U.S. Department of Health and Human Services


Agency Mission and Goals

Five divisions within the U.S. Department of Health and Human Services (HHS) support activities and research relating to juvenile justice and delinquency prevention. They are the National Institutes of Health (NIH), Substance Abuse and Mental Health Services Administration (SAMHSA), Administration for Children and Families (ACF), Centers for Disease Control and Prevention (CDC), and Health Resources and Services Administration (HRSA).

National Institutes of Health

The mission of NIH is to provide leadership for developing the knowledge necessary to prevent disease and promote the Nation's health. Violence places an enormous burden on mental and physical health and on the Nation's health care delivery system. Violence prevention -- and thus juvenile justice -- is an important part of NIH's mission. NIH has been funding research on violence since the early 1950's, with an emphasis on cumulative knowledge-building with practical applications for daily life. Four NIH institutes support initiatives that relate to juvenile delinquency and its prevention:

Substance Abuse and Mental Health Services Administration

The mission of SAMHSA is to provide national leadership to prevent and treat addictive and mental health problems and disorders and to provide comprehensive services that focus on preventing, intervening with, and treating substance abuse and mental health problems that result from or lead to juveniles' involvement in the juvenile justice system. Many of SAMHSA's adolescent populations become involved in the juvenile justice system through alcohol and other drug use and/or drug distribution and trade. This involvement, coupled with the relationship between alcohol and other drug use and violence, affects youth, their families, communities, and society as a whole. Three SAMHSA components support activities that relate to juvenile justice and delinquency prevention:

Administration for Children and Families

The mission of ACF is to provide leadership and direction for the delivery of programs and services aiding vulnerable children and their families. ACF plans, manages, coordinates, and finances a broad range of programs for children and families. ACF programs focus on children and youth with special problems, including those who have been abused or neglected, have run away from home, require adoption or foster-family services, have a disability, are at risk of gang involvement, or come from low-income families.

The Administration on Children, Youth and Families (ACYF) is the focal point within ACF for programs, activities, and initiatives designed to improve the quality of life for children, youth, and families. ACYF's Family and Youth Services Bureau (FYSB) provides support and assistance to aid and strengthen at-risk youth and their families through effective, comprehensive programs and provides national leadership on youth issues. FYSB offers positive alternatives for youth, ensures their safety, and maximizes their potential to take advantage of available opportunities.

Centers for Disease Control and Prevention

CDC promotes health and quality of life by preventing and controlling disease, injury, and disability. CDC provides leadership in preventing and controlling injuries by reducing the incidence, severity, and adverse outcomes of injury. Major categories of injuries studied at CDC include unintentional injury, intentional injury, acute care, rehabilitation, and disability prevention.

Violence prevention activities at CDC began in the early 1980's. In 1985, violence prevention activities were combined with efforts at CDC to prevent injuries not related to violence (those resulting from motor vehicle crashes, burns, and poisonings) and were placed within CDC's Division of Injury Control in the National Centers for Environmental Health and Injury. In 1992, the injury prevention activities were elevated to the status of a center at CDC: the National Center for Injury Prevention and Control (NCIPC). Early violence prevention activities focused on youth violence and youth suicide. In 1994, CDC funding for activities in the area of family violence was extended. The three priority areas for violence prevention in the Center now are youth violence, family and intimate violence, and suicide. CDC's National Institute for Occupational Safety and Health also engages in violence prevention activities, primarily directed toward violence in the workplace.

NCIPC brings a public health approach to violence prevention that complements the efforts of criminal justice, education, and many other disciplines that work in this area. The public health approach, however, focuses on primary prevention -- preventing violence from happening in the first place. Public health practitioners have considerable experience dealing with multidisciplinary strategies to address a problem, and overcoming violence is certainly a problem that requires many strategies.

NCIPC has helped to define violence as a public health issue. Public health brings a set of practical, time-tested practices and principles for reaching violence prevention goals. The public health model of surveillance and analysis and intervention design, implementation, and evaluation has been applied to a wide range of noninfectious and infectious public health problems with remarkable success.

