Health Disparities & Public Policy Program

The NJP is the first large-scale, longitudinal study of the mental health needs, substance abuse, antisocial and criminal behaviors, and adult outcomes of delinquent youth. From 1995 to 1998, we enrolled 1,829 randomly-selected youth, 1,172 males and 657 females, as they entered the Cook County Juvenile Temporary Detention Center.  Our sample is stratified by gender, race/ethnicity (African American, non-Hispanic white, Hispanic), age, and severity of charge.  Importantly, it includes sufficient African Americans and Hispanics (including diversity among Hispanics) to examine health inequities.  Funded by a consortium of federal agencies and private foundations (see Grants and Funding below), we have been tracking and re-interviewing our participants since April 1996.  Unlike many studies that lose participants if they are incarcerated at follow-up, we re-interview our participants regardless of whether they are living in the community or are incarcerated.  Thanks to the generosity of our participants, state-of-the-art search tools, a sophisticated data management system, and the cooperation of many agencies in Chicago, Cook County, and the State of Illinois, we re-interviewed 81.6% of participants still enrolled in the study at the 16-year follow-up.   

How Is the Northwestern Juvenile Project Unique?  Most prior investigations examined community populations to see who becomes delinquent; the Northwestern Juvenile Project studies youth already in the juvenile justice system.  We focus on these youth because they are at great risk for poor outcomes, including psychiatric disorders, life-threatening problem behaviors, HIV/AIDS, and premature violent death. Most studies of correctional populations focus only on criminogenic variables; the Northwestern Juvenile Project examines health and social outcomes and follows these outcomes over time.  To date, participants have been interviewed up to 13 times.  Our longitudinal design thus includes data on adolescence (10-17 years), emerging adulthood (18-24 years), and young adulthood (25+ years).  Our findings help guide the development of intervention strategies for youth and young adults involved with the criminal justice system.

We disseminate our findings to maximize the benefit of the study for the public. We publish articles in scientific journals that are widely read and broadly disseminated.  In addition, we archive a copy of de-identified data at National Archive of Criminal Justice Data, allowing other investigators to pursue additional analyses.  Finally, we collaborate with organizations such as the National Juvenile Detention Association, American Bar Association, and the National Institute of Corrections to ensure that our findings are available to guide innovative justice policy.  Our findings have been cited in Supreme Court amicus briefs, in congressional hearings, and by many federal agencies, private agencies, and advocacy groups.

The Next Generation study focuses on determining characteristics that promote resilience among children in at-risk families.  Funded again by a consortium of agencies, and private foundations (see Grants and Funding below).

We are currently interviewing participants from our original Northwestern Juvenile Project with children ages 10 to 18 years.  By identifying the strengths of children, their parents, their social networks and their communities, we can determine what helps youth avoid drug abuse, delinquent behavior, and firearm involvement and instead promotes mental health, healthy relationships, and educational achievement.  We also investigate what helps children be resilient in the face of a parent’s incarceration.

Started in 1995, the Northwestern Victimization Project was the first large-scale, longitudinal study of crime victimization patterns in persons with severe mental illnesses living in the community.  Prior studies of violence and mental disorders had focused on perpetration by persons with severe mental illnesses, not victimization.  We examined the rates, risk factors, and patterns of crime victimization in 936 persons with chronic, severe mental disorders.  More than one-quarter of the sample had been victims of a violent crime in the past year, a rate more than 11 times higher than general population rates, even after controlling for demographic differences between the two samples.  The Northwestern Victimization Project has been replicated in the Netherlands and other countries, where public health officials now realize that victimization of persons with severe mental illnesses is a far more serious threat to public health than perpetration.

The Health Disparities and Public Policy program conducted the first large-scale epidemiologic studies of psychiatric disorders among male and female adult jail detainees.  Between 1983 and 1995, a series of investigations examined (1) the prevalence of psychiatric disorders in jail detainees, and (2) whether detainees who had severe mental illnesses received treatment while in jail.  Our findings highlight the discrepancy between jail detainees’ need for mental health services and the services that they receive.  Only 20 percent of female detainees who needed psychiatric services received them.  Because jails were never intended to be psychiatric hospitals, few have the resources necessary to adequately treat the increasing numbers of people with psychiatric disorders entering detention nationwide.  Our findings demonstrated that funds must be provided for jails to systematically screen detainees upon admission, provide treatment during their stay, and refer them for services after they are released.

