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Welcome
Preventing Suicide among Justice-Involved Youth: Newly Developed Tools, Recommendations, and Research
Thursday, 17 April 20141:30-2:30pm EDT
If you have technical questions, please call 412.858.1395.
If you would like to submit a question to the speakers for the Q&A portion of the webinar, please click “Submit a Question”
on the right side of the screen.
Youth in Contact with Juvenile Justice System Task Force
Preventing Suicide among Justice- Involved Youth: Newly Developed
Tools, Recommendations, and Research
Joseph J. Cocozza, PhD – Director, National Center for Mental Health and Juvenile Justice
Linda A. Teplin, PhD – Vice-Chair for Research, Department of Psychiatry & Behavioral Sciences,
Feinberg School of Medicine, Northwestern University
Katherine Deal, MPH – Deputy Secretary, National Action Alliance for Suicide Prevention
17 April 2014
Presenters
Facilitator
Acknowledgments
Youth in Contact with Juvenile Justice System Task Force
About the Action Alliance
Vision: A nation free from the tragic experience of suicide.
Mission: To advance the National Strategy for Suicide Prevention (NSSP) by:
• Championing suicide prevention as a national priority
• Catalyzing efforts to implement high-priority NSSP objectives
• Cultivating the resources needed to sustain progress
Goal: Save 20,000 lives over the next five years.
Youth in Contact with Juvenile Justice System Task Force
About the Action Alliance
Current initiatives: Developing the Action Alliance Framework for Successful
Messaging to change public conversation
Improving healthcare for at-risk individuals (e.g. clinical workforce preparedness, quality of care, healthcare reform)
Increasing quality, timeliness, and usefulness of surveillance data
Disseminating a first-ever prioritized research agenda
Improving support for survivors of suicide attempts and loss
Improving workplace suicide prevention (e.g. law enforcement)
Work for other populations and settingsYouth in Contact with Juvenile Justice System Task Force
About the Speakers
Joseph J. Cocozza, PhD
Director – National Center for Mental Health and Juvenile Justice; Policy Research Associates, Inc.
Co-lead – Youth in Contact with the Juvenile Justice System Task Force
Youth in Contact with Juvenile Justice System Task Force
About the Speakers
Linda A. Teplin, PhD
Vice-Chair for Research – Department of Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University
Member – Suicide Research Workgroup, Youth in Contact with the Juvenile Justice System Task Force
Youth in Contact with Juvenile Justice System Task Force
Co-leads:
Melodee Hanes, JD – Acting Administrator, Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, US Department of Justice
Joseph J. Cocozza, PhD – Director, National Center for Mental Health and Juvenile Justice, Policy Research Associates
Youth in Contact with the Juvenile Justice System Task Force
Youth in Contact with Juvenile Justice System Task Force
Why Focus on this Population?
Youth involved with the juvenile justice system have a higher risk of suicide than non justice-involved youth.
Youth in juvenile justice residential facilities have nearly 3x the rate of suicide compared with their peers in the general population.
Suicide is the leading cause of death for youth in juvenile confinement.
Up to one-third of justice-involved youth report having experienced suicidal ideation in the past year.
Youth in Contact with Juvenile Justice System Task Force
Task Force Goal
The task force was established to focus attention on the unique needs of youth in the juvenile justice
system and develop new suicide prevention resources for the juvenile justice field.
Youth in Contact with Juvenile Justice System Task Force
Task Force Objectives
Youth in Contact with Juvenile Justice System Task Force
Raise awareness Review and integrate the available research Provide guidance around suicide prevention
programming and training Encourage greater collaboration among the mental
health and juvenile justice systems
The task force included leading experts in the field organized into workgroups to address the four objectives.
