New Pathways to Mental Health and Recovery for Adolescents in the Justice Systems

1. New Pathways to Mental Health and Recovery for Adolescents in the Justice Systems Anna Yee, LCSW Juvenile Court Consultant April 11, 2013

2. NCCD Center for Girls and Young Women “Gender-Responsive” • Reflect women’s realities • Validate women's pathways to justice systems

3. “Gender-Responsive” Programs • OJJDP (Office of Juvenile Justice and Delinquency Prevention) Created Guidelines (1998) for Gender Responsive Programming • Girls be treated in the least restrictive environment, whenever possible; • Close to their home … to help maintain family relationships • Assumes positive about youth and family • Change can be achieved through engagement and mutual learning

4. “Gender-Responsive” Programs • Consistent w/ female development • Emphasizes relationship between staff and girl; • Addresses needs of parenting and pregnant teens. • Assumes positive about youth and family • Change can be achieved through engagement and mutual learning

5. Gender-Responsive” Programs • # 1 Priority - Safety with self, others, staff • Identity , Communication, Relationship, Emotions, Trauma , Remembrance and Mourning • At the end of the shift, can staff say “Are the girls are safe "?

6. “Gender-Responsive” Programs • Take Time To Process Thoughts, Feelings, Emotions and to Share Stories. • Honor Girls Opinions and Input • Leadership Opportunities • Connection is central in girls' lives. • Effective communication = vocabulary to express emotion • Staff communicate in trauma – informed ways • Role model healthy relationships.

7. “Gender-Responsive” Programs • Strategies in resilience --Rebound from disappointment • Prevent re­-traumatization. Program is designed with a trauma-informed sensibility. • Alternatives to restraint and seclusion Traumatic Event : • Experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the integrity of self or others.

8. “Gender-Responsive” ProgramsStaff Training • Increase staff's understanding of the connection between trauma, behavior and needs of girls and young women. • Skill-building how to effectively address behaviors versus controlling behaviors • Be aware of clinical signs of depression, PTSD, mental illness • Validate as emotion coaches: All emotions acceptable. • Teach resilience -- how to rebound from disappointments

9. “Gender-Responsive” Programs • Appropriate assessment and access to counseling • Match girls with mentors • Self soothing activities and coping • Trauma – informed interventions • How to prevent re­-traumatization • Healing of trauma can take a long time. Programs that are “gender responsive” provide some essential tools for coping and affirming a stronger self, and re-entering the community • to continue the work of developing their identities.

10. 2012-10 Research and Evaluation Databits“What’s the Evidence for Evidence-Based Practice?”Jeffrey A. Butts, John Jay College of Criminal Justice, Research and Evaluation Center • “[Research] evidence does not emerge from a pristine and impartial search …The evidence we have today is the fruit of our previous research investments—investments made by funders and policymakers with beliefs, values, preferences, and even self-interest.” • “…practitioners must exercise caution in how they interpret and apply the evidence produced by evaluation research.” • “Evidence should inform, but never simply dictate the shape of policy and practice.”

13. Government Savings: Safe Reduction The Model Courts in Los Angeles, Chicago, and New York City, through their collaborative system reform efforts, have successfully contributed to the safe reduction of the number of children in foster care. Collaborative efforts by judicially-led system reform teams have resulted in the launch of reform initiatives, not only in the courts, but in child welfare agencies and other system partner agencies.

14. Government Savings: Safe Reduction Chicago (Cook County) Year # Children in Foster Care 2000 = 22,184 2009 = 7,369 Reduction = 14,815 Los Angeles (Los Angeles County) Year # Children in Foster Care 2000 = 40,117 2009 = 20,128 Reduction = 19,989 New York City (Borough of Manhattan) Year # Children in Foster Care 2000 = 46,653 2009 = 18,175 Reduction = 28,478

15. Cost Benefit of Model Court Programs Annual cost savings = $1,316,265,600 = 63,282 x $20,800 = (Savings in year 2009 compared to year 2000) • Sources Foster care roles: Adoption and Foster Care Analysis and Reporting System Preliminary Estimates for FY 2009. U.S Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau. Foster care costs: Peters, C.M., Dworsky, A., Courtney, M.E., & Pollack, H. (2009). Extending Foster Care to Age 21: Weighing the Costs to Government against the Benefits to Youth. Chapin Hall Issue Brief, June 2009. Calculations by: Permanency Planning for Children Department, National Council of Juvenile and Family Court Judges

16. Government Savings: Safe Reduction $1,316,265,600 Annual estimated savings to government from the reduction of the number of children in foster care in these three locations.

18. Los Angeles Juvenile Court • Honorable Michael Nash, Presiding Judge • Honorable Margaret Henry, Supervising Judge of Dependency • La Juvenile Court has been on the leading edge of improvements in several significant initiatives, including: • Developing a medication protocol that will be used consistently county-wide in psychotropic medication decisions. The protocol has been a collaboration of many agencies, with leadership by the court and the LADMH.

19. Medication Protocol for Juvenile Youth • RX’s for Dependency and Delinquency court youth are ordered by the court. • Juvenile Court Mental Health Services provides recommendations. • An order authorizing medication is valid for 6 months. • Protocol is likely to inform policies on national standards through the NCJFCJ

20. Juvenile Competence Protocol Why a Juvenile Competence Protocol is Needed • California’s adult criminal justice systemhas comprehensive statutes that govern competence proceedings. • Ample case law to provide further guidance in decision-making. • Case law holds that children must be competent to stand trial, but it also holds that they do not come within the adult statutory procedures. • Current California law fails to address many issues in juvenile cases involving competence issues.

21. Evolving Protocol for Competency • The protocol is intended as a tool for the development of future procedures; • To be ruled competent, youth must have: • A sufficient present ability to consult with his or her lawyer with a reasonable degree of rational understanding; or • Rational as well as factual understanding of the proceedings against him or her. • Incompetence may be the result of a mental disorder, developmental disability, developmental immaturity, or other conditions. • Sue Burrell or Corene Kendrick Staff Attorneys, Youth Law Center • 200 Pine Street, Suite 300, San Francisco, CA 94104 • (415) 543-3379 sburrell@ylc.org, ckendrick@ylc.org

22. Court and legal community are developing standards for public defenders representing youth in juvenile court; • Mental Health Court for complex cases • Collaboration with DCFS, DMH, legal services

23. Thank You • Anna Yee, LCSW