Incarceration of persons with psychiatric illnesses disproportionately affects minorities, who are least likely to be able to afford mental health care.  In an observational study of police officers, our findings showed that mentally ill persons had an arrest rate nearly double that of non-mentally ill persons.  Police reluctantly arrested mentally ill persons when a mental health evaluation and treatment would have been preferable but was not available.  The findings suggested that reduced community services had resulted in mentally ill persons being “criminalized”; for many, arrest had supplanted hospitalization.  The findings supported the thesis, set forth by public health experts, that for poor persons—especially racial/ethnic minorities—arrest and incarceration had become the entrée for receiving mental health services.  The findings of this study were cited in amicus briefs to the Supreme Court, were used in many hearings by Congress, and highlighted the need for special diversion programs for mentally ill persons in the criminal justice system.

Luna, M.J., Abram, K.M., Aaby, D.A., Welty, L.J., & Teplin, L.A. (2023). Inequities in Mental Health Service Use:  A 16-Year Longitudinal Study of Youth in the Justice System.  Journal of the American Academy of Child and Adolescent Psychiatry. Online ahead of print. https://doi.org/10.1016/j.jaac.2023.07.005

Stokes, M.L., Abram, K.M., Welty, L.J., Meyerson, N.S., Zawitz, C., & Teplin, L.A. (2023). Substance use disorders and HIV/AIDS risk behaviors in delinquent youth after detention: A 16-year longitudinal study. Journal of Adolescent Health, 73, 640-649. https://doi.org/10.1016/j.jadohealth.2023.05.015 

Zheng, N., Abram, K.M., Welty, L.J., Aaby, D.A., Meyerson, N.S., & Teplin, L.A. (2023). Firearm injury and mortality in high-risk youth and young adults: A 25-year prospective longitudinal study. JAMA Network Open, 6(4), e238902. https://doi.org/10.1001/jamanetworkopen.2023.8902

Teplin, L.A., Meyerson, N.S., Jakubowski, J.A., Aaby, D.A., Zheng, N., Abram, K.M., & Welty, L.J. (2021). Association of firearm access, use, and victimization during adolescence with firearm perpetration during adulthood in a 16-year longitudinal study of youth involved in the juvenile justice system. JAMA Network Open, 4(2), e2034208. https://doi.org/10.1001/jamanetworkopen.2020.34208

Teplin, L.A., Potthoff, L.M., Aaby, D.A., Welty, L. J, Dulcan, M.K., & Abram, K.M. (2021). Prevalence, comorbidity, and continuity of psychiatric disorders in delinquent youth after detention: A 15-year longitudinal study. JAMA Pediatrics. 175(7): e205807. https://doi:10.1001/jamapediatrics.2020.5807

Harrison, A.J., Jakubowski, J.A., Abram, K.M., Teplin, L.A., & Welty, L.J. (2020). Patterns of incarceration among youth after detention: A 16-year longitudinal study. Children and Youth Services Review, Vol 108, 104516. https://doi:10.1016/j.childyouth.2019.104516

Zwecker N.A., Harrison A.H., Welty L.J., Teplin L.A., & Abram K.M. (2018). Social support networks among delinquent youth: An 8-year follow-up study. Journal of Offender Rehabilitation, 57(7), 459-480. https://doi:10.1080/10509674.2018.1523821 PMC6561504

Welty, L.J., Hershfield, J.A., Abram, K.M., Han, H., Byck, G.R., & Teplin, L.A. (2017). Trajectories of substance use disorder in youth after detention: A 12-year longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 56(2), 140-148. https://doi:10.1016/j.jaac.2016.10.018  PMC5308462 

Abram, K.M., Stokes, M.L., Welty, L.J., Aaby, D.A., & Teplin, L.A. (2017). Disparities in HIV/AIDS risk behaviors after youth leave detention: A 14-year longitudinal study.  Pediatrics. 139(2): e20160360. https://doi.org/10.1542/peds.2016-0360 PMC5260145

Abram, K.M., Azores-Gococo, N.M., Emanuel, K.M., Aaby, D.A., Welty, L.J., Hershfield, J.A., Rosenbaum, M.S., & Teplin, L.A. (2017). Sex and racial/ethnic differences in positive outcomes in delinquent youth after detention: A 12-year longitudinal study. JAMA Pediatrics, 171(2), 123-132. https://doi:10.1001/jamapediatrics.2016.3260 PMC5704941

Welty, L.J., Harrison, A.J., Abram, K.M., Olson, N.D., Aaby, D.A., McCoy, K.P., Washburn, J.J., & Teplin, L.A. (2016). Health disparities in drug- and alcohol-use disorders: A 12-year longitudinal study of youths after detention. American Journal of Public Health, 106(5), 872-880. https://doi:10.2105/AJPH.2015.303032 PMC4985078

