juvenile justice diversion and treatment program jjdtp

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2. History of JJDTP. MHSA was approved by California voters in November of 2004 and the idea for a program to serve juvenile justice youth with mental health needs was submitted in 2005 Initially the program was not funded (in 2007/8) and 2 workgroups were designed by Mental Health Director Leland Tom to redesign and reconfigure the proposalThe funding was approved for a Full Service Partnership between Probation, Children's Mental Health, and a contract Mental Health agency in 2009 and Reque13

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1. 1 Juvenile Justice Diversion and Treatment Program(JJDTP) A Mental Health Services Act funded Full Service Partnership involving River Oak Center for Children, Sacramento County Juvenile Probation and Division of Behavioral Health Services – Child and Family Mental Health

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3. 3 River Oak Center for Children Committed to helping youth and families for over 30 years. Over 850 children and youth currently receiving services Services include prevention/intervention; integrated therapeutic outpatient; Wraparound and Therapeutic Behavioral Services. Invested in providing nine (9) research based services

4. 4 Full Service Partnership (FSP) Mental health service program for youth and their families who would benefit from an intensive in-home program designed to address the total needs of the child, including his/her family, who is experiencing significant, emotional, psychological and behavioral problems that are interfering with the child’s well being.

5. 5 Full Service Partnership (FSP) Consists of a team of mental health professionals and other service providers. Services may include: Individual and family counseling Peer support from people experiencing similar issues Transportation Access to physical health care Help finding suitable housing and paying rental subsidies when necessary Help getting the financial and health benefits to which they are entitled Assisting family members with substance use and domestic violence counseling as needed Assisting with education and/or employment Probation supervision and support

6. 6 Juvenile Justice Diversion & Treatment Program (JJDTP) Provides screening, assessments, intensive mental health services and Full Service Partnership supports. Designed to serve youth involved in the juvenile justice system with culturally and linguistically informed services to meet the needs of this underserved population. Availability of two (2) funding streams – MediCal and Mental Health Services Act (MHSA) Have the ability to provide these services to both MediCal and non-MediCal youth within the program

7. 7 Five (5) Goals of JJDTP To stabilize placements and reduce homelessness To increase school attendance and achievement To increase vocational training and employment To reduce psychiatric hospitalizations To reduce juvenile detention and/or young adult incarceration

8. 8 JJDTP Referral Process The Probation Referral Process consists of the following: Every minor coming into JJDTP must have Probation status which can consist of: 654, 654.2, 725(a), 725(b), or 790 DEJ. Referrals can be submitted from: Intake, Courts (PD, DA, Court Officer), Field PO, Placement, YDF-Mental Health, or School/SCOE Referrals are sent to Gary Nichols, Senior Mental Health Counselor, via e-mail.

9. 9 JJDTP Entry Points Citation received by Probation Arrest/Detained in YDF Arrest/Not Detained in YDF Minor on Probation (post-adjudication)

10. 10 JJDTP Youth Eligibility Criteria for Services Meet clinical criteria for being ‘seriously emotionally disturbed’ AND Be between the ages 13 through 17* when referred AND Are involved with the juvenile justice system Approximately 50 Diversion youth (pre-adjudicated) Approximately 42 Probation youth (post-adjudicated) Youth are voluntary participants, agreeing to participate in JJDTP whether entering the program through diversion or from ongoing probation services Youth may continue to receive services up to their 26th birthday as long as services are clinically necessary Youth who are in placement (group home) in Sacramento county, or an adjacent county, can be referred up to 90 days prior to their return date for services in this program *We have approximately 10 slots for youth aged 18-20. These youth need to meet the other criteria stated above.

11. 11 Seriously Emotional Disturbed (SED) Criteria SED means youth must have a mental disorder identified in the DSM-IV, and meet one of the following: As a result of the mental disorder the youth has substantial impairment in at least two of the following areas: self-care, school functioning, family relationships, or ability to function in the community; and either of the following occur: The youth is at risk of removal from home or has already been removed from the home. The mental disorder and impairments have been present for more than six months or are likely to continue for more than one year without treatment. (OR) The youth displays psychotic features, risk of suicide or risk of violence due to a mental disorder. (OR) The youth meets special education eligibility requirements under Chapter 26.5 (commencing with Section 7570) of Division 7 of Title 1 of the Government Code.

