Secure Detention Research Articles

An Evaluation of a Trauma-Informed Intervention in Secure Juvenile Detention: The Impact on Youth-Level Incidents of Violence

Few studies have examined the impact of trauma-specific interventions in juvenile justice settings, and juvenile justice-related outcomes are infrequently assessed. This study examined the impact of implementing youth skills groups ( Skills Training in Affective and Interpersonal Regulation [STAIR]) and trauma training for staff (Think Trauma) on individual-level assaults in two secure detention facilities. The impact of the intervention was primarily evidenced in one facility among Black youth. In the same facility, the staff training (pre-skills groups) cohort and skills group cohort (post-staff training) evidenced a significantly greater reduction in violent incident rates as compared to the pre-intervention cohort. These findings highlight the importance of trauma-focused training for staff as a promising step toward reducing violence and improving staff members’ responses to a large subset of vulnerable youth.

Mental Health Aftercare Availability for Juvenile Justice-Involved Youth in New York City.

The goal of our study was to describe the availability of community child and adolescent mental health services, trauma-informed care, and the geographic accessibility of these services for juvenile justice-involved (JJ) youth who received mental health services while in secure detention. Data collection occurred through direct contact with the child and adolescent outpatient clinics listed on the New York State Office of Mental Health website. Zip codes were collected from the juvenile secure detention census. Of the clinics contacted, 88.5 percent accepted JJ youth; however, 43.5 percent accepted them on a conditional basis. Only 62.1 percent offered trauma-informed care, including evidence-based interventions and unspecified care. Although 84.5 percent of the clinics that would accept this population reported currently accepting new patients, reported wait times were as high as six or more months. When JJ residents' home zip codes and those of the clinics were geographically mapped, there were few clinics in the zip codes where most residents lived. The clinics that accepted youth on a conditional basis often refused high-risk patients, essentially ruling out a large majority of this population. The geographical inaccessibility of these clinics limits their ability to provide care for this vulnerable population.

Moral Injury as a Transdiagnostic Risk Factor for Mental Health Problems in Detained Youth

Youth who become involved in the juvenile justice system are at highly elevated risk for many emotional and behavioral problems. Past research has often focused on trauma exposure as a transdiagnostic risk factor in this population. However, distress resulting from perpetrating or witnessing acts that conflict with one’s deeply held moral beliefs, termed moral injury, may also play a role in predisposing these youth toward negative mental health outcomes. This study utilized a sample of 96 youth housed in secure detention centers and tested associations between exposure to potentially morally injurious events (PMIEs) and mental health outcomes, including anxiety, depression, posttraumatic stress, and nonsuicidal self-injury (NSSI). After controlling for trauma exposure and demographic variables, PMIEs were significantly and positively associated with symptoms of depression and anxiety, as well as engagement in NSSI. Implications for research and clinical practice are discussed.

Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative.

Youth involved in the legal system (YILS) experience rates of opioid and substance use disorders (OUD/SUDs) and overdose that is well above those in the general population. Despite the dire need, and the existing programs that focus on treatment of these problems in YILS, research on opioid initiation, and OUD prevention, including feasibility and sustainability, are severely limited. We present four studies testing interventions that, while not necessarily novel as SUD treatments, test novel structural and interpersonal strategies to prevent opioid initiation/OUD precursors: (1) ADAPT (Clinical Trial No. NCT04499079) provides real-time feedback using community-based treatment information system data to create a more effective mental health and SUD treatment cascade to prevent opioid use; (2) HOME (Clinical Trial No. NCT04135703) provides youth experiencing homelessness, including YILS, with direct access to shelter in independent living without prerequisites as an opioid initiation prevention strategy; (3) LeSA (Clinical Trial No. NCT04678960) uses the Trust-Based Relational Intervention® to equip YILS and their caregivers with self-regulatory and communication skills during the transition from secure confinement to reduce opioid initiation/re-initiation; and (4) POST (Clinical Trial No. NCT04901312) tests two interventions integrating interpersonal/drinking and drug refusal skills, case management, and goal setting among YILS in transitioning out of secure detention as opioid initiation prevention strategies. We discuss early implementation barriers and facilitators, including complexities of prevention research with YILS and adaptations due to COVID-19. We conclude by describing anticipated end products, including implementation of effective prevention interventions and integration of data from multiple projects to address larger, multi-site research questions.