Public Awareness and EducationWorkgroup Members
Lead: Deborah Stone, ScD, MSW, MPH, Behavioral Scientist, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention
Christy (Lentz) Malik, MSW, Senior Policy Associate, National Association of State Mental Health Program Directors
Roy Praschill, Director of Operations, National Association of State Mental Health Program Directors
Steffie Rapp, LCSW-C, Program Manager, Office of Juvenile Justice and Delinquency Prevention
Kathleen Skowyra, Associate Director, National Center for Mental Health and Juvenile Justice
Youth in Contact with Juvenile Justice System Task Force
Suicide Research Workgroup Members
Lead: Denise Juliano-Bult, MSW, Chief, Systems Research Programs and Disparities in Mental Health Research Programs, National Institutes of Health
Laurie Garduque, PhD, Director, Justice Reform John D. and Catherine T. MacArthur Foundation
Thomas Grisso, PhD, Director, National Youth Screening Assessment Project, University of Massachusetts Medical Center
Karen Stern, PhD, Social Science Analyst, National Institutes of Justice Barbara Tatem-Kelley, MA, MEd, Program Manager, Office of Juvenile
Justice and Delinquency Prevention Linda A. Teplin, PhD, Vice Chair of Research, Director of Health Disparities
and Public Policy, Northwestern University, Feinberg School of Medicine Additional contributors include Karen M. Abram, PhD, Kathleen P. McCoy,
PhD, and Marquita L. Stokes, MA, Northwestern University
Youth in Contact with Juvenile Justice System Task Force
Prevention Programming and TrainingWorkgroup Members
Lead: Ned Loughran, MA, Executive Director, Council of Juvenile Correctional Administrators
Karen Abram, PhD, Associate Professor, Health Disparities Program, Northwestern University, Feinberg School of Medicine
Donald Belau, PhD, Psychologist, Geneva Youth Residential Treatment Center
Lindsay Hayes, MS, Project Director, NCIA Jail Suicide Prevention and Liability Reduction, National Center for Institutions and Alternatives
Shawn Marsh, PhD, Chief Program Officer, National Council of Juvenile and Family Court Judges
Kara McDonagh, MSW, Program Manager, Office of Juvenile Justice and Delinquency Prevention
Nicholas Read, MA, Research Analyst, Human and Social Development, American Institutes for Research
Youth in Contact with Juvenile Justice System Task Force
Collaboration Workgroup Members
Lead: Eric Trupin, PhD, Director, Division of Public and Behavioral Health and Justice Policy, University of Washington
David DeVoursney, MPP, Program Analyst, Substance Abuse and Mental Health Services Administration
Simon Gonsoulin, MEd, Principal Research Analyst, American Institutes for Research
Carl Wicklund, Executive Director, American Probation and Parole Association
James Wright, MS, LCPC, Public Health Advisor, Substance Abuse and Mental Health Services Administration
Youth in Contact with Juvenile Justice System Task Force
Public Awareness and Education Workgroup
Objective
To promote awareness among individuals who work with adjudicated youth and youth at risk of delinquency, and the public at large, that there is an increased risk for suicidal behaviors in youth involved with the juvenile justice system and that suicide for this target population is preventable.
Youth in Contact with Juvenile Justice System Task Force
Primary Products
Title: Need to Know: A Fact Sheet Series on Juvenile Suicide
Overview: Provides practical information about suicide prevention to three distinct groups: 1) judges and juvenile courts, 2) juvenile detention and secure care staff, 3) juvenile probation staff. Each fact sheet includes: Prevalence of suicide among youth in the juvenile justice system and
factors that may increase suicide risk Practical steps that staff can take to prevent suicide Practical steps that systems (i.e., juvenile courts, detention and secure
care facilities, probation departments) can take to prevent suicide
http://actionallianceforsuicideprevention.org/JJFactSheets
Youth in Contact with Juvenile Justice System Task Force
Selected Key Findings
Youth involved with the juvenile justice system have increased risk of suicide.
There are factors that may increase the risk of suicide among justice-involved youth, such as mental health or substance use disorders, suicide or other death of friend or family member, social isolation, relationship problems, or separation from family.
There are steps that juvenile justice personnel and systems can take to prevent suicide.
Youth in Contact with Juvenile Justice System Task Force
Suicide Research Workgroup
Objective
To review current research on suicide and its prevention among juvenile justice-involved youth to identify gaps and make recommendations for future research.
Youth in Contact with Juvenile Justice System Task Force
Primary Products
Title: Suicidal Ideation and Behavior Among Youth in the Juvenile Justice System: A Review of the LiteratureOverview: Summarizes relevant peer-reviewed literature on suicide in the juvenile justice system and identifies gaps and needed research directions.
http://actionallianceforsuicideprevention.org/system/files/JJ-5-R1-Literature-Review.pdf
Title: Screening and Assessment for Suicide Prevention: Tools and Procedures for Risk Identification and Risk Reduction Among YouthOverview: Examines the juvenile justice system’s responsibilities for identifying youth at risk of suicide, the contexts in which screening and assessment instruments are used, and specific instruments available to advance suicide prevention efforts.
http://actionallianceforsuicideprevention.org/system/files/JJ-6-R2-Screening-Assessment.pdf
Youth in Contact with Juvenile Justice System Task Force
Selected Key Findings
New research studies must be conducted to determine a current and reliable rate of suicide prevalence among youth involved in the juvenile justice system.
