The effectiveness of juvenile drug courts is mixed, and several factors could account for these findings. The present study examines whether and why youth with co-occurring mental health problems may have worse outcomes in juvenile drug court than youth who only have issues with substance use. In a sample of youth in juvenile drug court, 328 youth with co-occurring mental and substance use disorders were compared with 336 youth with only substance use disorders. Youth with co-occurring mental health problems had significantly worse criminal justice outcomes than youth without mental health problems. These outcomes were explained, in part, by more frequent violations of the drug court requirements, and in particular, violations surrounding treatment noncompliance. Results suggest that juvenile drug courts—as they currently operate—may be unsuccessfully managing youth who present with co-occurring mental health and substance use problems. Implications for policy and practice are discussed.
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