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Juvenile Justice Mental Health Initiative 2007 Data Book

Examples of Possible Targeted Areas for Improvement. Texas: Special Needs Diversionary ProgramStatewide funded initiative involving mental health

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Juvenile Justice Mental Health Initiative 2007 Data Book

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    1. Juvenile Justice & Mental Health Initiative 2007 Data Book

    2. Examples of Possible Targeted Areas for Improvement Texas: Special Needs Diversionary Program Statewide funded initiative involving mental health & juvenile justice agencies Co-located probation/licensed practitioner of healing arts Referrals allowed at every point in the process Teams provide case management, service provision, and supervision New York: PINS Diversion Program Collaboration between nine state agencies Divert status offenders from further penetrating system via community-based services Alternatives to formal processing and secure confinement Connecticut: CSCI Teams System-wide implementation of the MAYSI-2 County-based assessment model for providing expedited mental health evaluations Creation of multi-disciplinary case review teams to review assessments and make recommendations for services Significant expansion of evidenced-based treatment services Minnesota: Targeted Areas of Improvement Follow-up after the screen Coordinated Funding Streams Mental Health Case Management teams

    3. Data Book Organization Key National Reports related to Juvenile Justice and/or Children’s Mental Health to inform our work Key Minnesota reports/work related to Juvenile Justice and/or Children’s Mental Health to inform our work Available Minnesota data that informs our work Summaries of the national and Minnesota issues using the four cornerstones: Collaboration; Identification; Diversion; Treatment plus Funding A final summary of what Minnesota has in place and what needs improvement

    4. The National Perspective Surgeon General’s Report: 2001 President’s New Freedom Commission: 2003 Roadmap to Transforming Mental Health: 2005 NCMHJJ Issues and Emerging Trends: 2000 NCMHJJ Blue Print for Change 2006

    5. National Perspective Surgeon General’s Mental Health Commission 2001 Children at greatest risk for mental health disorders: Physical problems Intellectual disabilities Low birth weight Family history Multigenerational poverty Caregiver separation Abuse, neglect

    6. National Perspective Surgeon General’s Mental Health Commission 2001 Nationally, 1 in 5 youth experience symptoms of DSM-IV disorder Challenges and Solutions Organization and financing of mental health services Data privacy and information sharing Efficacy of treatment options Stigma of mental disorders Supply of providers and services Family involvement as partners Trained staff in schools, justice system Treatments that are tailored to age, gender, culture Systems of care approach Residential treatment and re-entry

    7. National Perspective President’s New Freedom Commission 2003 There are limited mental services in correctional facilities People who come in contact with JJ system are: Poor Uninsured Disproportionately members of minority groups Homeless Living with co-occurring disorders As youth progress through the JJ system, rates of mental disorder increase (Baerger et al, 2000)

    8. National Perspective President’s New Freedom Commission 2003 Goals with accompanying recommendations: MH is essential to overall health Services must be consumer and family-driven Disparities are eliminated Need for early mental health screening, assessment, and referral Services are quality and research-based

    9. President’s New Freedom Commission Consumer and Family-Driven Address mental health problems in the juvenile justice System with: Appropriate diversion and re-entry strategies Individualized care plans Align funding streams to improve access and accountability Collaborative, coordinated system of care (federal, state, local government, families and consumers)

    10. President’s New Freedom Commission Eliminate Disparities Improve access to culturally competent care Improve access in rural and remote areas

    11. President’s New Freedom Commission Screening, Assessment, and Referral Routine and periodic early screening Screen for co-occurring and link with integrated treatment Clear agency or system responsibility for SED children (partnership with schools) Payment for core services of evidenced-based, collaborative care including case management,

    12. President’s New Freedom Commission Quality and Research Advance evidenced-based practices Develop knowledge in understudied areas including mental health disparities, medications, trauma, acute care Reimbursement polices that foster converting research to practice

    13. National Perspective Roadmap for Federal Action on America’s Mental Health Crisis 2005 Concrete implementation steps for President’s New Freedom Commission Maximize effectiveness of scarce resources by coordinating programs Stop making criminals of those whose MH results in inappropriate behavior Get the right services to the right people at the right time Invest in children & include family in decision making Promote self-sufficiency

