Health Outcomes

The correlation of mental health and substance use in adolescence is very problematic. Many believe that the relationship between the two are so strong that it plays a causative role in the development of adolescents. It places adolescents at risk for problems within their families, communities, and as an individual. This disease can be severe enough that it impairs the adolescent 's ability to function as a person. Both mental health and substance abuse are entangled within one another, that it makes it difficult to decipher which condition is causing each symptom. However, several research studies concluded that adolescents who suffer from mental illness may self-medicate their symptoms by using drugs. The juvenile justice systems suffer from adolescents with mental health disorders, substance abuse or even both.

The juvenile justice system faces a significant challenge in identifying and responding to the psychiatric disorders of detained youth because research has shown that it is difficult to define the best means to use and enhance the scarce mental health resources (Kessler & Kraus, 2007). According to Cocozza and Skowyra (2000) “Children’s and adolescents’ mental health needs have historically been addressed inadequately in policy, practice, and research and have only the number of youth with mental illness and their level of unmet needs recognized” (p 4). Furthermore, that the juvenile justice system has gone from treatment and rehabilitation to retribution and punishment, that the prevalence is

Incidents like abuse from family members, bullying, neglect, and sexual abuse are the most common. Repeated abuse can lead to psychological damage and emotional scarring. Not only are traumatic psychological experiences causing these juveniles to commit violent crimes. Situations, where children have poor education, a household without discipline, peer pressure, inadequate role models, low income, and substance abuse coupled with the wrong environment, can lead to a life of crime. These negative influences guide these juveniles on the wrong path towards crime. However, it does not mean these juveniles cannot succeed; it is however up to the juvenile to make the correct choices in their

Increasing healthcare costs without a corresponding increase in health outcomes is something the United States has been dealing with for years. In fact, it is estimated that thousands of individuals die every year due to errors (To Err is Human, 2000). Finding a way to reign in those costs and increase health outcomes has been a hotly debated topic in United States politics. With the passing of the Affordable Care Act (ACA) there is now a sense that containing costs maybe on the horizon. This paper will focus on the Triple Aim model to improving health outcomes. It will breakdown implementation of Triple Aim, define the key element population health, and provide an example of a Triple Aim success story.

Rehabilitation for at risk teens has been an ongoing issue that runs deep in certain communities. When kids at young ages are exposed to stress and have to cope early on with dysfunction they are denied the opportunity to mature and conditioned to commit thinking errors that perpetuate a young offender into an adult offender. To find ways to break this cycle John Hubner accounts his time on the Giddings State School Capital Offenders Program and how a group of counselors are able to combine many strategies in rehabilitating young offenders who have committed serious crimes. Young people convicted of serious crimes are often transferred to adult prisons that institutionalize young people to prison life only increasing the likely hood of

Increasing healthcare costs without a corresponding increase in health outcomes is something the United States has been dealing with for years. In fact, it is estimated that thousands of individuals die every year due to errors (To Err is Human, 2000). Finding a way to reign in those costs and increase health outcomes has been a hotly debated topic in United States politics. With the passing of the Affordable Care Act (ACA) there is now a sense that containing costs maybe on the horizon. This paper will focus on the Triple Aim model for improving health outcomes. It will breakdown implementation of Triple Aim, define the key element population health, and provide an example of a Triple Aim success story.

The number of people with mental illness in the criminal justice system is one of the most pressing problems facing law enforcement and corrections today (Cuellar, McReynolds, & Wasserman, 2006). The Surgeon General’s Report on Mental Health estimated that about 20% of children and adolescents in the general population have mental disorders with some degree of at least mild functional impairment (USPH, 1999). Subsequent research has found much higher rates of serious mental health problems among youth in the juvenile justice system. Among youth who have been arrested, one study found that 31% of youth had received services from the mental health system (Rosenblatt, Rosenblatt, & Biggs, 2000). Two studies of youth in juvenile detention found that between 60% and 68% met the diagnostic criteria for a mental health disorder (Teplin, Abram, McClelland, Dulcan, & Mericle, 2002; Wasserman, Ko, & McReynolds, 2004). Once youth with emotional disturbances enter the justice system, repeated arrests are common through the remainder of childhood and into adulthood. Recidivism rates for individuals with a serious mental illness are nearly double those in the general population (Baillargeon, Binswanger, Penn, Williams, & Murray, 2009; Constantine, Petrila, Andel, Givens, Becker et al., 2010). In an analysis of juvenile trajectories, youth with emotional disturbances in their late adolescent years were more likely to fall into the high arrest trajectory class and much

Juvenile justice settings, especially in Texas, were not designed as sites for comprehensive psychological and psychiatric treatment of adolescents’ mental disorders. On national, state, and local levels there has been a major increase in the interest of mental health needs within the juvenile justice system. Evidence-based research and data has become more available with societies interest into this matter. A continuous struggle with Texas policymakers and officials is identifying and properly treating mentally ill juveniles and keeping them out of the justice system. Acknowledging established data and comparing it to current Texas mandates helps seek recommendations for improvement within all levels and jurisdictions of the Texas juvenile justice system.

