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Multisystem-Involved Youth: A Developmental Framework and Implications for Research, Policy, and Practice

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Abstract

Multisystem-involved youth are children and adolescents concurrently served in the child welfare, behavioral health, and/or juvenile justice systems. These youth are a high risk and vulnerable population, often due to their experience of multiple adversities and trauma, yet little is known about their multiple needs and pathways into multisystem involvement. Multisystem-involved youth present unique challenges to researchers, practitioners, and policymakers. In this article, we summarize the literature on multisystem-involved youth, including prevalence, characteristics, risk factors, and disparities for this population. We then describe a developmental cascade framework, which specifies how exposure to adverse experiences in childhood may have a “cascading” or spillover effect later in development, to depict pathways of multisystem involvement and opportunities for intervention. This framework offers a multidimensional view of involvement across service systems and illustrates the complexities of relationships between micro- and macro-level factors at various stages and domains of development. We conclude that multisystem-involved youth are an understudied population that may represent majority of youth who are already served in another service system. Many of these youth are also disproportionately from racial and ethnic minority backgrounds. Currently, for multisystem-involved youth and their families, there is a lack of standardized and integrated screening procedures to identify youth with open cases across service systems; inadequate use of available instruments to assess exposure to complex trauma; inadequate clinical and family-related evidence-based practices specifically for use with this population; and poor cross-systems collaboration and coordination that align goals and targeted outcomes across systems. We make recommendations for research, practice, and systems development to address the needs of multisystem-involved youth and their families.

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Acknowledgements

The authors would like to thank Erin Hoffman for her assistance in literature review.

Funding

This work was funded by a Grant from the National Institute on Drug Abuse (T32 DA 019426; Jacob Kraemer Tebes, Principal Investigator).

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Authors and Affiliations

  1. Child Welfare and Justice, Westat, Rockville, MD, 20850, USA

    Sarah Vidal

  2. Pennsylvania State University, State College, PA, USA

    Christian M. Connell

  3. Case Western Reserve University, Cleveland, OH, USA

    Dana M. Prince

  4. Yale University School of Medicine, New Haven, CT, USA

    Jacob Kraemer Tebes

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  1. Sarah Vidal
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  2. Christian M. Connell
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  3. Dana M. Prince
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  4. Jacob Kraemer Tebes
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Contributions

SV conceptualized the framework discussed in the article, conducted literature review, and drafted the manuscript; CM participated in conceptualization of the framework and helped draft and reviewed the manuscript; DP helped draft and reviewed the manuscript; JKT participated in conceptualization of the framework and helped draft and reviewed the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sarah Vidal.

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Vidal, S., Connell, C.M., Prince, D.M. et al. Multisystem-Involved Youth: A Developmental Framework and Implications for Research, Policy, and Practice. Adolescent Res Rev 4, 15–29 (2019). https://doi.org/10.1007/s40894-018-0088-1

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