Technical Assistance Partnership for Child and Family Mental Health

September 2005

Hill District a microcosm of mental health challenges for African Americans
http://www.post-gazette.com/pg/05194/536771.stm

This Q&A with Earl Hill, director of mental health at Hill House, which is a satellite of UPMC’s Western Psychiatric Institute and Clinic, illuminates the serious problem of racial disparities in access to quality mental health care. Only one third of all Americans get the mental health care they need, and for black Americans, the gaps in mental health treatment and services are wider than ever. Hill addresses questions on topics such as differential presentation of mental illness across cultures, risk factors within a community that push people towards mental illness, the role or religion and black clergy in improving mental health within the black community, distrust of the health system, and cultural taboos that decrease the likelihood that members of specific cultural groups seek care.

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Kids Count – State Level Data
http://www.aecf.org/kidscount/sld/compare.jsp

This easy-to-use on-line database contains state-level data for over 75 measures of child well-being. The database allows you to generate custom reports for a geographic area or to compare geographic areas on a topic (e.g. ranking, maps and line graphs).

Use this resource to search the KIDS COUNT 2005 Databook for state rates of various indicators in education, employment, health, population and family characteristics, poverty, and youth risk factors. More specific indicators can be searched for under each respective category, such as: teens not attending school and not working; children in poverty; and persons incarcerated in juvenile detention facilities.

The search produces a list of state-by-state rankings that allows the user to compare states and geographic areas; organize the data by state on a color-coded map; or view the data in a chart. In addition to this function, the site also includes a variety of other useful functions to search and organize data sets. Raw data is also available for download.

***

Children's Safety Act / Juvenile Sex Offender Registry
http://thomas.loc.gov

A number of bills in the federal legislature related to the Sexual Offender Registry will gravely impact juveniles. This web page allows you to search for these bills and find information about them, including who the bill sponsors are, what the status of the bill is, etc.

To search for bills related to the Sexual Offender Registry:

Visit http://thomas.loc.gov
Type in "HR3132" in the Search box, and click on the Enter Bill Number button to qualify the search.
Then click the SEARCH button.
You will see the Congressional Record, Summary, Status, and Printer Friendly Display selections.
Click on Printer Friendly Display to view.

Click here to read the American Psychological Association’s response to the Children’s Safety Act (H.R. 3132).

***

A Fresh Approach for Troubled Kids
Santa Clara County, California is joining other states around the nation in offering an alternative approach for youth entering the juvenile justice system. Rather than the traditional trip to juvenile hall, teens that are incarcerated for minor offenses such as petty theft and drug use may enter a 30 day program that teaches positive life skills that may alter the dangerous path many of the youth are currently on. The program teaches accountability, empathy, better decision-making, ways to overcome addiction, and conflict resolution. This program is a notable and positive departure from the traditional juvenile justice system which many young youth enter on minor charges and leave hardened by their more criminalized peers. Pilots of the program have made significant progress in different cities across the US, with over 90% of participants reaching their first court date crime free.

January 2005

Stevens, C. 2004. Overcoming barriers to school reentry. Office of Justice Programs, U.S. Department of Justice. Washington, DC

http://www.gao.gov/new.items/d04879.pdf

This article addresses the issues and barriers faced by youth involved in the juvenile justice system as they attempt to return to school from custody. It advocates for partnerships between the school system and the juvenile justice partners if youth are going to have a successful and timely return to school and achieve academically.

***

Study Published in Mayo Clinic Proceedings Finds Risk of Attention-Deficit/ Hyperactivity Disorder Greater in Boys and in Children With Low Parental Education Levels

Study Press Release: http://www.mayoclinic.org/news2004-rst/2418.html

This article presents clear evidence as to why it important to screen and assess children coming into the juvenile justice systems for mental health, behavioral and learning disabilities. The stated goal of many of the programs and services youth in the justice system are referred to is to improve their functioning successfully in the community and helping them to become contributing members of society.

***

Serious and Violent Offender Reentry Initiative (SVORI) Multi-site Evaluation website www.svori-evaluation.org

This site provides detailed information regarding the evaluation activities associated with the Serious and Violent Offender Reentry Initiative. RTI International and the Urban Institute are conducting the comprehensive implementation and impact evaluations and cost-benefit analysis.

