The impact of mental health and substance use issues on recidivism among youth on probation.

Background: Justice-involved youth have high rates of mental health and substance use disorders which are linked to re-offending. However, research on the impact of behavioral health issues, especially among those on community supervision, is limited.Objectives: This study examines the effects of co-occurring mental health and substance use indicators on recidivism among youth on probation using data from the JJ-TRIALS multi-site cooperative. We compare hazard rates for recidivism by type of behavioral health indicator.Methods: The sample includes 3,023 female and 9,617 male (N = 12,649) youth who were followed for up to 1,415 days after initial probation referral.Results: Cox proportional hazard models revealed that those with mental health issues only (HR = 1.5, p < .001), substance use only (HR = 1.5, p < .001), and co-occurring conditions (HR = 3.5, p < .001) had a greater recidivism hazard than those with no behavioral health issues. Survival analysis indicated that those with co-occurring indicators had a faster time to recidivism compared to other behavioral health groups. There was a significant interaction between behavioral health status and treatment initiation, particularly for those with substance use (HR = 0.34, p < .001) and co-occurring indicators (HR = 0.89, p = .02).Conclusion: Behavioral health affects recidivism among justice-involved youth. Treatment initiation, while shown to reduce recidivism, may differentially impact reoffending depending on specific behavioral health needs. Findings highlight the need for enhanced assessment and expanded co-occurring treatment and emphasize the importance of matching youth to appropriate community-based, integrated services to improve justice-related outcomes.