This special topic report examines the prevalence and characteristics of co-occurring substance abuse and mental health problems among juvenile detainees in Maricopa County. The findings come from the Co-occurring Disorder Addendum used during 2007. The findings reveal that almost 30 percent of juvenile detainees were at risk for a co-occurring disorder, and face significantly greater difficulties across a number of critical factors, including incarceration, homelessness, and victimization.

This special topic report examines the prevalence and characteristics of co-occurring substance abuse and mental health problems among adult arrestees in Maricopa County. The findings suggest that more than 28 percent of adult arrestees in Maricopa County are at risk for a co-occurring disorder, and they face significantly greater difficulties across a number of critical factors, including incarceration, homelessness, and victimization. Understanding the prevalence and particular characteristics of the dual-diagnosed arrestee population in Maricopa County is an important part of assessing demands on behavioral health and substance use treatment resources. Additionally, examining some of the current defining characteristics of this population relative to arrestees not dually diagnosed can serve as an indicator of future demand.

Arizona’s public behavioral health care system, which serves some 150,000 mentally ill and vulnerable state residents, is wrestling with a number of urgent challenges. In addition to budget cuts resulting from the current economic crisis, and the demands of a 28-year-old class-action lawsuit, the system has been repeatedly criticized in several areas, including for inadequate staff, data, housing support, and crisis services. On July 22, a panel of professionals who play key roles in the system discussed these and other issues before some 300 behavioral health providers, supervisors, and policymakers at the annual Summer Institute hosted by Arizona State University’s Center for Applied Behavioral Health Policy. This paper provides an abbreviated report of that discussion, which was partially designed and moderated by ASU’s Morrison Institute for Public Policy.

Severe and widespread budget cuts in behavioral health and substance abuse services for lower-income Arizonans who don’t qualify for AHCCCS have already taken effect across the state. Even before these cuts were implemented, it was clear that the publicly-supported behavioral health system in our state was not adequately serving many Arizonans who needed mental health or substance use disorder treatment. This paper represents an effort by Arizona State University’s Centers for Applied Behavioral Health Policy and the Morrison Institute for Public Policy to promote and enrich Arizona’s public dialogue about these problems and potential solutions.

In spring 1998, 1,057 10th-grade students were surveyed as one component of a statewide evaluation of Arizona's school-to-work system designed by the Morrison Institute for Public Policy. This second survey measured attitudes toward and participation in career activities. Results were compared to baseline data collected from over 2,000 10th-grade students in 1997. Data indicated that, in both years, nearly all students had at least an idea of their career area of interest; gender differences were observed in students' selections of career interests. Student participation in activities increased. Statistically significant differences in participation by sex were evident: more girls reported learning about careers in class and participating in volunteer activities; and more boys participated in internships with pay, worked for pay in a job unrelated to their careers, and had business mentors. The share of students who had selected a career interest increased as participation rose. All 14 activities were at least "somewhat" helpful to students in making career selections. In both years, students ranked family, teachers, and friends most highly as influencing career interests. One-fourth of students in 1998 compared to one-third of students in 1997 indicated they never received career guidance at school. Less than one-half of students were aware of courses related to career interests; even fewer actually took a course related to their interests.

One component of a multi-faceted evaluation of the state's STW initiative involves surveying tenth grade students. Thus, the survey was designed to assess the extent to which Arizona tenth grade students have selected career majors, planned a course of study for high school and beyond, and received adult guidance related to careers. As part of the evaluation, the intent was to look at the extent to which career preparation and work experiences truly are system-wide and impact students. In contrast, the purpose was not to evaluate whether STW program participants are receiving school-based learning components.

Tenth-grade students in Arizona school to work (STW) regional partnerships were polled in 1997, 1998, and 1999, to determine whether systemic change was occurring across the state. Study results were mixed. Three activities increased significantly over the baseline year: class projects, computer use, and volunteerism. The use of career inventories declined over the same period. The role of adults in helping students explore career choices remained relatively stable. Further, the number of students who had some idea of their career interests had not changed significantly. Gender differences still existed and were largely unchanged. Fewer students reported taking courses related to their career interests. The relationship of participation in career-related activities to an ability to state a career interest continued to be strong. Students felt job shadowing, business mentors, and internships would be most helpful. However, fewer students participated in these activities. The participating students were better able to articulate their career interests and, in general, had more frequent and positive attitudes about participation in STW. Statewide programs reported positive student outcomes as a result of STW activities. Evidence of systemic change was beginning to be seen. Most significantly, class projects, computer use, and volunteer projects showed consistent gains over the three years.

One component of a multi-faceted evaluation of the state's STW initiative involves surveying seventh grade students regarding career awareness and career exploration and counseling in order to help students who may be interested to identify, and select or reconsider, their interests, goals and career majors, including those options that may not be traditional for their gender, race, or ethnicity.

In spring 1998, 1,020 seventh-grade students were surveyed as one component of a statewide evaluation of Arizona's school-to-work system designed by the Morrison Institute for Public Policy. This second survey measured attitudes toward and participation in career activities. Results were compared to baseline data collected from over 2,000 seventh-grade students in 1997. Data showed that student participation in activities increased. Top-ranked activities were the same in both years: classroom speakers, discussions with adults, class projects, field trips, and job shadowing. In both years, more than 60 percent said at least one activity helped them think about choosing a career; roughly 35 percent indicated having a definite idea of what they want to do in the future; and student participation in various activities was positively related to their ability to define a career interest. In both years, mentoring by other adults was up, whereas mentoring by school personnel had decreased. Students who talked to adults about their careers were significantly more likely to have identified a career interest. In both years, fewer boys were apt to report any adult talked to them about careers. The number of students who planned to take classes in high school that teach job skills showed a statistically significant decrease. Girls were more certain they would take classes. In both years, about one-third of students agreed some jobs are best for women, and some for men; boys agreed most often.

Arizona seventh-grade students were polled in 1997, 1998, and 1999, to determine the extent of their participation in career awareness and exploration activities, the impact that the activities have had, and how they were delivered. Survey results provided evidence of systemic change in the regional school-to-work (STW) partnerships. Further, data suggested that the way career awareness activities are delivered makes a difference in their effectiveness. The comparative survey conducted in 1999 supported the contention that STW students differed from their classmates and that STW made a difference for students. The regional analysis compared randomly selected classrooms over 3 years. Changes between 1997 and 1999 were measured in participation metrics and the role of adult mentors. The relative share of students who had at least some idea of their career interests was consistently high (86.8 percent). The mean number of STW activities per pupil increased significantly and the share of students participating in five types of activities rose. A key finding supported over the 3-year period was that students who participated in a variety of activities were better able to identify their career interests. The role of adult mentors intensified. The share of students who talked to adults about careers, and who discussed careers with a counselor, increased significantly between 1997-99.