© 2005 Behavioral Health Research Institute of the Southwest
612 Encino Place NE / Albuquerque, NM 87102 / 505.244.3099 / www.bhrcs.org

Y-STOP and Y-START:
Projects that Help Teens Live Healthy, Drug-free Lives
Funded by the McCune Charitable Foundation

In 1997 the Behavioral Health Research Center of the Southwest (BHRCS) contracted with the New Mexico Traffic Safety Bureau (NMTSB) to study issues of underage substance abuse, its impact on the offender, the criminal justice system’s response, and recidivism. This study revealed that a high number of juveniles were arrested for substance abuse-related crimes. The report also pointed out gaps in services for juveniles in the criminal justice system, high offender recidivism rates, lack of compliance monitoring, and lack of systems to track offenders and evaluate the effectiveness of existing treatment programs. In response to these findings, BHRCS was given a second year of funding to develop a state-of-the-art screening program. Each juvenile was administered tests including such variables as substance abuse, domestic violence, mental health, physical health, peer relationship issues, values, etc. The results of these tests were discussed with the juvenile by his/her counselor or screener who is trained in motivational interviewing. The instrument, by summarizing areas of high risk, facilitated recommendations for treatment care. To determine offender needs, as well as to evaluate program effectiveness, test results and demographic data were entered into a computerized database. Compliance was monitored through a computerized tracking system.

At the program’s foundation is a comprehensive assessment tool crafted to ascertain health information in a juvenile justice setting. This tool contains a computer-based questionnaire that generates individualized summaries of identified risk areas to be discussed with the juvenile by a counselor or screener. Because results are presented visually (using graphs and feedback that compare the individual to a specific population), the instrument helps juveniles understand their problems in a more concrete and striking way. The tool we developed measures high-risk behaviors and situations, including substance abuse, domestic violence, symptoms of mental and physical health problems, and problems with peer and family relationships. Goals and Objectives. To continue efforts to assess high-risk youths throughout the juvenile justice system statewide, and among groups of youths not yet identified as being at-risk. Although we began this project in the criminal justice arena, non-criminal-justice organizations—such as schools, activity centers, and leadership programs—also needed an accurate and reliable screening instrument. Because the non-criminal-justice community wants a screening instrument designed for the general population of adolescents who have not been identified, we have modified Y-STOP (Youth Screening and Treatment Opportunities Program) for use with students, activity centers and as a health screening, substance abuse and violence prevention tool. This modified instrument will be called Y-START (Youth Screening to Avoid Risk Taking). Analysis of test results and feedback on the instrument from the juvenile offenders and counselors will be used to refine the instrument and evaluate its efficacy.

Although the instrument was pilot tested in an agency where the counselors are degreed and licensed, BHRCS’s goal is to make the instrument available in places where there are no, or very few, degreed and licensed counselors. This is particularly important in New Mexico, where communities are geographically isolated and degreed and licensed counselors are unavailable. BHRCS’s goal is to train lay counselors across the state in providing competent instrument feedback and appropriate referral techniques. In this way, the instrument can become a significant tool for communities with limited resources.

We will continue to refine Y-STOP AND Y-START to meet the demands of the broad spectrum of juveniles, agencies and systems. Planned changes to the program include administering the questionnaire as a computer-generated, rather than paper-and-pencil, assessment. New and exciting research has demonstrated the effectiveness of computer-based prevention/early intervention programs in providing preventive health services. The familiar personal computer is nonjudgmental, objective, and accurate. Previous studies, including those conducted at our Center, have found that in private, teens openly enjoy completing confidential computer interviews and readily accept automated medical advice. We also are exploring a collaboration to incorporate the instrument as a module of an already existing computer-based interview called the Youth Health Provider.

We will evaluate the effectiveness of Y-STOP and Y-START by 1) determining the test-retest reliability and internal consistency of questions and scales; 2) asking users, both staff and the juveniles, to evaluate it. To accomplish this, we will use both written evaluations and focus groups with the juvenile participants and with the program staff who administer the assessment instrument and provide the feedback to the participants. By making the test results accessible to those individuals working with these juveniles, New Mexico can attain valuable information on teen substance abuse and mental health needs, risk levels, compliance with referrals or treatment, and recidivism.

The results will enable the criminal justice system, schools, treatment centers, and other systems to evaluate and divert juveniles into treatment before their problems become chronic. Hence, even those juveniles who seem to be low risk could be identified early as to other possible problems and risk factors that need attention.

We hope, by using this screening tool designed to assess risk and recidivism, to be able to demonstrate the pervasive level of problems that exist when there is a cry for help due to criminal activity or substance abuse. The results could enable the criminal justice system to evaluate and divert juveniles into treatment before their problems become chronic. Furthermore, the screening process will facilitate identification of the best treatment alternatives for each offender. Hence, even those juveniles who seem to be low risk (i.e., who have a minor charge) could be identified early as to other possible problems and risk factors that need attention.