The Structured Trauma-Related Experiences and Symptoms Screener (STRESS): Assessing factor structure and clinical utility in a juvenile justice sample.

High prevalence of traumatic event exposure and posttraumatic stress disorder (PTSD) among justice-involved adolescents has necessitated the use of trauma screening in juvenile justice settings. The present study explored the psychometric properties, factor structure, and construct validity of a trauma screen, the Structured Trauma-Related Experiences and Symptoms Screener (STRESS), in a detained adolescent sample. Prior to the current study, psychometric characteristics of the STRESS were evaluated only in a child welfare sample (Grasso et al., 2015). The sample consisted of 132 adolescents in secure detention facilities in a southeastern state. Participants were included in the study if they engaged in the mental health screening process at intake and a follow-up assessment process with facility staff psychologists. Data consisted of de-identified, archival records. The STRESS total symptom and 4 criterion symptom count scores demonstrated high internal consistency. Confirmatory factor analysis revealed that the STRESS had excellent fit with the DSM-5 four-factor PTSD model. Equally strong evidence was found for a higher order PTSD model, thus reinforcing the use of both STRESS PTSD total and criterion symptom count scores with justice-involved adolescents. Additionally, preliminary evidence of convergent and discriminant validity was supported. Findings support the STRESS as a reliable and valid trauma screen for use with detained adolescents. Results suggest that both STRESS total symptom and criterion symptom count scores have clinical utility for intake-level mental health decisions in juvenile detention settings. Implications for expanding use of the STRESS to inform appropriate interventions for justice-involved adolescents are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Using structured implementation interventions to improve referral to substance use treatment among justice-involved youth: Findings from a multisite cluster randomized trial

IntroductionYouth involved in the justice system have high rates of alcohol and other drug use, but limited treatment engagement. JJ-TRIALS tested implementation activities with community supervision (CS) and behavioral health (BH) agencies to improve screening, identification of substance use service need, referral, and treatment initiation and engagement, guided by the BH Services Cascade and EPIS frameworks. This paper summarizes intervention impacts on referrals to treatment among youth on CS. MethodsThis multisite cluster-randomized trial involved 18 matched pairs of sites in 36 counties in seven states randomly assigned to core or enhanced conditions after implementing the core intervention at all sites for six months. Enhanced sites received external facilitation for local change team activities to reduce unmet treatment needs; Core sites were encouraged to form interagency workgroups. The dependent variable was percentage referred to treatment among youth in need (N = 14,012). Two-level Bayesian regression assessed factors predicting referral across all sites and time periods. Generalized linear mixed models using logit transformation tested two hypotheses: (H1) referrals will increase from baseline to the experimental period, (H2) referral increases will be larger in enhanced sites than in core sites. ResultsAlthough the intervention significantly increased referral, condition did not significantly predict referral across all time periods. Youth who tested drug positive, had an alcohol/other drug–related or felony charge, were placed in secure detention or assigned more intensive supervision, or who were White were more likely to be referred. H1 (p < .05) and H2 (p < .0001) were both significant in the hypothesized direction. Interaction analyses comparing site pair differences showed that findings were not consistent across sites. ConclusionsThe percentage of youth referred to treatment increased compared with baseline overall, and enhanced sites showed larger increases in referrals over time. However, variations in effects suggest that site-level differences were important. Researchers should carry out mixed methods studies to further understand reasons for the inconsistent findings within randomized site pairs, and how to further improve treatment referrals across CS and BH systems. Findings also highlight that even when CS agencies work collaboratively with BH providers to improve referrals, most justice-involved youth who need SU services are not referred.

