Racial and ethnic differences in reported criminal justice referral at treatment admission

In the U.S. and elsewhere, the criminal justice system is a frequent referral source for substance abuse treatment admission. To expand and improve pathways to treatment, outreach efforts need additional information about different demographic groups. Locally, clinicians observed racial and ethnic differences between minority groups in self-identifying criminal justice as the referral sources for admission. To test this clinical observation, reported criminal justice referral was examined by race/ethnicity and gender in multiple years of both national and local treatment admissions. Confirming the clinical observations, racial/ethnic referral source by gender systematically differed across years nationally (p < .001) and in an examination of verbatim recorded presenting problems locally (p < .001). African Americans and Puerto Ricans were less likely to have criminal justice referral sources than the White reference group, whereas American Indians, Arab Americans, Asian Americans, and other Hispanic ethnicities were more likely to have criminal justice referral sources. Racial/ethnic groups systematically differed in reported criminal justice involvement, suggesting hypotheses potentially impacting clinical treatment and outreach. Published primary referral sources may underestimate criminal justice involvement in treatment admissions.