RAND researchers evaluated two mental health care programs that serve justice-involved youth in Los Angeles County and found that support for staff—such as specialized training, hiring practices, and clinical supervision—are key facilitators of program success. By devoting resources to these and other supports, local and state governments can improve mental health care delivery and outcomes for affected youth.

Evaluation of Two Mental Health–Focused Programs for Justice-Involved Youth in Los Angeles

P'trice Jones, Sierra Smucker, Sarita D. Lee, Aarya Suryavanshi, Samantha Matthews, Laura Whitaker, Emily Allendorf, Susan Turner, Marylou Gilbert, Dionne Barnes-Proby, et al.

ResearchPublished Jan 6, 2025

In the United States, more than 43,000 youth are detained in juvenile centers on any given day. Many detained youth have mental health needs that the juvenile justice system must address, not only to help them in juvenile halls and other facilities but also to reduce recidivism and create better life outcomes.

The Los Angeles (L.A.) County Department of Mental Health receives funding from the Juvenile Justice Crime Prevention Act to operate programs for youth with mental health disorders. Two such programs are the Mental Health Screening, Assessment, and Treatment program (MHSAT), which serves youth placed on probation by the L.A. County Probation Department who are housed in county juvenile halls, and the Multisystemic Therapy (MST) program, which serves youth on probation who are living in the community.

RAND researchers conducted a qualitative process and outcome evaluation of these two programs, with a focus on understanding (1) how each program operates; (2) the barriers and facilitators to implementing each program; (3) other factors that have shaped implementation, such as considerations related to equity or resources; and (4) the outcomes associated with each program.

The researchers conducted qualitative interviews with leadership and staff members from each of the programs and analyzed their findings to develop recommendations to improve program implementation and youth mental health care outcomes.

Key Findings

MHSAT is often challenging to implement because of conditions at Probation Department facilities, although program staff find techniques to provide needed services

  • Program staff use a psychosocial assessment to develop an individualized mental health care plan.
  • Youth identified as having mental health needs are provided with services, including therapy, while at the juvenile hall.
  • Barriers to implementation include differences in the philosophies and goals of mental health and Probation Department staff, the need to educate Probation Department staff on how mental health disorders manifest in detained youth, inadequate staffing, and the limited ability to refer youth to services after discharge.
  • Facilitators of implementation include supervisor support, communication between Probation Department and mental health staff, and family involvement in the provision of services.

The MST program has faced implementation challenges, particularly during the height of the coronavirus disease 2019 (COVID-19) pandemic, but staff succeed in treating youth by adhering to the MST model

  • MST is an evidence-based, family-centered, strengths-based therapy approach for justice-involved youth.
  • Engaging youth and families can be a challenge, but after program therapists establish rapport, treating youth can become easier.
  • COVID-19 made it more challenging to reach youth who needed treatment because the ability to do in-person check-ins was limited, the number of referrals to the program declined, and there were issues with staff retention and hiring.
  • Implementation facilitators include telehealth services, connection with Probation Department staff, support from supervisors, the hiring of bilingual staff, and the staff's confidence in MST's strong evidence base.

Recommendations

  • For MHSAT, in particular, increase the availability of staff trainings on evidence-based treatment options, strategies for working with youth exhibiting disruptive behaviors, and approaches to better engage diverse youth.
  • For MHSAT, continue hiring diverse staff to ensure that youth have access to therapists who better fit their specific needs.
  • For both programs, continue to increase knowledge of and partnerships with community-based organizations to engage family members; facilitate youth transition back to the community after discharge from the facility; and connect families with community-based resources to meet basic needs, such as food and housing.
  • For both programs, provide additional supports for staff, which may include continuing to provide consultation and clinical supervision, ensuring effective leadership, and making mental health supports available to employees.
  • For the MST program, in particular, explore the feasibility of increasing staff salaries to remain competitive with other mental health providers in the region.
  • Expand MST program options to prevent at-risk youth from entering the juvenile justice system and to provide families with needed supports before youths' behavior becomes more difficult to manage.

Topics

Document Details

  • Copyright: Los Angeles County Probation Department
  • Publisher: RAND Corporation
  • Availability: Web-Only
  • Year: 2025
  • Pages: 51
  • DOI: https://doi.org/10.7249/RRA3217-3
  • Document Number: RR-A3217-3

Citation

RAND Style Manual

Jones, P'trice, Sierra Smucker, Sarita D. Lee, Aarya Suryavanshi, Samantha Matthews, Laura Whitaker, Emily Allendorf, Susan Turner, Marylou Gilbert, Dionne Barnes-Proby, Tara Laila Blagg, and Stephanie Brooks Holliday, Evaluation of Two Mental Health–Focused Programs for Justice-Involved Youth in Los Angeles, RAND Corporation, RR-A3217-3, 2025. As of May 1, 2025: https://www.rand.org/pubs/research_reports/RRA3217-3.html

Chicago Manual of Style

Jones, P'trice, Sierra Smucker, Sarita D. Lee, Aarya Suryavanshi, Samantha Matthews, Laura Whitaker, Emily Allendorf, Susan Turner, Marylou Gilbert, Dionne Barnes-Proby, Tara Laila Blagg, and Stephanie Brooks Holliday, Evaluation of Two Mental Health–Focused Programs for Justice-Involved Youth in Los Angeles. Santa Monica, CA: RAND Corporation, 2025. https://www.rand.org/pubs/research_reports/RRA3217-3.html.
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Research conducted by

This research was prepared for the Los Angeles County Probation Department and conducted in the Justice Policy Program within RAND Social and Economic Well-Being.

This publication is part of the RAND research report series. Research reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND research reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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