Mental Health Policy Luncheon

A special thank you to our sponsors:

WELCOME!

Robert Sanborn, Ed.D.President & CEO

&Tanya Makany-Rivera

Assistant Director of Public Policy

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Overview

Mental illness affects At least 1 in 5 children in the U.S. 50% of juvenile justice population

Texas ranks 49th in the U.S. for mental health expenditures

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Texas Juvenile Mental Health Courts

CHILDREN AT RISK independent evaluation, “Texas Juvenile Mental Health Courts: An Evaluation and Blueprint for the Future.”

Specialized court

Voluntary

Uses a team approach

Focuses on treatment

Wraparound services

What is a Juvenile Mental Health Court?

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Typical Juvenile Mental Health Court Process

Goals of the Juvenile Mental Health Court

Decrease recidivism

Improve family education and involvement

Reduce repeat contacts

Effective use of resources (saving taxpayers money)

Mental Health Courts in Texas

Travis County COPE Program Austin, TX

Special Needs Diversionary Program El Paso, TX

Harris County Juvenile Mental Health Court Harris County, TX

Bexar County Crossroads Court Program San Antonio, TX

Evaluation Methodology

Direct Observation

Key Informant Interviews

Participant Outcomes Recidivism Cost Analysis

Challenges

Travis County COPE Program

First Juvenile Mental Health Court in Texas

Eligibility: Ages between 10 and 17

Pending charge other than truancy or running away

No sexual offense

No previous adjudication

Axis 1 diagnosis (ex. Bipolar 1, Dementia, Schizophrenia)

Parent/guardian agrees to participate with child

Travis County COPE Program

Services available to both participant and family Therapy

Parent coach and liaison

Respite care

Rapid re-housing

Mentoring

Access to drug education

Substance abuse education

Wrap-around services

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Travis County COPE Program

Characteristics

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Travis County COPE Program

Characteristics

Travis County COPE Program:

Characteristics

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Travis County COPE Program

Characteristics $180.59 cost per day, per participant

Average length of stay is 158 days

33% recidivism rate

El Paso (SNDP)

Eligibility At risk of removal from home

Post-adjudicated boy or girl between the ages of 10 and 17

DSM-IV Axis diagnosis other than substance abuse, autism, mental retardation, pervasive developmental disorder

Global Assessment of Functioning (GAF) score below 50

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El Paso (SNDP)

Services Counseling (Individual and Family)

Case Management • Anger management • Home organization • Educate parents on school system, advocacy

24-hour crisis hotline

Referral to community based services• School Supplies • Food vouchers

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El Paso (SNDP)

Characteristics

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El Paso (SNDP)

Characteristics

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El Paso (SNDP)

Characteristics

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El Paso (SNDP)

Characteristics

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El Paso (SNDP)

Characteristics Average length of stay is 193 days

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Harris County Juvenile Mental Health Court

Eligibility Mental health diagnosis

Pre-adjudicated boy or girl between the ages of 10 and17

Family participation

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Harris County Juvenile Mental Health Court

Services Education to parent on mental illness

Counseling

Anger management

Referral and assistance in obtaining services

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Harris County Juvenile Mental Health Court

Characteristics

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Harris County Juvenile Mental Health Court

Characteristics Most common diagnosis - Affective Disorders

(67%)

$150 per day, per participant

Average length of stay is 243 days

33% recidivism rate

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Bexar County Crossroads Court Program

Eligibility Pre and post-arrest, girls aged 12 to 15

Mental health diagnosis

History of substance abuse

Experienced past trauma and/or abuse

Supportive adult participation

Legally competent

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Bexar County Crossroads Court Program

Services Anger management counseling

Family violence intervention/prevention

Adolescent counseling

Family counseling

School success services (includes mentoring)

Substance abuse treatment

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Bexar County Crossroads Court Program

Characteristics

78% Latino

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Bexar County Crossroads Court Program

Characteristics At the time of publication, diagnosis data was

unavailable

$105 per day, per child

Average length of stay is 212 days

10% recidivism rate

Observed Social Outcomes

Surveys in Harris County

School Performance

Attendance

Medication compliance

So what about social outcomes?

Recommendations from CHILDREN AT RISK

Conduct a follow up evaluation

Create a statewide committee for Juvenile Mental Health Courts

Sustain current funding for mental health services

Expand juvenile mental health courts across Texas

CHIP and Medicaid reimbursement

For more information…

Bob Sanborn, Ed.D.President and CEO

sanborn@childrenatrisk.org

Tanya Makany-RiveraAssistant Director of

Public Policytrivera@childrenatrisk.org

www.childrenatrisk.orgPhone: 713.869.7740

Harris County Mental Health Court

Olivia D. McGill, PhD

Mental Health Court Clinician

The Creation

• Community support and involvement was essential.

• MHA and the JEHT foundation assisted in getting the funding necessary to create a clinical tool to assess for mental health problems.

• Collaborative effort by the probation department, MHA, Children at Risk, and JEHT Foundation to secure funding for the mental health court.

The Development

• Visited existing juvenile mental health courts.

• Decided on our mission and goals.

• Our approach can be described as holistic, individualized, and collaborative.

• Monthly review hearings are conducted with the entire team present.

The Progress

• Since our inception in February 2009 we have had 67 youth enter into the mental health court.

• 42 youth have successfully graduated and 16 youth are currently in the program.

• Recidivism: 86% of the graduated youth had not been adjudicated for a new offense at the 6 month mark

The Youth

• Most common diagnosis is Affective Disorders (depression, anxiety & bipolar)

• Most common offense is assault.

• Several youth have had prior psychiatric hospitalizations.

• A significant number of the participants have trouble with school.

The Challenges & Lessons

• Defining success

• Path to success is often very bumpy

• Connecting families with needed resources can be difficult

• Collaborating with different agencies and different parts of the legal system can be tough, but always worth it.

The Best Practices

• Individual based treatment

• Important to meet the client where they are

• Remain flexible

• Networking and exploring available resources in the community is essential

Juvenile Mental Health Panel Discussion: Legislative Analysis, Future Outlook and

Recommendations

Dr. Curtis Mooney, President and CEO, DePelchin

Deborah Colby, LCSW, LMFT, TRIAD

Lillian Aguirre Ortiz, MSW, MHA Houston

Dr. Andrew Harper, University of Texas, Harris County Psychiatric Center