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Diverting Justice-Involved Youth to Community-Based Mental Health Services
26th Children’s Mental Health Research
& Policy Conference Tampa, FL
March 4, 2013
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Overview
Diverting Youth with Mental Health Disorders from the Juvenile Justice System: National Trends - Joseph J. Cocozza, Ph.D.; Karli Keator, MPH; Kathleen Skowyra
Changing Policies and Practices around Juvenile Justice: The Connecticut Experience - Catherine Foley-Geib, MPA; Louis Ando, Ph.D.
Collaborating for Alternatives to Arrest: The Connecticut School-Based Diversion Initiative - Jeffrey Vanderploeg, Ph.D.; Jeana Bracey Ph.D.
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Diverting Youth with Mental Health Disorders from the Juvenile Justice
System: National Trends
Karli J. Keator, MPH Division Manager, Juvenile Justice National Center for Mental Health
and Juvenile Justice Policy Research Associates, Delmar NY
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Juvenile Justice Population
Almost 2 million youth under age 18 are arrested every year
Over 600,000 youth a year are placed in detention centers
Slightly more than 70,000 youth reside in secure juvenile correctional settings
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Why Diversion to Treatment
Large numbers of youth in the juvenile justice system have mental health problems - Prevalence studies have consistently found that 60-70% meet criteria
for mental health disorders (NCMHJJ, 2006; Teplin et al, 2002)
Many of these youth experience multiple and severe disorders - 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
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Why Diversion to Treatment (cont.) Many youth appear to be inappropriately and unnecessarily involved in the juvenile justice system - 67% of incarcerated youth with high mental health needs were
committed for non-violent offenses (Texas Juvenile Probation
Commission, 2003) - 2/3 of juvenile detention facilities hold youth unnecessarily because of
lack of available mental health services (Congressional Committee on Government Reform, 2004)
Mental health services in the juvenile justice system are often inadequate or unavailable - A series of investigations of secure juvenile facilities has documented
poor training, inadequate clinical services, inappropriate use of medications, etc. (U.S. Department of Justice, 2010)
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MacArthur Foundation’s Models for Change
Juvenile Justice Reform Initiative
A comprehensive systems change initiative supported by the John D. and Catherine T. MacArthur Foundation
Goal to create sustainable and replicable models of juvenile justice reform through targeted investments in four key states: PA, IL, LA and WA
All four of these states identified “mental health” as a significant challenge in their juvenile justice reform efforts
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Models for Change Mental Health/Juvenile Justice
Action Network
MH/JJ Action Network created in response to shared concerns
Four new partnering states competitively selected- CO, CT, OH, and TX- to work with the four MfC states
Front-End Diversion - First priority of eight states
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Key Points in the Juvenile Justice System
for Mental Health Intervention
Initial
Contact
Intake
Detention
Court
Processing
Disposition:
Placement
Disposition:
Probation
Re-entry
Diversion
Treatment
Re-entry
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Three Critical Areas for Front-End Diversion
Law Enforcement-Based Diversion
Probation Intake-Based Diversion
School-Focused Diversion
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Law Enforcement-Based Diversion
Police are often the first point of contact youth with mental illness have with the juvenile justice system
Many police officers are not adequately trained to respond to youth in crisis
Police response at this initial contact has significant implications for determining what happens to youth
Existing Crisis Intervention Team (CIT) training focuses on mental illness among adults
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Probation-Based Diversion
Probation Intake often serves as the “gatekeeper” to juvenile court
Key decisions, including whether to dismiss, divert, or formally refer a juvenile to court, are made at probation intake
There is significant movement in the adult system to enhance probation supervision strategies to better meet the mental health needs of clients
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School-Focused Diversion
Schools are a major source of referral to the juvenile justice system
Schools often fail to appropriately respond to youth with mental health needs
Zero tolerance policies have increased the reliance by schools on the juvenile justice system
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Front-End Diversion Models
Law Enforcement-Based Diversion: Creating a juvenile Crisis Intervention Team training curriculum for community and school-based police (IL, PA, LA and CO)
Probation Intake-Based Diversion: Using specially trained mental health probation officers to work with small, specialized caseloads of youth with mental health needs (TX)
School-Focused Diversion: Creating a “mobile urgent response” to school incidents involving youth with mental health needs, instead of contacting the police (CT, OH and WA)
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Impact and Expansion
Research findings indicate probation and school-based models have impact on critical outcome variables
Jurisdictions have identified post-foundation support to sustain and expand their efforts to additional sites.
