Public Health Approach Being Adapted for Kids in Trouble with Substances, the Law

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Reclaiming Futures helps judges, community member, probation officers and substance abuse professional work together to help kids in the juvenile justice system.

Reclaiming Futures helps judges, community members, probation officers and substance abuse professionals work together to help kids in the juvenile justice system.

Many of the kids in juvenile detention with substance abuse disorders get poor or no treatment, according to Reclaiming Futures, a nonprofit that helps young people in trouble with drugs, alcohol and crime.

It’s now experimenting with a public health approach to the situation.

With a $2 million grant from the Conrad N. Hilton Foundation, it is setting up a three-year pilot program using SBIRT (Screening, Brief Intervention and Referral to Treatment.)

SBIRT was originally developed for medical settings such as health clinics and doctors’ offices, but “our setting is the juvenile justice system,” said Jim Carlton, deputy director of Reclaiming Futures.

See our previous coverage on SBIRT.

Among kids at risk for court involvement, 17 percent have substance abuse problems. However, by the time they go before a judge and receive permanent placement in the justice system, the proportion is 47 percent, the organization says.

Another organization, Policy Research Associates, has also received a Hilton grant to pioneer the use of SBIRT in juvenile justice work.

Reclaiming Futures normally works with kids who are already on probation or are incarcerated, Carlton said. However, it will use SBIRT with kids who “bump up against the juvenile justice system but are not quite in it yet,” he said.

Evan Elkin, special projects director for Reclaiming Futures, will adapt SBIRT to this use and be the clinical director of the program. SBIRT will be folded into several diversion programs.

“The first arrest is a great prevention point,” Elkin said. “It’s a great opportunity to catch a kid when a behavior issue has first emerged.”

Under SBIRT, a short questionnaire assesses a young person’s risky use of drugs or alcohol. Then the adult administering the questionnaire has a brief conversation with the youth using motivational interviewing.

When young people indicate risky use, the adult provides information and elicits possible motivations to change.

SBIRT doesn’t just focus on kids with full-fledged addictions, but on the large middle ground of those who engage in risky use. It’s not about punishment. It approaches risky use as a health issue that the young person can choose to address in different ways.

Carlton said SBIRT will be added to three existing Reclaiming Futures sites in Charlotte, N.C., Seattle and Long Island, N.Y.

In addition, Reclaiming Futures will set up two new sites — one in Vermont and one in Washington County, Ore. — where SBIRT will be included.

In Charlotte, SBIRT will be used as an option in school-based arrests, Elkin said. In Seattle, the King County School System will use it with chronically absent or truant kids.

When SBIRT is adapted for use in juvenile justice, police and probation officers may be the ones administering it.

Elkin said they’ll be trained to use a lighter touch than they usually do in talking to kids about drugs.

They’ll learn to ask with curiosity, to express interest and to elicit the context of a kid’s use. They will be trained to suggest options — “to essentially do nothing further,” Elkins said — rather than dictating the kid’s next move.

In 2012, the Hilton Foundation launched a substance abuse strategy based on prevention and early intervention. It sees SBIRT as a promising model that has not been widely used in the United States.