Behavioral health interventions for justice-involved youth

Children and adolescents involved in the juvenile justice system experience much higher rates of behavioral health concerns than their peers who are not involved in the system (see Kemp et al., 2025, for a review). After researchers first established these high rates of behavioral health concerns in the early 2000s, researchers and policymakers alike pushed to develop an evidence base of behavioral health interventions for justice-involved youth to divert them away from the juvenile justice system toward the behavioral health help they needed. However, it is unclear whether this desire to improve diversion from the juvenile justice system to evidence-based programs that did not yet exist resulted in an uptick in intervention development.

Kaitlin Sheerin, Alyssa Vieira, Shannon Williamson-Butler, Miyah Grant, Lindsey Nichols, Andrew Creamer, and Kathleen A. Kemp (2025) published a systematic review in Clinical Psychology: Science and Practice of randomized controlled trials conducted between 1990 and 2024. They focused on trials that tested psychosocial interventions for behavioral health concerns among justice-involved youth residing in the community. Their review sought to characterize the number of trials conducted over this time period, as well as the types of interventions tested and the outcomes these trials focused on.

The authors highlighted three important findings:

1. The number of unique trials published over the 34-year period (38 unique trials and 51 total studies) indicated that an average of 1.52 studies were published annually. This number incrementally increased from the 1990s to the 2000s, peaking in the mid-2010s.
2. The interventions tested were relatively intensive, averaging 25 hours, indicating that more interventions may be available to match the needs of youth at high risk of recidivating within the juvenile justice system. Yet, fewer lower intensity intervention options are available for youth at low to medium risk of recidivating but who may have high behavioral health needs.
3. Studies most often included delinquency and behavior problems as a primary outcome, with alcohol and substance use being the second-most-studied outcome. However, few studies focused on other issues prominent among justice-involved youth, including trauma-related concerns and suicidal thoughts and behaviors.

The increased desire among various stakeholders to implement evidence-based programs for justice-involved youth did not fully translate into a large number of clinical trials to help develop an evidence base of successful interventions. This issue could be due to barriers to conducting these trials, including a lack of training among researchers in working with systems, as well as hesitation from juvenile justice administrators to partner with researchers. Researchers also must evaluate whether existing evidence-based practices for youth without system involvement may be implemented successfully with youth who are involved, including those practices for trauma-related concerns and suicide prevention. Ultimately, more work is needed to develop interventions that can deflect youth with behavioral health needs away from the juvenile justice system in the first place.

This article is in the Forensic Psychology topic area.

Kemp, K., Sheerin, K., Pederson, C., Grant, M., Modrowski, C., & Spirito, A. (2025). Youth with behavioral health symptoms in the juvenile legal system: From assessment of needs to interventions to scalability. Annual Review of Clinical Psychology, 21(1), 327–352. https://doi.org/10.1146/annurev-clinpsy-081423-021503opens in new window

Sheerin, K. M., Vieira, A., Williamson-Butler, S., Grant, M., Nichols, L., Creamer, A., & Kemp, K. A. (2025). The landscape of randomized controlled trials for behavioral health–focused psychosocial interventions for youth in the juvenile legal system: A systematic review. Clinical Psychology: Science and Practice, 32(4), 329–346. https://doi.org/10.1037/cps0000282

Kaitlin M. Sheerin, PhD, is an assistant professor in the Department of Psychiatry and Human Behavior at Brown University. She also is a research scientist at Rhode Island Hospital and a consulting psychologist at the Rhode Island Family Court Mental Health Clinic. Her federally funded program of research focuses broadly on improving access to behavioral health services for youth involved in the juvenile legal system. Contact Kaitlin M. Sheerin.

Alyssa Vieira, MA, is a clinical psychology doctoral student at the University of Houston. Her work focuses on the link between sleep and mental health, with an interest in anxiety and depression among systems-involved youth.

Shannon Williamson-Butler, MA, is a 4th-year doctoral candidate in the clinical psychology program at the University of North Texas. She recently matched at the Tulane School of Medicine in New Orleans, where she will be completing her clinical internship.

Miyah Grant, PsyD, is a licensed forensic psychologist, training supervisor, researcher, and assistant clinical professor at Brown University. Her work centers on understanding, bringing attention to, and addressing the unique challenges and mental health consequences experienced by system-involved youth and families.

Lindsey Nichols, PhD, is a postdoctoral fellow in the Center for Alcohol and Addiction Studies at Brown University, specializing in behavioral health intervention adaptation, harm reduction, and co-occurring disorders among youth. Her research focuses on promoting the mental and behavioral health of young people across the spectrum of prevention through understanding the sources of variability in substance use interventions in a variety of implementation contexts.

Andrew Creamer, MSLIS, MAEd, is a health sciences librarian at Brown University and serves on the Brown Library’s Health and Biomedical Library Services team. He assists research teams with expert searching and open science services, including research data management and sharing.

Kathleen A. Kemp, PhD, is an associate professor (research) in the Department of Psychiatry and Human Behavior at Brown University. She is the director of the Success Clinical Research Collaborative and the Rhode Island Family Court Mental Health Clinic. Her research focuses on suicide prevention and the dissemination and implementation of evidence-based interventions with youth involved in the juvenile legal and child welfare systems.