Study on Cook County Juvenile Court recommends shift in priorities

Physicians for Criminal Justice Reform CORE ISSUE:  Reform of juvenile justice system to identify and divert at-risk youth.


According to a report prepared for the government by the Illinois Department of Juvenile Justice, almost 9 out of 10 youth who spend time in Illinois youth prisons end up going back to prison within three years of their release, with Cook County as the highest percentage out of ten counties (Smith 2014). This current study was conducted to increase understanding of the perceived strengths and weaknesses in the juvenile justice system. The more we know about the outcomes of detention and court involvement on youth and their overall neurological and social development, the better we can move forward. Further, our understanding that the majority of court involved youth have experienced complex trauma and have unmet basic needs is important as we consider the best options for rehabilitation and their overall success. This research allows us to increase our understanding further by tapping into the knowledge of juvenile justice stakeholders in order to identify best practices and opportunities that promote positive transformation for youth, families, and communities. This report documents the responses and identifies existing attributes, best practices and challenges in the Cook County Juvenile Court and in the community. The data lead to a wide range of recommendations for change that will increase the success of youth in Cook County, from those that can be implemented in the court and in the community, to recommendations that will result in a paradigm shift in the system and in the ways that we think about youth and juvenile justice. The findings point toward an increase in education and coordination system-wide, with the court taking on a greater role in promoting prevention strategies aimed at keeping youth from entering the system in the first place. Most significantly, the findings point toward the need to keep youth in their communities with a strong emphasis on the system utilizing, building and cooperating with communities to both stem the flow of youth into the system, and for the young people who are in the system, to create a solid strategy to reintegrate youth successfully back into their communities.

CLICK HERE to read the entire study.


Medication for Attention Deficit–Hyperactivity Disorder and Criminality

Physicians for Criminal Justice Reform CORE ISSUE:  PfCJR advocates for reform of the juvenile justice system to identify and divert at-risk youth.  Will you JOIN us?


About 5% of all children in the Western world fulfill diagnostic criteria for attention deficit–hyperactivity disorder (ADHD),1 and a large proportion of such children are treated pharmacologically.2 ADHD has been associated with criminality3,4 and externalizing disorders.5Beneficial short-term effects of ADHD medication on symptoms of ADHD and associated conduct problems have been shown in numerous randomized, controlled studies involving children6-8 and adults.9-11 ADHD symptoms are largely persistent from childhood into adulthood,12 but one prominent feature of ADHD treatment is that the discontinuation of medication is common,13,14especially in adolescence and early adulthood.15 The importance of treatment discontinuation for criminality and other longer-term outcomes is largely unknown.

The Multimodal Treatment of Attention Deficit–Hyperactivity Disorder (MTA) study is the largest randomized clinical trial of ADHD medication with long-term follow-up.16-19 The most sensitive measures of treatment (a composite of ADHD symptoms, as rated by parents and teachers) suggested that the benefit of medication at the 14-month assessment had diminished at 36 months.20 No association was observed with early delinquency and substance use at 36 months.19Although the study did not suggest long-term effects of medication, high rates of treatment discontinuation, a lack of placebo-treated controls, and a limited range of outcomes mean that the longer-term effects of ADHD medication remain uncertain. In this study, we used Swedish population-based data to investigate the association between the use of ADHD medication and criminality.  Click here to read the full study:

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Crisis Intervention Team (CIT) Training for Officers Considered a Best Practice in Law Enforcement

Physicians for Criminal Justice Reform CORE ISSUE:  PfCJR advocates for the decriminalization of mental health and addictive disorders.  Will you JOIN us?


As persons with mental illnesses and law enforcement become increasingly entangled, the collaboration of police and mental health service providers has become critical to appropriately serving the needs of individuals experiencing mental health crises. This article introduces the Crisis Intervention Team (CIT) Model as a collaborative approach to safely and effectively address the needs of persons with mental illnesses, link them to appropriate services, and divert them from the criminal justice system if appropriate. We discuss the key elements of the CIT model, implementation and its related challenges, as well as variations of the model. While this model has not undergone enough research to be deemed an Evidence-Based Practice, it has been successfully utilized in many law enforcement agencies worldwide and is considered a “Best Practice” model in law enforcement. This primer for mental health practitioners serves as an introduction to a model that may already be utilized in their community or serve as a springboard for the development CIT programs where they do not currently exist.  Click here to read the full study:

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Multisystemic Therapy Consistently Demonstrates Positive Outcomes for Chronic Juvenile Offenders

PfCJR CORE ISSUE:  PfCJR advocates for reform of the juvenile justice system to identify and divert at risk adolescents.  Will you JOIN us?

MST is an internationally recognized program for at-risk youth and their families. For more than 30 years, MST has

consistently demonstrated positive outcomes with chronic juvenile offenders. Based on the program’s success,

rigorous randomized trials were conducted to explore the feasibility and effects of adaptations of MST with other target

populations. Results have been positive for treating problem sexual behavior, child abuse and neglect, substance abuse,

serious emotional disturbances and chronic health care conditions. This document highlights the many areas of MST

research and proven outcomes with traditional MST and MST clinical adaptations as well as research on the transport of

MST to community practice settings.


