Mental Health in Juvenile Justice

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Cathy Craig-Myers Vicki Waytowich, Ed.D.

Mental Health in Juvenile Justice- what we want to learn

• Who are the kids coming into the system?

• What is the mental health data?

• What does it mean?

• Why is this so important?

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Youth Arrests – Fl Juvenile Justice Population

375-7676-77

77-7878-79

79-8080-81

81-8282-83

83-8484-85

85-8686-87

87-8888-89

89-9090-91

91-9292-93

93-9494-95

95-9696-97

97-9898-99

99-0000-01

01-0202-03

03-0404-05

05-0606-07

07-0808-09

09-1010-11

11-1212-13

13-140

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

200,000

Delinquency Arrests in Florida1975-76 through 2013-14

Source: Florida Department of Juvenile Justice, Bureau of Research & Planning

105,615

78,447

175,105

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Source: Florida Department of Juvenile Justice Comprehensive Accountability Report. Figures for Diversion and Probation are preliminary.

Prevention Detention Diversion Community Supervision Commitment0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,00047,302

28,070

21,070

26,267

4,754

Youth Served in the Juvenile Justice System in Florida (FY 2013-14)

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DJJ Priority Funding Issues Current Year 2015-2016

• Provide enhanced front end services i.e. SNAP, Respite, Prevention

• Security services at two Juvenile Assessment Centers

• Focus on Education/Career Education- Reentry and Transition

• Detention cost share between state and counties

• Funding to maintain safe and healthy facilities- FICO

2008- Blueprint Commission • Acknowledged youth with mental

health issues often ended up in the juvenile justice system.

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Mental Health in Juvenile Justice- Florida

Guiding principles of DJJ include:• Prevention and education are paramount• Strengthen partnerships with judicial, legislative and community

stakeholders• Promote public safety through effective intervention• Provide a safe and nurturing environment for our children• Preserve and restore physical and mental health

2012 -DJJ Roadmap to System Excellence • Change in philosophy• DJJ responsible to screen and refer• Emphasis on identification of trauma

Mental Health in Juvenile Justice- Georgetown Center for Juvenile Justice Reform

• 2/3 of the youth in the nation’s juvenile justice system have a diagnosable disorder. Georgetown JJ Reform Project

• 70% - diagnosable mental health disorder and 60% co-occurring disorder . Georgetown JJ Reform Project

• Community-based mental health services for youth suffering from mental health disorders has also been shown to lead to a significant reduction of youth placements in juvenile detention and other secure facilities.” Georgetown JJ Reform Project 7

National Center for Mental Health & Juvenile Justice • Studies have consistently documented that:

• 65% to 70% of youth in contact with the juvenile justice system have a diagnosable mental health disorder; • Over 60% of youth with a mental health disorder also have a substance

use disorder; and • Almost 30% of youth have disorders that are serious enough to require

immediate and significant treatment. In addition, youth in the juvenile justice system have higher rates of exposure to traumatic experiences. • Youth in the juvenile justice system experience mental health disorders

at a rate that is more than three times higher than that of the general youth population.

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• Youth with serious mental illness make up 25% of the juvenile justice population, and their numbers are increasing. (National Federation of Families for Children’s Mental Health, 2008)

• Girls have more incidents of mental illness than boys, while boys have more externalizing disorders. (National Council on Crime and Delinquency, 2010)

• 70% of youth have one or more psychiatric disorders.ii  NAMI -National Alliance of Mental Illness

• 20% of youth involved in the juvenile justice system have serious mental illnesses, including those that are suicidal, struggling with psychotic disorders and other serious illnesses.iii NAMI -National Alliance of Mental Illness 9

Mental Health in Juvenile Justice- National

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Mental Health in Juvenile Justice- Statewide

• State Methodology- gathering data• JJIS• Includes PACT and Pre-Pact

• Notice the stark difference in the numbers state profiles

Mental Health in Juvenile JusticePercentages of Florida Youth Reporting a History of Mental Health Problems, by Gender

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PACT Profile FY2013-2014

Percentages of Youth Reporting A History of Mental Health Problems

Males Females All Youth

Intake 19.1 21.6 19.8

Diversion 15.0 16.0 15.4

Probation 19.6 25.3 20.9

Commitments 31.0 48.8 33.3

. Source: 2014 PACT Profile. Available at: http://www.djj.state.fl.us/research/delinquency-data/pact-profile/pact-profile-fy2013-14