This initiative requires that transition planning be done during the three months prior to a youth's release from a juvenile institution to the community. The article shares how and what communities are doing as they attempt to reintegrate the most complex and vulnerable youth leaving juvenile corrections settings.

Also downloadable is the National Portrait of SVORI - the SVORI multi-site evaluation's preliminary assessment of all 69 sites funded under this initiative.

***

National Resource Center for Child Traumatic Stress http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/trauma_among_girls_in_jjsys.pdf

The National Resource Center for Child Traumatic Stress (NRC-CTS) supports the mission of the National Child Traumatic Stress Network by providing relevant, practical information and resources to professionals and the public, including survivors of childhood trauma, their families, and communities. The three articles cited under the weblink are on topics that have been of interest to many grant communities: Trauma Among Girls in the Juvenile Justice System; Victimization and Juvenile Offending and Assessing the Exposure to Psychological Trauma; and Post Traumatic Stress Among Juvenile Offenders.

The summaries below are taken directly from the NRC-CTS site:

Trauma Among Girls in the Juvenile Justice System

Despite differences in methodology and instrumentation, numerous studies done over the past ten years have documented high rates of mental and emotional disorders among youth in the juvenile justice system, including high rates of traumatic stress (Arroyo, 2001; Abram et al., 2004; Cauffman et al., 1998; Steiner, 1997; Wasserman et al., 2002; Wood et al., 2002a; Wood et al., 2002b). Prevalence rates of PTSD among youth in the juvenile justice system should be considered with caution as they vary significantly depending on the type of sample, the measure used, and the time frame assessed (Abram et al., 2004). Additionally, few studies have specifically investigated PTSD among female juvenile offenders, which also makes generating reliable estimates challenging. Generally, however, PTSD has been found to be more common among youth in the juvenile justice system than in community samples, and more common among incarcerated girls than boys.

Despite falling crime rates, more adolescent girls are arrested and incarcerated in the United States today than ever before (NMHA, 2003). Nearly three quarters of a million girls below the age of 18 were arrested in 1997, accounting for 26% of juvenile arrests. In the 1990?s, the number of juvenile females arrested for violent crime index offenses increased 25%, although there were no increases for male juveniles for the same offenses. The growing number of girls in the juvenile justice system and the high rates of exposure to violence among these girls pose special challenges and obligations for the juvenile justice facilities and programs.

Download - Trauma Among Girls in the Juvenile Justice System

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Victimization and Juvenile Offending

While some children survive victimization with relatively few adverse consequences, many studies show that victimization can disrupt the course of child development in very fundamental ways and can contribute to problems over the course of a life span. Numerous studies over the last ten years have shown a clear relationship between youth victimization and a variety of problems in later life, including mental health problems, substance abuse, impaired social relationships, suicide and delinquency. (OVC, 1999; Kilpatrick et al., 2003a). Violent victimization during adolescence is acknowledged as a risk factor for violent crime victimization, domestic violence perpetration, and problem drug use in adulthood (Ford, 2002).

While most professionals agree that no single risk factor or experience leads a young person to delinquency (Wasserman et al. 2003), the chances of offending clearly increase when a teenager is a witness or victim of violence and experiences traumatic stress as a result. Being victimized increases the likelihood of committing later offenses and engaging in aggressive and violent behavior. It also increases the likelihood of being victimized again.

Protecting juveniles against violent victimization of all types needs to be a priority for community leaders, policy makers and professionals. Along with preventing future problems like substance abuse, suicide and mental health problems, reducing rates of victimization and responding early to young victims to offset the adverse consequences of victimization may actually lessen the severity of juvenile violence and crime in society as a whole.

Download - Victimization and Juvenile Offending

***

Assessing Exposure to Psychological Trauma and Posttraumatic Stress in the Juvenile Justice Population

Thorough trauma assessment with children and adolescents is a prerequisite to preventing the potentially chronic and severe problems in biopsychosocial functioning that can occur when PTSD and associated or comorbid behavioral health disorders go undiagnosed and untreated (Nader, 1997). Although, like adults, most children who experience a traumatic stressor do not develop PTSD (Saigh, et. al., 1999), unresolved post-traumatic stress can lead to serious long-term consequences into and throughout adulthood (Briere, 1997). These long-term consequences can include, but are not limited to, problems with interpersonal functioning, cognitive functioning, mental health disorders including PTSD as well as substance abuse disorders, affective disorders, anxiety disorders, eating disorders and conduct disorders (Briere, 1997; Nader, 1997; Saigh, et. al., 1999).