Information on the number of attempts, preparatory acts, method of attempts, etc. remains scant, which hinders the development of research-based suicide prevention programming.
Little has been done to-date to empirically test the effectiveness of preventative interventions and programs in reducing suicide risk among justice-involved youth.
Juvenile justice providers should implement currently available tools for detecting and intervening with youth at risk for suicide.
Youth in Contact with Juvenile Justice System Task Force
Suicide Prevention Training and Programs Workgroup
Objective
To develop a national strategy for implementing accepted guidelines for juvenile suicide prevention at each critical intervention point within the juvenile justice processing continuum.
Youth in Contact with Juvenile Justice System Task Force
Primary Product
Title: Guide to Developing and Revising Suicide Prevention Protocols for Youth in Contact with the Juvenile Justice System
Overview: Describes eight critical components of a sound juvenile suicide prevention program and strategies for implementing components across all points of contact within the juvenile justice system.
http://actionallianceforsuicideprevention.org/system/files/JJ-7-P1-ProtocolGuidelines.pdf
Youth in Contact with Juvenile Justice System Task Force
Selected Key Findings
Suicide prevention programs should include strategies at all points of contact within the juvenile justice system, including: referral/arrest, courts, probation, detention and secure/non-secure care facilities, and aftercare.
Critical components of a comprehensive juvenile suicide prevention program – such as training, identification, housing, and treatment planning – should be incorporated at each point of contact.
Youth in Contact with Juvenile Justice System Task Force
Mental Health and Juvenile Justice System Collaboration Workgroup
Objective
To identify strategies for improving the level and quality of collaboration between the juvenile justice and mental health systems around juvenile suicide prevention and offer recommendations for promoting greater collaboration.
Youth in Contact with Juvenile Justice System Task Force
Primary Product
Title: Preventing Juvenile Suicide through Improved Collaboration: Strategies for Mental Health and Juvenile Justice Agencies
Overview: Recommends priorities and strategies that mental health and juvenile justice agencies at the state and local levels can pursue to inform joint policy and budgeting decisions associated with suicide prevention for youth involved in juvenile justice. Provides an environmental scan tool with which jurisdictions can assess strengths, weaknesses, opportunities, and threats across priority areas.
http://actionallianceforsuicideprevention.org/system/files/JJ-9-C2-CollaborationFullVersion.pdf
Youth in Contact with Juvenile Justice System Task Force
Selected Key Findings
Thoughtfully planned collaboration across all levels of government and jurisdiction is strongly urged.
Overarching collaborative priorities and strategies are offered to foster joint policy and budgeting decisions associated with suicide prevention for justice-involved youth.
Youth in Contact with Juvenile Justice System Task Force
Suicide Research Workgroup
Youth in Contact with Juvenile Justice System Task Force
Goals
1) Estimate prevalence of recent and past suicidal
ideation and attempts
2) Examine gender and racial/ethnic differences
3) Identify associated risk factors
4) Suggest future directions for research
Youth in Contact with Juvenile Justice System Task Force
Method
2 independent reviewers Databases: MEDLINE/PubMed, PsycINFO, PsycARTICLES Search and inclusion criteria:
Epidemiologic studies, conducted in USPublished since 1990Empirical studies Examined suicidal ideation or attempts
Youth in Contact with Juvenile Justice System Task Force
Study Selection
Identified 27 studies
Omitted 3 studies because
they reported scale means, not
prevalence
Final database: 24
studies
Youth in Contact with Juvenile Justice System Task Force
How Did Studies Vary?
