Diversion as a Pathway to Improving Service Utilization Among At-Risk Youth

Despite the high rates of mental illness among youth in the juvenile justice system, many justice-involved youth do not receive adequate behavioral health services. We examined differences in health service utilization outcomes between youth who were diverted through a community-based, precomplaint program (Safety Net; n = 41), and youth with juvenile justice involvement in neighboring cities (n = 154). Individual arrest and health care records were combined to evaluate the rate of health care service utilization before and after initial police contact. A difference-in-differences approach with propensity score weighting was used to evaluate the impact of Safety Net on health service use, including inpatient, outpatient, emergency department (ED), and primary care visits. Compared to their nondiverted counterparts, Safety Net youth had a significant increase in psychiatric outpatient visits (average treatment effect [ATE] of 26%; p < .05) and psychiatric outpatient and primary care visits among those with a diagnosed mental illness (ATE of 19% and 12%, respectively); p < .05). There were no significant differences in ED or hospitalization outcomes. Results suggest that precomplaint diversion through Safety Net fosters access to outpatient behavioral health and primary care services that address the underlying issues that put youth in contact with police.