Building a Juvenile Justice System of Care

1. Building a Juvenile Justice System of Care

2. A Juvenile Justice System of Care—A Comprehensive Approach • Definition and recognition of the problem • Screening and assessment to identify the problem • Integrated systems approach • Matching both risks & needs to appropriate interventions through a continuum of care that integrates both accountability (e.g., graduated sanctions), social interventions, and treatment interventions • Utilizing a strengths-based approach to assessment and service provision • Family involvement/engagement • Culturally competent/gender appropriate programming • Commitment and investment from key stakeholders, interested parties, supervisors, and line-staff

3. Defining Screening & Assessment • Screening: A brief process used to identify offenders who have a particular characteristic • Assessment: A more thorough investigation into this characteristic to assess the extent and level to which it exists and the appropriate system response it requires • Used for multiple purposes—in particular, they are used for two purposes in the juvenile justice system • To measure offender risk for reoffending • Detention screening tools • Risk/need assessment tools • To measure whether an offender has any mental health problems and/or substance abuse problems

4. What is Screening for Mental Health & Substance Abuse • The problem: Juvenile justice personnel are not trained as mental health professionals or substance abuse counselors—how can they identify the presence of a problem? • Solution: Screening • Screening=brief process used to identify youth who are at-risk of having disorders that warrant immediate attention, intervention, or more comprehensive review (e.g., Massachusetts Youth Screening Instrument, Version 2: MAYSI-2) • Facilitates a “triage” process • No special training (or minimal training) is required to administer screening tools • Scoring thresholds provide valuable information to “next step”

5. What is Assessment for Mental Health and Substance Abuse? • An assessment is completed by certified mental health professionals • Substantively, it is a comprehensive examination of: • Psychosocial needs and problems • Type and extent of mental health and substance use disorders • Other issues associated with the disorders • Recommendations for treatment • Requires much more time than screening • Can be administered at regular intervals to measure the impact of recommended supervision levels and treatment programming • Many screening and assessment tools exist—therefore, it is critical to choose the tools that are most appropriate for the population on whom it will be used • NEW RESOURCES • Thomas Grisso, T. Vincent, G., & Seagrave, D. (2005). Mental Health Screening and Assessment in Juvenile Justice. New York: Guilford Press. http://www.umassmed.edu/nysap/about.cfm • Screening and Assessing Mental Health and Substance Use Disorders Among Youth in the Juvenile Justice System: A Resource Guide for Practitioners http://www.ncjrs.org/pdffiles1/ojjdp/204956.pdf

6. Juvenile Justice Risk Assessment • Simultaneously, juvenile justice agencies should also assess a youth’s level of risk by consistently utilizing a standardized risk/need tool • Use of the tool provides several advantages: • Provides a scoring threshold for level of risk • Provides the basis for a case plan for supervision and intervention • Serves as the baseline for measuring change in behavior over time • Creates a level playing ground for offenders • Examples of risk/need tools: Youth Level of Service/Case Management Inventory (Hoge & Andrews, 1995), Washington State Juvenile Court Assessment

7. How Should Screening & Assessment be Used?

8. When Can Screening & Assessment be Used?

9. Achieving a Comprehensive Response through a Juvenile Justice System of Care

10. Barriers to Providing Effective Services • Herz, D. & Poland, A. (2002). Assessing the Need for and Availability of Mental Health Services for Juvenile Offenders • http://www.ncc.state.ne.us/documents/other/mental_health.htm • Focus groups held with detention facility staff, probation officers, Office of Juvenile Services personnel, and treatment providers • Surveys sent to judges, county attorneys, and public defenders • Barriers identified by these groups: • Few resources/funds • Caseload size and time available • No standardized process screening and assessment • Lack of availability of appropriate services • Inappropriate placements • Funding drives placements rather than need • Delays in Medicaid processing

11. Barriers to Effective Services, Continued • Inconsistent quality of treatment services • Removal of family from process • System’s reactive approach • Interagency conflict & turf boundaries • Lack of cross-training across juvenile justice and behavioral health • Lack of cross-training across juvenile justice agencies • Lack of training for providers on antisocial behavior • Politics • Availability in rural areas • Bilingual services/culturally and gender specific services

12. The Solution: Integrating SA, MH, and Justice Responses • Requires a shift in organizational cultural thinking in juvenile justice and behavioral health • Shared responsibilities rather than a shift from one system to another • Utilizing evidence-based programming within a continuum of care to address both risk and need • Build programming around youth and family strengths • Using a matrix of risk/need as an example

13. Integrating Responses: The Matrix Example

14. Key Components to Service Delivery • Utilizing a strengths-based approach to assessment and service provision • Measure youth and family strengths and incorporate them into programming • Family involvement/engagement • Make family a central component to intervention • Have alternatives in mind when incorporating families is not possible • Culturally competent/gender appropriate programming • Recognize differences and the value of traditional cultural values and beliefs • Incorporate individual/group experiences into evidence-based programming

15. Moving Toward a Comprehensive Response

16. What Does it Take? • Identification and inclusion of stakeholders • Support from policy-makers and agency heads • Working agreements across agencies • Inclusion and overcoming philosophical differences—finding room for compromise • Building trust in the other systems and fulfilling obligations

17. Who are the Stakeholders?(People impacted by a decision or with the ability to impact a decision) • Community: Schools, victims, media, local policy makers, state legislators, advocacy organizations, businesses, parents and youth • JJ: Police, Detention Personnel, Prosecutors, Defense Attorneys, Judges, Probation Officers, State Juvenile Correctional Agency, and Parole Officers • MH & AOD: Healthcare organizations, Substance Abuse Provider Organizations, Mental Health Organizations, State SA and MH Authority

18. Consequences of No Intervention and/or Ineffective Intervention • Consequences for System Processing • Inappropriate use of detention • Swinging pendulum between juvenile justice and behavioral health • System conflicts & Funding manipulation • Consequences for System Responses • Availability of resources and treatment providers • Using appropriate levels and types of treatment and accountability • Effective outcomes • Consequences for Youth • Missed opportunities for prevention and to improve youth’s quality of life • Missed opportunities • Race & gender disparities • Serious offenders

19. In Summary, A Comprehensive Response is Critical Because… • It increases public safety and enhances public health simultaneously • It promotes positive outcomes for offenders, families, and communities • It is a more efficient use of resources and is accountable for the impact it is having • It stresses resource and experience sharing across systems • It increases the likelihood that juvenile justice will reach its intended mission