In August, 2017, Dr. Angela Irvine released an important report examining new data on Lesbian, Gay, Bisexual, Questioning, Gender Nonconforming, and Transgender (LGBQ/GNCT) Youth in the Justice System. Here is a conversation between Reclaiming Futures Executive Director Evan Elkin and Dr. Irvine on the new report.
Blog: Reclaiming Futures
In two separate blog posts in 2016, we discussed opioid use rates and substance use issues among adolescent girls involved with juvenile justice. In July 2017, the United States Department of Health and Human Services, Office on Women’s Health (OWH) released a report on opioid use, misuse, and overdose in women. The report provides information on the gender-specific issues and gaps in knowledge regarding females with substance use concerns/disorders. The report discusses the differences among females and males regarding the progression of substance use, the biological, social, and cultural issues (e.g., pain; relationships; family/parenting; trauma, determinants of health), effective treatments and barriers to implementation, and areas for further research. As it relates to adolescent girls (ages 12-17 years old), the report indicates they are more likely to use and become dependent on non-medical uses of prescription drugs as compared to adolescent boys. Access to prescription drugs can come from a home medicine cabinet and may help relieve mental health or physical pain symptoms and/or be part of their peer culture.
Nearly two decades ago, our nation’s juvenile justice system began to slowly shift the way we think about young people. The prevailing punitive and heavily racialized narrative about justice-involved youth that produced the infamous term “super-predator” has gradually given way to a new, more humanistic narrative.
While we still have a long way to go, the field now looks at delinquent behavior through a more developmentally informed lens, is more willing to look at the root causes of racial disparities in the system, and understands that many youth arrive at the doorstep of the justice system with a history of significant trauma.
Many jurisdictions now actively look for opportunities to divert low-risk youth from court and employ an array of treatment-oriented alternatives to incarceration for youth who need a therapeutic intervention.
As many of you know, in 2016 the Office of Juvenile Justice and Delinquency Prevention (OJJDP) released the Juvenile Drug Treatment Court Guidelines (JDTC). The purpose for developing the Guidelines was to organize the most effective JDTC implementation components based on the best available research. Building on the 2003 Juvenile Drug Courts: Strategies in Practice (JDC: SIP), this systematic and thorough review developed seven objectives, each with corresponding guidelines statements, and supporting information.
In this month’s Reclaiming Futures newsletter, we turn our attention to one of the most important threads in the juvenile justice reform narrative of the past 15 years: the debate regarding the age of adult responsibility in the criminal justice system.
Research shows that adolescents have a high propensity for engaging in risk taking activities given the significant changes in neurology, biology, and other developmental issues (e.g., social; cultural; familial) they experience. Specifically related to decision-making, science shows the pre-frontal cortex region of the brain is underdeveloped until a young person is well into their 20’s. With these findings in mind, how should this influence the way we think about key juvenile justice policies and practices like the age of juvenile jurisdiction?
There are so many noteworthy aspects to the “first ever” Surgeon General’s Report on Alcohol, Drugs, and Health. For example, it is grounded in the best evidence available to date and it examines issues of neurobiology, prevention, treatment, recovery, and health care systems. It also has educational and promotional materials such as fact sheets and social media ideas and resources. If you have not reviewed it – now is the time. It’s my understanding that additional fact sheets are forthcoming including one on criminal/juvenile justice populations. As such, keep visiting the website for updates and let’s keep talking about this report and its importance to individuals, families, and communities impacted by substance misuse and/or disorders.
In this month’s Reclaiming Futures newsletter, we focus our attention on the question that has preoccupied many of us in recent months: What will be the impact of the new presidential administration on juvenile justice policy? In this uncertain time, the field of juvenile justice should certainly be concerned about funding, but many of us are more concerned about protecting the significant progress we’ve made as a field to humanize and improve juvenile justice policy and practice over the last two decades.
Topics: Reclaiming Futures
On December 13th, President Obama signed into law the 21st Century Cures Act. This sweeping legislative initiative is likely to be the final piece of legislation Barack Obama signs, and it is anything but an afterthought. The act is not without its critics, but some of the provisions of the 21st Century Cures ACT, for example those that pave the way for cross agency coordination, promise to reverberate in positive ways in the treatment field by accelerating the impact of research and innovation and catalyzing more collaborative work across government agencies and professional fields.
