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Psychiatr Serv. 2012 Oct;63(10):997-1003.

Use of outpatient care by juvenile detainees upon community reentry: effects of mental health screening and referral.

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  • 1Department of Pediatrics, Indiana University School of Medicine, 410 West 10th St., Suite 1001, Indianapolis, IN 46202, USA.



This study assessed rates of mental health care utilization among juvenile detainees upon community reentry and examined the impact of a mental health screening and referral program.


A pre-post cohort design was used: 24 months before and after implementation of the program. The sample included 7,265 observations from 6,345 participants age 13 to 18 (first cohort, 4,812; second, 2,453). Outcomes included mental health care utilization (30 and 60 days postdetention) and recidivism (three and six months postdetention).


Logistic regression models of utilization at 30 days, controlling for cohort differences with propensity scores, found that males were less likely than females to have a mental health visit (odds ratio [OR]=.54, 95% confidence interval [CI]=.45–.64, p<.01); the likelihood was also lower among black (OR=.52, CI=.44–.62, p<.01) and Hispanic (OR=.12, CI=.07–.22, p<.01) youths, compared with white youths, and among older youths (OR=.53, CI=.50–.57, p<.01) (similar results at 60 days). No overall significant differences between cohorts were found in visits at 30 (first cohort, 14%; second, 16%) and 60 (17% and 19%, respectively) days postrelease. An age interaction with cohort indicated a cohort difference among adolescents in the middle tertile (14.6–16.5 years) in utilization at 30 (first cohort, 12%; second, 17%) and 60 (16% and 21%) days. Compared with the preimplementation cohort, the postimplementation cohort had higher recidivism rates at three (first cohort, 24%; second, 31%) and six (36% and 43%) months.


Connection to services upon community reentry was poor among detained youths. A screening and referral program was not sufficient to increase utilization rates.

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