Assessing the Validity of Self-Reports of Marijuana Use among Adolescents Entering the Juvenile Justice System: Gender Differences

ABSTRACT Objective: Scant research exists on the validity of self-reported marijuana use using biological assays among adolescents involved in the juvenile justice system. This exploratory study examined gender (sex) differences in underreporting of marijuana use and the impact of age, race/ethnicity, living situation, depression, family problems, sexual risk behaviors, previous drug treatment, and juvenile justice placement. Methods: Self-reports of past year marijuana use were validated with urinalysis, and those testing positive for marijuana use were selected for study. The sample was 256 females and 885 males, aged 12 to 18, entering an urban juvenile assessment center in a southeastern U.S. state between 2017 and 2019. Results: Results indicated significant differences in marijuana underreporting (tested positive but self-reported no use), with 37% of females and 55% of males underreporting use. For males, Hispanic ethnicity, African American race, sexually transmitted infection (STI), and secure detention placement increased the odds of underreporting, while having an incarcerate parent and previous drug treatment decreased the odds. For females, number of sexual partners decreased the odds of underreporting of marijuana use. Conclusion: These findings imply use of collateral information, such as urine tests, as a recommendation for juvenile justice intake to corroborate self-reports and guide risk assessment.

Delivering Trauma-Informed Care in the Juvenile Justice Setting

Youth taken from the home and placed in emergency shelter, secure detention, and residential set-tings are exposed to new sources of trauma and danger that may re-activate severe stress symptoms leading to re-traumatization. A juvenile justice center planned a trauma-informed, system-focused in-tervention that included recommended elements: appropriate assessments of trauma symptoms, evi-dence-based programs and treatments to build resilience skills in youth and families, staff training, community collaboration and partnerships, and a safe environment to reduce the risk of re-traumatization. The purpose of this study was to describe the implementation over two years of the trauma-informed, system-focused intervention in the juvenile justice center and associated effects on youth trauma symptoms. Current and past traumatic event exposure, change in youth participants’ emotional regulation, effects of an evidence-based, trauma-informed therapeutic intervention on youth participants’ stress symptoms, and quality of the organizational trauma-informed care plan were assessed. Although efforts to improve participant emotional regulation and post-traumatic stress symptoms did not demonstrate significant differences, efforts to screen for trauma exposure at intake provided important information about participant multiple traumas to assist with the therapeutic pro-cess. Efforts in changing organizational culture and policy did result in minor self-reported facility envi-ronmental improvements. For the practitioner, even when an intervention is well planned, results are not always positive in actual practice.

Forensic Treatment Services in the Czech Republic: Current State and Future Challenges

In the Czech Republic, Forensic Treatment (FT) services consist of inpatient protective treatment (PT), outpatients treatment and secure detention (SD). Currently, there are 13 facilities providing inpatient PT; 386 clinics providing outpatient treatment and 2 SD. 950 patients receive inpatient and 2,300 outpatient treatment. 85 patients are currently in SD. Czech psychiatric care reform aims to separate the inpatient care from the rest of psychiatric care as well as create Protective Multidisciplinary Teams and services for minority populations. The whole system of care needs to implement risk assessment and adjust recovery management plans to indicated risks.

"Dyspepsia," "seduction" and "violent hysteria": reports, reforms and the Irish asylums of the 1850s.

While many countries developed asylums for the mentally ill during the nineteenth century, Ireland's asylum system grew faster than those elsewhere, was larger in size and was slower to decline. This paper focuses on two reports central to this process in the 1850s: the 1854 "Report on the status of disease" and the 1858 "Report of the commissioners of inquiry into the state of the lunatic asylums and other institutions for the custody and treatment of the insane in Ireland." In 1854, the "Report on the status of disease," based on the 1851 census, was published, co-authored by Dr. William Wilde, now best known as father of Oscar. Wilde, however, was also a prominent surgeon and author of works on medicine, archaeology and folklore. He was knighted in 1864 owing in large part to his work on the census, which highlighted an apparently high rate of mental illness with such diverse causes as "dyspepsia," "seduction" and "violent hysteria." Four years later, in 1858, the "Report of the commissioners of inquiry into the state of the lunatic asylums and other institutions for the custody and treatment of the insane in Ireland" added fuel to the fire by reporting that "the lunatic asylums of Ireland wear more the aspect of places merely for the secure detention of lunatics than of curative hospitals for the insane." Reform, it seemed, was urgently needed. This contribution examines these two key reports in the fevered, panicked context of Ireland's perpetual reform and expansion of its nineteenth-century asylums.

