Co-Occurring Disorders and Engagement in Behavioral Health Treatment Among Justice-Involved Adolescents

Abstract

Our study examined co-occurring substance use and major depressive disorders among justice-involved adolescents to inform behavioral health services planning within U.S. criminal justice systems. We used data from the 2015–2017 administrations of the National Survey on Drug Use and Health (NSDUH), an annual survey of non-institutionalized U.S. individuals aged 12 and older, to yield a national sample of 41,579 adolescents. Rates of co-occurring disorders were 4.5 times higher among justice-involved adolescents than non-justice-involved adolescents, with 6.3% of justice-involved adolescents meeting criteria for co-occurring disorders in the past year compared to 1.2% of non-justice-involved adolescents. Justice involvement was associated with greater substance use treatment but not mental health treatment. High rates of co-occurring disorders among justice-involved adolescents suggest the criminal justice system to be a unique opportunity for treatment engagement. The integrated mental health and substance use treatment needs of justice-involved adolescents with co-occurring disorders should be prioritized.