UCSF

Justice-involved youth experience high rates of Adverse Childhood Experiences (ACEs), placing them in great need of behavioral health treatment and risk for continued justice involvement. Policy makers, government agencies, and professionals working with justice-involved youth have called for trauma-informed juvenile justice reform. Yet, there is currently no available review of the literature on ACEs and their impact on justice-involved youths’ psychological, legal and related (e.g., academic) outcomes to rigorously guide such reform efforts. The current systematic scoping review synthesizes existing literature related to the impact of ACEs on justice-involved youth and offers recommendations for data-driven intervention along the Sequential Intercept Model, which describes five different points of justice system contact (i.e., first arrest, court diversion, detention, community supervision) in which there is opportunity to intervene and improve youth behavioral health, legal and associated outcomes. Eight unique studies were included in 40 articles examining ACEs among justice-involved youth; 38% were longitudinal/ prospective analyses and none were intervention studies. Studies included delinquency (e.g., recidivism; n=5), psychiatric (n=4), substance use (n=3), and other (n=2; e.g., academic, pregnancy) outcomes, documenting high prevalence of ACEs and significant associations between ACEs and a variety of outcomes. Implications for clinical services (e.g., targeting youth dysregulation and aggression), agency context (e.g., training police officers in trauma-responsive practices), and system-level changes (e.g., intervening at the time of first ACE documentation such as parent’s arrest) are discussed.

Public Significance Statement: Systematic scoping review results demonstrate youth in contact with the juvenile justice system have high rates of Adverse Childhood Experiences (ACEs), which are associated with greater behavioral health needs and worse legal outcomes. Studies point to critical public health need for data-driven, trauma-informed responses at multiple levels across the continuum of juvenile justice involvement, including: clinical service (e.g., addressing youth dysregulation and aggression versus requiring trauma diagnosis), agency (e.g., training police officers in trauma-responsive practices), and systems (e.g., intervening at time of first ACE documentation, such as parent’s incarceration).