PfCJR Indiegogo Campaign Nearing Goal!

We’re ending our third work week on a high – we have crossed the $1000 mark and we are nearing 800 likes on Facebook! Thank you to all who have donated, liked our page or followed us on Twitter (@pfcjreform). It’s not too late to make an impact – no donation is too small, and you could get a PfCJR button, t-shirt or pin!   Click below to support PfCJR!



Re-Examining Juvenile Incarceration

PfCJR CORE ISSUE:  Reform of the juvenile justice system to identify and divert at risk adolescents.


A growing body of research demonstrates that for many juvenile offenders, lengthy out-of-home placements in secure corrections or other residential facilities fail to produce better outcomes than alternative sanctions. In certain instances, they can be counterproductive. Seeking to reduce recidivism and achieve better returns on their juvenile justice spending, several states have recently enacted laws that limit which youth can be committed to these facilities and moderates the length of time they can spend there. These changes prioritize the use of costly facilities and intensive programming for serious offenders who present a higher risk of reoffending, while supporting effective community-based programs for others.

Click here to read the entire report.

Patient Safety: Moving the Bar in Prison Health Care Standards

Physicians for Criminal Justice Reform CORE ISSUE: Provision of adequate access to physical and psychiatric health care for current inmates.


Improvements in community health care quality through error reduction have been slow to transfer to correctional settings. We convened a panel of correctional experts, which recommended 60 patient safety standards focusing on such issues as creating safety cultures at organizational, supervisory, and staff levels through changes to policy and training and by ensuring staff competency, reducing medication errors, encouraging the seamless transfer of information between and within practice settings, and developing mechanisms to detect errors or near misses and to shift the emphasis from blaming staff to fixing systems. To our knowledge, this is the first published set of standards focusing on patient safety in prisons, adapted from the emerging literature on quality improvement in the community.

Click here to access the full article.

Human Rights Watch Report

Human Rights PfCJR CORE ISSUE:  Provision of adequate access to physical and psychiatric health care for current inmates. Human Rights Watch has issued a 127-page investigative report that describes the use of excessive force by the criminal justice system in America. The report, “Callous and Cruel: Use of Force Against Inmates With Mental Disabilities in US Jails and Prisons,” charges that, “Jails and prisons staff throughout the United States have used unnecessary, excessive and even malicious force against prisoners with mental disabilities.”

Physicians for Criminal Justice Reform Official Launch

On May 11, 2015, neurosurgeon Dr. Edjah Nduom, officially launched Physicians for Criminal Justice Reform. Using Facebook as a the main vehicle, he and his co-founder, Dr. Nzinga Harrison, a highly-respected psychiatrist invited physician colleagues and non-physician allies to join the organization which was formed to provide a collective voice through which physicians can advocate to eliminate the damaging health consequences that can result from interactions with the criminal justice system. Below is a copy of the inaugural Facebook post.

Dear Friends and Colleagues,

I am very proud to announce the official launch of an organization that I have founded, together with a small team of like-minded physicians – Physicians for Criminal Justice Reform.

You all may have noticed the difference in my Facebook activity over the last several months. Several recent tragic events involving the deaths of unarmed men at the hands of the police have highlighted longstanding concerns regarding how the police interact with certain at-risk communities. These events have captured my attention, along with the attention of the media and concerned people worldwide.

While it may be tempting to feel gratified that these events have received publicity and leave it at that, I have spent the last several months feeling that we all need to spend more time addressing the factors that are truly at the root of many of the issues we see today.

In my own research, this led me to Criminal Justice Reform as a major root cause, time and time again. As a physician, the next question became – is there a specific role for physicians to make a significant impact on this issue? I quickly decided that the answer was, “Yes, but how?” I started by looking for an organization for physicians interested in these issues, and I could not find anything that spoke to the concerns that I have with the current criminal justice system.

About four months ago, I reached out to Nzinga Harrison, a leading psychiatrist in Atlanta, GA with the idea of founding an organization for physicians to address these issues. Instead of telling me that I was insane, she was excited, and we quickly reached out to others, who all expressed their enthusiasm and lent their expertise to the cause.

Over the last four months, I have spent hours of my own free time studying, speaking with colleagues, reading articles and searching for resources on this topic. After numerous brainstorming sessions, conference calls and emails back and forth, we have created the language for this organization that we feel truly represents the best way forward for physicians to have a real impact on creating lasting reform in the criminal justice system that can help our most vulnerable patients.

Physicians can no longer stand on the sidelines while our patients suffer due to flaws in the criminal justice system. The time is now to make our voices heard.

Please join us on Facebook at and on Twitter: @PfCJReform.

Our Indiegogo page, to raise funds to establish our organization as a 501c3 organization and create a permanent website is live at:

We look forward to working with you soon!


If you are interested in joining or supporting Physicians for Criminal Justice Reform (PfCJR), you can: