title: The consequences of juvenile detention reform for mental health and sexually transmitted infection screening among detained youth.
abstract: OBJECTIVE
  To understand how diversion of low-risk youth from juvenile detention affected screening practices for detained youth.
  
  
  METHODS
  In a 22-month cross-sectional study of 2,532 detainees (age, 13-18 years), mental health and sexually transmitted infection (STI) screening data were compared before and after the beginning of diversion efforts through implementation of a Risk Assessment Instrument (RAI).
  
  
  RESULTS
  Detention diversion resulted in a 30% census reduction. In a logistic regression, younger age (odds ratio [OR] = 1.10 for a 1-year increase; confidence interval [CI]: 1.03, 1.17), Hispanic versus white race/ethnicity (OR = .53; CI: .35, .82), and less severe crime (OR = .90 per 1 point; CI: .89, .91) predicted reduced likelihood of detention. Mental health and STI screening increased significantly after implementation of the RAI. Additionally, the rate of positive STI tests increased among detained males (9% pre-RAI to 14% after implementation of the RAI, p = .01). However, implementation of the RAI did not result in a significant increase in the number of positive mental health screens.
  
  
  CONCLUSIONS
  Universal mental health and STI screening are increasingly common public health practices in detention centers. The results of this study indicate that juvenile justice diversion programming affects public health screening rates among detained youth in our population. Future study of the possible unintended consequences of criminal justice initiatives on public health outcomes is recommended.
authors.affiliation: Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA. maalsma@iupui.edu
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Aalsma
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Gudonis
authors.forename: G Roger
authors.initials: GR
authors.lastname: Jarjoura
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Blythe
authors.forename: Yan
authors.initials: Y
authors.lastname: Tong
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Harezlak
authors.forename: Marc B
authors.initials: MB
authors.lastname: Rosenman
mesh_terms: D000293:Adolescent; D003415:Crime / Q000706:statistics & numerical data; D003416:Criminal Law / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D007604:Juvenile Delinquency / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000453:epidemiology / Q000517:prevention & control; D008603:Mental Health / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*