Health Resources and Services Administration

Three bureaus within HRSA support programs and activities that are aimed at addressing issues associated with juvenile delinquency. The mission of the Maternal and Child Health Bureau (MCHB) is to improve the health and well-being of the Nation's mothers and children by building the infrastructure for the delivery of health care services through a Federal-State partnership. The Bureau of Health Resources Development and the Bureau of Primary Health Care support programs and initiatives to prevent and reduce violence and its negative health consequences.

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Activities and Priorities Relating to Juvenile Justice and Delinquency Prevention

National Institutes of Health

Many of the activities and programs funded by the various divisions within NIH relate to research on juvenile delinquency and delinquency prevention:

Substance Abuse and Mental Health Services Administration

SAMHSA is responsible for preventing and treating addictive and mental health problems. SAMHSA's mission is threefold: to reduce the incidence and prevalence of mental disorders and substance abuse and improve treatment outcomes for persons suffering from addictive and mental health problems and disorders; to provide national leadership to ensure the best use of knowledge based on science to prevent and treat mental and addictive disorders; and to reduce barriers and improve access to high-quality, effective programs.

The work of each of SAMHSA's centers contributes to the agency mission by ensuring comprehensive and quality services to the populations SAMHSA serves. SAMHSA's goals and priorities related to juvenile justice issues include:

In addition, most, if not all, of the CSAP community partnerships have a prevention component for youth, and a significant number work directly with local and State juvenile justice agencies and organizations. CSAP also supports training programs with a juvenile delinquency focus, such as the New and Emerging Issues program. This program develops training and technical assistance to develop skills in preventing ATOD abuse. The program currently has a curriculum to train communities to prevent violence related to AOD abuse. This training is also available to other agencies.

Administration for Children and Families

The Runaway and Homeless Youth program encompasses three service programs that relate to juvenile delinquency prevention. They are the Basic Center Program, the Transitional Living Program, and the Drug Abuse Education and Prevention Program.

The Basic Center Program and the Transitional Living Program were authorized under the Runaway and Homeless Youth Act to:

The Basic Center Program provides grants to community-based public and private agencies for outreach, crisis intervention, temporary shelter, counseling, family reunification, and aftercare services to runaway and homeless youth and their families. A network of 400 youth shelters nationwide helps an estimated 80,000 runaway and homeless youth each year. About 56 percent of the youth's parents also receive services through these programs. In FY 1993, more than half of the youth receiving services were reunited with their families or guardians and approximately one-third were placed in other appropriate living arrangements. Less than 5 percent of the youth receiving services returned to the streets.

Ninety percent of the funds under the Basic Center Program are allocated to States based on the State population under the age of 18 (as it relates to the national total). In addition to the funds that directly support youth shelters, about 10 percent is used for training and technical assistance activities, research and demonstration projects related to runaway and homeless youth, and a national toll-free hotline. The National Runaway Switchboard Hotline is a confidential telephone information, referral, and counseling service for runaway and homeless youth and their families. The hotline has helped about 300,000 youth and their families in the past 5 years. More than 10,000 calls are received monthly on the toll-free number, 800-621-4000.

The Transitional Living Program for Homeless Youth authorizes grants to public and private agencies to address the long-term needs of street youth, to promote their transition to self-sufficient living, and to prevent their long-term dependence on social services. The 78 grantees funded under this program nationwide provide various services to youth between the ages of 16 and 21, including residential care for up to 18 months, information and counseling in basic life skills, interpersonal skill building, educational achievement, job attainment skills, and physical and mental health care.

The Drug Abuse Education and Prevention Program was established by the Anti-Drug Abuse Act of 1988 as a prevention program for youth at risk of involvement with gangs or drugs. Through the Youth Gang Drug Prevention Program, communities are assisted in taking a proactive approach to halting the escalation of illegal gang and drug activity. Since 1989, FYSB has awarded grants to develop community-based consortia; to implement single-purpose youth gang prevention, intervention, and diversion programs; to implement employment and training programs for at-risk youth; to explore methods for gang-proofing young children; and to implement research aimed at gang families and identification of factors that predispose youth to avoid gang involvement.

