Efforts that are likely to improve services and policies for youth with mental health needs involved with the juvenile justice system
The Front-End Diversion Strategic Innovation Group (SIG) is focusing on the pre-adjudicatory diversion of youth with mental health needs from the earliest points of contact with the juvenile justice system. The group identified three critical points of contact to target with a diversion strategy so that each state in the Front End Diversion SIG is pursuing one of the following approaches: 1) intake-based diversion 2) school-based diversion or 3) law enforcement-based diversion.
1. Intake-Based Diversion (Texas)
Probation intake is a critical intervention point within the juvenile justice system. It is often viewed as the “gatekeeper” to juvenile court and plays a vital role in determining whether a juvenile’s case is dismissed, diverted or formally referred to juvenile court. Considering the potential influence that intake decisions can have on subsequent juvenile processing, it also constitutes one of the most critical points for identifying the need for mental health and other types of services.
There has been significant movement at the adult level to examine probation supervision strategies for adults with mental health needs and to create specialized programs specifically for offenders with mental illness (Skeem, Emke-Francis & Louden, 2006). However, these specialized probation programs are rare at the juvenile level, and research suggests that juvenile probation officers do not posses sufficient knowledge about youth mental disorders, assessment and treatment (Vilhauer, Wasserman, McReynolds & Wahl, 2004).
To address this, this SIG is focusing on using specialized mental health probation officers to work with youth who have mental health problems. In particular, this approach helps to:
- implement an intake-based diversion strategy using probation officers who undergo substantial mental health training and certification to enable them to work effectively with youth with mental health needs;
- establish exclusive mental health caseloads for these specialized probation officers in certain jurisdictions that are smaller than the caseloads of traditional juvenile probation officers in order to provide intensive case management and support to youth;
- create community-based linkages with service providers to allow the specialized probation officers to link youth to the mental health services they need and monitor youth in the community throughout the period of diversion.
2. School-Based Diversion: (Connecticut, Ohio, Washington)
Schools are a primary source of referrals to the juvenile justice system, and frequently refer disruptive or unruly youth to the police or to juvenile court. It is recognized that a youth’s acting out behavior is often the result or symptom of a mental heath need that has gone undiagnosed or untreated (Skowyra & Cocozza, 2006). Further, many of these referrals involve students with special education needs whose behavior is related to their disability (Lynagh & Mancuso, 2004). Schools, lacking the resources to appropriately respond to these youth and operating under the pressure of school safety and zero tolerance policies, often find it easier to refer youth to the police than to address the underlying reasons for their misbehavior.
This SIG approach is working to reduce the number of youth with mental health needs who are referred by the schools to the police by employing a “mobile urgent response model”. Under this model, schools become the focal point for recognizing mental health problems among its student population, and contacting the mental health system, instead of the police, to appropriately respond and intervene. Strong linkages between the schools and the mental health system, as well as training and support for school staff on how to recognize the signs and symptoms of mental illness among youth, work to establish a new “process” for responding to these youth. In particular, the states involved with this effort work to:
- Provide training to school resource officers, school police officers and other school officials on how to effectively and appropriately respond to youth with mental health needs using a new approach that involves contacting the new mobile urgent response crisis team instead of the police;
- Create linkages between the school and mobile urgent response crisis teams and community mental health treatment providers who can accept school referrals and provide treatment as necessary.
3. Law Enforcement-Based Diversion (Louisiana, Pennsylvania, Colorado)
Law enforcement is often the first point of contact that a youth will have with the juvenile justice system, and the police response at this point has significant implications in determining what happens next to the youth. In this respect, it represents the ideal time to prevent youth with mental health needs from further penetrating the system by diverting them to community-based mental health treatment. This response, however, requires that law enforcement officials responding to incidents involving youth have been sufficiently trained to identify the signs and symptoms of mental disorders among the youth with whom they are interacting, and that law enforcement officials have access to services and supports for those youth who require immediate attention.
