Shairi R. Turner, MD, MPH


Chief Transformation Officer Crisis Text Line, Tallahassee, FL

Shairi R. Turner MD, MPH is the Chief Transformation Officer for Crisis Text Line a Not-For-Profit volunteer-supported organization delivering crisis interventions using a text platform. She is responsible for guiding the organizations’ culture transformation at a time when it is at a necessary inflection point. Previously she served at CTL as the Chief Medical Officer from 2017-2019. In this role she provided oversight to the Crisis Supervision team and led many of the clinical policy and quality initiatives within the Organization. A Stanford graduate and a Harvard-trained Internist and Pediatrician with a Master of Public Health from the Harvard School of Public Health, Dr. Turner has a long history in organization transformation. In 2005 Dr. Turner was appointed as the first Chief Medical Director in the eleven-year history of the Florida Department of Juvenile Justice (DJJ). She established the Office of Health Services that provided oversight of the provision of Health, Mental Health, Disability and Substance Abuse services to the nearly 100,000 justice-involved youth. During her tenure with the Department of Juvenile Justice, Dr. Turner’s focus also included the impact of childhood trauma (physical, sexual and emotional abuse) on youth involved in the juvenile justice system, as well as the importance of gender specific services designed to meet the unique needs of girls in the system. She has given numerous presentations nationally on issues relating to health/mental health care in the juvenile justice setting. She was instrumental in the introduction of trauma informed care to DJJ.

As the Deputy Secretary for Health and Interim State Surgeon General for the Florida Department of Health (DOH), she led the legislatively mandated reorganization for one of the largest state public health departments in the country. After her departure, she was a faculty consultant for the National Center for Trauma Informed Care where she performed numerous national trainings on the neurobiology of trauma to state and local entities including mental health and criminal/juvenile justice administrators and staff. Dr. Turner was the Project Co-Director for the U.S. Office on Women’s Health-funded Trauma Informed Care e- Cases, a comprehensive series of online virtual patient cases targeting primary care providers these cases are focused on effective approaches to the care of patients who have survived traumatic life experiences such as sexual assault, interpersonal and community violence, military sexual trauma, child abuse, neglect, and family dysfunction. She has presented internationally on the neurobiology of trauma (Shanghai, China). She currently also holds a Research Faculty appointment at the Florida State University, College of Social Work and is a Voluntary Associate Professor of Public Health Sciences at the University of Miami, Leonard M. Miller School of Medicine. The native of New York City earned an undergraduate degree in Biology from Stanford University in 1991, a Doctor of Medicine degree from Case Western University School of Medicine in Cleveland, Ohio and in 1996 she was also inducted into the Alpha Omega Alpha Honors Medical Society. Dr. Turner then completed the four-year Harvard Combined Internal Medicine and Pediatrics Residency Program at the Massachusetts General Hospital and the Children's Hospital of Boston in 2000. From 2001 to 2002, she was a Commonwealth Fund/Harvard University Fellow in Minority Health Policy and earned a Master of Public Health from the Harvard School of Public Health with a concentration in Health Policy and Management. She is married and the mother of two teenage student-athletes.


Substance Abuse Policies: Implications for Minority Adolescents in the Department of Youth Services


Assess the extent of substance use, specifically by minorities in the Department of Youth Services (DYS) in the State of Massachusetts, and aid in the redevelopment of policies that improve interventions and treatment in the DYS Day Reporting Centers.


In the United States, illegal drug and alcohol use by adolescents have been a serious problem for nearly four decades.  Based on self-reporting, the rates of illicit drug use by American adolescents peaked in the early eighties at 66%, declined until the early nineties, then after a steady rise has leveled at approximately 54%.  Over the past 26 years, the drug of choice for teenagers has been marijuana.  Although other more addictive and lethal drugs have entered the market during this time period, the perceived lower health risks of marijuana continue to make it more widely used.  Alarmingly 80% of today’s teens have consumed alcohol and 51% have done so before the age of 13.