A number of approaches and instruments are available for the clinician and researcher seeking to conduct trauma and PTSD assessment with children and adolescents in juvenile justice settings and their caregivers. Relatively few instruments, however, have been used, let alone systematically evaluated, with juvenile justice populations. Also, no studies have systematically examined potential differences by assessment format or respondent gender, age, or ethnocultural background in the assessment process or outcomes related to trauma history or PTSD in juvenile justice settings. Given the high prevalence of trauma exposure and PTSD in juvenile justice populations, careful clinical application and scientific study of the trauma history and PTSD assessment instruments is an important step toward enhanced services and outcomes for this large, high risk, and typically under-served population.

Download - Assessing Exposure to Psychological Trauma and Posttraumatic Stress in the Juvenile Justice Population

***

Trauma-Focused Interventions for Youth in the Juvenile Justice System

A number of effective trauma-focused treatments have either been designed or adapted for adolescents. Unfortunately, few of these trauma-focused treatments are used much in juvenile justice settings, due to lack of clinical resources in these settings, under-identification of trauma symptoms, and a greater focus on behavioral management issues.

Research studies done with the juvenile justice population over the last ten years show generally that the most effective programs with this population are highly structured, emphasize the development of basic skills, and provide individual counseling that directly addresses behavior, attitudes and perceptions (Altschuler, 1998). Cognitive behavioral approaches have been shown to be particularly effective with youth in the juvenile justice system, as well as for children with anger and disruptive behaviors more generally.

Juvenile justice facilities have an opportunity to raise the standard of care for youth by providing effective trauma-focused treatments and family-based interventions. Additionally, since some youth express trauma symptoms behaviorally, treatments which address trauma symptoms can also be expected to assist juvenile justice staff with issues related to behavioral management.