Harnisher, J.L., Abram, K.M., Washburn, J.J., Stokes, M., Azores-Gococo, N.M., & Teplin, L.A. (2015). Loss due to death and its association with mental disorders in juvenile detainees. Juvenile and Family Court Journal, 66(3), 1-18. https://doi:10.1111/jfcj.12029 PMC4577059

Stokes, M.L., McCoy, K.P., Abram, K.M., Byck, G.R., & Teplin, L.A. (2015). Suicidal ideation and behavior in youth in the juvenile justice system: A review of the literature. Journal of Correctional Health Care, 21(3), 222-242. https://doi:10.1177/1078345815587001 PMC5704936

Elkington, K.S., Teplin, L.A., Abram, K.M., Jakubowski, J.A., Dulcan, M.K., & Welty, L.J. (2015). Psychiatric disorders and violence: A study of delinquent youth after detention. Journal of the American Academy of Child and Adolescent Psychiatry, 54(4), 302-312 e305. https://doi:10.1016/j.jaac.2015.01.002 PMC4369770

El Bcheraoui, C., Zhang, X., Welty, L.J., Abram, K.M., Teplin, L.A., & Sutton, M.Y. (2015). HIV knowledge among a longitudinal cohort of juvenile detainees in an urban setting. Journal of Correctional Health Care, 21(2), 112-124. https://doi:10.1177/1078345815572596 PMC5704944

Abram, K.M., Zwecker, N.A., Welty, L.J., Hershfield, J.A., Dulcan, M.K., & Teplin, L.A. (2015). Comorbidity and continuity of psychiatric disorders in youth after detention: A prospective longitudinal study. JAMA Psychiatry, 72(1), 84-93. https://doi:10.1001/jamapsychiatry.2014.1375 PMC4562696

Teplin, L.A., Jakubowski, J.A., Abram, K.M., Olson, N.D., Stokes, M.L., & Welty, L.J. (2014). Firearm homicide and other causes of death in delinquents: a 16-year prospective study. Pediatrics, 134(1), 63-73. https://doi:10.1542/peds.2013-3966 PMC4067641

Lansing, A.E., Washburn, J.J., Abram, K.M., Thomas, U.C., Welty, L.J., & Teplin, L.A. (2014). Cognitive and academic functioning of juvenile detainees: implications for correctional populations and public health. Journal of Correctional Health Care, 20(1), 18-30. https://doi:10.1177/1078345813505450 PMC4292927

Teplin, L.A., Welty, L.J., Abram, K.M., Dulcan, M.K., & Washburn, J.J. (2012). Prevalence and persistence of psychiatric disorders in youth after detention: a prospective longitudinal study. Archives of General Psychiatry, 69(10), 1031-1043. https://doi:10.1001/archgenpsychiatry.2011.2062 PMC3737771

King, D.C., Abram, K.M., Romero, E.G., Washburn, J.J., Welty, L.J., & Teplin, L.A. (2011). Childhood maltreatment and psychiatric disorders among detained youths. Psychiatric Services, 62(12), 1430-1438. https://doi:10.1176/appi.ps.004412010 PMC3742320

Abram, K.M., Choe, J.Y., Washburn, J.J., Romero, E.G., & Teplin, L.A. (2009). Functional impairment in youth three years after detention. Journal of Adolescent Health, 44(6), 528-535. https://doi:10.1016/j.jadohealth.2008.10.005 PMC2759315

Washburn, J.J., Teplin, L.A., Voss, L.S., Simon, C.D., Abram, K.M., & McClelland, G.M. (2008). Psychiatric disorders among detained youths: A comparison of youths processed in juvenile court and adult criminal court. Psychiatric Services, 59(9), 965-973. https://doi:10.1176/ps.2008.59.9.965 PMC2718561

Elkington, K.S., Teplin, L.A., Mericle, A.A., Welty, L.J., Romero, E.G., & Abram, K.M. (2008). HIV/sexually transmitted infection risk behaviors in delinquent youth with psychiatric disorders: A longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 901-911. https://doi:10.1097/CHI.0b013e318179962b PMC2754224

Abram, K.M., Paskar, L.D., Washburn, J.J., & Teplin, L.A. (2008). Perceived barriers to mental health services among youths in detention. Journal of the American Academy of Child and Adolescent Psychiatry, 47(3), 301-308. https://doi:10.1097/CHI.0b013e318160b3bb PMC2945389

