Health and Justice最新文献

{"title":"Gender differences in criminal justice system involvement and associations with post-deployment factors among Post-9/11 veterans.","authors":"Julia Naganuma-Carreras, Elizabeth Collazo, Nicholas Livingston, Jaclyn Kearns, Julia Sager, Daniel Lee, Terence Keane, Brian Marx","doi":"10.1186/s40352-026-00432-1","DOIUrl":"10.1186/s40352-026-00432-1","url":null,"abstract":"<p><strong>Background: </strong>Veterans are overrepresented in the United States criminal justice system, yet limited research has examined how mental health, substance use, and psychosocial factors intersect to shape involvement in the justice system-particularly across gender. As the population of women veterans grows, understanding gender-based differences in criminal justice involvement is critical to developing targeted, patient-centered interventions.</p><p><strong>Methods: </strong>We analyzed data from 1,360 post-9/11 veterans (M_age = 37.49; 51.3% women) to examine gender-specific associations between individual and co-occurring factors and criminal justice involvement. Justice involvement was defined as being arrested and charged with a crime after deployment, which was measured through self-report.</p><p><strong>Results: </strong>Overall, 15.0% of veterans reported post-deployment justice involvement (11.3% of women and 18.7% of men). Several factors were related to higher likelihood of post-deployment justice involvement in both groups (i.e., younger age, provisional alcohol use disorder diagnosis) while others were only related in one group (e.g., problematic anger among women; history of homelessness among men).</p><p><strong>Conclusions: </strong>Our findings underscore the importance of integrated, gender-responsive approaches to reduce justice involvement among veterans. Public health and criminal justice system interventions should address overlapping domains of need, including mental health, housing instability, and substance use, while tailoring strategies to gender-specific risk profiles.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of self‑harm prediction models among formerly incarcerated individuals using health data.","authors":"Hsueh-Han Yeh, Sheryl Kubiak, Erin Comartin, Zachary Farrell, Yong Hu, Philip Huynh, Diane Wisnieski, Bethany Hedden-Clayton, Athena Kheibari, Grant Victor, Jennifer E Johnson, Lauren M Weinstock, Greg E Simon, Brian K Ahmedani","doi":"10.1186/s40352-026-00425-0","DOIUrl":"10.1186/s40352-026-00425-0","url":null,"abstract":"<p><strong>Background: </strong>Individuals released from jail die by self‑harm at nearly nine times the rate of the general U.S.</p><p><strong>Population: </strong>Most jails rely on traditional screening methods, such as brief self-report questionnaires, which are often inconsistently administered and have limited sensitivity and predictive accuracy. This highlights the urgent need for alternative self-harm risk identification methods during and after incarceration.</p><p><strong>Objective: </strong>To evaluate the feasibility of applying an existing self-harm risk prediction model to jail populations.</p><p><strong>Methods: </strong>We analyzed data from 4,154 individuals incarcerated in Michigan jails who were enrolled in Medicaid. We applied a prediction model, originally developed by the Mental Health Research Network (MHRN), to identify individuals at elevated risk for self-harm. Predictors included demographics, mental health and substance use diagnoses, medical comorbidities, prior history of self-harm, mental health-related hospitalizations, and dispensing of psychotropic medications.</p><p><strong>Results: </strong>The study cohort was predominantly male (70%) and racially diverse (50% Black, 43% White), with a median jail stay of just one day. Overall, the model demonstrated good discrimination, achieving a C-statistic of 0.77, with 68% sensitivity and 77% specificity, and a 99% negative predictive value. Notably, among individuals with shorter jail stays, predictive performance was better, with the C-statistic increasing to 0.80.</p><p><strong>Conclusions: </strong>Health records-based models demonstrated good predictive performance and may offer a scalable, data-driven alternative to traditional screening tools in jails. Integrating health records-based risk prediction tools in jails could improve early detection of self-harm risk and support more targeted prevention efforts.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The public health impacts of drug-induced homicide laws: a community-engaged scoping review.","authors":"Jennifer J Carroll, Dmitri Fisher, Bayla Ostrach","doi":"10.1186/s40352-026-00419-y","DOIUrl":"10.1186/s40352-026-00419-y","url":null,"abstract":"<p><strong>Background: </strong>Drug-induced homicide (DIH) laws are state laws that confer criminal liability equivalent to homicide for the sale or delivery of drugs subsequently associated with a fatal overdose.