Blog: Public Policy

Integrating Substance Abuse Treatment and Medical Care - TRI Forum

adolescent-substance-abuse-treatment_reflections-on-streetBe sure to grab the "lessons learned" document from a forum focused on the need to integrate substance abuse treatment and general medical care
Held in April 2010 by the Treatment Research Institute (TRI) and funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). the forum brought together leaders and innovators in this area to talk about financing, coordination, barriers, and opportunities. 
According to the authors of the resulting issue brief, here's why integration matters:

Juvenile Justice System: How Much are Evidence-Based Practices Worth?

juvenile-justice-system_piggy-bankUsing evidence-based practices in the juvenile justice system reduces delinquency and avoids costs. Those of us in the field hear this regularly – but it can be hard to see their impact on a day-to-day basis. 
How do we know they work? Let's start at the beginning. What we commonly refer to as "evidence-based practices" in the juvenile justice field are based on over 40 years of research regarding what works to reduce juvenile crime. Unlike studies that look at single programs, this research looked at over a hundred studies and found what consistently worked to reduce crime versus what consistently made crime worse. [1]

Video: Q&A on SAMHSA's 8 Strategies

adolescent-substance-abuse-treatment_character-with-question-markI've already posted about the Substance Abuse and Mental Health Services Administration's (SAMHSA) call for public input on its eight strategies.
The agency plans to organize its work and funding priorities around these strategies, and wants input (and your votes on input from others) by October 22, 2010. 
I included links in my previous post to information online about the strategies, but here's something else you might find useful: the agency held an open house to talk about the initiatives last Friday. Video of that meeting has been archived, so you can review Q&A about SAMHSA's eight strategic initiatives, which made up a large portion of the event.

Adolescent Substance Abuse Treatment - SAMHSA Wants Your Input on its Eight Strategies

adolescent-substance-abuse-treatment_SAMHSA-strategic-plan-coverI mentioned this in last week's roundup of news on the juvenile justice system and adolescent substance abuse treatment, but this deserves to be highlighted because it will guide the agency's work and funding priorities for years to come:
The Substance Abuse and Mental Health Services Administration (SAMHSA) plans to organize its work into eight strategic initiatives, and you have the chance to give your own input (and vote on the merit of others' ideas) until October 22, 2010.  Here's the eight areas:

Roundup: JDAI Sets its Sights on State Training Schools

juvenile-justice-reform_news-signJuvenile Justice System News and Speculation

For sheer breadth of coverage in the juvenile justice arena this week, you couldn't beat John Kelly of Youth Today.

  1. First, Kelly covered a year-long, national survey on the use of psychotropic meds in juvenile justice facilities. Sixteen states participated; 17 didn't reply; the remainder did not comply for a variety of reasons, although it appeared that  many states did not track the drugs, or the diagnoses for which they were prescribed. Youth Today's coverage offered useful background on several of the most commonly-used drugs, and a point/counterpoint on whether they should be used as a first resort for behavior management, or whether their use helps make youth "treatment-ready."

Federal Strategic Plan on Youth Policy - Your Input Needed (Still)

juvenile-justice-system_strategic-plan-for-youth-graphicThe federal Interagency Working Group on Youth Programs wants your input on its strategic plan for youth policy. The group, made up of 12 federal agencies, oversees the excellent website on youth-related resources at
Now, it's true that they've been seeking input for a while, but the good news is that if you didn't participate back in May 2010, when I last posted about this, you've still got an opportunity. They've also adopted an interesting approach, using a "question of the month."
This month's question: "If you could design a neighborhood to support youth, what would it look like?"

Roundup: Justice Atlas of Sentencing and Corrections, and More

juvenile-justice-system_news-signJuvenile Justice News and Related News

Public Attitudes about Youth in the Juvenile Justice System: Recent Polls

juvenile-justice-system_angels-camp-coverSometimes, it seems as though public attitudes about youth in the juvenile justice system haven't moved on since 1950, when the book pictured at right was published. But the next time you talk to policy makers about the need for more treatment options and positive activities for youth in the juvenile justice system, wouldn't it be great to be able to tell them that the majority of Americans:

  • believe that rehabilitation and treatment can reduce crime AND are willing to pay extra taxes to provide those services;
  • support rehabilitation even for young people who commit violent crimes;
  • oppose young offenders being sent to adult criminal court without an individual determination made in each case;
  • agree that non-white youth are more likely than white youth to be prosecuted as adults; and
  • believe strongly in a separate juvenile justice system?

