Mental Health and Juvenile Justice: Issues and Trends Joseph J. Cocozza, Ph.D National Center for...
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Transcript of Mental Health and Juvenile Justice: Issues and Trends Joseph J. Cocozza, Ph.D National Center for...
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