</p><p><strong>Methods: </strong>We undertook a scoping review of literature on the public health impacts of DIH laws and held focus groups to seek guidance on the interpretation of review results from three directly-impacted community groups: public health and harm reduction professionals; people who use drugs (PWUD); and family members of adult victims of fatal overdose.</p><p><strong>Results: </strong>Eight publications met our inclusion criteria. Three of those publications presented the results of a systematic analysis of DIH laws and/or their effects; the remaining five publication presented exploratory results related to these topics. Six of the eight publications suggest that DIH laws actively deter people from calling 911 to report an overdose. Two publications suggest that DIH laws have small but disruptive impacts on drug market participation. One publication suggests that friends and family of overdose victims constitute about half of all people charged under DIH laws and the conclusion that DIH charges are overwhelmingly brought in response to the death of a white person. Public health and harm reduction professionals and PWUD reported, generally, that these conclusions align with their lived experience and prior understandings of DIH laws. Family members rejected the evidence that DIH laws deter calling 911, asserting that such a relationship makes no sense, often relying on stereotyped understandings of substance use to support that claim. Public health and harm reduction professionals advocated for additional research documenting the negative impacts of DIH laws, with the goal of informing more effective drug policy. Family members advocated for more research on friends and loved ones affected by overdose.</p><p><strong>Conclusions: </strong>Current evidence on the impacts of DIH laws remains limited but consistently indicates negative consequences for public health. Additional research is needed, especially research that addresses the expressed needs and priorities of directly impacted community groups.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I decide for myself. I'm like the boss of myself. I can cook when I want.\" Prisoners' experiences with a self-catering food system in a Norwegian low-security prison.","authors":"Astrid Kolderup Hervik, Stein Egil Kolderup Hervik","doi":"10.1186/s40352-026-00426-z","DOIUrl":"10.1186/s40352-026-00426-z","url":null,"abstract":"<p><strong>Background: </strong>Food is a central part of everyday life in prison, carrying meanings and values that shape identity and social relations and may have important implications for health and well-being. Previous research suggests that self-catering systems, whereby prisoners plan, shop for, and prepare their own meals, may increase opportunities for agency, participation, and health promotion. Despite growing interest in prison food systems, little empirical research has explored how prisoners themselves experience such self-catering arrangements. This study explores prisoners' experiences with a self-catering food system in a Norwegian low-security prison, with particular attention paid to its potential for promoting health and well-being.</p><p><strong>Method: </strong>The study draws on 20 individual semi-structured interviews with male prisoners aged between 20 and 70, representing diverse ethnicities and social backgrounds. The interviews were analysed using Braun and Clarke's six-phase thematic analysis.</p><p><strong>Results: </strong>Four themes were developed through the analysis, reflecting prisoners' experiences of the self-catering system: food-related agency, social skills and relations, food-related skills, and support and guidance. Prisoners generally described self-catering as a meaningful increase in agency, offering control over day-to-day food practices, dietary preferences, and identity work. Socially, the self-catering system facilitated social relationships through co-operation, mutual support, and shared routines that fostered experiences of normality, emotional well-being, and social cohesion. Collaborative food groups often supported skill development, healthier eating and cost-sharing. However, experiences varied widely. Prisoners who lacked supportive social networks, sufficient financial resources, or food-related skills and competencies faced significant barriers. Many described a need for support and guidance, such as cooking courses or mentoring.</p><p><strong>Conclusion: </strong>The study illustrates how food-related practices enabled by a self-catering system may function as meaningful aspects of everyday life in prison. When adequately supported, self-catering systems can serve as one way to promote health within prison settings. However, limited resources to take advantage of food-related agency, including aspects related to food literacy and lack of social support, emerged as key barriers to realising the health-promoting potential. To more fully realise such potential, self-catering systems require attention to be paid to inequalities, support needs, and structural conditions.