    14. National Perspective Roadmap for Federal Action on America’s Mental Health Crisis 2005 Stop making criminals to those whose mental illness results in inappropriate behavior: Fund diversion programs for nonviolent offenders – treatment instead of detention Eliminate warehousing of youth in juvenile facilities Promote successful community re-entry

    15. National perspective NCMHJJ Trends and Emerging Issues 2000 Clarity needed-which agency is lead agency for providing mental health services Inadequate screening and assessment Lack of training, staffing and programs Lack of funding and clear funding streams to support services Lack of balance between community-based services and mental health beds

    16. National Perspective Blueprint for Change 2006

    17. National Perspective Blueprint for Change Cornerstones Collaboration: The JJ and MH systems must work jointly to address the issue Identification: Systematically identify needs at all critical stages Diversion: Whenever possible divert youth to community-based services Treatment: Provide youth with effective treatment to meet their needs

    18. National Perspective Blueprint for Change: Critical Intervention Points Places within the juvenile justice system where opportunities exist to improve collaboration, identification, diversion and treatment for these youth.

    19. Blueprint for Change Practical Application at Critical Intervention Points Initial Contact Specialized training for law enforcement officials Co-responding teams Probation Intake Standardized mental health screening for all youth Creation of diversion mechanisms

    20. Blueprint for Change Practical Application at Critical Intervention Points Detention Standardized mental health screening Establishment of linkages with community-based mental health providers Judicial Processing Ensure that Judges have access to the information they need to make informed dispositional decisions

    21. Blueprint for Change Practical Application at Critical Intervention Points Dispositional Alternatives Community-based alternatives with a strong probation supervision component whenever possible Access to evidence-based mental health treatments for youth committed to juvenile corrections Re-Entry Discharge planning that begins shortly after placement Linkages with community providers to ensure access to mental health services Planning to ensure that a youth is enrolled in Medicaid or some other type of insurance

    22. Past and Current Mn Initiatives Children’s Comprehensive Mental Health Act 1989 DHS Integrated Fund 1992 Supreme Court JJ Task Force 2001 DHS Blueprint for a MN MH System of Care 2002 Juvenile Justice Mental Health Screening 2003 PACER Survey 2004 Umbrella Rules 2005 Mn Mental Health Action Group 2005 State Advisory Council on Mental Health 2006 JDAI and DMC 2006 Doing Juveniles Justice 2007 Evidenced-based projects and grants

    23. Minnesota Comprehensive Children’s Mental Health Act 1989 Governs the state’s county-based, publicly funded children’s mental health service system Based on system of care model with 3 entities: state authority, local authority, providers Children’s Mental Health Collaborative can assume duties of local authority

    24. Minnesota Comprehensive Children’s Mental Health Act 1989 Services Education and prevention Mental health identification and intervention Emergency services Additional services for children with ED and SED

    25. Minnesota DHS Children’s Integrated Fund 1992 A legislatively mandated study of the feasibility of a children’s mental health integrated fund. Identified barriers: Many seriously emotionally disturbed children are not classified as SED. Many children accused of breaking the law are emotionally disturbed. Emotionally disturbed and delinquent populations are the same children. Maintaining the distinction hinders treatment allowing one agency to pass the child off to another agency.

    26. Minnesota DHS Children’s Integrated Fund 1992 Identified barriers: Efforts at coordination are often informal, taking the form of interpersonal relationships Inadequate funding levels Eligibility criteria limit matching youth to services “Least restrictive setting” can limit tx options State agencies’ missions are narrowly defined, the result is fragmented delivery

    27. Minnesota DHS Children’s Integrated Fund 1992 Identified Barriers cont: Family preservation policy when children shouldn’t return home Resources go to most seriously ill leaving little for prevention and early intervention The “conduct disorder” label can exclude children from mental health tx and EBD services instead placing them in correctional settings No one agency has overall responsibility

    28. Minnesota Supreme Court Juvenile Justice Services Task Force 2001 Gaps in services include: Assessment; Mental health services; CD services; Fetal alcohol screening & assessment; Culturally and gender specific services; a family-centered approach Unified, systematic approach to assessments throughout the state Use of evidenced-based services

    29. Minnesota DHS Blueprint for a Children’s Mental Health System of Care 2002 A blueprint for repairing and re-building the Minnesota children’s mental health system of care. The report identified service gaps and made recommendations for change. One significant outcome from this report was the 2003 Juvenile Mental Health Screening legislation for youth in the corrections and child protection systems