Abram, K.M., Choe, J.Y., Washburn, J.J., Teplin, L.A., King, D.C., & Dulcan, M.K. (2008). Suicidal ideation and behaviors among youths in juvenile detention. Journal of the American Academy of Child and Adolescent Psychiatry, 47(3), 291-300. https://doi:10.1097/CHI.0b013e318160b3ce PMC2945393

Washburn, J.J., Romero, E.G., Welty, L.J., Abram, K.M., Teplin, L.A., McClelland, G.M., & Paskar, L.D. (2007). Development of antisocial personality disorder in detained youths: the predictive value of mental disorders. Journal of Consulting and Clinical Psychology, 75(2), 221-231. https://doi:10.1037/0022-006X.75.2.221 PMC2804474

Romero, E.G., Teplin, L.A., McClelland, G.M., Abram, K.M., Welty, L.J., & Washburn, J.J. (2007). A longitudinal study of the prevalence, development, and persistence of HIV/sexually transmitted infection risk behaviors in delinquent youth: Implications for health care in the community. Pediatrics, 119(5), e1126-1141. https://doi:10.1542/peds.2006-0128 PMC2813809

Abram, K.M., Washburn, J.J., Teplin, L.A., Emanuel, K.M., Romero, E.G., & McClelland, G.M. (2007). Posttraumatic stress disorder and psychiatric comorbidity among detained youths. Psychiatric Services, 58(10), 1311-1316. https://doi:10.1176/ps.2007.58.10.1311 PMC2818309

Swahn, M.H., Whitaker, D. J., Pippen, C.B., Leeb, R.T., Teplin, L.A., Abram, K.M., & McClelland, G.M. (2006). Concordance between self-reported maltreatment and court records of abuse or neglect among high-risk youths. American Journal of Public Health, 96(10), 1849-1853. https://doi:10.2105/AJPH.2004.058230 PMC1586157

Teplin, L.A., McClelland, G.M., Abram, K.M., & Weiner, D.A. (2005). Crime victimization in adults with severe mental illness: Comparison with the National Crime Victimization Survey. Archives of General Psychiatry, 62(8), 911-921. https://doi:10.1001/archpsyc.62.8.911 PMC1389236. Summary Tables 

Teplin, L.A., McClelland, G.M., Abram, K.M., & Mileusnic, D. (2005). Early violent death among delinquent youth: A prospective longitudinal study. Pediatrics, 115(6), 1586-1593. https://doi:10.1542/peds.2004-1459 PMC1351295

Teplin, L.A., Elkington, K.S., McClelland, G.M., Abram, K.M., Mericle, A.A., & Washburn, J.J. (2005). Major mental disorders, substance use disorders, comorbidity, and HIV-AIDS risk behaviors in juvenile detainees. Psychiatric Services, 56(7), 823-828. https://doi:10.1176/appi.ps.56.7.823 PMC1557408

Teplin, L.A., Abram, K.M., McClelland, G.M., Washburn, J.J., & Pikus, A.K. (2005). Detecting mental disorder in juvenile detainees: Who receives services? American Journal of Public Health, 95(10), 1773-1780. https://doi:10.2105/AJPH.2005.067819 PMC1449435

McClelland, G.M., Elkington, K.S., Teplin, L.A., & Abram, K.M. (2004). Multiple substance use disorders in juvenile detainees. Journal of the American Academy of Child and Adolescent Psychiatry, 43(10), 1215-1224. https://doi:10.1097/01.chi.0000134489.58054.9c PMC2791706

Abram, K.M., Teplin, L.A., Charles, D.R., Longworth, S.L., McClelland, G.M., & Dulcan, M.K. (2004). Posttraumatic stress disorder and trauma in youth in juvenile detention. Archives of General Psychiatry, 61(4), 403-410. https://doi:10.1001/archpsyc.61.4.403 PMC2861915

Teplin, L.A., Mericle, A.A., McClelland, G.M., & Abram, K.M. (2003). HIV and AIDS risk behaviors in juvenile detainees: implications for public health policy. American Journal of Public Health, 93(6), 906-912. https://doi.org/10.2105/AJPH.93.6.906 PMC1447866

Abram, K.M., Teplin, L.A., McClelland, G.M., & Dulcan, M.K. (2003). Comorbid psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry, 60(11), 1097-1108. https://doi:10.1001/archpsyc.60.11.1097 PMC2893728

Teplin, L.A., Abram, K.M., McClelland, G.M., Dulcan, M.K., & Mericle, A.A. (2002). Psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry, 59(12), 1133-1143. https://doi:10.1001/archpsyc.59.12.1133 PMC2861992

Teplin, L.A., Welty, L.J., Abram, K.M., Dulcan, M.K., Washburn, J.J., McCoy K., & Stokes, M.L. (2015). Prevalence and Persistence of Psychiatric Disorders in Youth after Detention: A Prospective Longitudinal Study.  (Beyond Detention Series, OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ246824). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice. 