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating family-based interventions into specialty court programs: qualitative guidance from sex trafficking specialty court participants and their supportive family members.","authors":"Aaron Murnan, Jane Mahon, Gwen Jackson, Symone Pate, Susan Thompson, Christina Stewart, Jennifer Brown, Sarah Manchak, Melinda Butsch Kovacic","doi":"10.1186/s40352-026-00421-4","DOIUrl":"10.1186/s40352-026-00421-4","url":null,"abstract":"<p><strong>Background: </strong>The intersection of sex trade involvement and substance use disorder is a deeply complex and tragic issue for many women, as decades of research reflect that traditional substance use treatment modalities often fail to meet many of these women's unique needs. Sex trafficking specialty court programs constitute a unique and promising avenue to deliver evidence-based practices to treat substance use disorders and to support health and well-being among this largely service disconnected and marginalized population. A growing body of evidence suggests these specialty court programs may be strengthened by the inclusion of family-based interventions. A critical preliminary step to the potential integration of family interventions is the development of processes to identify and engage supportive family members, as well as guidelines on discerning which family members' inclusion is likely to be beneficial versus detrimental. The current study provides direct insights from sex trafficking specialty court participants and their family members regarding family involvement within specialty court treatment programming and potential family therapy services.</p><p><strong>Methods: </strong>Fifteen family dyads consisting of one sex trafficking specialty court program participant paired with a supportive family member (identified by program participants) were invited to participate in interviews exploring best practices for identifying and engaging supportive family members in sex trafficking specialty court programming. Inductive Content Analysis was used to analyze interview transcript data.</p><p><strong>Results: </strong>Four themes were identified: (1) characteristics and dynamics within familial relationships; (2) selection criteria for family members to be invited to participate; (3) barriers to successful family participation; and (4) perceptions of family therapy.</p><p><strong>Conclusions: </strong>This study provides insights to inform efforts to engage family supports through the development and integration of family interventions that may bolster substance use treatment success among sex trafficking specialty court participants.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Bridging crisis and care: exploring the role of behavioral health professionals in a police co-response model.","authors":"Rachel Oblath, Corinne A Beaugard, Carolina-Nicole Herrera, Cindy Xu, Sarah Syed, Christal Sadatis, Alison Duncan, Geneva Gann, Elizabeth Plange, Tasha Ferguson, Sarosh Khan, Faris Katkhuda, David C Henderson, Jenna Savage, Melissa S Morabito","doi":"10.1186/s40352-026-00418-z","DOIUrl":"10.1186/s40352-026-00418-z","url":null,"abstract":"","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"14 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiles of behavioral health service utilization among youth involved in the juvenile legal system.","authors":"Kaitlin Piper, Tasfia Jahangir, Elizabeth Van Alstine, Laura Tyrone, Aanya Ravichander, Kaitlin Sheerin, Crosby Modrowski, Kathleen Kemp","doi":"10.1186/s40352-026-00416-1","DOIUrl":"10.1186/s40352-026-00416-1","url":null,"abstract":"<p><strong>Background: </strong>Juvenile legal-involved youth (JLIY) experience behavioral health conditions at more than twice the rate of their peers yet face significant barriers to accessing care. These barriers span predisposing (demographic and social), enabling (logistical and resource-related), and need-based (clinical) factors. To better understand how JLIY navigate the fragmented behavioral healthcare system, we examined their use of services across eight different sectors, including formal treatment settings, non-specialized systems (e.g., schools and courts), and informal community supports.</p><p><strong>Methods: </strong>We surveyed 100 caregiver-youth dyads enrolled in a juvenile court diversion program, all of whom had youth with documented behavioral health needs. We collected information on caregiver and youth demographics, behavioral health symptoms, treatment barriers, motivation for treatment, and service utilization. Latent Class Analysis (LCA) was used to identify distinct patterns of youth behavioral health service utilization across eight care sectors. Multinomial logistic regression was then conducted to examine how predisposing, enabling, and need-based factors, guided by the Andersen Behavioral Model of Health Services Use, predicted class membership.