    30. Minnesota DHS Blueprint for a Children’s Mental Health System of Care 2002 Funding Mn children’s mental health system of care is fragmented because of federal and state funding streams Funding has not been adequate to meet the mandates of Mn Comprehensive Children’s Mental Health Act Enhance multiagency coordination and develop reimbursement schemes that encourage coordination Educate PO’s that children in juvenile justice system are eligible for services under Children’s Mental Health Act

    31. Minnesota DHS Blueprint for a Children’s Mental Health System of Care 2002 Coordination Coordinate screening, referral, and assessment activities across agencies Integrate appropriate transition services into service systems and case planning at all levels (juvenile justice to community)

    32. Minnesota DHS Blueprint for a Children’s Mental Health System of Care 2002 Early Identification Both locally and nationally, correctional systems in particular are becoming default mental health providers – a direct consequence of a lack of early intervention Create/expand targeted venues for mental health screening i.e. juvenile corrections Create incentive for agencies to invest in front end services .

    33. Minnesota Juvenile Justice Mental Health Screening 2003 Who? Juvenile Justice Population Children ages 10 to 18 Judicial finding of delinquency Allegedly committed a delinquent act and who have had an initial detention hearing, with court ordering the child in detention (parent consent required) Committed a juvenile petty offense for the third or subsequent time

    34. Minnesota Juvenile Justice Mental Health Screening 2003 Funding and Data Counties receive an allocation based on the number of completed screens Counties report data through the Court Services Tracking System and submit to DHS

    35. Minnesota Juvenile Justice Mental Health Screening 2003 Next Steps: Continue to promote the benefits of early identification and intervention Training: mental health disorders & evidenced-based mental health treatment Work with Counties to increase screenings Develop better data analysis strategies

    36. Minnesota PACER Family Needs Research Project 2004 The goal was to better understand what parents & families need from mental health system Public Policy Recommendations include: Access and information Training Funding

    37. Minnesota PACER Family Needs Research Project 2004 Access and Information Easier access to service Access to information regarding the right to services Need for an effective oversight mechanism Well defined roles and responsibilities Include parents in planning & implementation Appropriate use of medication

    38. Minnesota PACER Family Needs Research Project 2004 Training Service providers are competent with cultures they serve Professionals are adequately trained Professionals deliver quality services

    39. Minnesota PACER Family Needs Research Project 2004 Funding Simplify Clarify financial responsibility of insurers and providers More prevention and early intervention for adolescents Funding so schools have adequate resources to provide mandated services for children with mental health concerns

    40. Minnesota Umbrella Rule 2005 Joint DHS and DOC rules promulgated to provide consistent secure and non-secure "licensing" and "program" standards Enables juvenile facilities to provide appropriate services to juveniles with single or multiple problems who are in out-of-home placement programs. 

    41. Minnesota Umbrella Rule 2005 The Rules promulgate: Program outcomes that promote healthy development including mental health Mental health screening Chemical abuse/dependency screening Case plans that provide needed services identified by screening Timely access to services Coordinated delivery of social services Trained staff

    42. Minnesota Mental Health Action Group 2005 MMHAG is a coalition of agencies and organizations including Depts. of Human Services and Health and created to transform the mental health system to better serve children and families. Public/private partnerships that are responsive to consumers Fiscal framework that delivers right services at right time in right setting Quality of care that is measurable Adequate supply of trained & qualified professionals Earlier identification and intervention Coordination of care and services so system is easy to navigate

    43. Minnesota State Advisory Council on Mental Health and Subcommittee on Children’s Mental Health 2006 Develop and fund an adequate infrastructure within the correctional system to identify and treat mental health Increase public awareness of service gaps addressing MN issues as a priority in JJ system Develop database to monitor the long terms outcomes of youth in the corrections system with MH or co-occurring disorders Establish a task force to develop and implement a comprehensive system to prevent youth with MH issues from entering JJ system

    44. Minnesota Juvenile Detention Alternative Initiative 2006 JDAI Mission: To make systemic changes to juvenile detention practices by: Addressing issues of detention utilization Reducing reliance on secure detention Addressing minority over-representation Establishing process for improvement Pilots in Hennepin, Ramsey, Dakota counties