A Juvenile Diversion Guidebook has been produced
Models are being implemented in eight additional sites through a public-private initiative supported by SAMHSA and the MacArthur Foundation
CT is an example of state level policy changes and implementation of Front-end School-based Diversion Programs
Catherine Foley Geib, MPA
Louis Ando, PhD
Connecticut Judicial Branch
Court Support Services Division
Connecticut in Context
Statewide juvenile justice system across
2 agencies/2 branches of government
169 towns
Child population less than 800,000
15,000 – 10,000 juvenile court referrals
annually
Increasing and shifting investment in
juvenile justice system
Connecticut in Context
Increased attention to children’s mental
health by DCF and SDE
Local Youth Service Bureaus
School-based Health Clinics (71)
State Dept. of Education commitment to
PBIS since 2000
BUT
Little attention to juvenile justice population
despite higher rates of mental health &
educational needs
Changing Step by Step
Policy: Agencies and Legislature
Mental Health Screening
Status Offenders
Raise the Age
Education
Behavioral Health Partnership
Juvenile Competency
Practice Changes
Evidence-based services and practices
Data collection and analysis
Interagency coordination and
collaboration
Court Diversion
Expansion of Juvenile Review Boards, including mental health screening and EBP treatment access
Referral to emergency mobile psychiatric services
Police and school training
Establishment of Family Support Centers for status offenders
Return of Referrals
Juvenile Court Clinic
Mental Health Screening
Clinical Coordinators
Referrals for evaluation, treatment and
hospitalization
Credentialing, Standards, Training and
Quality Assurance for Court Evaluators
Evidence-based Treatment
Home-based services (MST, MDFT,
FFT, BSFT, IICAPS, MTFC, Mentoring)
Center-based cognitive behavioral
therapy and psychoeducational groups
(TF-CBT, TARGET, ART, MET/CBT)
Residential and Transition Supports
(DBT, FIT, MDFT)
Interagency Efforts
Joint Juvenile Justice Strategic Plan
Legislative Oversight Councils/Advisory Boards
Diversion Review Committee
Local Interagency Service Teams (LISTs)
School-based Arrest Reduction Partnership Legislative Changes re: School Climate
Positive Behavioral Interventions and Supports
School-based Health Clinics
School-based Diversion Initiative
Outcomes
Court intake reduction
Detention intake reduction
Wait reduction
Commitment reduction
Recidivism reduction
Court Intake Reduction
Detention Reduction: Admissions
Detention Reduction: Daily
Population
Wait Reduction
Commitment Reduction
Recidivism Reduction
Recidivism Reduction
Change in Investment
Creating Change: Putting the
Elements Together
Leadership
Opportunity
Planning
Collaboration
Data
Time
Commitment
Contact Information
Catherine Foley Geib, MPA
Manager of Clinical and Educational Services
860-721-2187
Louis Ando, PhD
Mental Health Projects Consultant
860-712-9137
Jeffrey J. Vanderploeg, PhD and Jeana R. Bracey, PhD
Connecticut Center for Effective Practice of the
Child Health and Development Institute
Collaborating for Alternatives to Arrest: The Connecticut School-Based
Diversion Initiative
Goals of the School
Based Diversion Initiative
• Reduce the number of discretionary arrests in school; reduce expulsions and out-of school suspensions
• Build knowledge and skills among teachers, school staff, and school resource officers to recognize and manage behavioral health concerns in the school and ensure appropriate in-school accountability
• Link youth who are at-risk of arrest to appropriate school and community-based services and supports
Primary Local Partners
•Continuum of services and
supports in CT Judicial Branch,
incl. juvenile intake, referral
CSSD
• Child protection, behavioral
health, juvenile justice,
prevention
DCF
•Develop, train, implement,
evaluate effective
mental health practices
CHDI
•External evaluation of community-level court
referral and EMPS data
Yale
•Legislative education and
advocacy, community
coalition building
CTJJA
•Administrative arm of CT State
Board of Ed, ensures equal opportunity education
SDE
SBDI Key Activities
Following school selection and needs assessment, SBDI has three core
components:
• Customized Professional Development in MH and JJ
• Revise School Disciplinary Policies (Graduated Response
Model, restorative justice)
• Linkage to Community-Based Resources
• Other activities include: data collection and evaluation; manual
development; school arrest toolkit development; post-initiative
follow-up
Professional Development Participants Goals Modules
Training Classroom Teachers, Support Staff, Administrators
Increase: Understanding Awareness Skills Values/Principles Decrease: Stigma Isolation
• Classroom Behavior Management (Good Behavior Game)
• Adolescent Development and Child Trauma
• Promoting Positive School Climate and Connectedness
• Multicultural Competence in Schools
Workgroup Administration, Social Worker, Psychologist, SpEd Director, Security
Increase: Service Utilization Collaboration Communication Decrease: Arrest Suspension Expulsion
• Effective collaboration w/EMPS and Care Coordination
• Implementing Graduated Response
• Restorative Justice Practices as Alternatives to Arrest
• Partnering with the JJ System
Revise School Discipline
Practices
• Examine and revise existing school discipline policy and practice to
include Graduated Response Model
– 1. Classroom level interventions
– 2. School Administrative Interventions
– 3. Assessment and Service Provision*
– 4. Law Enforcement Intervention
• Include restorative justice practices
– Alternative approach to ensuring accountability
– Peer and adult mediation; restorative dialogue techniques; peer juries
Linking to Community-Based
Resources • Emergency Mobile Psychiatric Services (EMPS)
– A component of Connecticut’s behavioral health system
– Statewide coverage
– Funded and managed by DCF
• Rapid response to behavioral health
crises: highly mobile and responsive
• Available FREE to all CT children
• Access: Dial 2-1-1
– Mobile hours M-F 8am-10pm; weekends/holidays 1pm-10pm
– Phone support all other hours
EMPS Referrals Increased
Delayed Court Referral
CSSD 55%
Summary of Outcomes
• Arrests are down, re-arrests reduced and delayed
• Suspensions dropping
• EMPS utilization has increased in participating schools
• School staff report better awareness of community resources, resulting in better referrals for families
• Graduated Response Model is being used to clarify school staff roles and responses to behavioral incidents, including administrators and SROs
• Multi-level approaches (policy, systems coordination, intensive in-school efforts) are most effective in disrupting the school-to-prison pipeline
Contact Information
For more information about the Connecticut School-Based Diversion Initiative or this presentation, contact :
Jeff Vanderploeg, Ph.D.
Associate Director, CCEP
Phone: 860-679-1542
Jeana Bracey, Ph.D.
Senior Associate, CCEP [email protected]
Phone: 860-679-1524
www.ncmhjj.com
Further Information
National Center for Mental Health and Juvenile Justice: www.ncmhjj.com
Models for Change Initiative: www.modelsforchange.net
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