Although the burden of mental health disorders among youth involved with the juvenile justice system is high, few communities have effectively integrated mental health resources with law enforcement (Myers & Farrell, 2008). The city of Cambridge, Massachusetts has developed the Safety Net Collaborative, which is a multiagency integrated model of preventive services for at-risk youth involving mental health providers, police officers, schools, and the department of youth and families. There are 6,000 youth in the city's public schools under the local police jurisdiction. Youth are referred to this program by schools, courts, and parents. There are approximately 30 active cases each year. Initial outcome measures were tracked, including number of arrests, diversions, and mental health referrals. Rate of decline in arrests was compared pre and post implementation. Community arrests have decreased by more than 50% since implementing this model. Contracting with mental health services has led to an average 94 outpatient mental health provider referral per year. The results show positive trends in arrest rates after implementation of this collaborative model of preventive services. These findings support greater research and utilization of integrated, preventive service models for at-risk youth. (PsycINFO Database Record

Youth involved in the juvenile justice system typically have a high prevalence of mental health disorders. Although police are frequently the first point of contact for these youth, they are often not trained to understand or address their mental health challenges. To combat this, interventions through community policing have increased police awareness of mental health and decreased arrests of these youth throughout the country. Yet there is scant research examining the effects these changes have had on access to mental health treatment for youth. This study aims to assess whether Cambridge's police-mental health collaboration increased utilization of youth mental health care. This study included 207 subjects who were either diverted (n ϭ 71) or summonsed/arrested (n ϭ 136). Their individual arrest and health care records were combined to retrospectively evaluate the rate of health care service utilization before and after initial police contact. Both groups showed similar rates of mental health diagnoses. Youth who were diverted had significantly increased outpatient mental health visits when comparing before with after diversion. This rate was also significantly higher than that of those with an initial arrest or summons. There was no difference between groups for acute inpatient visits or emergency department (ED) visits. These findings support translational efforts to partner police with community mental health providers to increase access to treatment, decrease stigma, and keep our neighborhoods safe. What is the significance of this article for the general public?Youth at risk for arrest or detention typically suffer from high rates of mental health difficulties and have poor access to needed services. The results of this study demonstrate that a model of ongoing collaboration between psychologists, community services, and community police can divert youth from arrest, increase at-risk youth access to outpatient mental health treatment, and decrease the likelihood of incarceration.

Cat-scratch disease-associated vertebral osteomyelitis and epidural involvement are rare and may manifest with nonspecific chronic symptoms in children, such as fever or torticollis. We present only the fourth case in the literature describing epidural involvement in an immunocompetent boy presenting with fever, torticollis, and indiscriminate left upper back tenderness. Bartonella henselae serologies are important to consider because such atypical complications often are responsive to conservative management with antibiotics.

This column reports results from a qualitative study of employees' knowledge of and access to mental health benefits after implementation of New York State's parity law in 2007. Fifty-four employed individuals with insurance coverage were interviewed by telephone (32 adults with mental illness and 22 parents of children with mental illness). Contrary to findings of previous studies, most had been informed of their coverage limits before the parity law but were unaware of their extended parity benefits. They cited their lack of knowledge and inadequate communication from their health plan as barriers to accessing benefits. They also reported barriers to accessing high-quality services. The findings indicate an urgent need for benefits education and monitoring of health plan communications on a federal level.

This study evaluates the effectiveness of a police diversion program between 2008 and 2016. Youth participating in the diversion program were compared to youth not participating in diversion on the probability of, and time to, second offense using unadjusted comparisons at 6, 12, 18, 24, and 36 months, unadjusted lifetable comparisons of time to second arrest, and Cox multivariate proportional hazards regression models. Diverted youth had significantly fewer second offenses. The rate of recidivism among diverted youth was lower than non-diversion youth at all time periods in unadjusted models, and statistically significant at 6 months, 12 months, and 18 months.