Abram, K.M., Paskar, L.D., Washburn, J.J., Teplin, L.A., & Zwecker, N.A. (2015). Perceived Barriers to Mental Health Services Among Youths in Detention. (Beyond Detention Series, OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ248522). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice. 

Washburn, J.J., Teplin, L.A., Voss, L.S., Simon, C.D., Abram, K.M., McClelland, G.M., & Olson, N.D. (2015). Psychiatric Disorders Among Detained Youths: A Comparison of Youths Processed in Juvenile Court and Adult Criminal Court. (Beyond Detention Series, OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ248283). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice.

Teplin, L.A., McClelland, G.M., Abram, K.M., Mileusnic-Polchan, D., Olson, N.D., & Harrison, A.J. (2015). Violent Death in Delinquent Youth After Detention (Beyond Detention Series, OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ248408). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice.

Abram, K.M., Choe, J.Y., Washburn, J.J., Teplin, L.A., King, D.C., Dulcan, M.K., & Bassett, E. D. (2014). Suicidal Thoughts and Behaviors Among Detained Youth. (Beyond Detention Series, OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ 243891). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice.

Abram, K.M., Choe J.Y., Washburn, J.J., Romero, E.G., Teplin, L.A., & Bassett, E.D. (2013). Functional Impairment in Youth Three Years After Detention. (Beyond Detention Series, OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ 239996).  Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice.

Abram, K.M., Teplin, L.A., King, D.R., Longworth, S.L., Emanuel, K.M., Romero, E.G., McClelland, G.M., Dulcan, M.K., Washburn, J.J., Welty, L.J., & Olson, N.D. (2013). Posttraumatic Stress Disorder, Trauma, and Comorbid Psychiatric Disorders in Youth in Juvenile Detention. (Beyond Detention Series, OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ239603). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice.

Teplin, L.A., Abram, K.M., Washburn, J.J., Welty, L.J., & Hershfield, J.A. (2013). The Northwestern Juvenile Project: Overview. (Beyond Detention Series, OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ234522). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice.

Teplin, L.A., Abram, K.M., McClelland, G.M., Mericle, A.A., Dulcan, M.K., & Washburn, J.J. (2006). Psychiatric Disorders of Youth in Detention. (OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ210331). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice.

McClelland, G.M., Teplin, L.A., Abram, K.M. (2004). Detection and Prevalence of Substance Use Among Juvenile Detainees. (OJJDP Juvenile Justice Bulletin, NCJ Pub. No. NCJ20394). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Department of Justice.

Teplin, L.A. (2001). Assessing Alcohol, Drug, and Mental Disorders in Juvenile Detainees (OJJDP Fact Sheet, NCJ Pub. No. FS200102). Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US, Department of Justice.

• National Institutes of Justice (Department of Justice (DOJ))
• National Institute of Child Health and Human Development (National Institutes of Health (NIH))
• National Institute on Drug Abuse (NIH)
• National Institute on Minority Health and Health Disparities (NIH)
• Centers for Disease Control and Prevention (Health and Human Services (HHS))

• Center for Mental Health Services (Substance Abuse and Mental Health Services Administration (SAMHSA))
• Center for Substance Abuse Prevention (SAMHSA)
• Center for Substance Abuse Treatment (SAMHSA)
• Centers for Disease Control and Prevention (HHS)
• National Institute of Child Health and Human Development Health (NIH)
• National Institute of Mental Health (NIH)
• National Institute on Alcohol Abuse and Alcoholism (NIH)
• National Institute on Minority Health and Health Disparities (NIH)
• Office of Behavioral and Social Sciences Research (NIH)
• Office of Juvenile Justice and Delinquency Prevention (DOJ)
• Office of Rare Disease Research (NIH)
• Office of Research on Women’s Health (NIH)
• S. Department of Housing and Urban Development (HUD)
• S. Department of Labor (DOL)
• Charles Koch Foundation
• Chicago Community Trust
• Isaac Ray Center (Northwestern University Feinberg School of Medicine)
• John D. and Catherine T. MacArthur Foundation
• Joyce Foundation
• Open Society Foundations
• Robert Wood Johnson Foundation
• William T. Grant Foundation