NCMHJ JNational Center for Mental

Health and Juvenile Justice

Mental Health and Juvenile Justice: Issues and Trends

Joseph J. Cocozza, Ph.D

National Center for Mental Health and Juvenile Justice

Policy Research Associates, Inc.

Coordinating Council on Juvenile Justice and Delinquency Prevention

Washington, DCSeptember 8, 2006

NCMHJ JNational Center for Mental

Health and Juvenile Justice

National Center for Mental Healthand Juvenile Justice

Key Functions:– Serve as National Resource Center– Conduct Research– Foster Policy and Systems Change

Funding:− John D. and Catherine T. MacArthur Foundation− Office of Juvenile Justice and Delinquency Prevention− Substance Abuse and Mental Health Services

AdministrationWebsite:

− www.ncmhjj.com

NCMHJ JNational Center for Mental

Health and Juvenile Justice

1. Research studies consistently report high rates of mental health disorders among youth in the juvenile justice system

• Recent OJJDP/NCMHJJ study confirms high rates-regardless of geographical location or type of residential setting– Multi-state, understudied sites (LA, TX, WA) – Continuum of settings – Sample of 1,437 boys and girls, age 11-18– Data collected using standardized

Screening/Assessment Instruments

NCMHJ JNational Center for Mental

Health and Juvenile Justice

Comparison of Prevalence Finding From Recent Juvenile Justice Studies

Positive Diagnosis

NCMHJJ (2006) 70.4%

Teplin et al. (2002) 69.0%

Wasserman et al. (2002) 68.5%

Wasserman, Ko, McReynolds (2004) 67.2%

2. Approximately 70% of youth meet the criteria for at least one psychiatric disorder

NCMHJ JNational Center for Mental

Health and Juvenile Justice

• More than half (55.6%) of youth met criteria for at least two diagnoses

• Over 90% of youth with Conduct Disorders also experienced at least one other mental disorder

• 60.8% of youth with a mental disorder also had a substance use disorder

• About 27% of justice-involved youth have disorders that are serious enough to require immediate and significant treatment

3. Many of These Youth ExperienceMultiple and Severe Disorders

NCMHJ JNational Center for Mental

Health and Juvenile Justice

4. Other factors are fueling the growing sense of crisis surrounding youth with mental disorders

• Numbers entering the juvenile justice system increasing– Texas data show a 27% increase of youth with high mental health

needs over a six year period (Texas Youth Commission, 2002)

• Youth being inappropriately placed – 2/3 of juvenile detention facilities’ youth held unnecessarily

because of unavailable services (Congressional Committee on Government Reform, 2004)

• Mental health services often unavailable or inadequate– Series of DOJ investigations document poor training, inadequate

clinical services, inappropriate use of medications etc. (U.S. Department of Justice, 2005)

NCMHJ JNational Center for Mental

Health and Juvenile Justice

5. There are a number of trends, services and strategies that are developing to support the better identification and treatment of these youth

a. Standardized mental health screening and assessment procedures

b. Evidence-based interventions and promising practices

c. Comprehensive mental health and juvenile justice programs and models

NCMHJ JNational Center for Mental

Health and Juvenile Justice

MAYSI now used system wide in 39 states

MAYSI™-2 Statewide by Gate

AK

AL

ARAZ

CA CO

CT

DC

DE

FL

GA

HI

IA

ID

IL IN

KS

KY

LA

MA

MD

ME

MI

MN

MO

MS

MT

NC

ND

NE

NH

NJ

NM

NV

NY

OH

OK

OR

PA

RI

SC

SD

TN

TX

UT

VA

VT

WA

WI

WV

WY

Detention

Corrections

Probation

Detention & Corrections

Corrections & Probation

Probation & Detention

Corrections & Probation & Detention

Substance Use & Detention

Other – Non JJ

Grisso, 2006

5a. Spread of Mental Health Screening

NCMHJ JNational Center for Mental

Health and Juvenile Justice

-12%

-13%

-31%

-14%

-4%

-8%

10%

-5%

-2%

-1%

-31%

-25%

-18%

-37%

-27%

-5%

0%

-4%

-14%

13%

-17%

-15%

-12%

10%

-80% -60% -40% -20% 0% 20% 40%

Early Childhood Education for Disadvantaged Youth (N = 6)

Seattle Social Development Project (N = 1)

Quantum Opportunities Program (N = 1)

Children At Risk Program (N = 1)

Mentoring (N = 2)

National Job Corps (N = 1)

Job Training Partnership Act (N = 1)

Diversion with Services (vs. Regular Court) (N = 13)

Diversion-Release, no Services (vs. Regular Court) (N = 7)

Diversion with Services (vs. Release without Services) (N = 9)

Multi-Systemic Therapy (N = 3)

Functional Family Therapy (N = 7)

Aggression Replacement Training (N = 4)

Multidimensional Treatment Foster Care (N = 2)

Adolescent Diversion Project (N = 5)

Juvenile Intensive Probation (N = 7)

Intensive Probation (as alternative to incarceration) (N = 6)

Juvenile Intensive Parole Supervision (N = 7)

Coordinated Services (N = 4)

Scared Straight Type Programs (N = 8)

Other Family-Based Therapy Approaches (N = 6)

Structured Restitution for Juvenile Offenders (N = 6)

Juvenile Sex Offender Treatment (N = 5)

Juvenile Boot Camps (N = 10)

Lower Recidivism Higher Recidivism

The number in each bar is the "effect size" for each program, which approximates a percentage change in recidivism rates.

The length of each bar are 95% confidence intervals.

Type of Program, and the Number (N) of studies in the Summary

Source: Meta-analysis conducted by the Washington State Institute for Public Policy

The Estimated Effect on Criminal Recidivism for Different Types of Programs for Youth and Juvenile Offenders

5b. Growing understanding of “What Works”

NCMHJ JNational Center for Mental

Health and Juvenile Justice

5c. Comprehensive Programs and Models

• SAMHSA’s Policy Academies

• MacArthur Foundation’s Models for Change Initiative

• OJJDP/NCMHJJ’s Blueprint for Change

NCMHJ JNational Center for Mental

Health and Juvenile Justice

Blueprint for Change- Conceptual Framework

NCMHJ JNational Center for Mental

Health and Juvenile Justice

6. Despite progress, much needs to be done

• Effective treatment diversion programs, expanded community-based mental health services, gender-specific services, increased use of EBP’s, integrated programs for youth with co-occurring disorders, linkages at re-entry

• At the Federal level:– Greater recognition and support for the needs of

these youth and the systems that serve them– Modeling and encouraging cross-agency collaborative

actions