Hoskins et al. (2018) recently conducted a study of First-Time Offending, Court-Involved Non-Incarcerated (FTO CINI) Latinx youth and found a high prevalence of unmet behavioral health needs (mental health, substance use, and HIV/STI Risk). Interestingly, in terms of behavioral health needs, Hoskins et al. concluded that FTO-CINI among Latinx youth with who had a mean age of 14.6, their unmet behavioral health needs fell somewhere between that of general community and detained youth samples. Unmet behavioral health needs have been shown to be one of the most salient predictors of recidivism for incarcerated youth (Abram et al., 2013). Thus, providing specialty services that addresses both mental health and substance use at very first contact with the justice system can help to offset the pernicious trajectory of FTO CINI Latinx youth. Recent findings from meta-analytic studies provide evidence that ethnic and racial minorities can benefit from culturally adapted treatment (Benish, Quintana, & Wampold, 2011). What is problematic is that Latinx youth have some of the lowest rates of linkage to speciality care and the highest rates of dropout rates once enrolled in specialty treatment (Falicov, 2009). While attending to behavioral health needs at first contact with the justice system offers an opportune window to offset continued justice involvement, the lack of engagement and attendance when obtaining specialty services is problematic. Therefore, identifying an evidenced-based practice for specialty providers that can link FTO CINI Latinx youth to specialty services, engage them once they are enrolled, and can simultaneous treat mental health and substance use is needed.
Thanks for the summary of this topic, David. This approach is conceptually promising as I believe the data is pretty strong on differential trajectories of outcomes based on race/ethnicity after first contact with the justice system. I wonder if there is evidence for such approaches already of helping young people immediately after first contact with the justice system. There is the classic Griner and Smith meta-analysis that showed that interventions that were appropriately tailored were four times more efficacious, so it makes conceptual sense. However, I think, like other areas, Latino/as underutilize specialized psychiatric services, with disparities present even when are insured, so this is a similar challenge. One way I tend to approach these problems is through the framing of optimization given that the tools that are available work, but not for everyone. Looking forward to future discussions.
-John S
David, this sounds like a great subject to study. Has research examined differences in gender? If the rates of unmet behavioral health needs are significantly different between males and females, then the approach to connect each to services may need to be tailored.
Another question that I would ask is what types of interventions have proven to be effective in other racial groups. Are there equivalent approaches for Latinx youth?
Overall, it seems like there is much opportunity
for improvement.
Looking forward to learning more about your project. Indeed culturally relevant treatments can help retention and adherence. Curious if lack of billingual providers is an issue?