    45. Minnesota Doing Juveniles Justice March 2007 A blueprint for reform from the Juvenile Justice Committee of the Children’s Mental Health Collaborative in Henn Co. Reduce Institutionalization Reduce Racial Disparity Ensure Access to Quality Counsel Create a Range of Community-based Programs Recognize and Serve Youth with Specialized Needs Improve Aftercare and Reentry Maximize Youth, Family, and Community Participation Keep Youth Out of Adult Prisons

    46. Minnesota Doing Juveniles Justice Reducing Racial Disparities Uniform statewide structure for documenting a youth’s racial/ethnic identity Data collection by race and/or ethnicity at in comparison to proportionality at each point of contact in the JJ system

    47. Minnesota Doing Juveniles Justice Ensure Access to Quality Counsel Specialized training for attorneys on topics such as adolescent development, mental health and special education Cross-system representation when adolescents are involved in multiple systems Evidenced-based practices that meet individualized youth needs

    48. Minnesota Doing Juveniles Justice Community-Based Programs Conduct an audit in each county to assess the availability of local treatment for mental health, chemical health, family/cultural issues. Shift funding priorities from out-of-home placement to increasing community-based programming

    49. Minnesota Doing Juveniles Justice Youth with Special Needs Silos are replaced by holistic care, wrap-around models Screening tool for mental health and chemical dependency issues Expansion of services for mental health and chemical dependency issues County-funded, community-based mental health services

    50. Minnesota Doing Juveniles Justice Improve Aftercare and Reentry Statewide use of risk to re-offend tool Uniform standards for aftercare Require all juvenile treatment programs to report recidivism data and risk adjusting factors

    51. Minnesota Doing Juveniles Justice Maximize Participation Assessments of family system/support Use of family-strengthening community–based interventions including MST, FFT, and ART

    52. Minnesota Challenges in Children’s Mental Health (from DHS 2007) Decrease in state and county spending since 2003 Reductions in funding to Children’s and Family Collaboratives Overcoming fragmentation as different public systems who serve same children struggle to integrate resources More meaningful partnerships between public and private systems

    53. Minnesota New 2007 Children’s Mental Health Legislation Approximately 50% of the proposed infrastructure investments for children’s mental health in the Governor’s Mental Health Initiative was approved by the legislature. Increase in funds available for school-based mental health services Increase to providers awarded a children’s mental health grant including CTSS Funds for early intervention services Funds for respite care for youth at risk of out-of-home placement Funds for lost funding to Collaboratives Funds for adolescent integrated dual diagnosis treatment services Funds for culturally competent mental health professionals and services Targeted dollars for victims of trauma and refugees Expanded case management Funding for ACE Funding for voluntary opt-in suicide prevention efforts in schools

    54. Minnesota Evidence and Community-Based Practices The Hawaii Model: Evidenced-based practices for Children’s Mental Health (3 year systems change grant) Northwest Council of Collaboratives (systems of care grant) involving 6 counties including Kittson, Marshall, Mahnomen, Norman, Polk, and Red Lake STARS for Children’s Mental Health is a six year cooperative agreement created by Central Minnesota Mental Health Center and Benton, Stearns, Sherburne and Wright counties to design a system of care that improves the coordination of access to and effectiveness of services for youth with social, emotional, and behavioral concerns FFT, MST, and ART in several counties Early intervention programs like ACE, Ramsey County Truancy Diversion Programs in various counties Treatment foster homes and group homes (MITH)

    55. Minnesota Interviews Legislators including: Reps. Walker, Loeffler, Paymer, Greiling, Johnson, Sens. Berglin, Huntley Director, Ramsey County Children’s Mental Health Ombudsman,State Mental Health Director, Wilder Children’s Mental Health Director, Tri County Community Corrections (Polk, Norman, Red Lake) Deputy Director and Mental Health Liaison, Dakota County Juvenile Probation Supervisor, Olmsted County Pacer Family Advocates Washington County team including probation, mental health, detention, residential placement MCCCA Residential Treatment Providers

    56. Interview Themes from County Corrections Funding Funding for mental health services is inadequate Payment for mental health services for corrections youth is an issue The size of agency placement budgets drives the degree to which agencies collaborate Mental Health Collaboratives are increasingly reliant on grants for funding Funding is not available for probation to consult with mental health professionals Mental health professionals are needed in education and justice system but funding is in mental health and social service divisions