One approach for providing this type of training and support to law enforcement is the Crisis Intervention Team (CIT) training model which uses specially trained police officers to respond to all crisis calls that involve an individual with mental illness. This CIT model includes the following core components: selective recruitment and intensive training of police officers who become specialists in crisis intervention and de-escalation techniques; and improved access to mental health care and services.
Most of the work to develop CIT programs in this country has focused on the adult criminal justice population (Council of State Governments, 2002), with only a handful of communities expanding or modifying their police training curricula to specifically target juveniles. Recognizing this void, the states pursuing this SIG approach are expanding the existing CIT model to train police officers on how to respond specifically to calls and incidents involving youth with mental health needs. In particular, this group is working to:
- Partner with the Colorado Regional Community Policing Institute to develop a new juvenile CIT training curriculum;
- Work with existing, successful CIT programs to expand the focus of their police training by pilot-testing this new, youth-focused curriculum in select jurisdictions;
- Integrate community-based mental health supports and linkages into the new strategy for CIT involved youth;
- Create mechanisms for follow-up to monitor those youth who are diverted through the CIT model.
The Workforce Development Strategic Innovation Group (SIG) is focusing on community education and training as a way to recruit and retain staff. The group developed two approaches for this work so that each state in the Workforce Development SIG is pursuing one of the following: 1) the creation of a multi-system workforce collaborative to build support for cultivating a workforce for an evidence-based practice initiative and 2) the provision of comprehensive mental health training and education to personnel in juvenile justice agencies to improve functioning and workplace safety.
1. Workforce Collaborative on Evidence-Based Practices (Louisiana)
The Workforce Collaborative is focusing on the behavioral health care workforce challenges of recruitment, retention, training and education of individuals working in Louisiana’s communities with children and youth who are involved with the juvenile justice system or at risk for involvement. This Collaborative is working to:
- Establish a sustainable infrastructure for coordinated public/private workforce development;
- Increase collaboration on workforce development among the state’s higher education and behavioral health provider systems;
- Assess workforce needs and create a plan to address those needs; and
- Identify strategies to leverage existing workforce development resources.
The Workforce Collaborative is building on the work of Louisiana’s Models for Change (MfC) initiative by involving state agencies, colleges and universities, professional organizations, private providers, and advocacy groups along with LA MfC grantees. Agencies involved in juvenile justice, mental health, and substance abuse are being invited to participate. A key component is the input of youth and families as consumers of these services.
2. Mental Health Training, Education and Workforce Enhancement Initiative
(Connecticut, Illinois, Ohio, Texas and Washington)
It is well established that the majority of youth in contact with the juvenile justice system have mental health needs. Despite this, agencies providing assistance to youth involved with the juvenile justice system do not routinely provide training to personnel on basic mental health related issues, nor do most juvenile justice staff have sufficient knowledge to understand how mental health needs can present in a variety of behaviors. This lack of mental health knowledge and understanding can pose significant challenges for individuals working with these young people, may exacerbate the mental health problems of youth, and may lead to staff turnover, resulting in an ineffective workforce.
Recognizing this need, this SIG is working with Dr. Holly Hills of the University of South Florida, Florida Mental Health Institute to develop and implement a youth mental health training and education package for personnel working within juvenile justice agencies and programs to improve juvenile justice personnel’s basic understanding of mental illness among youth, improve their skills and ability to interact with the youth they serve, and improve their functioning and the overall safety of their workplace, leading to greater employee retention and better outcomes for youth. Content areas for the training package include:
- Purpose and Overview of Training
- Juvenile Justice and Mental Health Interface
- Adolescent Brain Development
- Mental Health Disorders
- Screening and Assessment
- Family and Community
- Communication Techniques and Strategies
Each state participating on the SIG will implement the education and training package in at least one of the identified juvenile justice settings- probation, juvenile court, detention or corrections. It is expected that this training will improve juvenile justice staff’s basic understanding of mental illness among youth, improve their ability to interact with the youth they serve, improve their functioning and the overall safety of their workplace, leading to greater staff retention and better outcomes for youth.