Home About Us About Systems of Care Contact Us Events & Presentations Newsletter Consultant Pool Special Topics Column Grantee Locator Webinars Resource Specialties Child Welfare Education Family Involvement Juvenile Justice Mental Health Primary Care Substance Abuse Sustainability Youth Involvement Regional Technical Assistance Region I Region II Region III Region IV Region V Region VI Communities of Practice Cultural and Linguistic Competence Early Childhood Transition-Aged Youth	Juvenile Justice Resources
	September 2005 Hill District a microcosm of mental health challenges for African Americans http://www.post-gazette.com/pg/05194/536771.stm This Q&A with Earl Hill, director of mental health at Hill House, which is a satellite of UPMC’s Western Psychiatric Institute and Clinic, illuminates the serious problem of racial disparities in access to quality mental health care. Only one third of all Americans get the mental health care they need, and for black Americans, the gaps in mental health treatment and services are wider than ever. Hill addresses questions on topics such as differential presentation of mental illness across cultures, risk factors within a community that push people towards mental illness, the role or religion and black clergy in improving mental health within the black community, distrust of the health system, and cultural taboos that decrease the likelihood that members of specific cultural groups seek care. * Kids Count – State Level Data http://www.aecf.org/kidscount/sld/compare.jsp This easy-to-use on-line database contains state-level data for over 75 measures of child well-being. The database allows you to generate custom reports for a geographic area or to compare geographic areas on a topic (e.g. ranking, maps and line graphs). Use this resource to search the KIDS COUNT 2005 Databook for state rates of various indicators in education, employment, health, population and family characteristics, poverty, and youth risk factors. More specific indicators can be searched for under each respective category, such as: teens not attending school and not working; children in poverty; and persons incarcerated in juvenile detention facilities. The search produces a list of state-by-state rankings that allows the user to compare states and geographic areas; organize the data by state on a color-coded map; or view the data in a chart. In addition to this function, the site also includes a variety of other useful functions to search and organize data sets. Raw data is also available for download. * Children's Safety Act / Juvenile Sex Offender Registry http://thomas.loc.gov A number of bills in the federal legislature related to the Sexual Offender Registry will gravely impact juveniles. This web page allows you to search for these bills and find information about them, including who the bill sponsors are, what the status of the bill is, etc. To search for bills related to the Sexual Offender Registry: Visit http://thomas.loc.gov Type in "HR3132" in the Search box, and click on the Enter Bill Number button to qualify the search. Then click the SEARCH button. You will see the Congressional Record, Summary, Status, and Printer Friendly Display selections. Click on Printer Friendly Display to view. Click here to read the American Psychological Association’s response to the Children’s Safety Act (H.R. 3132). * A Fresh Approach for Troubled Kids Santa Clara County, California is joining other states around the nation in offering an alternative approach for youth entering the juvenile justice system. Rather than the traditional trip to juvenile hall, teens that are incarcerated for minor offenses such as petty theft and drug use may enter a 30 day program that teaches positive life skills that may alter the dangerous path many of the youth are currently on. The program teaches accountability, empathy, better decision-making, ways to overcome addiction, and conflict resolution. This program is a notable and positive departure from the traditional juvenile justice system which many young youth enter on minor charges and leave hardened by their more criminalized peers. Pilots of the program have made significant progress in different cities across the US, with over 90% of participants reaching their first court date crime free. January 2005 Stevens, C. 2004. Overcoming barriers to school reentry. Office of Justice Programs, U.S. Department of Justice. Washington, DC http://www.gao.gov/new.items/d04879.pdf This article addresses the issues and barriers faced by youth involved in the juvenile justice system as they attempt to return to school from custody. It advocates for partnerships between the school system and the juvenile justice partners if youth are going to have a successful and timely return to school and achieve academically. * Study Published in Mayo Clinic Proceedings Finds Risk of Attention-Deficit/ Hyperactivity Disorder Greater in Boys and in Children With Low Parental Education Levels Study Press Release: http://www.mayoclinic.org/news2004-rst/2418.html This article presents clear evidence as to why it important to screen and assess children coming into the juvenile justice systems for mental health, behavioral and learning disabilities. The stated goal of many of the programs and services youth in the justice system are referred to is to improve their functioning successfully in the community and helping them to become contributing members of society. * Serious and Violent Offender Reentry Initiative (SVORI) Multi-site Evaluation website www.svori-evaluation.org This site provides detailed information regarding the evaluation activities associated with the Serious and Violent Offender Reentry Initiative. RTI International and the Urban Institute are conducting the comprehensive implementation and impact evaluations and cost-benefit analysis. This initiative requires that transition planning be done during the three months prior to a youth's release from a juvenile institution to the community. The article shares how and what communities are doing as they attempt to reintegrate the most complex and vulnerable youth leaving juvenile corrections settings. Also downloadable is the National Portrait of SVORI - the SVORI multi-site evaluation's preliminary assessment of all 69 sites funded under this initiative. * National Resource Center for Child Traumatic Stress http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/trauma_among_girls_in_jjsys.pdf The National Resource Center for Child Traumatic Stress (NRC-CTS) supports the mission of the National Child Traumatic Stress Network by providing relevant, practical information and resources to professionals and the public, including survivors of childhood trauma, their families, and communities. The three articles cited under the weblink are on topics that have been of interest to many grant communities: Trauma Among Girls in the Juvenile Justice System; Victimization