Background

Justice-involved youth report high rates of substance use and related problems that are associated with treatment needs; however, data on screening and linkage to treatment within the justice system is lacking. To further inform the juvenile justice behavioral health cascade of care, this study examined factors associated with identified problematic substance use and treatment referral using two screening tools.

Method

As part of a family court intake process, 348 justice-involved youth received two screening measures, the MAYSI-2 alcohol/drug use subscale and the CRAFFT. Both tools are designed to indicate early warning signs of substance use problems and signal referral for further clinical evaluation or treatment. Chart review analysis examined whether demographic variables (sex & race), severity of use, and type of substance used were associated with positive screens on either or both measures and subsequent treatment referral.

Results

Half (51.2%) of youth were identified as having problematic substance use (a positive screen) on at least one of the screeners. Overall, 38.5% positively screened on the CRAFFT with only 0.3% positively screening on just the MAYSI-2 alcohol/drug scale. Cannabis only users were less likely to positively screen on the MAYSI-2 compared to youth who reported use of both alcohol and cannabis. Positively screening on one versus both screeners was not associated with referral, yet many (28%) who positively screened were not referred for services.

Conclusions

The CRAFFT may be more accurate at identifying youth specifically at risk for problematic cannabis use compared to the MAYSI-2 alcohol/drug subscale. Regardless of tool used, treatment referral was low, highlighting the need for accurate identification of treatment needs of substance-using, justice-involved youth. Interventions to facilitate referrals for youth with problematic substance use are needed.

中文翻译：

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参与司法的青年的物质使用筛查和治疗转诊率

背景

参与司法的青年报告了与治疗需求相关的物质使用和相关问题的高比率；然而，缺乏司法系统内筛查和治疗联系的数据。为了进一步了解少年司法行为健康护理的级联，本研究使用两种筛选工具检查了与确定的有问题的物质使用和治疗转诊相关的因素。

方法

作为家庭法庭受理程序的一部分，348 名参与司法的青少年接受了两项筛查措施，即 MAYSI-2 酒精/药物使用子量表和 CRAFFT。这两种工具都旨在指示物质使用问题的早期预警信号，并发出转诊信号以进行进一步的临床评估或治疗。图表审查分析检查了人口统计变量（性别和种族）、使用的严重程度和使用的物质类型是否与一项或两项措施的阳性筛查以及随后的治疗转诊相关。

结果

半数 (51.2%) 的青少年在至少一项筛查中被确定为有问题的物质使用（阳性筛查）。总体而言，38.5% 的 CRAFFT 阳性筛查，仅 MAYSI-2 酒精/药物量表的阳性筛查只有 0.3%。与报告使用酒精和大麻的年轻人相比，仅大麻使用者不太可能在 MAYSI-2 上进行积极筛查。对一个筛查者与两个筛查者进行阳性筛查与转诊无关，但许多（28%）阳性筛查的人没有被转诊接受服务。

结论

与 MAYSI-2 酒精/药物子量表相比，CRAFFT 在识别特别有大麻使用问题风险的青年方面可能更准确。无论使用何种工具，治疗转诊率都很低，这突出表明需要准确识别吸毒、参与司法的青年的治疗需求。需要采取干预措施来促进有问题物质使用的青少年的转诊。