When surveyed, minority adolescents (particularly African American youth), report substantially lower rates of alcohol use when compared to Caucasians. Hispanic youth have rates of alcohol use which are closer to those of Caucasians.  The rate of marijuana use among all youths is essentially the same (25-29%) but African American youth are much less likely than Caucasians and Hispanics to use drugs other than Marijuana.

With persistent drug use at earlier and earlier ages, many adolescents become involved with criminal activities, crimes of drug possession or crimes related to drug use.  In fact, data reveals that there is a direct correlation between substance abuse, delinquency, violent behavior and arrest.    Despite lower rates of substance use, minority adolescents are processed through all levels of the criminal justice system in numbers greater than their white counterparts.   This trend continues into adulthood where the number of drug offense admissions to U.S. prisons has increased disproportionately for African American men.


This project was designed to assist the Department of Youth Services (DYS), the juvenile justice system in the State of Massachusetts, in re-developing its substance abuse policy.   An extensive review of the literature centered on substance use among adolescents, substance use among minority adolescents, and substance use in the juvenile justice system.  The review also covered multiple substance abuse policy recommendations including those made by the Office of Juvenile Justice and Delinquency Prevention, and compared successful existing juvenile intervention programs.

Secondary analysis was performed on the quantitative data of an anonymous survey done March 2000 of 1470 youths in DYS detentions centers and Day Reporting Centers.  The data was examined to determine the rates of substance abuse among minority adolescents and to identify differences in their substance abuse preferences.  Quarterly data from the Day Reporting Centers was analyzed to determine actual urine drug test results by site.

The existing substance abuse policy was reviewed.  It was determined that given the numerous sites in Massachusetts, the Dorchester DRC- the Dorchester Community Network Center, would be the principle focus of this project. This site was comprised predominantly of African American and Latino youth.  Personal interviews were conducted with the Director of Substance Abuse Services, the Metro Area Substance Abuse Policy specialist, the Program Director and Assistant Director for the Dorchester DRC and the Substance Abuse clinician for the Dorchester DRC.  The interviews concentrated on the implementation of the current policy and the adequacy of the substance abuse interventions and treatments.


The anonymous survey done in March of 2000 revealed that the primary drug of choice for all adolescents in the Department of Youth Services was marijuana at almost equal rates between Blacks (49.8%), Hispanics (53.3%) and Caucasian (46.9%) youth with significantly less use by Asians (26%).  However, the use of alcohol as a primary drug was the greatest amongst Asians (21.9%) and then Caucasian (11.9%) and Hispanic (10.3%) youth and least amongst Black youth (7.1%).  However Black youth were least likely to report that their drug or alcohol use was a problem when compared to the other youth.

The analysis of the quarterly random drug testing data revealed that marijuana was the drug detected most frequently.  One of the limitations of the urine test is its inability to detect alcohol use in all but those who were intoxicated at the time of the test.  The types of drugs used by adolescents of different races and ethnicities at each site could not be analyzed since it was not specified when the actual tests were obtained.

The personal interviews revealed much of the challenges faced when attempting to treat adolescents who do not view substance use as a problem.


Given the unique issues faced in treating the adolescent substance abusers and the different etiologies for substance use amongst minorities when compared to non-minorities, the following recommendations were proposed for the Department of Youth Services:

  •     Place race/ethnicity identifiers on the drug tests to track the trends of use between groups at each site
  •     Establish a database for the tracking of interventions, treatment and follow-up for all adolescents with positive drug tests
  •     Require cultural competency and diversity training for the staff and clinicians
  •     Develop curriculums focused specifically on marijuana and alcohol for those adolescents who do not wish to abstain
  •     Mandate the separation and accessibility of substance abuse histories from the sealed criminal records at the time of a youth’s release from DYS.
  •     Develop written policies with community outpatient substance abuse treatment centers
  •     Increase formal communication between case managers and community treatment centers
  •     Cultivate faith based collaboration within the communities

Faculty Preceptor:

Boyles, Director of Substance Abuse Services, Department of Youth Services, Boston, MA