how state, local communities and universities work together to implement evidenced based practices...

How State, Local Communities and Universities Work Together To Implement Evidenced Based

Practices and Reduce Recidivism of Juvenile Offenders

WORKING TOGETHER TO GET IT RIGHT

Eric Shafer – Assistant Court Administrator – Montgomery County Juvenile Court

Barbara Keen-Marsh, MSW, LISW-S, LICDC - South Community, Inc.

Jeff M. Kretschmar, Ph.D. - Begun Center for Violence Prevention Research and Education, Jack, Joseph, and Morton Mandel School of Applied Social Sciences,

Case Western Reserve University

Montgomery County Juvenile Court Dayton, Ohio

• Ohio’s Behavioral Health Juvenile Justice Initiative (BHJJ)

-Began in 2005 with 6 Counties-Required the introduction of Evidenced Based Practices-Funding through:

Ohio Dept. of Mental HealthOhio Dept. of Youth

Services

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Montgomery County Juvenile Court Dayton, Ohio

• Learning Independence and Family Empowerment LIFE Program

• Functional Family Therapy (FFT)

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Multiple Pathways to South Community Inc. – Function Family Therapy

• Ohio Department of Youth Services– Parole

• Nicholas Residential Treatment Center– 24 bed facility for boys 12-18– Open Setting

• Juvenile Cognitive Alternative Rehabilitation Effort– 18 bed program for boys housed within the Detention

Center– 90 Day Stay– Aggression Replacement Training (ART)

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Multiple Pathways to South Community Inc. – Function Family Therapy

• The Center for Adolescent Services– Community Correctional Facility– 44 bed facility, 34 for boys, 10 for girls

• MCJC Probation– 950 youth on Probation– 4 Dedicated Probation Officers

• MCJC Intervention Center (Diversion)– 24/7 Reception and Assessment Center– 2,900 cases diverted annually– Disproportionate Minority Contact Mediation Program

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Montgomery County Juvenile Court Dayton, Ohio

• Keys to Success– Early Involvement

• Make a connection on day one

– Opening our facilities and providing space• Become true partners with providers

– Constant Collaboration• Line Staff• Administrative staff

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LIFE ProgramLearning Independence and Family

EmpowermentLocal Partnership

ADAMHS Board of Montgomery County

Montgomery County Juvenile Court and Reclaiming Futures

South Community, Inc.

SBHI/Crisis Care

LIFE ProgramLearning Independence and Family

EmpowermentState and Federal Partners

REFERRAL STRUCTURE

Youth is Released from ODYS, JCARE,

Nicholas or CAS

Crisis Care Completes an Assessment

LIFE Program is Recommended

Parole, Probation Officer or Other Court Personnel Refer Family to Services

Youth Enters Into the Juvenile Court System

LIFE PROGRAM STRUCTURETherapist Contacts Family Within 48 Hours of

Referral

Services Provided:• Home Based Family Therapy• Psychiatric Services• Intensive Probation• Case Management

Other Collaboration:• FAMILY • PROBATION/PAROLE OFFICER• INTERVENTION CENTER• NATURAL HELPER• CHILD WELFARE• OTHER SYSTEMS• CASE WESTERN UNIVERSITY• FUNCTIONAL FAMILY

THERAPY, INC.

Why FFT?Blueprints Model – Evidenced Based Practice• Well Documented

• Highly Successful Family Intervention Program for Juvenile Offenders

Strength-based• Consistent with local and state initiatives• Focus on strengths and assists families to

recovery

Goals:• Significant and Long-Term Reduction in Youth Re-Offending and Violent Behavior

• Low Drop-Out and High Completion Rates• Positive Impacts On Family Conflict, Family

Communication, Parenting, and Youth Problem Behavior

• Significant Reduction in Sibling Entry into High-Risk Behaviors,

CONTINGENCY MANAGEMENT MODEL

Macro LevelKey Concepts

Top Down Cooperation and Collaboration

Ongoing Problem Solving

Attention to Customer Service—the other agencies are Our Customers too!!

Ongoing Needs Assessment

Planning for Sustainability from Day 1 and adjusting Sustainability Plan as Program Grows

Current Challenge is Ohio’s move to an IHBT Rate

Service with a Smile• Weekly meetings with Probation officers to maximize

collaboration and keep everyone on the same page• Including Probation Officers and Administration in FFT

Trainings• Problem Solve any interruption in the flow of referrals–

eliminate barriers and SELL SELL SELL to all links in the referral chain---Judges, Magistrates, Traditional Probation Officers, Mental Health Assessors in and out of our agency.

• Key Attitude is how can we make Our Process fit Your Process and Your Needs

Marketing = Matching

• A site is Selling Two Things – Service (Micro Level)– Results (Macro Level)

• You have to do both in ways that MATCH a particular customer

Demographics

• From 2006 through June 2013, 2,545 youth enrolled– average age at intake 15.6 years– 58.4% male– 52.3% Caucasian

• From July 2011 – June 2013– 67.4% male– 42.9% Caucasian

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Youth CharacteristicsQuestion Females Males

Has the child ever been physically abused? 20.5% (n=194)**

15.3% (n=208)

Has the child ever been sexually abused? 28.1% (n = 262)***

7.1% (n = 95)

Has the child ever had a problem with substance abuse, including alcohol and/ or drugs?

43.9% (n = 411)

50.3% (n = 674)**

Has the child ever talked about committing suicide?

49.6% (n = 468)***

31.3% (n = 425)

Has the child ever attempted suicide? 22.2% (n = 207)***

9.6% (n = 129)

Has the child ever been exposed to domestic violence or spousal abuse, of which the child was not the direct target?

