PT  - JOURNAL ARTICLE
AU  - Marina Tolou-Shams
AU  - Johanna B. Folk
AU  - Evan D. Holloway
AU  - Catalina M. Ordorica
AU  - Emily F. Dauria
AU  - Kathleen Kemp
AU  - Brandon D. L. Marshall
TI  - Psychiatric and Substance-Related Problems Predict Recidivism for First-Time Justice-Involved Youth
AID  - 10.29158/JAAPL.220028-21
DP  - 2023 Mar 01
TA  - Journal of the American Academy of Psychiatry and the Law Online
PG  - 35--46
VI  - 51
IP  - 1
4099  - http://jaapl.org/content/51/1/35.short
4100  - http://jaapl.org/content/51/1/35.full
SO  - J Am Acad Psychiatry Law2023 Mar 01; 51
AB  - Justice-involved youth with clinically significant co-occurring psychiatric and substance-related problems are at increased risk for recidivism. Less is known about how psychiatric symptoms (i.e., internalizing and externalizing) and substance-related problems (i.e., alcohol and cannabis) interact to predict recidivism, especially at first court contact. Among 361 first-time justice-involved youth aged 12 to 18, we used nested multivariate negative binomial regression models to examine the association between psychiatric symptoms, substance-related problems and 24-month recidivism while accounting for demographic and legal covariates. Clinically significant externalizing symptoms and alcohol-related problems predicted recidivism. Moderation analyses revealed that alcohol-related problems drove recidivism for youth without clinically significant psychiatric symptoms and externalizing symptoms predicted recidivism, regardless of alcohol-related problems. After accounting for other predictors, Latinx, Black non-Latinx, and multiracial non-Latinx youth were more likely to recidivate at follow-up than White non-Latinx youth. Systematic screening, referral, and linkage to treatment for psychiatric and substance-related problems are needed to reduce recidivism risk among first-time justice-involved youth. Differences in recidivism rates by race/ethnicity not attributable to behavioral health needs suggest it is imperative to concurrently deploy large-scale structural interventions designed to combat systemic racial bias and overrepresentation of ethnoracial minoritized youth within the juvenile justice system.