Pilot Project: Family Law Navigation Model
Background
In the United States, nearly 14 million people seek services through the Family Court System each year as they divorce, legally separate, or seek child support from a co-parent. Divorce and parental separation are a risk factor for the development of mental health issues, substance use, and suicide death among those separating and their children. For many, the Family Court System is their first point of contact with the legal system, making it a potential early intervention point in providing mental health and suicide prevention service information directly to families. Increasing the Family Court System’s capacity to intervene to support mental health could have a major impact on suicide prevention efforts nationally. This project intends to pilot a Family Law Navigation Model (FLN) that aims to increase the use of mental health services for youth and families, prevent suicide, and prepare for a larger evaluation of the model.
Project Details
This NCHATS project will build on an ongoing investigation into whether it is feasible and appropriate to offer legal and mental health navigation to parents and youth in family law settings, as well as whether this service improves family court processes. This project will collect data on mental health service engagement, mental health and suicidality outcomes, and overall program costs, with a goal of providing feasibility data for future widespread implementation of the FLN Model for parents and children in family court.
The proposed pilot will examine the feasibility of three areas:
- Aim 1: Assessing parent and child receipt of and level of engagement with the mental health services recommended through the FLN program;
- Aim 2: Assessing parent and child mental health and suicidality outcomes, and criminal/juvenile legal involvement via self-report and administrative data; and
- Aim 3: Conducting an economic evaluation for the FLN.
Principal Investigator
Pilot Project: Disrupting Youth Suicide
Background
Suicide is the second-leading cause of death in the U.S. for youth between the ages of 10 and 24. Suicidal thoughts and behaviors confer greater risk for suicide. That risk is amplified when interactions with the juvenile legal system occur. To accelerate innovations in intervention and prevention, this team will use qualitative interviews, quantitative meta-analysis, and integration of stakeholders from many systems and professions to better understand the prevalence of suicidal thoughts and behaviors in youth, as well as their key risk and protective factors. The project will evaluate youth at multiple touchpoints within the juvenile legal system.
Project Details
Disparities in suicidal thoughts and behaviors among youth overall, and especially those with juvenile legal system involvement, are likely to grow without innovations in prevention and intervention. This requires improved knowledge about the prevalence of these behaviors. To accelerate discoveries, several innovations should be prioritized.
- Aim 1: To meta-analyze the prevalence of suicidal thoughts and behaviors among youth involved in the juvenile legal system across multiple intercepts, ranging from court-involvement to youth with a history of juvenile detention.
- Aim 2: To test structural-level risk factors for suicidal thoughts and behaviors among youth. Current risk factors mostly reflect clinical and family factors. This project hypothesizes that structural factors like arrest history, recidivism, treatment receipt, child welfare involvement, out-of-home-placements, will uniquely predict suicidal thoughts and behaviors over and above clinical and family risk factors.
- Aim 3: To employ mixed methods to characterize potential protective factors by conducting qualitative interviews with youth with various juvenile legal system involvement, ranging from court involved to those with a history of detention.
Principal Investigators
Pilot Project: Understanding and Addressing Suicide Stigma and Misinformation Among Criminal Legal Practitioners
Background
The Addiction Policy Forum (APF), in partnership with the National Center for Health and Justice Integration for Suicide Prevention (NCHATS), aims to address suicide stigma and misinformation among criminal legal practitioners and stakeholders. Individuals in the criminal legal system, especially those with substance use and mental health disorders, are at significantly higher risk for suicide. This population often views suicide through a punitive lens, associating it with guilt or criminality instead of recognizing it as a behavioral health issue. This creates barriers to adopting evidence-based practices for suicide prevention and contributes to systemic challenges in providing care.
Project Details
This two-year project seeks to improve suicide prevention within the criminal legal system through three key activities:
- Stakeholder Engagement: APF will partner with the National District Attorneys Association (NDAA) and other stakeholders to build trust and facilitate communication. These partnerships will ensure those perspectives inform project strategies and messaging.
- Survey: Deploy a survey to identify and understand the experiences, challenges, barriers, and needs regarding suicide prevention efforts in the criminal legal system among a broad cross-section of stakeholders, including prosecutors, judges, law enforcement, healthcare providers, patients/caregivers, and peer recovery coaches.
- Resource Development and Dissemination: Using insights from the survey, APF will co-create targeted materials, including webinars, toolkits, infographics, and policy guides, tailored to the needs of criminal-legal system professionals. These materials will correct misinformation, reduce stigma, and promote the adoption of EBPs.
The project will bridge gaps between research and practice, equipping practitioners with tools to better understand and address suicide. It will also generate preliminary data for future NIH-funded research, enhancing the dissemination of suicide prevention strategies in the criminal legal system.
Principal Investigator
Pilot Project: Crisis Diverted: Adapting Scalable Crisis Response Interventions for People Involved in a Criminal Legal System Diversion Program
Overview
The National Center for Health and Justice Integration for Suicide Prevention (NCHATS) is seeking to expand evidence-based crisis response interventions for individuals involved in the criminal-legal system. This pilot project will assess the feasibility and acceptability of a combined Crisis Line Facilitation (CLF) and Take-Home Naloxone (THN) intervention for individuals participating in Baltimore’s pre-booking diversion program.
Objectives
- Identify usability and implementation factors necessary for adapting the CLF+THN intervention for individuals involved in the criminal-legal system.
- Develop a tailored intervention model, including training protocols, workflows, and data resources.
- Conduct a pilot study to evaluate the acceptability and feasibility of the intervention within a criminal-legal system pre-booking diversion program.
Individuals involved in the criminal-legal system face heightened risks for suicide and overdose, but often encounter barriers to seeking help. CLF shows promise for reducing suicide attempts, while THN is designed to prevent overdose fatalities. This project will be the first to integrate these two interventions within a diversion program, leveraging human-centered design principles and collaboration with Baltimore Crisis Response, Inc. Findings will inform a larger-scale study to assess intervention effectiveness and implementation strategies, potentially leading to broader adoption in diversion programs nationwide.
Principal Investigators
Co-Investigators
- Stephanie Holliday, PhD
