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Journal Issue: Juvenile Justice Volume 18 Number 2 Fall 2008

Juvenile Justice and Substance Use
Authors: Laurie Chassin

Unmet Need for Treatment in Juvenile Justice Settings

Getting precise figures for the extent of "unmet need" for substance use disorder treatment in the juvenile justice system is difficult. One study, based on 1999 data, estimated that 30 percent of juveniles arrested, or a total of 840,000 adolescents, needed treatment. That figure is six times the number of publicly funded treatment slots.33 Like the data presented earlier—that 25 percent to 65 percent of adolescents in various justice system settings meet diagnostic criteria for a substance use disorder—the figure suggests that many youths who need treatment go untreated. A similar unmet need has been reported among adolescents more generally.34 Another estimate of unmet need was based on a sample of youths entering the Juvenile Division of the Illinois Department of Corrections.35 Of all the youths who had a substance use disorder and thus needed treatment, only 48 percent reported ever having been treated. (There were no gender, racial and ethnic, or educational differences.) The level of unmet need here too was substantial, but because these youths were just entering the justice system, their lack of treatment does not necessarily reflect their experience in the system. In fact, youths with prior arrests and with a history of childhood neglect were more likely than others to have been treated, suggesting that the juvenile justice and child welfare systems provided treatment.

One study, using the 2002 OJJDP data, estimated that 66 percent of juvenile justice system facilities provide treatment services, the most common being drug education (97 percent).36 Approximately two-thirds of the facilities provide group counseling by a professional, and 20 percent provide all youth in the facility with onsite counseling. Because these figures exclude facilities that did not provide data on substance use treatment, however, they may over-estimate the treatment provided.

A study by Douglas Young, Richard Dembo, and Craig Henderson found that most facilities (75 percent) provided drug and alcohol education classes, which were attended (on average) by 21 percent of residents.37 Education alone, however, is not enough for youth with substance use disorders, and only 44.6 percent of programs provided some other form of treatment. Treatment varied widely by type of setting, with low rates of treatment in jails and detention centers. Of course, assessing unmet need requires knowing not only the rates of services provided by particular settings but also the individual treatment needs of the adolescents in these settings. All current available estimates, however, suggest substantial unmet treatment need among juvenile offenders.