Adolescence is a critical time of development. During this period there are significant changes in brain development, emotions, cognition, behavior, and personal relationships. It is during this time that most major mental health disorders appear, many of which carry over into adulthood. Behavior patterns such as substance abuse also often develop during this time and may continue throughout adulthood. Many adolescents struggling with mental health issues begin to exhibit symptoms such as acting out at home or in school, showing a decreased interest in activities that they previously enjoyed, or bringing home poor grades. Others ultimately are charged with offenses ranging from status

In order to properly address mandatory incarceration for chronic juvenile offender’s criminal activities, it is important to begin with psychological assessments and evaluations. Half of our youths have experienced some type of psychological trauma such as depression, PTSD, personality disorders, anxiety, anger issues, or dissociation, just to name a few (Moroz, K. 2009). In order to determine mandatory incarceration, all of these factors must be considered. I will agree with most of our society that is , if they are a danger to society and serious of the crime, they need to be put into detention, where they cannot cause harm but where they can received the right intervention program and mental health treatment for them, it’s the law. The juvenile justice system is to rehabilitate not punish young offenders. Punishment is not the answer in solving their delinquent behavioral patterns.

Rehabilitation is not “the easy way out” to escape legal punishment, but is rather a key crime prevention strategy, the aim of which is to sway young offenders from their criminal paths. In many cases, rehabilitative techniques are more effective than prison sentences. For instance, David Clayton Thomas, who received a prison sentence at age 15 in Canada, provides a description of the prison, calling it “a predatory, upside-down society where the strong rule, the weak are victimized and the inmate code is all that matters.” Thomas says, “Break the code and you could get killed.” These are not the conditions in which our youth should be expected to restore their moral values! It has also been proven that rates of depression, anxiety disorders, ADHD, and substance abuse- all of which rehabilitation counsellors work with in our young offenders- are higher among youth in custody than among those in the general population. Participation in a rehabilitative program is not a lenient sentence; it is a healing process that is often difficult, but at the end of which the goals of the offender and his/her mentors are hopefully

There is a moderate portion of juvenile law violations that are minor; however some young offenders are extremely dangerous and violent. (Caldwell, 2002) Studies have shown that most delinquent behavior stems from some sort of underlining issue or issues in a youth’s present or past history. State and county authorities must deal with these offenders while also responding to their personal social problems. This could range from child abuse and neglect, family issues and drug abuse, exposure to pornography and exposure to aggressive role models.

The National Registry for Evidence-Based Programs and Practices (NREPP), which is preserved by the United States’ Substance Abuse and Mental Health Services Administration (SAMHSA), provide a list of all evidence-based practices that are beneficial for youth offenders (SAMHSA, 2017). Per SAMHSA (2017), between 50-70 percent of the youth in the juvenile justice system, have a mental disorder and up to 60 percent have been diagnosed with a substance use disorder (SAMHSA, 2017). Of those youth with dual diagnosis, approximately 30 percent have lost the ability to function as a result of their disorder (SAMHSA, 2017). Therefore, to determine the best treatment plan for youth offenders, evidence-based practices focus on the importance of

Finally, literature on the juvenile justice system often focuses on program implementation and effectiveness at addressing rehabilitation, as well as diversion techniques within the system (Greenwood, 2008). This review audits these problems in detail and establishes them within the bigger struggle in the juvenile justice system to rehabilitate youth offenders.

More than a century ago, the first health outcome measure was proposed by Florence Nightingale by classifying patients into relieved, unrelieved and dead (1). Other guides such as mortality rates have historically been used to measure health outcomes at a population level (2). However, the definition of health has changed in the past century to include a wider view of outcomes which includes freedom from disease, ability to perform daily activities, happiness, social and emotional well-being, and quality of life. The World Health Organization (WHO) has defined health as “physical, mental, and social well-being, and not merely the absence of disease and infirmity” (3). As a result numerous measures have been developed in an attempt to quantify health. Health outcome measures are tools used to evaluate an individuals’ health using different health related parameters. Patient Reported Outcomes Measures (PROMs) are instruments that are completed by patients and capture one or more aspects of health (4, 5). The use of PROMs formally to monitor surgical outcomes in England has been an important development (6). Since 2007, the Department of Health has required the routine measurement of patient- reported health outcomes for all NHS patients via its PROMs programme (5, 6). PROMs are increasingly used in decision-making to encourage a patient-centered approach (5, 7). For this reason, PROMs must be valid, reliable, and clinically useful measures.