43.8% (n = 414)*

39.4% (n = 536)

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*p = .05, ** p < .01, *** p < .001

Youth CharacteristicsQuestion Females Males

Has anyone in the child’s biological family ever been diagnosed with depression or shown signs of depression?

68.2% (n = 626)***

60.3% (n = 793)

Has anyone in the child’s biological family had a mental illness, other than depression?

47.8% (n = 440)***

39.7% (n = 511)

Has the child ever lived in a household in which someone was convicted of a crime?

40.6% (n = 372)

40.9% (n = 540)

Has anyone in the child’s biological family had a drinking or drug problem?

43.9% (n = 439)**

57.2% (n = 480)

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*p = .05, ** p < .01, *** p < .001

Juvenile Court History

County Youth with Felony Charges in the 12 Months prior to BHJJ

EnrollmentCuyahoga (Cleveland) 35/156 (22.4%)Franklin (Columbus) 147/221 (66.5%)Montgomery (Dayton) 124/634 (19.6%)Hamilton (Cincinnati) 30/90 (33.3%)Lucas (Toledo) 33/59 (55.9%)Summit (Akron) 46/49 (93.9%)Total 415/1209 (34.3%)

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OYAS Risk

• Ohio Youth Assessment System (OYAS) – Criminogenic risk tool designed to assist juvenile

court staff with placement and treatment decisions

– Helps identify likelihood to re-offend

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Risk Level Low Moderate High

24% (n = 59) 48% (n = 118) 28% (n = 67)

DSM Axis I Diagnoses

DSM-IV Axis I Diagnosis Females MalesOppositional Defiant Disorder 41.3% (n = 419) 38.9% (n = 553)Cannabis-related Disorders 27.5% (n = 279) 35.3% (n = 501)***

Attention Deficit Hyperactivity Disorder 26.5% (n = 269) 42.5% (n = 604)***

Depressive Disorders 23.0% (n = 233)*** 12.5% (n = 178)Alcohol-related Disorders 13.3% (n = 135)** 9.9% (n = 140)Bipolar Disorder 10.3% (n = 105)* 7.5% (n = 106)Conduct Disorder 9.7% (n = 98) 21.2% (n = 301)***

Post-traumatic Stress Disorder 9.4% (n = 95)*** 5.3% (n = 75)Adjustment Disorder 7.2% (n = 73)* 5.1% (n = 72)Mood Disorder 11.1% (n = 113) 9.1% (n = 130)Disruptive Behavior Disorder 6.6% (n = 67) 7.8% (n = 111)

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*p < .05, ** p < .01, *** p < .001

Trauma

Intake Termination0

1

2

3

4

5

6

7

8

9

10

TSCC Scores from Intake to Termination

AnxietyDepressionAngerPosttraumatic StressDissociationSexual Concerns

Scal

e Sc

ores

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* all comparisons significant at the p < .01 level; effect sizes between .30 - .60.

Ohio Scales Problem Severity

Ohio Scales Functioning

Substance Use

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Substance UseSelf-Reported Previous 6 Month Substance Use from Intake to Termination for Females

Termination Information

Termination Reason All Youth Youth Enrolled from July 2011 through June

2013Successfully Completed Services

65.1% (n = 1315) 71.9% (n = 323)

Client Did Not Return/Rejected Services

6.2% (n = 125) 2.9% (n = 13)

Out of Home Placement 7.3% (n = 148) 8.0% (n = 36)

Client/Family Moved 3.0% (n = 60) 2.4% (n = 11)

Client Withdrawn 6.9% (n = 139) 5.6% (n = 25)

Client AWOL 2.9% (n = 58) 3.6% (n = 16)

Client Incarcerated 3.2% (n = 65) 3.6% (n = 16)

Other 5.4% (n = 109) 2.0% (n = 9)

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Termination Information• 2,019 youth terminated from BHJJ services (918 from Montgomery)• ALOS = 209 days (147 days in Montgomery)

– 224 days successful completers– 180 days for unsuccessful completers

• ALOS from July 2011 – June 2013 = 163 days (131 days in Montgomery)– 174 days for successful completers– 135 days for unsuccessful completers

• At intake, 47.9% of youth were identified as at risk for out of home placement

• At termination, 24.0% of youth were identified as at risk for out of home placement – 7.3% of successful completers– 56.7% of unsuccessful completers

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Recidivism• At termination, police contacts for 68% of youth had been

reduced – Police contacts for 24% of youth remained the same

• One year after termination, 10% of successful completers and 19% of unsuccessful completers had new felony charges

• Eighty-nine (89) youth (3.5%) enrolled in BHJJ for whom we had recidivism data were sent to an ODYS facility at any time following their enrollment in BHJJ, including after a youth’s termination from BHJJ. – 24/1040 (2.3%) in Montgomery County

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Financial Considerations

• Using only the direct State contribution to BHJJ of $8.4 million from 2006 - 2011, the average cost per youth enrolled in BHJJ was $4778. The FY11 per diem to house a youth at an ODYS institution was $442 and the average length of stay was 12.6 months. Based on these numbers, the estimated cost of housing the average youth at an ODYS facility in FY11 was $167,960.

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Contact Information

Eric ShaferMontgomery County Juvenile Court

937-225-4164eshafer@mcjcohio.org

Jeff KretschmarBegun Center for Violence Prevention Research and Education

Case Western Reserve University216-368-2305

jeff.kretschmar@case.eduBarbara Keen-Marsh

South Community, Inc.937-534-1325

bmarsh@southcommunity.com