12. 12 Examples Of Referred Youth “Dougie” 14 yr. old male charged with misdemeanor battery Extensive history of mental health services and acknowledges difficulties with anger and suicidal ideations Prior diagnoses: depression, oppositional defiance disorder (ODD), panic attacks, PTSD History of 6 different medications to address mental illness Several psychiatric hospitalizations, beginning at 12, to address self injurious behavior Assaultive towards family members and hospital staff 15 referrals to CPS since 5/98, 10 were substantiated

13. 13 Examples of Referred Youth “Janie” 14 yr old female charged with assault History of AWOL behavior and fighting with caregiver and older sister Diagnosis of depression and medications have been prescribed but client is not consistently compliant Admits to occasional drug use (marijuana and ecstasy) Overall school performance is good but fights with students and staff Suspensions in the last couple of years for: fighting, drugs and assault on a teacher

14. 14 Final Step in Referral Process Sr. Mental Health Clinician verifies client meets the eligibility criteria and: For post-adjudicated youth: submits referral to ACCESS* team For youth in the court process: submits findings of assessment for eligibility to referring party (PD, DA, etc) An informational copy of the referral is also sent to River Oak ACCESS* Team authorizes River Oak to provide services from the date of the referral *ACCESS is the governing body through Sacramento County that provides billing authorization and timelines

15. 15 JJDTP River Oak Services Intensive Mental Health Services Full Service Partnership Support Multidisciplinary Treatment Team Program Evaluation

16. 16 JJDTP River Oak Services Throughout the initial six (6) months of service, each youth will have both a Case Manager and a Therapist assigned Staff will have the ability to provide services five (5) hours per week (or more as needed) After six (6) months, service intensity may be reduced based upon the individual needs of the youth and the content of their treatment plan.

17. 17 JJDTP Mental Health Services Immediate response Initial appointment within three (3) business days Crisis plan developed within seven (7) days Psychiatric appointment within fifteen (15) days for youth referred from an inpatient psychiatric hospital, juvenile justice institution, or other 24-hour residential facility and have been prescribed psychotropic medications Available 24/7 throughout services

18. 18 JJDTP Mental Health Services Youth will have an individualized treatment plan with specific goals that define what will be done to achieve the goals Treatment plan may include individual therapy, family therapy, collateral work with a family member, crisis intervention, case management and rehabilitation services Treatment plans will be updated to add new goals and resolve met goals based in each youth’s needs

19. 19 JJDTP Mental Health Services Facilitate or provide services for youth experiencing co-occurring substance misuse problems Focus on recovery and increasing resiliency, improving problem-solving and developing and maintaining positive relationships within the family All youth are assessed for the appropriateness of an Evidence-Based Practice (e.g., Multisystemic Therapy, Functional Family Therapy, Trauma-Focused Cognitive Behavioral Therapy, etc.)

20. 20 JJDTP Mental Health Services Development of daily living skills, life and social skills, stress management, symptom management and medication compliance Culturally and linguistically appropriate services for both youth and family Frequency of services is determined by youth’s and family’s needs (daily, bi-weekly, weekly, etc.)

21. 21 JJDTP Support Services Involve family members and natural supports (e.g., friends, community organizations, doctors, etc.) Promotes successful school attendance Assist youth with appropriate supportive employment services Provide housing subsidies when other resources are unavailable to reduce homelessness and attain stability

22. 22 JJDTP Support Services Screen for physical and nutritional health needs and assist the family in locating and securing services Assist youth in appropriate entitlements (e.g., MediCal, SSI, etc.) Provide transportation support to ensure participation Assist in obtaining respite services for families in crisis.

23. 23 JJDTP Multidisciplinary Team Multidisciplinary Team meets weekly under the direction of the ROCC Clinical Supervisor and may include youth, family members, Case Manager, Therapist, Youth Peer Mentor, Family Partner, Housing and Benefits Specialist, School Social Worker (SCOE), Probation Officer and Sacramento County Senior Mental Health Clinician Deputy Probation Officers and the Senior Mental Health Clinician are integral part of the Multidisciplinary Team and will join the meetings each week

24. 24 JJDTP Multidisciplinary Team Psychiatrist will attend all MDT meetings Collectively develops treatment goals and interventions Develops transitional living plan Youth’s treatment and service plans can be reviewed as often as necessary, but not less than quarterly.

25. 25 JJDTP Program Evaluation Complete MHSA required documentation regarding outcome measures and forward to Sacramento County Utilization of external consultation to train and measure adherence of case managers to “Transition to Independence Process” model Internal benchmarks to ensure JJDTP goals are being met Complete and track outcomes for Evidence Based Practices

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