We describe over 300,000 crisis calls made to a large national hotline over a 5-year period. Callers consisted of males and females between the ages of 10 and 89. Overall, a slight majority of callers were first time callers (52%) and most (73%) sought assistance with issues related to parenting, youth concerns, and mental health. Across the lifespan, issues dealing with loneliness increased with age whereas depression-related calls decreased. Additionally, females were more likely than their male counterparts to call the hotline by over a 2-to 1-margin. Findings lend preliminary support to the efficacy of crisis call centers to utilize a flexible, yet well-defined problem-solving approach to assist those of all ages calling with the wide range of problems.

Background In November 20012, Washington State and Colorado became the first states in the United States to legalize recreational marijuana use for adults, and Uruguay became the first country to allow the cultivation, distribution, possession, and use of marijuana. One possible consequence of these changes is increased adolescent marijuana use. Parents may mitigate this adverse consequence; however, whether parents and adolescents have accurate knowledge about the laws and are discussing marijuana use in light of the law changes is unknown. Objective We examine perceptions, knowledge, and parent-child discussions about Washington State’s recreational marijuana law in a sample of low-income families. Methods Participants were a subset of families (n = 115) in an ongoing study that originally recruited parents and adolescents from middle schools in Tacoma, Washington. In summer 2013, when students were entering the 11th grade, students and their parents were asked questions about the recreational marijuana law. Results Participants perceived that their marijuana-related attitudes and behaviors changed little as a result of the law, and displayed uncertainty about what is legal and illegal. Most parents reported discussing the new law with their children but only occasionally, and conversations emphasized household rules, particularly among parent lifetime marijuana users compared to non-users. Conclusions/Importance Results suggest that there should be a public health campaign focused on families that provides clear information about the recreational marijuana laws.

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Background A growing number of states have new legislation extending prior legalization of medical marijuana by allowing non-medical marijuana use for adults. The potential influence of this change in legislation on adolescent marijuana and other substance use (e.g., spillover or substitution effects) is uncertain. We capitalize on an ongoing study to explore the prevalence of marijuana and other substance use in two cohorts of adolescents who experienced the non-medical marijuana law change in Washington State at different ages. Method Participants were 8th graders enrolled in targeted Tacoma, Washington public schools and recruited in two consecutive annual cohorts. The analysis sample was 238 students who completed a baseline survey in the 8th grade and a follow-up survey after the 9th grade. Between the two assessments, the second cohort experienced the Washington State non-medical marijuana law change, whereas the first cohort did not. Self-report survey data on lifetime and past month marijuana, cigarette, and alcohol use were collected. Results Multivariate multilevel modeling showed that cohort differences in the likelihood of marijuana use were significantly different from those for cigarette and alcohol use at follow-up (adjusting for baseline substance initiation). Marijuana use was higher for the second cohort than the first cohort, but this difference was not statistically significant. Rates of cigarette and alcohol use were slightly lower in the second cohort than in the first cohort. Conclusions This exploratory study found that marijuana use was more prevalent among teens shortly after the transition from medical marijuana legalization only to medical and non-medical marijuana legalization, although the difference between cohorts was not statistically significant. The findings also provided some evidence of substitution effects. The analytic technique used here may be useful for examining potential long-term effects of non-medical marijuana laws on adolescent marijuana use and substitution or spillover effects in future studies.

This study examined patterns of movement for youth receiving services within a continuum of intensive and restrictive residentially-based programs. Data were collected for 701 completed episodes of care within a three-program residential continuum of care over a 5 year period, and examined time within program, movement between programs, in-program disruptive behavior, and discharge status. Results showed that most youth either remained in a stable placement in the least restrictive of the programs, or followed a pattern of placements that systematically moved them from more restrictive to less restrictive settings. Of note, transitions from more restrictive to less restrictive programs correspond to deescalating levels of problem behavior; and over 80% of the youth were stepped down to either family-based or independent living situations at the time of departure. Findings support the notion that a continuum of intensive residential services can serve the needs of youth with significant emotional and behavioral needs.

Using data from a U.S. survey of residential care providers on the utilization of evidence-based practices (EBPs) in residential care, this study examines outcomes, processes, and barriers related to the implementation of EBPs. Descriptive data on 115 EBPs implemented in 66 residential care agencies were analyzed with regard to multiple domains of implementation outcomes, such as the adoption, appropriateness, fidelity, and sustainability of EBPs. Study results showed that residential care programs are primarily implementing EBPs that target specific client problems and populations and address prevalent problems of trauma and emotional disorders. A low rate of utilization of milieu-based program models, which were specifically designed for residential care, was noted. Child care staff were mostly excluded from the training and delivery of EBPs. Although providers reported that implementation of EBPs yielded desired results, considerable barriers persisted. Fidelity data raised questions about the degree to which agencies are in fact implementing EBPs. Findings from this exploratory study are meant to encourage further inquiry of the conditions necessary in residential care programs to foster openness toward the implementation of EBPs and to achieve sustained success.

Highlights Trauma symptoms were related to emotional problems & self‐injurious incidents. High and low trauma groups both showed decreases in behavioral incidents and psychopathology. Youth deemed by clinicians to have lower trauma had greater decrease in emotional problems. Trauma symptoms and exposure should both be assessed when determining services.

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