalent among youth involved with the criminal justice system, however, evidence-based substance use disorder treatment is often unavailable to this population. The goal of this study was to identify barriers to effective implementation of evidence-based practices among juvenile justice and community mental health organizations through the lens of an adopter-based innovation model.MethodsIn this mixed-methods study, qualitative interviews were conducted with n = 15 juvenile justice staff and n = 14 community mental health staff from two counties implementing substance use services for justice involved youth. In addition, n = 28 juvenile justice staff and n = 85 community mental health center staff also completed quantitative measures of organizational effectiveness including the implementation leadership scale (ILS), organizational readiness for change (ORIC), and the implementation climate scale (ICS).ResultsOrganizationally, staff from community mental health centers reported more “red tape” and formalized procedures around daily processes, while many juvenile justice staff reported a high degree of autonomy. Community mental health respondents also reported broad concern about their capacity for providing new interventions. Staff across the two different organizations expressed support for evidence-based practices, agreed with the importance of treating substance use disorders in this population, and were enthusiastic about implementing the interventions.ConclusionsWhile both community mental health and juvenile justice staff express commitment to implementing evidence-based practices, systems-level changes are needed to increase capacity for providing evidence-based services.

Highlights

Substance use disorders are prevalent among youth involved with the criminal justice system, evidence-based substance use disorder treatment is often unavailable to this population
Juvenile justice staff serve as gatekeepers, initially identifying youth in need of services and connecting them to appropriate services offered by community mental health systems
For the purpose of this study, we focused our analyses on themes regarding the organizational social context of the juvenile justice and community mental health centers across both sites; we provide examples pertaining to the larger study when they illustrate the social context of each organization

Summary

Introduction

Substance use disorders are prevalent among youth involved with the criminal justice system, evidence-based substance use disorder treatment is often unavailable to this population. One reason for the gap between those who need treatment and those who receive treatment is due to [1] juvenile justice organizations’ lack of appropriate substance use screening and [2] community mental health centers’ lack of available evidence-based substance use treatments [6]. Further complicating this is the difficulty in communication and collaboration between juvenile justice and community mental health centers

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