"Dream on," I can hear you saying. But it's no dream.

Roundup: Teens Saving Teens - and More

juvenile-justice-reform-adolescent-substance-abuse-treatment_News-signJames Bell on Juvenile Justice Reform

I am still, at 51, propelled by outrage. I am just p***d off that the greatest country in the world -- that the only way they can figure out to socially control teenagers is to put them in cages... But we don't do that to White people. That is the bottom line.
It's worth watching all 10 minutes of this video, because Bell is passionate, entertaining, and motivating. My only caveat (which I'm sure Mr. Bell would agree with) has to do with his urgent call to people of color to put pressure on vested interests and the White community to reform the justice system. It can't just be on people of color to change the system -- allies from all communities are needed so that the effort is not pigeonholed by skeptics. (Hat tip to the W. Haywood Burns Institute on Facebook.) 


Health Care in the Juvenile Justice System: Recommendations to Increase Medicaid's Role

adolescent-substance-abuse-treatment_Medicaid-survey-reportCould juvenile justice agencies and Medicaid agencies work together to make sure teens in the juvenile justice system get evidence-based care when it comes to treatment for substance abuse, mental health issues, and medical care?
Could they improve the continuity of health care for youth leaving the justice system for the community? 

Why Can't We Treat Addiction as a Chronic Disease?

[The following is reposted with permission from Jim Gogek's excellent new blog, alcohol, tobacco, and other drugs, where it appeared under a different title. -Ed.]
adolescent-substance-abuse-treatment_cover-of-JAMAIt’s been ten years since a special communication in the Journal of the American Medical Association [JAMA] by four leading experts declared that drug dependence (including alcohol) should be treated as a chronic medical problem, not a social problem. This was not a brand new idea, but seeing it in JAMA was like the golden seal of approval. Or it should have been.
Ten years later, are we closer to that goal? There’s been a lot more thinking about how we should integrate treatment of substance use disorders into primary care and public health systems. A few places are doing it, including some pilot projects. But when it comes to health system-wide, daily clinical level — that remains abysmal.

Roundup: America Behind Bars, and More

Last year, we posted about a hugely important study by the Center for Court Innovation. In it, young people reported that they did not receive a clear explanation of the juvenile justice system when they entered. Nor did they -- or their parents and guardians -- learn how their actions affected what happens in juvenile court
Our Reclaiming Futures site in Orange/Chatham Counties, North Carolina is trying to change this and created the video above for parents/guardians of youth entering juvenile court. Congratulations!  (They're also working on a handbook for youth; I'll share it when it's available.)
Has your jurisdiction done something similar? Leave a comment or drop me an email and we'll be glad to post it!

Juvenile Justice Reform: Join the Movement

juvenile-justice-reform_Join-the-Movement-sign-Motivate-Advocate-ActivateOur nation has long been a leader in economic and military might, but we have forgotten about our children, too many of whom continue to languish in adult prisons. We are behind in our efforts to decrease our incarcerated population, especially our incarcerated youth. The U.S. has the highest reported incarceration rate of any nation in the world. On any given day, more than 7,500 youth are locked up in adult jails and prisons even though the vast majority of youth prosecuted in adult court are charged with non-violent offenses.
In the 1990’s most states passed laws that made it easier to try, sentence, and incarcerate youth in the adult criminal system in response to growing fears of a new generation of so-called adolescent “superpredators.” Even though youth crime rates are the lowest they have been in two decades, an estimated 200,000 youth continue to be prosecuted in the adult criminal justice system every year. Research shows that youth incarcerated in adult jails and prisons face an increased risk of being physically, mentally, and sexually abused. Prosecuting kids as adults also increases the likelihood that they will reoffend, and youth who are transferred to the adult criminal system are approximately 34% more likely than youth retained in the juvenile court system to be re-arrested.

Marijuana vs. Alcohol: A made-up story brought to you by the MJ lobby

[The following post on adolescent substance abuse and the fight over legalizing marijuana is reposted with permission from Jim Gogek's excellent new blog, alcohol, tobacco, and other drugs, or for short. I recommend you bookmark it - I have. Also, hat tip to Minnesota Recovery Connection for bringing the Join Together story on Gogek's blog to my attention. -Ed.]
adolescent-substance-abuse-treatment_youth-smoking-joint-as-another-reaches-for-itOne of the craziest arguments from the marijuana lobby is that young people should smoke marijuana because it’s less dangerous than alcohol. We were recently subjected to the strange spectacle of a group of mothers in Colorado pushing for marijuana legalization because alcohol is so dangerous for kids. There’s a whole organization dedicated to this cause. I’ll let you find the website yourself.