    57. Interview Themes from County Corrections Collaboration Mental health system is very fragmented There are no incentives for collaboration among agencies Agency leadership drives the degree to which county agencies collaborate Relationships drive the degree to which county agencies collaborate Don’t know how many corrections kids are open for case management because SS has the data If youth aren’t labeled SED they don’t have access to a case manager Large case manager caseloads dampens collaboration Youth go from one system to the other so things get dropped and cases get closed Collaboratives are designed for deep end kids Probation agents are not trained in mental health Probation has little contact with social service agencies Lack of resources and services to meet mental health needs The case management model does not work well

    58. Interview Themes from County Corrections Identification The differences in the language and assumptions of the two systems influences access to services Debate about what’s driving the behavior influences subsequent decisions Follow-up to screenings are expensive and not timely Monitoring of mental health screen follow-up is not centralized and is inconsistent from county to county Not enough resources are put into the identification of co-occurring disorders Data is not available i.e., How many corrections kids in social service system? How many screens are positive? What happens to positive screens? What happens to SED kids?

    59. Interview Themes from County Corrections Diversion When case management caseload size gets high, kids have a lower chance of getting case management services Kids with mental health issues get mixed with hard-core corrections kids in detention when they should be diverted Lack of treatment beds and hospital beds keep youth in juvenile justice system when they could be diverted to mental health system State hospitals won’t work with kids with aggressive behavior Expectations for family involvement are low School’s zero tolerance policies send students to juvenile justice system Not enough resources are put into diverting youth with co-occurring disorders into appropriate treatment options

    60. Interview Themes from County Corrections Treatment Not enough community-based services available Evidenced-based services like FFT, MST, and ART are not MA reimbursable. When a family is finished with corrections, these services are no longer available The debate about what’s driving the behavior (mental health vs corrections) drives subsequent decisions Not clear what system should be paying for residential services when the family is not insured Not clear what system should oversee the length and type of mental health services/treatment Hospital and residential beds are shrinking and not available Aftercare and transition plans are inconsistent and lacking Parents are often not involved in the treatment process or aftercare process Inadequate treatment resources that integrate mental health services along with security Lack of resources that deal for DD and JJ youth

    61. Interview Themes from other interviews Funding Corrections doesn’t know or have access to mental health funding streams and therefore has less resources Identifying a youth as needing mental health services vs a correctional consequence may increase costs Funding drives system access When funding is tight, agencies work in silos Need for integrated funding streams between corrections, social services, mental health (Iowa) Placing agencies want integrated mental health services but aren’t willing to pay the price

    62. Interview Themes from other interviews Collaboration Corrections, mental health, social services, schools do not share data nor do they pass it along to providers Systems close cases once corrections is involved Need one identified lead person to coordinate services throughout child’s involvement in multiple systems Quality of relationships among agencies drives collaboration County oversight of cases is lacking Smaller counties seem to have greater success at collaborating

    63. Interview Themes from other interviews Identification Over-representation in correctional and out of state placements vs. residential placements Behavioral symptoms not causal factors drive system access Funding drives identification Diagnostic information does not follow the youth as they move through systems In need of one system that screens, diagnoses, and develops a case plan that will follow the youth through the systems

    64. Interview Themes from other interviews Diversion De-linking the responsibility of schools to pay for mental health services once kids are identified will improve mental health services delivered in schools When acting out behavior in schools gets referred to Police Liaison Officers, special education youth are more likely to get referred to court Victims of child abuse and young truants are two identifiable high risk populations that will benefit from diversion and early intervention The “least restrictive alternative” court philosophy often means that youth do not get the “most appropriate services” and are not being placed until they are too far along The expectation that families get involved needs to occur at the earliest stages (Indiana)

    65. Interview Themes from Residential Providers Treatment Need better transition and re-entry services to integrate youth back into community and family Need for placements that provide safety, security, and integrated mental health services Umbrella rules allow programs to think more broadly about the integration of mental health and corrections services in one program Providers need to improve quality assurance and fidelity Placing agencies want integrated mental health services but aren’t willing to pay the price

    66. Current Available Minnesota Data A picture of children’s mental health in Mn 2007 Juvenile Arrest Data 2005 Juvenile Probation Data 2005 Red Wing Data 2007 Mental Health Screening Data 2005 YLS Data 2005/06 Department of Human Services SSIS Data 2005 Department of Education Data 2006 MCCCA Annual Reports 2006 Overrepresentation in Minnesota 2004 Minority Youth Corrections Placements in Dakota County 2007 Residential Facilities for Juvenile Offenders: OLA, 1995

