Objective. Crossover youth are broadly defined as youth who have had contact with both the child welfare and youth justice systems. Although there has been increased research on crossover youth, including the numerous negative outcomes they experience (e.g., high rates of recidivism, multiple out-of-home placements; Herz, Ryan, & Bilchik, 2010), much of this research has been based on data drawn from large child welfare and youth justice administrative databases. This approach may limit our understanding of crossover youth in other domains in which they also experience difficulties (e.g., mental health and substance use), as well as limit our understanding of these youth from a variety of perspectives (e.g., community service providers). Given that high rates of mental health and substance use difficulties are of concern for crossover youth (Turpel-Lafond & Kendall, 2009), we need more specific information on their mental health needs, how these needs are met, and how service providers conceptualize the needs of crossover youth. To begin to address these questions, the two papers that make up my dissertation examined the mental health needs of crossover youth and service providers' perspectives on those needs, respectively. Paper 1. The first part of this paper examined whether crossover youth have unique mental health symptomatology (in terms of symptom type and/or severity) compared to their peers involved in a single-system (i.e., youth justice or child welfare alone) and their non-system-involved peers. Part two examined whether youth system involvement and symptom presentation predicted receipt of mental health services. To address these questions, 389 youth in Grades 7 to 10 were recruited from school boards and mental health agencies across Ontario, Canada to complete self-report surveys. Crossover youth had the highest rates of all types of mental health symptoms and a significantly higher rate of externalizing symptoms compared to child welfare and non-system-involved youth. With respect to service receipt, findings are discussed in terms of the differential impact of internalizing versus externalizing symptoms, as well as system-level barriers. Paper 2. The aim of the second paper was to gather information on service providers' perspectives on crossover youth, their needs, and the barriers they may face while navigating various systems. Semi-structured interview data from 10 service providers from multiple service domains (e.g., mental health, child welfare, housing) resulted in the following five themes grounded in the data: 1) crossover youth have unique experiences and needs that make them a distinguishable group; 2) family struggles---particularly difficulties with relational connectedness or attachment---impact crossover youth as they move through various systems; 3) crossover youth struggle to engage in positive relationships with others (e.g., peers and service providers); 4) crossover youth require multiple services across multiple service domains; and 5) crossover youth face numerous barriers in having their needs met, which are exacerbated by the behavioral and relational difficulties they experience. These findings exemplified that crossover youth are impacted by both individual factors (e.g., behavioral and relational difficulties) and system level factors (e.g., multiple service providers), which interact to create further challenges for crossover youth. These themes, along with previous research, were used to create an exploratory model encompassing the experiences of crossover youth at the individual and system levels, with the aim of providing a more holistic perspective on the needs of crossover youth as well as stimulating future research. Conclusions. Together, the findings from both papers highlight the importance of continued research that broadens our understanding of crossover youth beyond their experiences and outcomes in the child welfare and youth justice systems. To help inform the development of effective treatment programs and prevent negative outcomes, a more in-depth exploration is required of individual factors (particularly behavioral and relational difficulties), system level factors, and how these factors may interact to exacerbate negative outcomes for crossover youth.
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