Juvenile Justice Reform: Improving Outcomes for Status Offenders

juvenile-justice-reform_status-offenders-article-photoOne of the four core principles of the Juvenile Justice and Delinquency Prevention Act (JJDPA) is that juvenile status offenders not be placed in secure detention. ("Status offenders" are minors who do things that would not generally be a offense if they were adults. For example, truants, runaways, and curfew violators are status offenders.)
However, an exception to the law was made in 1980 to allow courts to detain young people who had committed status offenses if they had also violated a "valid court order" -- the so-called "VCO exception."
As Nancy Gannon Hornberger writes in, "Improving Outcomes for Status Offenders in the JJDPA Reauthorization," which appeared in the summer 2010 issue of Juvenile and Family Justice Today from the National Council of Family and Juvenile and Family Court Judges (NCJFCJ), "The nation is split. Twenty-five U.S. states and territories do not allow or do not use the VCO exception; in 30 states [including the territories, and Washington, D.C.], the VCO exception is allowable."
Approximately 12,000 non-delinquent status offenders are locked-up with delinquent youth each year. Serious concerns have been raised about whether such detentions do more harm than good. Juvenile justice practitioners, advocates and members of Congress have responded to these concerns with an amendment to the JJPDA to eliminate the VCO exception.

Juvenile Justice Reform: Finding Opportunities When Budgets are Slashed

juvenile-justice-reform_NJJN-real-costs-benefits-report-coverIt's easy to focus on juvenile justice reform during good times; the real test comes with budget cuts.
But even wrenching cuts to staff and services can provide a chance to achieve lasting improvements to juvenile justice policies and programs.
Don't believe me? The National Juvenile Justice Network (NJJN) has just provided us all with a road map that's concrete, helpful, and surprisingly inspiring. Titled, "The Real Costs and Benefits of Change: Finding Opportunities for Reform During Difficult Fiscal Times," it's a model of cool-headed resourcefulness.

Juvenile Justice: Why Investing in Trauma-Informed Care for Children Makes Sense

juvenile-justice-reform_old-TVJuvenile Justice Reform and Related News

We Can Close the Treatment Gap. Will We?

[The following text is reposted with permission from the Join Together blog, where it first appeared on May 25, 2010. --Ed.]
adolescent-substance-abuse-treatment_mind-the-gap-stencil-on-pavementThe Rhode Island Closing the Addiction Treatment Gap initiative released its report this morning. They asked me to speak at the event. That got me thinking.
Why do we have this enormous gap? Why is such a complicated but treatable brain/behavioral disease treated mostly in a separate and unequal system where care is provided almost entirely without physicians by individuals with relatively modest formal training?

How to Get Teens to Engage in Treatment, and More: Bonus Roundup

Last week, I received too many links and resources to put in last week's roundup of links related to the juvenile justice system and adolescent substance abuse treatment.
So here's a bonus roundup - there's something here for everyone!
Mentoring At-Risk Teens

Juvenile Justice Reform: An End Run Around the Supreme Court?

juvenie-justice-reform_Supreme-Court-columns[The following post, on the state-level interpretation of the Supreme Court decision banning life without parole for juveniles who commit crimes short of homicide, is reprinted with permission from a May 28th blog post on Youth Today. You can get more background on the decision in this post from the National Juvenile Justice Network. -Ed.]
Youth Today already posted a story on the U.S. Supreme Court decision in Graham v Florida, and our subscribers can look for a more in-depth look at its ramifications in our June issue. But here’s yet one more point we think should be made about the aftermath of the decision.
There are 37 states that have life without parole sentences for certain juveniles and now must replace with new sentencing provisions. The court mandated that juveniles have a “meaningful opportunity” for release.  
JJ Today has contacted many people, all of whom were willing to pontificate on what they think would be the best way for states to change those laws. Suggestions include: review sentences after inmates turn 30, review them after 10 years of the sentence, and try all juveniles in juvenile court.
Not one person wished to discuss what they felt would be the worst revision they could tolerate.  As Terrance Graham’s attorney Bryan Gowdy put it, there is a point at which a really high term of years or wait for parole would be the “functional equivalent” of a life sentence.