    67. Minnesota Children’s Mental Health (from DHS website 2007) A state-supervised, county-administered human services system An estimated 91,000 children need treatment for emotional disturbance 9% of school-age children have a serious emotional disturbance 42,600 children annually receive publicly funded mental health service MA and Minnesota Care accounted for 56% of funding for children’s mental health services and has been increasing Counties provided 24% of children’s mental health funding and this has been decreasing

    68. Minnesota Juvenile Arrest Data 2005 An overall decrease of 30% in juvenile arrests between 1999 and 2005. In 2005, 50,592 arrests of youth between the ages of 10-17. 66% male 34% female

    69. Minnesota 2003 Petitions Adjudicated/Found Guilty (Courts)

    70. Minnesota Red Wing & Juvenile Probation Race/Ethnicity (DOC)

    71. Minnesota Red Wing Mental Health Unit 1990’s: an increase of residents with significant mental health needs; Response: 2001 Mental Health unit that provides temporary housing (12) and specialized programming for offenders whose mental illness prevented their participation in regular programming A continuum of mental health services from psychological assessment to treatment plan 47% of RW population on psychotropic meds 54% of RW population with special needs

    72. Minnesota Juvenile Justice Mental Health Screening Data 2005(DHS) In 2005, 14,785 new juvenile probation entries. 9594 youth in detention or found delinquent met screening criteria: 56% (5334/9594) completed screens: 71% (3772/5334) were referred for assessment: 1777/9594 completed a screen and were referred 1068/9594 were under Care of MH Professional 571/9594 already screened within 180 days 356/9594 already assessed within 180 days 11% (1107/9594) not screened for known reasons 12% (1158/9594) not screened, reason unknown 1777 + 1068 + 571 + 356 = 3772 who were referred for assessment 9594 – 5334 = 4260 who did not complete screen Of those 4260 who did not complete screen: 1068 + 571 + 356 were already under care + 1107 not screened for refusal etc + 1158 not screened for unknown reasons = 42601777 + 1068 + 571 + 356 = 3772 who were referred for assessment 9594 – 5334 = 4260 who did not complete screen Of those 4260 who did not complete screen: 1068 + 571 + 356 were already under care + 1107 not screened for refusal etc + 1158 not screened for unknown reasons = 4260

    73. Minnesota Youth Level of Service Inventory Data 2005/06 (DOC) Co-occurring Disorders: Of those youth who scored medium to high on Personality factors, approximately (60%) scored medium to high on Substance abuse. Lots of caveats associated with this data. Personality and Behavior include: Inflated self-image Physically aggressive Tantrums Short attention span Poor frustration tolerance Inadequate guilt feelings Verbally aggressive, impudent Substance Abuse includes: Occasional drug use Chronic Drug use Chronic alcohol use Substance abuse interferes with life Substance use linked to offensePersonality and Behavior include: Inflated self-image Physically aggressiveTantrums Short attention span Poor frustration tolerance Inadequate guilt feelings Verbally aggressive, impudent Substance Abuse includes: Occasional drug use Chronic Drug use Chronic alcohol use Substance abuse interferes with life Substance use linked to offense

    74. Minnesota DHS SSIS Data Corrections Youth in Placement 2005 14,723 Minnesota youth experienced out of home care in 2005: 12% (1738 but under-reported) corrections youth in care Of those, 53% (924) had disabilities; Of the 924 corrections kids in care with disabilities: 42% (386) were chemically dependent; 58% (534) emotionally disturbed