For organizations like Reclaiming Futures whose mission includes efforts to bring systems together in the delivery of services to youth and families, this new set of laws is good news. In this month’s Reclaiming Futures Newsletter, we draw your attention to this important piece of legislation and to a new blog post by Reclaiming Futures’ Bridget Murphy that highlights some of the key moving parts and implications that this important piece of legislation has for us in the field of substance use and behavioral health treatment.
Acknowledged as the final signed legislation for President Obama’s Administration, the 21st Century Cures Act is important for behavioral health and juvenile justice. The key components of this Act include provisions for:
- Addressing the heroin and prescription opioid epidemic
- Providing funding for the BRAIN initiative and precision medicine
- Improving mental health care by increasing the availability of treatment and improving justice systems to ensure individuals in need of mental health services - actually get it
- Improving clinical trials
- Expanding cancer research and treatment efforts
In this month’s Reclaiming Futures newsletter, we draw your attention to a new report issued by US Surgeon General Vivek Murthy on November 17, 2016. The report is significant because it marks the first time a United States Surgeon General has taken such a clear and strong position that substance use and addiction should be viewed first and foremost as a public health issue. This is a position many advocates and organizations, like Reclaiming Futures, have taken for many years because we know firsthand the collateral consequences of continuing to view substance use and addiction as a moral failing and as a matter for the criminal justice system, and not the public health system and/or through a racially biased lens.
Collaboration. A word we use a lot at Reclaiming Futures. Why? Because based on our fifteen years of working in jurisdictions across the country, collaboration can be an impactful catalyst for change. While the National Office puts collaboration into action regularly it was recently visibly demonstrated.
As you may know, Reclaiming Futures is part of the Regional Research Institute (RRI) at Portland State University. We are affiliated with such efforts as the National Wraparound Initiative, The Center to Advance Racial Equity, and Pathways Transition Training Partnership (PTTP). A few months ago, Evan Elkin, Christa Myers and I began conversations with Drs. Eileen Brennan and Pauline Jivanjee of PTTP to develop a joint webinar. Both groups understand the importance of collaboration between stakeholders in juvenile justice settings to improve the health and wellness of young people with substance use and/or mental health concerns. However, our focus for the webinar did not become immediately clear. We spent time examining our commonalities to decide the best topic for diverse fields and individuals (e.g., juvenile justice; behavioral health; community members). We decided to emphasize our respective work in the area of evidence-based practices.
In this month’s Reclaiming Futures newsletter, we reflect on President Obama’s proclamation which, for the second year in a row, makes October National Youth Justice Awareness Month. President Obama’s focus on juvenile justice has been impressive, but it is important that the field does not become complacent as we contemplate what the future holds for juvenile justice reform.
As Reclaiming Futures enters its 16th year of operation, we reflect on our unique contributions to the juvenile justice reform efforts of the past couple decades. What is most concretely evident to the field is our public health oriented approach and the creation of an accessible stepwise model, designed for juvenile justice settings, to organize the way they identify treatment need and then deliver developmentally appropriate and evidence-based treatment responses that are then sustained by community supports. In order to make our six-step approach work at the local level, we partner with jurisdictions to break down silos and build authentic collaboration across a number of systems that serve youth.
Researchers from John Jay College of Criminal Justice (John Jay) have been involved in evaluating Reclaiming Futures since its inception. Beginning in 2002, Jeffrey Butts, PhD and colleagues began studying the relationship between the Reclaiming Futures’ system-level change approach and the way stakeholders across all the inter-connected systems in juvenile justice settings perceive the effectiveness of their system of care and the delivery of services to youth. In his approach, Dr. Butts examined variables in key domains like administration, collaboration and quality. While no evaluation is perfect, the work Butts and colleagues did to begin to quantify system-level change variables in a meaningful way was quite original and generated useful information for Reclaiming Futures and the field. The initial evaluation results were also helpful in guiding subsequent evaluations by The University of Arizona, Chestnut Health Systems, and Carnevale Associates, LLC.
