There are many reasons to be concerned about systemic failures that impede the promotion of healthy lifestyles for youth growing up in America’s economically challenged communities. Among the most notable are diminished academic institutions, lack of access to quality health care, limited exposure to the world of work, and trauma-induced behavioral and physical health effects associated with victimization and exposure to violence. And concerned we should be, as a growing body of research provides compelling evidence that these experiences persist far beyond adolescence.
As research linking childhood and youth experiences to adult health status has evolved, two subpopulations—youth in child welfare and juvenile justice systems—have become the primary focus of policy and practice reform. Recent research, however, suggests we may be paying too little attention to a third and perhaps more vulnerable group—youth with histories in both the child welfare and juvenile justice systems. Increasingly referred to as “crossover youth,” a recent path-setting report funded by the Conrad Hilton Foundation found “membership in the crossover group to be a strong and consistent predictor of less desirable [adult] outcomes,” including heavy use of public services, high likelihood of criminal justice involvement, lower educational attainment, and extremely high use of outpatient mental health treatment (Culhane et al. 2011).
Aligning Priorities, Lessons and Opportunities to Improve Outcomes for Crossover Youth
Over the past decade, Sierra Health Foundation has invested in community efforts to improve the health and well-being of youth. This journey began with our multisite REACH Youth Development Initiative and was advanced by the recent release of two foundation-commissioned reports, Healthy Youth/Healthy Regions and Renewing Juvenile Justice. Researched by the University of California, Davis Center for Regional Change and cofunded by The California Endowment, Healthy Youth/Healthy Regions demonstrated the link between the health status of youth and long-term regional prosperity and offered recommendations for making improvements. Renewing Juvenile Justice, developed by the Center on Juvenile and Criminal Justice, took a subpopulation approach and focused on the history of the juvenile justice system and the youth it was designed to serve. The report also identified reform opportunities resulting from California’s decision to realign (devolve) the state’s diminishing role in juvenile justice to counties.
At Sierra Health Foundation, we believed this to be a critical and opportunity-laden moment in which a regional funder could influence juvenile justice policy and practice across the entire state and perhaps the nation. After a year-long exploration designed to merge lessons from our investments, as well as learn from the wealth of experience shared by other foundations, we launched the Positive Youth Justice Initiative (PYJI). The initiative is intended to support juvenile justice system redesign at the county level in order to produce better outcomes for crossover and, ultimately, all system-involved youth. The initiative will provide grant funding and technical support to a cohort of California counties interested in making the healthy development and well-being of youth—positive youth development—a key feature of their broader public safety charge.
We appreciate our partnership with The California Endowment and The California Wellness Foundation who, much like Sierra Health Foundation, see a window of opportunity and have joined us on this journey.
Innovation: Blending Evidence-Based Practices to Generate Impact
While positive youth development is not currently found in abundance in juvenile justice settings, there is a growing body of evidence that suggests it could be an effective juvenile justice intervention (Butts et al. 2010). Accordingly, PYJI combines evidence-based services and data-driven management practice to create a scalable, multidisciplinary intervention. PYJI’s four design elements include:
- Positive Youth Development – As the cornerstone of PYJI’s framework, positive youth development fosters a youth-as-resource approach. Integral to the aforementioned REACH Initiative’s design and recommended by the Healthy Youth/Healthy Regions study, the positive youth development component will facilitate the design and implementation of interventions that meet youths’ developmental needs in education, workforce, healthy relationships, mentalhealth, and community/civic engagement. The goal is to divert juvenile justice systems from their current service pathway, which attempts to “control, punish, treat, supervise, and incapacitate youth...” to one that views youth development as an important public safety strategy (Public/Private Ventures 2000). Implementing positive youth development will be a significant undertaking, requiring savvy and committed leadership possessing the ability to cultivate and sustain frontline support. The payoff, however, can be powerful as practice shifts to create consistent access to the supports, experiences, and opportunities that high-need youth require to successfully transition to adulthood.
- Trauma-Informed Care – A wealth of research validates trauma as a specific risk factor for future involvement with the justice system, particularly for children and youth (Shaffer and Ruback 2002). While there is a growing awareness of the impact of childhood trauma, the intervention remains unavailable to the vast majority of high-need youth. Trauma-informed care within the context of PYJI acknowledges the trauma experienced by these youth and seeks to minimize one of its most unfortunate repercussions: children and youth exposed to violence often grow up to engage in or become repeat victims of violence (Shaffer and Ruback 2002). Gender-related biases further compound this problem as girls entering the juvenile justice system are often placed in programs designed for boys. These programs consistently fail to meet their specific developmental needs or address the types of trauma girls are more likely to experience.