    75. Minnesota DHS SSIS Data Corrections Youth in Placement 2005

    76. Minnesota Department of Education State Enrollment Data 10/1/06

    77. Minnesota Department of Education Top Disciplinary Incident Types 5/06

    78. Minnesota Department of Education DIRS Reported Law Enforcement Referrals General Education 17 C (70%) AA (12%) Special Education 11 C(54%) AA (18%) EBD 6 Average ages: 13-15 Slow Increase in ages 6-9 This is the from the Disciplinary Incident Reporting System or DIRS.  This is an online report that schools use to be in compliance with state and federal statutes regarding disciplinary incidents in the schools.  Each school is required to report the following For general education students: Any incident resulting in an expulsion or exclusion Any incident resulting in an out of school suspension/removal for one day or longer For special education students: Any incident resulting in an expulsion or exclusion Any incident resulting in an out of school suspension/ removal of any length Any incident resulting in an in-school suspension of any length.   Information is collected regarding the type of incident, weapons involved (if appropriate), the disciplinary action taken, along with specific information related to the offenders age, grade, gender, race and special education status.   All of this is reported based on a schools disciplinary policies and is up to the schools to report.    The law enforcement referrals are any in the year.  There hasn’t been a clear definition of what this is – a referral to the SRO, referral to an outside agency, or something else…so it’s been up to each site to determine what this means to them…. As for the race data – we only use what MDE categories there are…so this is bad.  It’s all VERY limited.   The race categories we have are:  White, African American, American Indian, Asian and Hispanic.  So not so great.  We do ask about Limited English Proficiency. This is the from the Disciplinary Incident Reporting System or DIRS.  This is an online report that schools use to be in compliance with state and federal statutes regarding disciplinary incidents in the schools.  Each school is required to report the following For general education students: Any incident resulting in an expulsion or exclusion Any incident resulting in an out of school suspension/removal for one day or longer For special education students: Any incident resulting in an expulsion or exclusion Any incident resulting in an out of school suspension/ removal of any length Any incident resulting in an in-school suspension of any length.   Information is collected regarding the type of incident, weapons involved (if appropriate), the disciplinary action taken, along with specific information related to the offenders age, grade, gender, race and special education status.   All of this is reported based on a schools disciplinary policies and is up to the schools to report.    The law enforcement referrals are any in the year.  There hasn’t been a clear definition of what this is – a referral to the SRO, referral to an outside agency, or something else…so it’s been up to each site to determine what this means to them…. As for the race data – we only use what MDE categories there are…so this is bad.  It’s all VERY limited.   The race categories we have are:  White, African American, American Indian, Asian and Hispanic.  So not so great.  We do ask about Limited English Proficiency.

    79. Minnesota Council Child Caring Agencies 2006 Annual Report MCCCA agencies include: Residential treatment center; Therapeutic group homes; Treatment foster care; Corrections residential treatment programs Mesabi Academy Mille Lacs Academy VOA Bar None residential treatment center Woodland Hills Short-term shelter and/or Diagnostic Programs

    80. Minnesota Council Child Caring Agencies 2006 Annual Report

    81. Minnesota Council Child Caring Agencies 2006 Annual Report

    82. Minnesota Overrepresentation (DPS 2005) Overrepresentation occurs at each point in the system and accumulates as youth are processed through. 17% of Mn youth between 10-17 are minorities 35% were arrested 36% cases were petitioned 40% cases resulted in delinquent findings 45% cases resulted in confinement 54% cases transferred to adult court

    83. Dakota County Minority Youth Corrections Placements 33% of offenses occur in school African Americans over-represented in offenses reported at school (68%) Offenses involved theft, assault, disorderly

    84. Dakota County Minority Youth Corrections Placements Equal likelihood of behavioral issues occurring in detention among races 21% of corrections population is African American 13% of African Americans received tx African American least likely to be rated by self-report and by detention staff) as having mental health or CD concerns

    85. Dakota County Minority Youth Corrections Placements Treatment Services 62% white youth successfully completed tx 33% black youth successfully completed tx Tx staff felt their programs served all youth equally effectively 55–59% PO’s did not know the ability of programs to serve minority youth

    86. Minnesota Rates of Juvenile Re-offense Legislative Auditor 1995 The most recent statewide re-offense rates are for youth released in 1991 from 7 Mn juvenile facilities: 3 operated by DOC; 2 operated by Counties; 2 privately operated 53-77% of males (889) were arrested or petitioned with 2 yrs of release 41-53% of females (167) were arrested or petitioned with 2 yrs of release

    87. Minnesota What Does the Data Tell Us? Juvenile crime appears to be decreasing A significant number of misdemeanants end up in out-patient treatment or placement compared to felony and gross misdemeanants Most youth are on probation in the community and not in placement or at Red Wing Youth on probation are disproportionately represented, the majority being male, therefore, the number of youth with MH and co-occurring disorders are likely disproportionately represented Youth of color tend to be placed in correctional facilities vs Caucasian youth placed in residential treatment (MCCCA) High overlap between youth supervised in corrections who have emotional disturbance &/or chemical abuse (SSIS) About 70% of youth on probation in Minnesota have mental health needs (Screening Data) About 60% of youth on probation with medium to high personality factors have medium to high substance abuse issues (YLS Corrections Data) About half of the children supervised by corrections have disabilities (SSIS)

