Improving the Reclaiming Futures System of Care: Building on 14 years of Innovation

A “system,” with all its interconnected parts, is something we don’t really notice when it’s working well. That’s the hallmark of an effective system and when things are working well enough, most people rarely take the time to stop and reflect on how they can improve the systems they are part of. When your car is working well, you are less likely to take the time to lift up the hood and check things out. You’re even less likely to consider making improvements.  You may do that, however, if you are about to head out on a journey and anticipate challenges along the way.

At the Reclaiming Futures National Program Office, we’re looking toward the future and have recently challenged ourselves to do just that – to look under the hood. Not because of concerns about the effectiveness of the Reclaiming Futures model and our public health-oriented approach to improving treatment outcomes for juvenile justice system involved youth. To the contrary, we've seen strong outcomes for youth and evidence of better-integrated systems of care in every community where we've worked. Rather it’s because we are looking for ways to improve on our good outcomes and broaden our impact. We are well aware that the landscape of juvenile justice reform is evolving (we've been influential in that evolution) and we are committed to evolving and innovating along with it. This is critical if we are to continue to help jurisdictions improve their systems of care and to equip our now 39 sites - and the field in general - with the necessary tools to impact the health and well being of the vulnerable youth they serve as the landscape inevitably changes.

How has the landscape of juvenile justice reform evolved since our launch in 2000? Notably, fewer and fewer youth are detained and incarcerated for minor offenses just because they have unmet treatment needs. We’ve seen an increasing number of communities using state of the art screening and assessment tools to accurately estimate a youth’s treatment needs and disentangle those needs from the factors that suggest that they may continue to pose a risk to their communities. More and more communities are triaging youth into community-based treatment, using evidence-supported treatment methods, and going beyond treatment by counterbalancing those treatment approaches with strengths-based programming. There is great acceptance of the notion that involving the young people we serve in positive youth development-oriented programming like mentoring and community engagement projects is just as important as the treatment we may provide. And finally, the use of reliable assessment and research tested treatment approaches has helped build trust in community treatment, and many jurisdictions are relying less on residential placement as a way of guaranteeing that youth get services.

Communities and the systems that work to support at-risk youth are collaborating with the courts and other government systems in ways thought unimaginable when Reclaiming Futures first launched. Reclaiming Futures is proud to have been a catalyst in setting a new standard for cross-system collaboration and leading a national movement to enhance therapeutic jurisprudence with state-of-the-art assessment and evidence-based treatment practices.

Still, youth are falling through the cracks. National studies estimate that only one in thirteen youth who need substance use treatment actually end up getting help. Behavioral health services are still most easily accessed for youth who penetrate deeper into the system and fewer options are available for youth “upstream” of the courts in settings where high numbers of youth show signs of risk, but don’t get appropriate intervention. These settings include status offender programs in the courts, pre-trial and detention diversion programs, and school discipline settings. Research and best practices in public health tell us that focusing on the vulnerable youth in these settings is critical, and that developing prevention strategies and engaging treatment approaches tailored to youth in these settings will prevent emerging substance use and mental health problems from getting worse. These are not areas where Reclaiming Futures has focused systematic attention in the past, but where our expertise is needed.

Last month Reclaiming Futures received a $2 million grant from the Conrad N. Hilton Foundation to take up the challenge and bring the skills and experience of our national learning collaborative to bear in prevention and diversion settings just “upstream” of the courts. With this grant, Reclaiming Futures joins a cohort of 17 Hilton Foundation grantees tasked with innovating and testing the hypothesis that intervening early with at risk youth by adapting and disseminating an exciting new prevention and treatment framework known as Screening Brief Intervention and Referral to Treatment (SBIRT) will pay off for this underserved population.

Reclaiming Futures will return to it’s roots as an innovator in the public health and treatment field by designing a new adaption of SBIRT that we have termed SBIRT-JJ, tailored specifically for youth at immediate risk of juvenile justice involvement. This winter, Reclaiming futures will launch a 3-year, five-site national pilot of SBIRT-JJ. Participating sites for the pilot will include three existing sites as well as two entirely new Reclaiming Futures sites that will be fully funded by this initiative. This week we have issued a call for proposals  from sites interested in adding SBIRT-JJ to their continuum of care and in joining the Reclaiming Futures initiative. The link for this call for proposals can be found here.

Reclaiming Futures is excited by the opportunity to stay ahead of the curve and continuing to innovate in order to meet the changing needs of the youth, families and the systems we support.

Evan Elkin is a senior advisor to Reclaiming Futures and has been involved with the initiative in a variety of capacities since it’s launch in 2000. Evan will serve as the treatment model developer for the Reclaiming Futures SBIRT adaptation (SBIRT-JJ) and Clinical Director overseeing the three-year, five-site pilot.