Troubled or Troubling? Characteristics of Youth Referred to a System of Care Without System-Level Referral Constraints

The characteristics of 128 youth with emotional and behavioral disorders referred to a system of care were investigated according to agency referral, behavioral and emotional issues, and risk factors. The referral process in this system of care was unique, with each agency referring youth deemed to need multiagency services. The primary analysis used a two-step clustering procedure to examine characteristic profiles, and results produced evidence of four types of referral profiles: Troubled, Troubling. Troubled and Troubling, and At Risk. It was found that youth with various impairments and corresponding needs were referred by different agencies (e.g., troubling youth were most likely to be referred by juvenile probation), but all agencies referred youth across the four clusters. The results of this study are examined with respect to the long-standing policy debate regarding which youth with emotional and behavioral disorders should be given priority to receive services. Implications about evaluating outcomes in systems of care are also discussed.