    88. Summary Issues Funding Corrections doesn’t know or have access to mental health funding streams Need for joint identification of mental health funding mechanisms to support strategies at each critical stage for youth in juvenile justice system Identifying a youth as needing mental health services vs correctional consequence may increase costs Funding drives system access When funding is tight, agencies work in silos Need for collaborative, integrated funding streams De-link funding for mental health services in schools Funding mechanisms are needed that pay for evidenced-based community interventions

    89. Summary Issues Collaboration Agency missions are too narrowly defined and result in fragmented delivery Unclear lines of responsibility for MH services when several agencies are involved-eliminate silos A need for greater comprehensive planning for mental health services at each critical intervention point of the juvenile justice system Greater efforts to include family members and caregivers Better data sharing and joint information systems among agencies (law enforcement, corrections, mental health, schools, courts) More cross-training and cross-staffing so professionals better understand each other’s system A true “systems of care” approach across the state not based on “interpersonal relationships” Educate probation agents that youth are eligible for services under Children’s Mental Health Act

    90. Summary Issues Identification Comprehensive mental health screening in two steps: emergency and general screen Access to immediate emergency MH services Work with counties to increase the number of screenings for eligible youth Further assessment administered when indicated Combined mental health and risk to re-offend assessments MH screens and assessments administered by trained staff Mental health services that are governed by appropriate use and privacy policies Screening and assessment performed routinely as youth move through juvenile justice system Assessments that integrate substance use & mental health Individualized case plans that address mental health or co-occurring services and follow the individual Greater availability of mental health case managers to provide appropriate mental health referrals and follow-up for justice-involved youth Develop better data analysis strategies

    91. Summary Issues Diversion More prevention and early intervention for youth Procedures put in place to identify youth appropriate for diversion Funding so schools have adequate resources to provide mandated services Written criteria that governs role of school police liaison officer Diversion mechanism instituted at every critical intervention point in JJ continuum Youth are diverted to community-based treatment when possible Diversion to mental health services are available as an alternative to traditional incarceration for serious offenders when appropriate Diversion programs are regularly evaluated

    92. Summary Issues Treatment Greater access to mental health treatment when needed Treatment programs that are evidenced-based Juvenile justice and mental health systems share responsibility with one agency established as the lead Qualified MH personnel are available to provide treatment Families are fully involved Sensitivity to trauma-related histories Availability of gender-specific services Availability of culturally sensitive services Correctional facilities integrated with mental health services Consistent, statewide, discharge planning services upon release from placement

    93. Funding Summary Issues What’s in Place/What We Might Improve

    94. Collaboration Summary Issues What’s in Place/What We Might Improve

    95. Identification Summary Issues What’s in Place/What We Might Improve

    96. Diversion Summary Issues What’s in Place/What we Might Improve

    97. Treatment Summary Issues What’s in Place/What We Might Improve

    98. Definitions Case Management Services: activities that coordinate the provision of services for individual children and their families who require services from multiple service providers (SG, 01); Disability: severe, chronic condition due to mental &/or physical problems with major life activities such as language, mobility, learning, self-help, and independent living (NCD); Emotional Disturbance: an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior that is listed in ICD-9-CM or DSM, Axes I, II, III, and seriously limits child’s capacity to function in daily living… (Mn legislation) Mental disorders: health conditions characterized by alterations in thinking, mood, behavior associated with distress &/or impaired functions Mental Illness: an organic disorder of the brain or clinically significant disorder of thought, mood, perception, orientation, memory or behavior that is listed in the ICD-9-CM or DMS-MD, Axes I, II, or III and that seriously limits a person’s capacity to function…(245.462) Mental Health Problems: signs & symptoms of insufficient intensity or duration to meet criteria for any mental disorders Multisystemic Therapy (MST): a short term, home and family focused treatment approach with demonstrated effectiveness for youth in juvenile justice system with SED Serious Emotional Disturbance (SED): persons from birth to 18 who currently or at any time during the past year had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the DSM III-R and resulted in functional impairment which interferes with or limits child’s role or functioning in family, school, community activities Therapeutic Group Homes: for adolescents with SED, provides an environment conducive to learning social & psychological skills.

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