</p><p><strong>Results: </strong>On average, youth accessed services in 4 of the 8 behavioral health care sectors. Service sectors utilized by JLIY included school-based support (86%), outpatient care (67%), community network supports (61%), crisis services (59%), general healthcare (58%), juvenile legal services (32%), inpatient care (26%), and residential treatment (11%). Latent Class Analysis revealed three distinct service use profiles: (1) low-intensity, school-centric users; (2) high-intensity, multi-sectoral users; and (3) moderate-intensity, community-based users. Class membership was significantly associated with child welfare involvement, court-mandated treatment, caregiver trauma exposure, caregiver motivation for youth treatment, and youth symptom severity.</p><p><strong>Conclusion: </strong>JLIY navigate a wide range of behavioral health services, often in fragmented or reactive ways. While individual need was a strong predictor of service use, enabling factors such as caregiver influences and system mandates also played a critical role. The reliance on school-based services suggests systemic gaps, and extensive multi-sector involvement may reflect lack of integration across systems. Findings have implications for policy, including the need to strengthen cross-system coordination among juvenile legal, school and behavioral health systems; expanded family-centered service navigation; and improved access to community-based care before needs escalate.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young adults' conceptions of health and well-being during reentry.","authors":"Noor Toraif, Laura Abrams, Christopher Bondoc, Taylor Reed, Elizabeth Barnert","doi":"10.1186/s40352-026-00412-5","DOIUrl":"10.1186/s40352-026-00412-5","url":null,"abstract":"<p><strong>Background: </strong>In the United States, young adults (ages 18-25) represent 1 in 10 of the prison population and 1 in 5 of the jail population. They face significant physical and mental health challenges during their transition from incarceration back to community life. These challenges are compounded by the structural barriers of reentry, including challenges accessing housing, employment, and healthcare. While previous research has explored young adults' health status during the transition, less is known about their perspective on what constitutes health and well-being, and how their understanding of health is shaped or influenced by the reentry process. This study investigates the following research questions: 1) How do young adults in reentry conceptualize health and well-being? and 2) How do they describe the relationship between their health and the reentry process? The study draws on longitudinal semi-structured interviews (N = 66) with 16 young adults, aged 18-25, who were recently released from jail or on probation in June and July 2020.</p><p><strong>Results: </strong>Findings suggest that the young adults define health as the ability to exert control over their lives. This control is demonstrated through abstaining from substances-though cannabis is often viewed as a legitimate exception-managing daily responsibilities, and coping with stressors such as mental health challenges and strained relationships. Participants also described their health status as intertwined with the reentry process, a process they viewed as both a major stressor exacerbating existing health challenges and an opportunity to break from their perceived past unhealthy behaviors. While they ascribed personal responsibility for their health outcomes, their efforts to improve their well-being were constrained by systemic barriers imposed by reentry, such as housing instability, lack of healthcare access, and employment challenges. These barriers undermined both their reentry- and health-related goals.</p><p><strong>Conclusions: </strong>Findings highlight a contrast between young adults' conceptions of health as the exertion of agency and the structural constraints they face during reentry. Their transition from incarceration shapes health in both symbolic and material ways, informing how they define and understand health, while also impacting their physical, emotional, and mental well-being.