Cornerstone #2: Identification

2. stages of juvenile justice processing.

Background

Arguably, the most important first step to better respond to mental health treatment needs among youth in the juvenile justice system is to systematically identify these needs as youth become involved with the system. The development of a sound screening and assessment capacity is critical in order to effectively identify and ultimately respond to mental health treatment needs. Despite the fact that we now know that large numbers of youth in the juvenile justice system have mental health disorders, many of the youth who enter the system do not routinely undergo a comprehensive mental health screen and, when necessary, a full evaluation. In fact, while almost 90 percent of facilities for which completed staff surveys were obtained reported screening for mental health problems, less than half of these facilities actually reported screening all youth in their facility (NCMHJJ, 2005). If screening does happen, it is likely to occur after a youth has been adjudicated and placed in a secure juvenile correctional facility. While it certainly is important to screen and assess for mental disorders upon placement in a secure juvenile correctional facility, for many youth, this is too late. Screening and assessment should occur at a youth’s earliest point of contact with the system, such as at probation or juvenile court intake, as well as at all key transition points, and should be used to inform decision-making around diversion or other next steps. ¹

Screening and assessment share a common objective to evaluate youth, but they differ in terms of their purposes and the manner in which they are accomplished. Screening describes a relatively brief process to identify youth who are at increased risk of having disorders or conditions that warrant immediate attention or further evaluation. Assessment, on the other hand, is a more comprehensive examination of psychosocial problems identified during the initial screen. Assessments are not typically performed on all youth; rather they are necessary for some subset of youth who undergo an initial mental health screen. They are generally more time-consuming, often involving discussions with a youth’s parents or teachers, and can include psychological testing, clinical interviewing, and the review of past records from other agencies or systems. There is also a growing movement to conduct assessments that are “strength based” as opposed to “deficit based.” Strength-based assessment offers a strategy for empowering youth by building on the personal strengths and resources that are frequently overlooked or given minimal attention in more problem-oriented approaches to assessment (Rudolph & Epstein, 2000).

Screening and assessing mental health needs is part of a larger process designed to collect information about a youth that will assist in making decisions about next steps and further processing. Often this larger process includes the administration of a risk assessment to determine a youth’s risk of reoffending, receiving technical violations, failing to appear before court or other negative outcomes (Austin, Johnson, & Weitzer, 2005). Like mental health screens and assessments, risk assessments are typically performed at key decision making points within the juvenile justice system, such as at the initial detention decision, at disposition, at the point of commitment to a secure juvenile correctional facility, and in preparation for release from placement. The results of a risk assessment, linked with the results of a mental health screen and evaluation, should be used to help guide decisions about a youth’s suitability and need for diversion to community-based services and programs. If diversion is not possible, the results can be used to ensure that detained or confined youth are assigned to the most appropriate program that addresses both public safety and the youth’s needs, while allowing youth to maintain relationships with their families and communities whenever possible (Austin et al., 2005).

Recently, significant progress has been made around mental health screening and assessment for youth in contact with the juvenile justice system. New screening and assessment tools and instruments for youth have been developed, many tested and designed specifically for use with youth in juvenile justice settings. In addition, there are now resources describing screening and assessment tools available for use in juvenile justice settings, as well as information on models and approaches that have been developed for this purpose.

The creation and implementation of a screening and assessment capacity within a juvenile justice setting will depend upon a wide range of factors—the specific point of contact within the justice system where screening and assessment will occur; the resources available to support this effort; the amount of time available to conduct the evaluations; the qualifications of the staff responsible for administering the evaluations; and the extent to which need and risk levels can be balanced to develop treatment plans that appropriately reflect the level of risk presented by the youth and their need for treatment. All of these factors must be taken into account when developing a screening and assessment capacity for a particular point in the juvenile justice processing continuum, as well as when selecting the instruments to be used for this purpose.

¹ Grisso (2004) suggests that screening and assessment serves an important role in protecting the legal rights of youth in the juvenile justice system. Some youths’ mental health problems may place them at risk of incompetence to stand trial. Virtually all jurisdictions require that in cases being processed for adjudication, all parties (judges, defense attorneys, prosecutors) are obligated to raise the question of incompetence if there is even a slight doubt that a youth is competent to stand trial (Melton, Petrila, Poythress, & Slobogin, 1997). In part, then, the juvenile justice system’s obligation to identify the mental health needs of juveniles is embedded in its obligation to assure due process.