Population Parameters Youth in Contact with the Juvenile Justice System• About 2.1 million youth under 18 were arrested in 2008• Over 600,000 youth a year are placed in detention centers• Over 90,000 youth reside in secure juvenile correctional

settings

Mental Health Disorders Among Youth in the General Population• 20% have a diagnosable mental disorder• 10% have a serious emotional disturbance

Large number of youth in the JJ system are experiencing mental

health disorders

NCMHJJ (2006) 70.4 %

Teplin et al. (2002) 69.0%

Wasserman et al. (2002) 68.5 %

Wasserman, Ko, McReynolds (2004) 67.2 %

NCMHJJ

Types of Disorders by Gender (n=1437)--NCMHJJ

Any Disorder 70.4% 66.8 % Males 81.0% Females

Anxiety Disorder 34.4% 26.4 % Males 56.0 % Females

Mood Disorders 18.3 % 14.3 % Males 29.2 % Females

Disruptive Disorder 46.5 % 44.9 % Males 51.3 % Females

Substance Abuse Disorder 46.2 % 43.2 % Males 55.1 % Females

NCMHJJ

How Can Systems of Care Respond?

Recognize that youth with mental health needs are found in all child serving systems- especially the juvenile justice system

Commit to partnerships with the juvenile justice system to identify ways to respond at key points of contact

Use grants to create more community-based capacity

Why is this so difficult?

Lack of a collaborative “history”/difficulties with past collaborations

Different goals, philosophies and language

Youth have complex needs

Youth are often a low priority

Critical Intervention Points

Places within the juvenile justice system where opportunities exist to improve collaboration, identification, diversion and treatment for youth

SecurePlacement

ProbationSupervision

Re-Entry

InitialContact

andReferral

Intake

Detention

JudicialProcessing

NCMHJJ

Collaboration Opportunities at Critical Intervention Points

1. Initial Contact: Law enforcement and the schools Specialized training for Law Enforcement Expansion of CIT programs to serve youth Crisis services for schools Training of school staff including teachers, counselors,

school administrators and school resource officers on prevalence of trauma , behaviors of youth who have experience trauma, de-escalating techniques, triggers of trauma related behaviors

Agency led training and supports for families whose children have been known to experience trauma

Co-responding with police officer if youth is girl (trauma trained mental health professional or trained family member)

Collaboration Opportunities at Critical Intervention Points

2. Intake: “Gatekeeper” to Juvenile Court Creation of diversion mechanisms and programs Employ a validated trauma screening tool for all youth at this

point in the process Trained staff to ask trauma informed questions of youth and to

identify potential experiences that could have been traumatic to youth---based on young person’s responses and history. The questionnaire or interview should be an objective tool, not a blaming tool.

If decision to return to family then follow-up with trauma assessment and services in the community

Collaborative Program Examples at Critical Intervention Points

3. Detention: Generally used as a short-term holding facility for youth awaiting adjudicationEstablishment of linkages with community-based mental health

providers for clinical assessments and treatmentTrauma assessment provided, if screening warrants.Trauma informed milieuDiversion program placement or services very quicklyRe-traumatization can occur in detention – this may be the first

separation from family –triggers and stressors in an environment that can be traumatic

Accommodations and modifications

Collaborative Mental Health/Juvenile Justice Initiatives

4. Judicial Processing: Adjudication and Disposition Mental Health liaisons placed in juvenile court to provide a mental

health “presence” in the court Specialized courts that offer treatment in lieu of placement Judge must have screening/assessment information in order to make

best informed decisions Exercise the use of diversion programs(community based)with

continuous monitoring versus placement in secure care Specialized court services – girls’ court, drug court, mental health court Courts should have knowledge of each child serving agency’s services

and supports (resource binder) – continuum of services/sanctions

Collaborative Mental Health/Juvenile Justice Initiatives

5. Secure Correctional Placement: Most restrictive level of care in the juvenile justice systemEmphasize the provision of evidence-based treatments whenever

possibleTraining for all staff on adolescent mental healthTrauma informed care models such as SanctuaryCognitive Behavioral Therapy programming Specialized programming designed for girls Significant coordination of visits and communication between youth

and familyGreat likelihood of re-traumatizationEstablish a tracking system for girls with a trauma history – seclusion,

self injurious behaviors, fights

Collaborative Mental Health/Juvenile Justice Initiatives

6. Probation Supervision: Most common juvenile court disposition

Often accompanied with other court-imposed conditions, like treatment

Trauma informed probation staff Probation should have contract with specialized community

based trauma provider Agency awareness and understanding of trauma Allowances need to be provided youth with trauma history –

provide greater interventions Be aware of trauma triggers and determine if a trigger

contributed to behaviors that violate probation plan

Collaborative Mental Health/Juvenile Justice Initiatives

7. Re-Entry: The point at which a youth transitions from placement back into the community Think “exit at entry” Provide mental health treatment planning, services and case

management to transitioning youth Connect services in facility to like services in community Address trauma issues across risk and protective factors Medication compliance Track behaviors that can be attributed to triggers Prepare the home for the youth’s return and prepare the youth for

return home Passes or furloughs are useful tools to aid in reentry

Conclusion:

Many youth with mental health needs end up in the juvenile justice system because there are no other options for them

Systems of care can partner with the juvenile justice system to develop and implement strategies that target youth at (or at risk of involvement with) key points of juvenile justice system contact