Race and Stereotypes Matter When You Ask About Conduct Problems: Implications for Violence Risk Assessment in Juvenile Justice Settings

We examined the impact of stigma priming on self-reported severe conduct problems in two studies conducted with African American adolescents involved in the juvenile justice system. Data-collection interviews were conducted in a secure detention setting following arrest. In Study 1 ( N = 193), stigma was primed by manipulating the ordering of surveys. Adolescents who completed a questionnaire about racial identity attitudes prior to questions about severe conduct reported substantively more problematic behaviors than control group peers (β = 0.43). In Study 2 ( N = 264), stigma was primed by manipulating whether adolescents were interviewed by an African American or European American mental health professional. Racial group membership of the interviewer did not have a substantial effect on self-reported conduct problems (β = −0.04). Although the studies were not without limitations, they highlight the need for more research on the degree to which interview methods and context influence self-reported severe conduct behavior in forensic settings.

Do Disproportionate Minority Contact (DMC) Mandate Reforms Change Decision-Making? Decomposing Disparities in the Juvenile Justice System

To reduce disproportionate minority contact (DMC) in their juvenile justice systems, policy makers must alter decision-making processes through policy interventions. Effective DMC reforms should ideally diminish the influence of race on processing outcomes and give more weight to objective differences in cases such as charge severity or a youth’s prior adjudications. This study evaluates the impacts of DMC interventions on secure detention and placement decisions. It introduces the Gelbach decomposition approach to estimate unexplained racial differences in processing outcomes. The method also illuminates the relative importance of case factors in reducing or aggravating explainable group differences over time. Findings suggest DMC reforms can moderate the effect of race on processing outcomes. When detailed, decomposition estimates show a greater emphasis on prior contact for detention and legal factors and prior history for placement following reform. DMC interventions may then help diminish unwarranted processing distinctions, and decomposition methods can inform these policy debates.

Laying the Groundwork: Conceptualizing a Trauma-Informed System of Care in Juvenile Detention

ABSTRACTYouth involved in the juvenile-justice system experience trauma at a disproportionately higher rate compared with the general population. Posttraumatic stress reactions place youth at greater risk for penetrating deeper into the juvenile justice system and being placed in secure detention settings. Juvenile detention settings with a systemic approach to addressing youth traumatic stress reactions promote an environment positioned to support the physical and psychological safety of youth and detention center staff. This article reviews key elements of a trauma-informed juvenile detention system and explores implications for trauma-informed interventions and cross-system collaboration.

Forensic follow-up care for outpatients in Germany

Legislation has revived forensic psychotherapy for outpatients in Germany. Since 2007, in almost all 16 federal states of Germany forensic outpatient clinics have been and are being established for criminal and sex offenders who have been released from prison or secure detention under conditions imposed by the court. This paper reviews the consequences of this legislation for forensic outpatients, and will focus on some of the central organisational, institutional and social aspects that stem from the experience of the author. Although the conclusions may not be new, they require repeated reflection and well-considered political commitment.

What Works for Whom? The Effects of Gender Responsive Programming on Girls and Boys in Secure Detention

Objectives: This study investigates whether gender responsive programming is effective at reducing recidivism relative to traditional, reinforcement-based programming for both girls and boys in secure detention. Methods: Event-history analysis is used to examine recidivism outcomes for two propensity score matched samples of girls ( n = 148) and boys ( n = 140) released from gender responsive versus traditional detention facilities in Connecticut. The contingent effects of trauma, depression/anxiety, alcohol/drug abuse, anger/irritability, and somatic complaints are also examined. Results: Compared to traditional programming, gender responsive programming for youth in secure detention is associated with a lower risk of recidivism for girls with gender-sensitive risk factors but a higher risk of recidivism among girls who do not display these risk factors. Gender responsive programs are no more or less effective at reducing recidivism for boys, regardless of whether they display risk factors commonly associated with girls’ delinquency and confinement. Conclusions: The results suggest that girls in secure detention require different approaches depending on their histories of trauma and associated mental and physical health issues. While girls who follow gendered pathways into detention benefit from the relational approach employed in gender responsive programs, girls without such issues benefit more from traditional reinforcement programming.

