TY - JOUR T1 - Psychiatric and Substance-Related Problems Predict Recidivism for First-Time Justice-Involved Youth JF - Journal of the American Academy of Psychiatry and the Law Online JO - J Am Acad Psychiatry Law SP - 35 LP - 46 DO - 10.29158/JAAPL.220028-21 VL - 51 IS - 1 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 Y1 - 2023/03/01 UR - http://jaapl.org/content/51/1/35.abstract N2 - 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. ER -