Mental Health in Juvenile JusticePercentages of Florida Youth Reporting a History of Mental Health Problems, by Race

12Source: 2014 PACT Profile. Available at: http://www.djj.state.fl.us/research/delinquency-data/pact-profile/pact-profile-fy2013-14

PACT ProfilePercentages of Youth Reporting a History of Mental Health Problems

Black White Hispanic Other All Youth

Intake 16.4 24.7 18.3 11.7 19.8

Diversion 12.1 18.8 14.1 6.1 15.4

Probation 16.8 28.6 17.1 11.5 20.9

Commitments 28.5 44.7 28.7 16.7 33.3

Mental Health in Juvenile JusticeFlorida DJJ addresses youth’s mental health needs by:

• Screening and re-screening through PAT, CPACT, and RPACT• Referring for assessment • Referral for mental health treatment services• Matching youth with appropriate service providers• Case management and follow-up• Service continuum mapping• Annual trauma-informed care training

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• Local Methodology- At intake• DJJ

• PACT pre screen is done• Trauma Screen• Suicide Screen• CSEC Screening

• Community Providers• Gain (1st time offenders)• SAMH-2-3• Comprehensive assessments 14

Mental Health in Juvenile Justice- Local

May

June

July

Total

Number of Youth Processed at the JAC

305

253

234

792

Number of Youth With a Hit on the Pre-PACT

197

216

180

593 (75%)

Number of First Offenders Referred for Assessment

50

40

47

137

Number of First Time Offenders Assessed w/GAIN

33

27

31

91 (66%)

Number of Youth with MH/SA issue 31 24 28 83 (91%)

Remaining Youth Referred for Assessment

147

176

133

456

Number of Youth Assessed by Gateway

42

56

48

146 (32%)

Number of Youth with MH/SA issue

*27 (64%)

*42 (75%)

*29 (60%) 98 (67%)

Total Number of Youth Screened/Assessed

197/75 (38%)

216/83 (38%)

180/79 (44%)

593/237 (40%)

Total Number of Youth Assessed/Identified 75/58 (77%) 83/66 (80%) 79/57 (72%)

237/181 (76%)

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Mental Health in Juvenile Justice- Circuit 4

Florida DJJ defines Mental Health: An emotional or behavioral condition that interferes with daily activities and is diagnosed using well-recognized and standardized guidelines.

Florida DJJ defines Trauma: Personal experience of violence and victimization including sexual abuse, physical abuse, severe neglect, loss, domestic violence, and/or the witnessing of violence, terrorism, or disasters.

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Mental Health and Trauma

• Source: National Association of State Mental Health Program Directors (2006). DJJ Staff Development and Training.

Trauma-Informed Care• Adverse Childhood Experiences (ACE)s may exert powerful

influence over childhood brain development

• Youths with greater experiences of ACEs may become involved in the juvenile justice system earlier and comprise a greater proportion of those juveniles classified as Serious, Violent, and Chronic

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Sources: Fox, B.H., Perez, N., Cass, E., Baglivio, M., Epps, N. (2015). Trauma changes everything: Examining the relationship between adverse childhood experiences and serious, violent and chronic juvenile offenders. Child Abuse & Neglect, 46: 163-173. Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256: 174–186.

Trauma-Informed Care

Trauma may create a roadblock for other meaningful delinquency intervention and/or mental health intervention to take place.

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Trauma-Informed CareThe prevalence of adverse childhood experiences (ACEs) among youth who received a full PACT screen (typically deeper-end youth)

19Source: Baglivio, M. T., Epps, N., Swartz, K., Sayedul Huq, M., Sheer, A., & Hardt, N. S. (2014). The Prevalence of Adverse Childhood Experiences (ACE) in the Lives of Juvenile Offenders. Journal of Juvenile Justice, 3: 1–23.

• Accurately identify the need• Develop a more coordinated approach to data collection• Differentiate the data (trauma/MH/SA)

• DJJ should require their providers to report on the number of youth in their programs that receive mental health assessments and the resulting outcome. (state currently cannot query this information from JJIS)

• Modify/expand the capacity of JJIS to collect MH/SA information that can be aggregated

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Potential Recommendations