Most probation or parole admissions were males between the ages of 18 and The most common substances reported by these referrals were alcohol, marijuana, and methamphetamine. Treatment for SMI in incarcerated settings is both costly and challenging. Moreover, people with mental illness may remain incarcerated longer than those without mental illness.
Mental Health and Substance Abuse Services in Juvenile Detention Facilities Psychotropic Medications There are no published national data on the rates of use of psychotropic medications in detention facilities. However, two recent surveys inside juvenile facilities in Pennsylvania and Oregon indicate that the use of such medications is not uncommon.
In Pennsylvania, detention center directors indicated that there were at least some juveniles in every facility who were taking psychotropic medication at the time of their admission, and at the smaller facilities the rate was as high as 40 to 50 percent.
However, taken together, these surveys suggest that a substantial proportion of those entering deten-tion may already be taking or need psychotropic medication. Potential Service Strategies in Detention Settings The final section of this article reviews what is known about effectiveness of services delivered in detention settings.
Owing to the short lengths of stay as well as other difficulties with performing Juveniles with mental disorders in these settings, there are virtually no controlled studies of interventions in detention. However, this section draws on intervention research performed in the community that may be effectively translated across settings.
We chose these interventions based primarily on the possibility of their implementation in 30 days or less. It should be noted that there are no widely accepted or published best practice standards of behavioral health care in juvenile detention settings.
In fact, there is controversy over the findings in much of the literature regarding treatment strategies for children in general. For example, one review found strong methodologically sound evidence of successful treatment strategies for only four psychiatric, non-substance abuse disorders: There is additional concern that strategies found to be effective in controlled trials may be much less so in real-world environments.
Future research will be tasked with rigorously evaluating such strategies in detention settings. Screening and Assessment Ina national panel of experts was convened to respond to the lack of best practice standards for assessing mental health needs in the juvenile justice system. The instrument most widely used for screening, and one that was developed specifically for this age group and population, is the Massachusetts Youth Screening Instrument-2 MAYSI Cutoff scores are set at a threshold where respondents require immediate clinical attention; however, the MAYSI is not meant to substitute for a more thorough psychiatric assessment.
To date, over detention facilities in 30 states routinely use the MAYSI to screen all incoming juveniles 33 and it has been tested for reliability and validity in this population. They encourage more research to develop instruments to collect accurate and reliable data on all of these domains.
Case management refers to a system whereby a single provider coordinates a myriad of services, both within and across service systems. In the case of detention facilities, case managers conduct intake assessments and evaluations to identify individual needs, assist detainees and their families in securing mental and physical health treatment and social welfare services, monitor service utilization, and occasionally serve as a liaison between the families and the court.
Such services can be crucial to detainees who have psychiatric and substance abuse problems. Although the case manager often provides little traditional clinical care, the coordination of services is deemed so crucial as to make case management a clinical service by itself.
Case management programs have been instituted in many adult correctional settings and outcomes data indicate that offenders enrolled in such programs have less drug use and recidivism and more employment after release to the community than offenders who did not receive case management. However, it has been fairly extensively studied in community samples of youths with mental health and substance abuse problems, showing clear benefits.
Drug and Alcohol Treatment Of all the behavioral health services provided in juvenile detention facilities, among the most common are drug and alcohol treatment.
A recent comprehensive review and meta-analysis of adolescent substance abuse treatment in non-detention settings found only 53 treatment studies in the past 30 years, and only 21 were methodologically sound enough to warrant including in the analysis.
Recently, a non-profit group called Drug Strategies convened a panel to review, synthesize, and make recommendations on substance abuse treatment for adolescents.
Their report identified key elements of effective drug treatment programs in this age group 41 and surveyed programs that were identified by the consensus panel, national organizations, or state mental health agencies as being exemplary in at least one of nine key areas.
Of the programs, 16 indicated that their standard treatment cycle lasted for 30 days or less, making them potential candidates for adoption in a detention center setting.
It should be noted that only 4 of the programs surveyed by Drug Strategies had any data on clinical outcomes and none of those four had short lengths of stay. Recognizing that substance abuse rates are high and that detention centers are restricted in their ability to treat such problems in a short time, the Vera Institute of Justice has developed a new program called Adolescent Portable Therapy APT.
The program utilizes principles of family and cognitive-behavioral therapy and has appeal as an innovative approach.
However, it has only recently been implemented in New York detention centers, and no clinical data on outcomes are yet available. However, elements of this treatment, as well as other related therapies, have been used to address anxiety, depression, and anger management in adolescents.
CBT has several features that make it well-suited for application in a juvenile detention setting. First, it is brief, time-limited, and structured, with an emphasis on treatment gains in a short time.Criminal and Juvenile Justice | SAMHSA - Substance Abuse Overview. Abstract.
Juvenile detention facilities have come under increasing legal pressure to provide mental health services to detainees, and mental health clinicians may be asked to design and implement programs in detention facilities. August • Many youth enter the juvenile justice system with mental health, substance use and other mental/emotional disabilities that were overlooked, misdiagnosed, or inadequately addressed by other social service agencies, including child welfare, schools, and mental health vetconnexx.com • Youth in the juvenile justice system suffer from various mental health disorders .
Aug 10, · An inmate at the Ohio River Valley Juvenile Correctional Facility. Two-thirds of the nation’s juvenile inmates have at least one mental illness.
Rates of some of the most common mental health disorders among juveniles, including depression, anxiety, attention deficit hyperactivity and substance use are summarized.
Throughout the review, issues related to co-morbidity and gender differences are highlighted. The implications of mental health disorders for juvenile justice policy and.
The mental health needs of juveniles in custody is another area of concern to juve- nile justice practitioners that needs to be addressed. Suicide is a particularly disturb-.