In addition to these three service programs, the Community Schools Youth Services and Supervision Grant Program (Community Schools) was created by the Violent Crime Control and Law Enforcement Act of 1994. Through this initiative, local schools will provide afterschool, evening, weekend, and holiday activities, and summer education and recreational programs. Through public-private partnerships, grantees will provide a broad spectrum of supervised recreational, extracurricular, and academic programs. These programs also will train teachers, administrators, social workers, guidance counselors, and parent and school volunteers to provide concurrent social services for at-risk students.

Centers for Disease Control and Prevention

CDC's NCIPC supports both intra- and extramural projects in its violence prevention strategy, which encompasses the following steps:

Health Resources and Services Administration

Through MCHB, HRSA administers the Maternal and Child Health Block Grant, Title V of the Social Security Act. Fifteen percent of the block grant appropriation does not go to fund the State Block Grant program but is available for discretionary grants under the Special Projects of Regional and National Significance (SPRANS) program. SPRANS covers a broad range of MCHB responsibility and includes training, research, genetics, hemophilia, and maternal and child health improvement programs.

The objectives of SPRANS are to develop and disseminate new knowledge and approaches to health problems of mothers and children, to develop skilled leadership for maternal and child health programs, and to demonstrate new approaches to service delivery. Projects that relate specifically to violence prevention include:

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Collaborative Efforts

Many HHS programs and initiatives involve collaboration with other Federal agencies and organizations.

NIH currently cofunds projects with other NIH institutes as well as with CSAP. Other projects are cofunded with the U.S. Department of Defense, the National Institute for Occupational Safety and Health, and the National Institute of Justice (NIJ). Staff at NIMH also serve on relevant interagency working groups such as the Department of Education's Early Childhood Research Working Group. Individual grantees may seek additional funds for their projects from other Federal, State, local, and private sources.

NIAAA currently has several linkages with other agencies in preventing alcohol abuse and juvenile delinquency and seeks to expand existing opportunities to coordinate with other Federal agencies. CSAP and NIAAA are jointly funding three community-based intervention studies that focus exclusively on underage drinking, have a component focused on youth, or are assessing the effect of a law that is designed to reduce drinking and driving through license revocation. During the past 2 years, NIJ and NIAAA have sought to jointly fund research on alcohol-related violence (as stated in the NIJ annual program plan), but none of the dual-submitted applications have received scores of sufficiently high priority at either agency to merit funding. Similar opportunities exist for joint funding of research with the Office of Juvenile Justice and Delinquency Prevention and with CDC.

Collaborative efforts of SAMHSA that relate to juvenile justice include the Pre-Adolescent/ Children Initiative (including U.S. Department of Education (ED) and U.S. Department of Justice (DOJ)); funding for NIMH grants involving at-risk youth (conduct disorder); the Communities [formerly Cities] in Schools (CIS), Inc., Project (including DOJ and the U.S. Department of Commerce (DOC)); and a project to reduce substance abuse-related violence and crime in adult and juvenile offenders. In collaboration with DOJ, SAMHSA has cooperative agreements to reduce substance-related violence and crime in juvenile populations.

CSAP is involved in an interagency agreement with DOJ and DOC to implement CIS. This initiative's goal is to reduce school dropout rates, address school-related violence, and coordinate and collaborate substance abuse prevention through its national, regional, State, and local programs.

The Community Schools Youth Services and Supervision Grant Program announcement and award process was administered by ACF in conjunction with ED.

CDC is working with several Federal departments and agencies to better integrate the Federal response to addressing youth violence. CDC is working with the U.S. Department of Housing and Urban Development to fund an organization to provide technical assistance and training to public housing authorities in the area of youth-violence prevention; with NIJ to fund community efforts to bring law enforcement and public health agencies together to address the problem of youth violence and guns; and with ED and DOJ in an epidemiologic study of homicides and suicides that occur in or around schools. CDC organized the National Violence Prevention Conference in Des Moines, Iowa, in 1995, which included broad participation of other Federal agencies. Finally, CDC is collaborating on Project PACT (Pulling America's Communities Together), a Federal initiative designed to help metropolitan area governments address violence and crime in their communities.