Assessing the Impact of the Juvenile Detention Alternatives Initiative (JDAI): Predictors of Secure Detention and Length of Stay Before and After JDAI

The Annie E. Casey Foundation’s Juvenile Detention Alternatives Initiative (JDAI) seeks to reduce the reliance on pre-dispositional detention. While anecdotal evidence indicates that the program has enjoyed some success in reducing detention populations, no controlled study has assessed the efficacy of the program. The current study investigated the impact of JDAI following its adoption in one Virginia juvenile court. Specifically, using data on all juveniles referred to intake over a seven-year period, the research analyzed predictors of detention and length of stay before and after JDAI. Results indicate that after the implementation of JDAI, greater emphasis was placed on legal factors including offense seriousness and prior record, though the increased emphasis was greater for non-whites than for white youth. Additionally, results suggest that after JDAI’s adoption, older non-white youth were more likely to receive secure detention while non-white females received some degree of leniency compared to non-white males.

Significant Gender Differences in Factors Related to the Detention of Youthful Offenders

An important priority of the U.S. juvenile justice system is to reduce the number of youthful offenders who are placed into secure detention placement. Though significant research examining these predictors exists, there is limited analysis of gender-specific predictors. Using existing juvenile court and mental health assessment case records of 433 youthful offenders from two Midwestern U.S. counties, this study sought to identify separately for males and females the legal (including number of delinquency adjudications, age at first delinquency adjudication, number of court offenses, and type of offense) and extralegal (including demographic, maltreatment, mental health, and school-related disabilities) factors that impact recidivism to detention placement. Multivariate logistic regression analyses revealed that the predictors of recidivism leading to repeat secure detention placement were indeed different for males and females, although there were some shared predictors. For both genders, the number of court offenses and having a previous suicide attempt were significant predictors. In addition, for females, having a diagnosis of attention-deficit/hyperactivity disorder and a misdemeanor offense were protective against recidivism. For males, three other variables significantly predicted recidivism: age, race, and a conduct disorder diagnosis.

Changing How the System Responds to Status Offenders: Connecticut's Families with Service Needs Initiative

AbstractConcerned by the number of status offenders in secure detention and the processing of noncriminal behavior through the juvenile and family courts, Connecticut began efforts to reform their approach to troubled and troublesome youth in 2005 (Weithorn, 2005). Between 2005 and 2007, Connecticut enacted a series of legislative changes to both improve services for troubled youth and Families with Service Needs (FWSN), and achieve systematic reforms for processing status offenses. At a systems level, the reforms sought to divert non‐criminal behaviors from formal court processing and prevent secure confinement for status offenders who violated court orders related to their behavior. Connecticut's attempt at second‐order, or system change, is the focus of this outcome evaluation.

Race, Probation Violations, and Structured Secure Detention Decision Making in Three Jurisdictions

The relationships between race and probation violations with preadjudication secure detention decision and detention hearings are examined in three jurisdictions in a Midwestern state that use a detention screening instrument. Interpretations of consensus theory and the racial or symbolic threat thesis with an emphasis on race stereotyping serve as the theoretical background for the study. The results reveal race to be influential in detention decisions in one jurisdiction, while involvement in probation violations is associated with the initial detention decision in all three jurisdictions. Implications for future research and for assessing whether the structuring of detention decision-making results in greater equality in detention proceedings for minority youth relative to White youth are discussed.

Vocational Training in Juvenile Detention: A Call for Action

Given high recidivism rates and the vulnerability of detained youth, the authors posit that juvenile detention centers may be most efficacious by serving as both place and process to create career opportunity through vocational training. The authors review the psychosocial factors contributing to delinquency and the primary theories of rehabilitation that extend to detained youth. They highlight key ingredients to effective vocational programming in juvenile detention, such as integration of traditional career theories with constructs pertinent to this population (emerging adulthood, sociopolitical development, social cognitive career theory). Considerations for successful implementation of vocational programs in juvenile detention are also offered.