In the current Reclaiming Futures newsletter we focus our attention on Screening Brief Intervention and Referral to Treatment (SBIRT). SBIRT is a public health-oriented framework revolutionizing the way we think about behavioral health and substance use screening and prevention. Buoyed by strong evidence from the adult research literature, there has been a surge in national interest in translating the successes of the adult SBIRT model for youth populations.
Reasons why I am proud to write this blog post...
Reason 1: My former colleagues (and friends) at The University of Arizona, Southwest Institute for Research on Women (UA SIROW) (UA SIROW) have been leading the efforts on the national evaluation of Juvenile Drug Courts and Juvenile Drug Courts blended with Reclaiming Futures (JDC/RF). UA SIROW collaborated with Chestnut Health Systems and Carnevale Associates, LLC to implement a comprehensive evaluation that included data from Juvenile Drug Courts, Juvenile Drugs Courts blended with Reclaiming Futures, and non-justice related intensive adolescent outpatient programs. The purpose was to examine processes, outcomes, and costs.
It is widely known that arrest rates for adolescents have steadily declined over the past two decades. During this time, we’ve also seen a gradual shift in the nation’s juvenile justice practices away from the use of out-of-home placement for minor, non-violent offenses and toward more treatment-oriented, trauma-sensitive and community-based responses.
This, unfortunately, has not been the story for girls involved in the juvenile justice system. In fact, the proportion of girls involved at all stages of the juvenile justice continuum increased over this time period. Experts and policymakers agree that the system remains insensitive and ill-equipped to serve the needs of girls – particularly girls of color – at all levels of juvenile justice continuum.
While we are pleased to see the recent report by the Office of Juvenile Justice and Delinquency Prevention, meaningful reform focused on girls in the system is long overdue. In this month’s Reclaiming Futures Newsletter, we focus our attention on girls in the juvenile justice system and feature a new blog post by Bridget Murphy as well the latest Reclaiming Futures Data Brief, focused on gender trends in juvenile drug arrests.
In 2008 my colleagues and I wrote for and were awarded a recovery-oriented systems of care grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). The primary goal of this grant was to develop and implement a trauma-informed and recovery-oriented system of care for adolescent girls. My colleagues and I were concerned about the increasing juvenile justice involvement and substance use rates among adolescent girls with little to no increases in their rates of enrollment in treatment. Our previous research highlighted the significant levels of trauma and other co-occurring mental health problems among girls. In addition, we found girls had higher rates of “harder” drug use such as cocaine, amphetamines, and heroin/opiates as compared to boys. And on the positive side, we also found that girls who accessed treatment responded really well and made significant behavioral improvements over time.
Other juvenile justice and behavioral health policy makers and program developers have recognized the importance of responding to these increased rates of behavioral health and substance use problems among adolescent girls. We now have a better understanding that while males and females are equally vulnerable to addiction, that from a physiological standpoint, females can have lower tolerance and may progressive to physical dependence at different rates. We also have a better understanding of the critical role played by trauma in substance use and addiction as well as a broader range of available approaches for providing gender-specific and trauma-informed treatment. The positive news is that we have seen the rates of illicit substance use significantly decrease for girls from 2008 to 2014 (26.5% versus 23.7%) and decreases in comparison to boys.
On June 1, 2016, our Reclaiming Futures national executive director Evan Elkin spoke at Red Emma's in Baltimore for Open Society Institute-Baltimore's second event in their "Talking About Addiction" series. Elkin was accompanied on the panel by Dr. Hoover Adger from Johns Hopkins Children's Center and by Carin Callan Miller, who founded Save Our Children Peer Family Support. The conversation was moderated by Scott Nolen, director of OSI-Baltimore's Drug Addiction Treatment Program. A full room of community members joined them for the evening, including families affected by adolescent addiction.
Youth, Addiction and the Juvenile Justice System
Whereas the first "Talking About Addiction" event explored alternative law enforcement approaches to addiction, this event focused on youth, addiction, and the juvenile justice system. Despite public acknowledgment of the failures of the "War on Drugs," and an increased understanding of addiction as a public health issue rather than a criminal justice issue, OSI-Baltimore recognizes that research and policy around adolescent addiction are slow to reach the mainstream. Indeed, during the discussion, some attendees expressed frustration with how long addiction treatment reform is taking; OSI moderator Nolen suggested reassurance that the addiction paradigm is finally shifting.