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Future Directions

While many activities and priorities of these HHS divisions will remain constant during the next fiscal year, there are a few new priorities for FY 1996. In FY 1996 a special joint solicitation coordinated by the NIH Office of Behavioral and Social Sciences Research, in conjunction with the Office of Research on Women's Health and four NIH institutes (NIA, NIAAA, NIDA, and NIMH), will focus on violence against women and family violence. This activity is being supported in conjunction with NIJ, the National Center on Child Abuse and Neglect, and CDC and is responsive to NIJ's mandates under Title IV, the Violence Against Women Act (VAWA), of the Violent Crime Control and Law Enforcement Act of 1994 (the Crime Act). Title IV mandates a variety of specific studies and evaluation efforts, including the development of a research agenda to increase the understanding and control of violence against women.

In FY 1996, SAMHSA will promote the coordination and integration of services and systems to provide a full range of prevention, treatment, and rehabilitation services for children, increasing the availability of comprehensive services (including other health and supportive services in addition to substance abuse and mental health services) and to reduce the impact of substance abuse and mental illnesses as contributing factors to other threats to health. A critical priority is enacting the 0-7 Children's Initiative.

In addition, the first set of awards for the Prevention of Sexual Abuse and Exploitation Grant program, created by the Crime Act, will be awarded in 1996. Grants will be awarded to private, nonprofit agencies for street-based outreach and education, including treatment, counseling, information dissemination, and referral for runaway, homeless, and street youth who have been sexually abused or who are at risk of sexual abuse.

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FY 1995 Funding

The total FY 1995 NIH funds spent on delinquency prevention was $54 million. This amount represented less than 1 percent of NIH's total grant budget of approximately $9.1 billion. This delinquency prevention budget amount has remained relatively constant since 1993.

NIMH spent approximately $31 million on juvenile justice-related research in FY 1995, $30.5 million in FY 1994, and $30 million in FY 1993. The overall NIMH budget for FY 1995 was $631 million; for FY 1994, $613 million; and for FY 1993, $583 million.

The total FY 1995 funds that SAMHSA spent on juvenile justice-related issues was approximately $17 million. Approximately 5 percent of these funds were indirectly spent on juvenile justice-related issues. This amount accounts for approximately 3 percent of SAMHSA's total agency budget. The budgets were relatively stable between FY 1993 and FY 1994 and rose approximately 10 percent between FY 1994 and FY 1995.

In FY 1995, HRSA's violence prevention activities accounted for approximately $2.5 million in discretionary funds.

Research grants for NIAAA totaled $10.3 million in FY 1995. This amount represents 7.3 percent of NIAAA total grant expenditures.

In FY 1995, VTSRB awarded approximately $3.3 million to 13 projects to increase the scientific understanding of factors associated with youth antisocial behavior.

Funding for the Runaway and Homeless Youth program totaled $68.6 million in FY 1995. Of this amount, $40.5 million was allocated to the Basic Center Program; $13.6 million was allotted to the Transitional Living Program; and $14.55 million was used for the Drug Abuse Education and Prevention Program. In addition, $10 million was allocated to the Community Schools program, and $10.4 million was allocated to the Youth Gang Drug Abuse Prevention Program.

Funding for CDC's violence prevention activities totaled $22 million in FY 1995.

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Legislative Citations

Pub. L. No. 102-321, section 113(f), authorizes the Center for Substance Abuse Prevention's Community Programs (section 509 of the Public Health Service Act, 42 U.S.C. § 290aa-7).

Pub. L. No. 102-321, section 114, authorizes the Center for Substance Abuse Prevention's Prevention, Treatment, and Rehabilitation Model Projects for High-Risk Youth.

Pub. L. No. 102-321, section 110, authorizes the Center for Substance Abuse Prevention's Grants for Substance Abuse Treatment in State and Local Criminal Justice Systems.

The Runaway and Homeless Youth Act, Pub. L. No. 93-415, Title III (1974), 42 U.S.C.

§ 5701 et seq., parts A and B, authorizes the Basic Center Program and the Transitional Living Program.

The Anti-Drug Abuse Act of 1988, Pub. L. No. 100-690, section 3511, authorizes the Drug Abuse Education and Prevention Program.

The Violent Crime Control and Law Enforcement Act of 1994, Pub. L. No. 103-122, sections 30401 and 40155, 42 U.S.C. §§ 13791 and 5712d, created the Community Schools Youth Services and Supervision Grant Program and the Prevention of Sexual Abuse and Exploitation Program.

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