Point of contact and adjudication status
Measures of suicidal behavior
Recall periods (“recent,” past year, lifetime)
Youth in Contact with Juvenile Justice System Task Force
Overall Prevalence Rates
Overall Prevalence Rates
Recent a Past Year Lifetime
Suicidal Ideation
3 – 52%(n = 12) b
10 – 29.2%(n = 4)
11.8 – 58%(n = 7)
Suicide Attempts
1.4 – 8.5%(n = 9)
7.6 – 24%(n = 5)
10 – 31%(n = 17)
a Recent assessment period ranges from “current” up to 6 monthsb n=Number of studies
Youth in Contact with Juvenile Justice System Task Force
Gender Differences
Gender Differences
Recent Past Year Lifetime
Suicidal Ideation
Females > Males (n = 5)
Females > Males (n = 1)
Females > Males (n = 2)
Suicide Attempts
1.4 – 8.5%(n = 3)
Females > Males (n = 2)
Females > Males (n = 8)
Youth in Contact with Juvenile Justice System Task Force
Racial/Ethnic Differences
Racial/Ethnic DifferencesRecent Past Year Lifetime
Suicidal Ideation
W > AA, H (n = 2)
Females: H > AA
W > AA, H (n = 1)
----
Suicide Attempts
W > AA, H(n = 3)
W > AA, H (n = 1)
W > AA, H (n = 3)
W & H > AA
(n = 1)
Males: W > AA & HFemales: W & H > AA
Youth in Contact with Juvenile Justice System Task Force
Suicidal Ideation: Point Of Contact
Recent Past Year LifetimeYOUTH IN THE COMMUNITY
Pre-Adjudication 8 – 12.7%(n = 2)
--- 11.8%(n = 1)
Post-Adjudication 29.5%(n = 1)
--- 22%(n = 1)
YOUTH IN SECURE FACILITIESDETENTION
Intake to detention 3 – 21%(n = 4)
10%(n = 1)
13.9 – 36%(n = 3)
During detention 36.2 – 52%(n = 2)
--- ---
POST-DISPOSITION
Intake to post-disposition facility 9.6%(n = 1)
--- ---
During stay at post-disposition facility 7.7%(n = 1)
--- 51 – 58%(n = 2)
YOUTH AT MULTIPLE POINTS OF CONTACT
Combined samples18%
(n = 1)19 – 29.2%
(n=3)---
Youth in Contact with Juvenile Justice System Task Force
Suicide Attempts: Point Of Contact
Recent Past Year LifetimeYOUTH IN THE COMMUNITY
Pre-Adjudication 1.4 – 2.9%(n = 3)
--- 10 – 13.2%(n = 3)
Post-Adjudication 2.5%(n = 1)
7.6 – 24% (n =2)
12.2 – 16.3%(n = 2)
YOUTH IN SECURE FACILITIESDETENTION
Intake to detention 3 – 3.7%(n = 2)
--- 11 – 27%(n = 5)
During detention 8.5%(n = 1)
9.5%(n = 1)
15.5 – 31%(n = 2)
POST-DISPOSITION
Intake to post-disposition facility 3.1%(n = 1)
--- 12.3%(n=1)
During stay at post-disposition facility --- 19.3%(n = 1)
25.5%(n = 1)
YOUTH AT MULTIPLE POINTS OF CONTACT
Combined samples 2.4%(n = 1)
15.5%(n = 1)
12.4 – 14.4%(n = 3)
Youth in Contact with Juvenile Justice System Task Force
Risk Factors
Psychopathology
• Depression
Substance abuse
History of sexual abuse
History of physical abuse
Youth in Contact with Juvenile Justice System Task Force
Overall Limitations
Inconsistency in measures
Little information on where in the process samples were
drawn
Few statistics on completed suicides
Few data on Hispanics
Insufficient information on females
Youth in Contact with Juvenile Justice System Task Force
Recommendations For Future Research
Study different points of contact
Studies of females and racial/ethnic minorities, e.g., Hispanics
Examine additional risk and protective factors
Evaluate screening tools and procedures
Evaluate effectiveness of preventive interventions
Youth in Contact with Juvenile Justice System Task Force
Improve Current Practices
Routinely screen for suicidal ideation
Provide interventions during in facilities
Provide referrals when youth return to their
communities
Youth in Contact with Juvenile Justice System Task Force
Q&A
Please use “Submit a Question” on the right side of the screen to
send your question to the speakers.
Youth in Contact with Juvenile Justice System Task Force
Thank You
Visit the Action Alliance website:• www.ActionAllianceForSuicidePrevention.org – more
information about the Action Alliance and the NSSP• www.ActionAllianceForSuicidePrevention.org/task-
force/juvenilejustice – more information about the task force
Contact:• [email protected]• [email protected]
Youth in Contact with Juvenile Justice System Task Force