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Building a Juvenile Justice System of Care. 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

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a juvenile justice system of care a comprehensive approach
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
defining screening assessment
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
what is screening for mental health substance abuse
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”
what is assessment for mental health and substance abuse
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
juvenile justice risk assessment
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
barriers to providing effective services
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
barriers to effective services continued
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
the solution integrating sa mh and justice responses
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
key components to service delivery
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
what does it take
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
who are the stakeholders people impacted by a decision or with the ability to impact a decision
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
consequences of no intervention and or ineffective intervention
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
in summary a comprehensive response is critical because
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