and Juvenile Offending and Assessing the Exposure to Psychological Trauma; and Post Traumatic Stress Among Juvenile Offenders. The summaries below are taken directly from the NRC-CTS site: Trauma Among Girls in the Juvenile Justice System Despite differences in methodology and instrumentation, numerous studies done over the past ten years have documented high rates of mental and emotional disorders among youth in the juvenile justice system, including high rates of traumatic stress (Arroyo, 2001; Abram et al., 2004; Cauffman et al., 1998; Steiner, 1997; Wasserman et al., 2002; Wood et al., 2002a; Wood et al., 2002b). Prevalence rates of PTSD among youth in the juvenile justice system should be considered with caution as they vary significantly depending on the type of sample, the measure used, and the time frame assessed (Abram et al., 2004). Additionally, few studies have specifically investigated PTSD among female juvenile offenders, which also makes generating reliable estimates challenging. Generally, however, PTSD has been found to be more common among youth in the juvenile justice system than in community samples, and more common among incarcerated girls than boys. Despite falling crime rates, more adolescent girls are arrested and incarcerated in the United States today than ever before (NMHA, 2003). Nearly three quarters of a million girls below the age of 18 were arrested in 1997, accounting for 26% of juvenile arrests. In the 1990?s, the number of juvenile females arrested for violent crime index offenses increased 25%, although there were no increases for male juveniles for the same offenses. The growing number of girls in the juvenile justice system and the high rates of exposure to violence among these girls pose special challenges and obligations for the juvenile justice facilities and programs. Download - Trauma Among Girls in the Juvenile Justice System * Victimization and Juvenile Offending While some children survive victimization with relatively few adverse consequences, many studies show that victimization can disrupt the course of child development in very fundamental ways and can contribute to problems over the course of a life span. Numerous studies over the last ten years have shown a clear relationship between youth victimization and a variety of problems in later life, including mental health problems, substance abuse, impaired social relationships, suicide and delinquency. (OVC, 1999; Kilpatrick et al., 2003a). Violent victimization during adolescence is acknowledged as a risk factor for violent crime victimization, domestic violence perpetration, and problem drug use in adulthood (Ford, 2002). While most professionals agree that no single risk factor or experience leads a young person to delinquency (Wasserman et al. 2003), the chances of offending clearly increase when a teenager is a witness or victim of violence and experiences traumatic stress as a result. Being victimized increases the likelihood of committing later offenses and engaging in aggressive and violent behavior. It also increases the likelihood of being victimized again. Protecting juveniles against violent victimization of all types needs to be a priority for community leaders, policy makers and professionals. Along with preventing future problems like substance abuse, suicide and mental health problems, reducing rates of victimization and responding early to young victims to offset the adverse consequences of victimization may actually lessen the severity of juvenile violence and crime in society as a whole. Download - Victimization and Juvenile Offending * Assessing Exposure to Psychological Trauma and Posttraumatic Stress in the Juvenile Justice Population Thorough trauma assessment with children and adolescents is a prerequisite to preventing the potentially chronic and severe problems in biopsychosocial functioning that can occur when PTSD and associated or comorbid behavioral health disorders go undiagnosed and untreated (Nader, 1997). Although, like adults, most children who experience a traumatic stressor do not develop PTSD (Saigh, et. al., 1999), unresolved post-traumatic stress can lead to serious long-term consequences into and throughout adulthood (Briere, 1997). These long-term consequences can include, but are not limited to, problems with interpersonal functioning, cognitive functioning, mental health disorders including PTSD as well as substance abuse disorders, affective disorders, anxiety disorders, eating disorders and conduct disorders (Briere, 1997; Nader, 1997; Saigh, et. al., 1999). A number of approaches and instruments are available for the clinician and researcher seeking to conduct trauma and PTSD assessment with children and adolescents in juvenile justice settings and their caregivers. Relatively few instruments, however, have been used, let alone systematically evaluated, with juvenile justice populations. Also, no studies have systematically examined potential differences by assessment format or respondent gender, age, or ethnocultural background in the assessment process or outcomes related to trauma history or PTSD in juvenile justice settings. Given the high prevalence of trauma exposure and PTSD in juvenile justice populations, careful clinical application and scientific study of the trauma history and PTSD assessment instruments is an important step toward enhanced services and outcomes for this large, high risk, and typically under-served population. Download - Assessing Exposure to Psychological Trauma and Posttraumatic Stress in the Juvenile Justice Population * Trauma-Focused Interventions for Youth in the Juvenile Justice System** A number of effective trauma-focused treatments have either been designed or adapted for adolescents. Unfortunately, few of these trauma-focused treatments are used much in juvenile justice settings, due to lack of clinical resources in these settings, under-identification of trauma symptoms, and a greater focus on behavioral management issues. Research studies done with the juvenile justice population over the last ten years show generally that the most effective programs with this population are highly structured, emphasize the development of basic skills, and provide individual counseling that directly addresses behavior, attitudes and perceptions (Altschuler, 1998). Cognitive behavioral approaches have been shown to be particularly effective with youth in the juvenile justice system, as well as for children with anger and disruptive behaviors more generally. Juvenile justice facilities have an opportunity to raise the standard of care for youth by providing effective trauma-focused treatments and family-based interventions. Additionally, since some youth express trauma symptoms behaviorally, treatments which address trauma symptoms can also be expected to assist juvenile justice staff with issues related to behavioral management.

Juvenile Justice Resources