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C no more: a prospective single-arm study to evaluate the effectiveness of a nurse and peer-led mobile model of hepatitis C testing and treatment at community corrections offices.","authors":"Samara Griffin, Timothy Papaluca, Jacinta A Holmes, Bridget Reid, Anne Craigie, Jane Dicka, Sione Crawford, Amanda Callus, Mark Belzer, Tim Spelman, Margaret Hellard, Shelley Walker, Mark Stoové, Alexander J Thompson, Rebecca J Winter","doi":"10.1186/s40352-026-00411-6","DOIUrl":"10.1186/s40352-026-00411-6","url":null,"abstract":"<p><p>BACKGROUND: The community corrections population in Australia shares similar risk factors for hepatitis C virus (HCV) infection with people incarcerated in prisons, but without access to prison-based testing and treatment. While hepatitis C testing and treatment programs are well established in prison settings in Australia, little attention has been paid to equivalent programs in community corrections settings. C No More is a study to evaluate the acceptability and efficacy of a novel, mobile, nurse and peer-led model of hepatitis C testing and treatment at community corrections offices in Melbourne, Australia. METHODS: A clinically equipped van staffed by a hepatitis clinical nurse consultant and peer workers will spend scheduled periods parked adjacent to four community corrections offices in metropolitan Melbourne. People attending community corrections offices will be opportunistically approached by a peer worker and invited to undertake hepatitis C testing. Other individuals in the vicinity of the community corrections office may also be invited to access the service. Following enrolment, study staff will conduct hepatitis C point-of-care testing and clinical assessments in the van. Point-of-care HCV antibody tests will be used for initial screening, and where positive, point-of-care HCV RNA tests performed. Participants with self-reported HCV antibody will be reflexed to RNA testing. RNA positive participants will be assessed for rapid treatment initiation, and prescribed DAA treatment. Treatment dispensation will occur from the van or through a community pharmacy. Participants will be monitored throughout treatment and offered point-of-care HCV RNA testing four or more weeks after treatment completion to confirm sustained virological response (SVR-4 +). The primary outcomes of this study are the proportion of those who are HCV RNA positive who initiate DAA treatment and the acceptability of this model of care. DISCUSSION: This study will provide evidence of acceptability, feasibility, and clinical effectiveness of a nurse and peer-led, mobile model of hepatitis C care at community corrections offices. The outcomes of this study will inform other models of care aiming to provide hepatitis C testing and treatment to individuals involved in the criminal justice system. TRIAL REGISTRATION: This study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623001043628). Date of registration: 27/09/2023. </p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health diversion and criminal justice outcomes: a population-based cohort study of 53,605 justice-involved adolescents.","authors":"Emaediong I Akpanekpo, John Kasinathan, Claire Gaskin, David Greenberg, Peter W Schofield, Tony Butler","doi":"10.1186/s40352-026-00413-4","DOIUrl":"10.1186/s40352-026-00413-4","url":null,"abstract":"<p><p>BACKGROUND: Incarceration of adolescents is associated with a range of adverse outcomes, yet high-quality evidence comparing its effectiveness to non-custodial alternatives is limited. We compared mental health diversion, community-based legal orders, and custodial sentencing in reducing reoffending among justice-involved adolescents. We conducted a population-based retrospective cohort study using linked health and justice records from New South Wales, Australia, including all adolescents aged 10 to 17 years with a conviction between an index court finalization between 2 July 2001 and 24 December 2020. The primary outcome was first proven reoffending within 12 months following first court finalization in adolescence. RESULTS: Among 53,605 justice-involved adolescents, 2,171 (4.0%) received mental health diversion, 44,887 (83.8%) community orders, and 6,547 (12.2%) custodial sentences. Standardized any-reoffending risk was 47.2% under diversion, 56.6% under community orders, and 64.5% under custody. Diversion was associated with an absolute risk difference of − 17.7% points compared with custody (95% CI − 23.2 to − 12.1) and − 9.9% points compared with community orders (95% CI − 14.9 to − 4.1). The risk difference for community orders compared with custody was − 7.8% points (95% CI − 12.8 to − 3.3). Reduction in reoffending under diversion were greatest among adolescents with disruptive behavioural disorders (− 26.5% points, 95% CI − 34.9 to − 18.3), mood disorders (− 22.9% points, 95% CI − 37.2 to − 6.4), and intellectual disability (− 38.0% points compared with community orders, 95% CI − 60.0 to − 14.5). CONCLUSIONS: Mental health diversion and community orders reduced reoffending risk compared with custody. Effects were greatest among adolescents with disruptive behavioural disorders, mood disorders, and intellectual disability. These findings support the use of non-custodial sentencing for justice-involved adolescents with mental health disorders and indicate that those with neurodevelopmental and externalizing presentations may benefit most. </p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}