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Unmet Needs: Adverse Childhood Experiences and Mental Health

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Unmet Needs: Adverse Childhood Experiences and Mental Health UNMET NEEDS: ADVERSE CHILDHOOD EXPERIENCES AND MENTAL HEALTH ISSUES AS PATHWAYS TO RECIDIVISM IN JUSTICE-INVOLVED YOUTH By MELISSA ALLYN KOWALSKI A dissertation submitted in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY WASHINGTON STATE UNIVERSITY Department of Criminal Justice and Criminology MAY 2019 © Copyright by MELISSA ALLYN KOWALSKI, 2019 All Rights Reserved © Copyright by MELISSA ALLYN KOWALSKI, 2019 All Rights Reserved To the Faculty of Washington State University: The members of the Committee appointed to examine the dissertation of MELISSA ALLYN KOWALSKI find it satisfactory and recommend that it be accepted. Zachary K. Hamilton, Ph.D., Chair Mary K. Stohr, Ph.D. Amelie Pedneault, Ph.D. Michael T. Baglivio, Ph.D. ii ACKNOWLEDGMENTS Over the past four years I have received much encouragement from many individuals, and this dissertation would not have been realized without that support. I would like to express my deep gratitude to my dissertation committee for their assistance, guidance, and feedback. I thank my chair, Zachary Hamilton, for fostering my interest in statistics and research when I thought it was not the route for me and for providing me with the skills and resources I needed to become a capable and successful scholar. I thank Mary Stohr for her keen editing, attention to detail, and always providing a nurturing environment and looking out for my best interests. I thank Amelie Pedneault for her insightful feedback, push to include theory, and time spent reviewing my dissertation. I thank Michael Baglivio for his expertise on my dissertation subject and asking questions that made my work better. My gratefulness extends to Craig Hemmens, who has always provided support and valuable feedback to help me become a successful teacher and researcher. Advice given by Dale Willits has also assisted me in strengthening my research skills. I would also like to thank all of the other faculty members of the Department of Criminal Justice and Criminology at Washington State University who have helped shape my scholarly work, aided me in becoming a stronger academic, and stoked my continued interest in the criminal justice system. My special thanks are also extended to the staff of the department, whose work behind the scenes keeps the department running. To all of the other graduate students, I thank you for the support with research, teaching, and the Graduate Student Association as well as making my experience in graduate school wonderful. I would also like to express my appreciation to the Oregon Youth Authority, which has helped me further develop my research skills. The work you do is inspiring, and you have furthered my interest in conducting research in the juvenile justice system to help those in need. I iii would also like to express my gratitude to the Washington State Center for Court Research in the Administration Office of the Courts for allowing me to examine the data used for this dissertation and providing insight on any questions I had pertaining to the data. To my parents, Lori and Daniel Cerutti and Duane Ray, I am indebted to you for teaching me the importance of a strong work ethic in addition to continuously supporting me. For my brother, Bryant Ray, I thank you for challenging me to better myself and insisting that I pursue my doctorate. Finally, I thank my husband Erik Kowalski and son Quinten Kowalski. Erik, you have been there for me through the best and worst of times, always providing unconditional support and weathering my stubbornness and stress-provoked moodiness with an astounding amount of patience. Thank you for your love and always pushing me to better myself. Quinten, despite your toddler-driven tantrums and many nights of sleep lost (which also allowed me to complete a lot of work), thank you for showing me the importance of taking a break and enjoying the moment. You are a little spitfire, and I would not change a thing about you. iv UNMET NEEDS: ADVERSE CHILDHOOD EXPERIENCES AND MENTAL HEALTH ISSUES AS PATHWAYS TO RECIDIVISM IN JUSTICE-INVOLVED YOUTH Abstract by Melissa Allyn Kowalski, Ph.D. Washington State University May 2019 Chair: Zachary K. Hamilton Standard practice within the correctional system dictates that certain needs, such as antisocial personality, cognitions, and peers, are to be prioritized when providing interventions. However, greater concern has arisen regarding the prevalence of non-criminogenic needs, including traumatic experiences and mental health problems, in the justice-involved youth population and whether these youths’ needs are being met while in the juvenile justice system. The juvenile justice literature indicates that Adverse Childhood Experiences (ACEs), which may act as a proxy for trauma, and mental health concerns are prevalent in the justice-involved youth population. While these topics have been examined independently, the current study utilized a large sample of male (n = 38,100) and female (n = 12,762) youths on community supervision to identify whether these youths’ needs are currently being addressed in Washington State. Moreover, the effect of programming on these youths’ adverse experiences and specific mental health problems (internalizing, externalizing, or co-occurring symptoms) was examined to ascertain whether provided interventions ameliorated the effect of these needs on youths’ recidivism. Life course theory was also tested to assess whether early-onset youth differed from v those with a late onset on their reoffending. In a statistically weighted sample of youth with need-service matches versus those with mismatches, results demonstrated that mismatches were not associated with increased recidivism. Additionally, mediated path analyses showed that only substance abuse treatment impacts the relationship between ACEs and reoffending for males. Internalizing symptoms presented as a protective factor that was mediated by substance use treatment. Conversely, both externalizing and co-occurring symptoms presented as risk factors, but the effect of the latter was decreased by substance abuse programming for males. Lastly, early-onset of deviance resulted in higher recidivism odds. These findings have implication for practice, insofar that they add context regarding which youth histories (ACEs) and attributes (mental health symptomatology) affect treatment efficacy, thus potentially reducing risk to the public and improving youths’ personal well-being. In short, the results suggest a move away from a hyper-focus on risk to consideration of both youths’ needs and their responsivity to programming. vi TABLE OF CONTENTS Page ACKNOWLEDGMENTS ............................................................................................................. iii ABSTRACT .....................................................................................................................................v LIST OF TABLES ......................................................................................................................... ix LIST OF FIGURES .........................................................................................................................x CHAPTERS CHAPTER ONE: INTRODUCTION ..................................................................................1 Purpose of the Study ....................................................................................................13 CHAPTER TWO: REVIEW OF THE LITERATURE .....................................................15 Life Course Theory ......................................................................................................16 Risk-Need-Responsivity Model ...................................................................................18 The Positive Achievement Change Tool .....................................................................34 Adverse Childhood Experiences ..................................................................................36 Youth and Mental Health Issues ..................................................................................48 Prevention and Programming ......................................................................................62 Gender Responsivity ....................................................................................................74 Summary ......................................................................................................................85 The Current Study ........................................................................................................85 CHAPTER THREE: RESEARCH METHODOLOGY ....................................................87 Research Questions ......................................................................................................87 Data ..............................................................................................................................88 Analytic Plan ................................................................................................................93 vii CHAPTER FOUR: FINDINGS .......................................................................................100 Effect of Need-Service Matching on Recidivism ......................................................101 ACEs as Potential Needs and Responsivity Factors ..................................................110 Effect of MHPs on the Relationship between Gender and Recidivism .....................118 Mental Health Symptoms as Needs and Responsivity Factors ..................................121
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