- Wraparound Services – Wraparound services are designed to advance the problem-solving skills, coping skills, and self-efficacy of young people, family members, and other nurturing adults in the young person’s life (National Wraparound Initiative 2011). The wraparound ecological model further distinguishes itself from traditional, siloed approaches by including consideration of the multiple systems in which the young person and family members are involved, and the multiple community and informal supports required to support the youth and family in their community and home (Burns et al. 2010). Most encouraging is the wealth of evidence that suggests wraparound is not only an effective service delivery model, but it is also adaptable to a variety of populations and settings.
- Improved Operational Capacity – To increase the efficacy of PYJI’s programmatic elements, the initiative includes a capacity-building component. Here the goal is to support county system efforts to address barriers that hamper reform and contribute to operational deficiencies. Key areas of focus would include the implementation of data collection and reporting systems; the use of validated screening and assessment tools; and the cultivation of institutional norms that build, sustain, and reward staff participation. These enhanced capacities will be used to monitor and assess strate- gies designed to address disproportionate minority contact and the efficacy of community-based services, and meaning- fully engage family and community in reform efforts.
The Role of Advocacy: Supporting Voices for Change
Ongoing shifts in public attitude and corresponding changes in public policy present a window of opportunity to improve the long-term health trajectory of high-need youth. The potential for reform is bolstered by the growing number of states, political leaders, researchers, and senior public safety officials committed to transforming their jurisdictions’ approach to juvenile justice. These policymakers, researchers, innovators, and early adopters acknowledge that the status quo has failed to produce hoped for results and is therefore a poor use of public funds. Their efforts are helping to set the stage for systemic changes in the administra- tion of juvenile justice in California and the nation. Our plan includes support for their advocacy agenda.
At Sierra Health Foundation, along with our partners, we expect PYJI to become a catalyst for important and powerful change. We also believe that if we can improve outcomes for the crossover population, we can add to the growing chorus of voices and literature calling for the transformation of systems that serve all high-need youth. Research shows that improvement to these deep-end systems are called for, and that positive youth development may hold real promise for helping them better achieve the missions—troubled youth becoming productive and healthy adults—for which they were created. We believe it is the right time to vigorously pursue this course of action in California; high-need youth should no longer be expected to bear the documented health, economic, and social consequences of our failure to do all we can to make change happen now.
Burns, E.J., et al., “Intervening in the Lives of Youth with Complex Behavioral Challenges and Their Families: The Role of the Wraparound Process,” American Journal of Community Psychology, 46(3-4):314-331, 2010.
Butts, Jeffrey A., Gordon Bazemore, and Aundra Saa Meroe, Positive Youth Justice: Framing Justice Interventions Using the Concepts of Positive Youth Development (Washington, DC: Coalition for Juvenile Justice, 2010).
Culhane, D.P., Stephen Metraux, et al., Young Adult Outcomes of Youth Exiting Dependent or Delinquent Care in Los Angeles County, <http://ceo.lacounty.gov/sib/pdf/RES/Youth%20 Exiting%20Dependent%20&%20Delinquent%20Care%20In %20LA%20November%202011.pdf>, 2011.
National Wraparound Initiative, Portland State University, Wraparound Implementation Guide, <http://www.nwi.pdx.edu/ pdf/ImplementationGuide-WelcomeToWraparound.pdf>, September 2011.
Public/Private Ventures, Youth Development: Issues, Challenges and Direction (Philadelphia, PA: 2000).
Shaffer, J.N., and R.B. Ruback, “Violent Victimization as a Risk Factor for Violent Offending among Juveniles,” Juvenile Justice Bulletin, December 2002.
￼The post above is reprinted with permission from Grantmakers in Health.
Chet P. Hewitt has more than 25 years experience working in the public and nonprofit sectors, and has served as the President and CEO of Sierra Health Foundation since September 2007. Prior to joining the foundation, Chet spent five years as the Agency Director for the Alameda County Social Services Agency, where he was credited with transforming its child welfare system into a national model. He also worked as Associate Director for the Rockefeller Foundation in New York, and established and managed the West Coast office in San Francisco. Chet has received several national awards, including the Annie E. Casey Foundation Child and Family Leaders Fellowship and the 2009 Black Child Welfare Administrator of the Year.
Matt Cervantes is a Senior Program Officer at Sierra Health Foundation. With a focus on youth programming and grantmaking, he oversees the foundation’s emerging juvenile justice work; Healthy Youth/Healthy Regions, a study on the health and well-being of young people in the California Capital Region; and the REACH Youth Development Program.
Matt brings a great deal of experience in youth development, policy and advocacy to his work at the foundation. During his public health career, he has managed youth advocacy programs at the Yolo County Department of Health, the Great Valley Region of the American Cancer Society, the California Youth Advocacy Network and the Western States Affiliate of the American Heart Association. A fellow of Sierra Health Foundation’s Health Leadership Program, Matt has a passion for ensuring youth not only have a “seat at the table,” but are given the opportunity and space to contribute in meaningful ways.
*Photo at top by Flickr user Fora do Eixo
Updated: February 08 2018