Critical Intervention Point:  Intake

Overview of the Intervention Point

Once a case is referred to juvenile court, an intake assessment process is initiated. In many jurisdictions, juvenile intake is both the initial point of formal juvenile justice system contact, as well as the entity responsible for making decisions about diversion or further referral to juvenile court (Grisso & Underwood, 2004). The intake function is structured differently across jurisdictions. In some states, this function is the responsibility of the juvenile court. In other states, it occurs outside of the juvenile court, for example, within the juvenile probation system, a state juvenile justice agency or the prosecutor’s office. Some states have created centralized juvenile intake centers (JACs) to provide comprehensive intake and assessment services to all youth referred to the juvenile justice system. Regardless of who takes responsibility for the function, intake officers are responsible for making a determination about whether a case should be dismissed, handled informally, or referred to juvenile court for formal intervention. Depending on state law, a decision to waive a case to adult criminal court may also be made at intake processing (McCord, Spatz-Widom, & Crowell, 2001).

When making these decisions, intake officers exercise considerable discretion (Butts & Harrell, 1998). First, an intake officer must conduct an initial screen to review the facts of the case and determine if there is sufficient evidence to prove the allegation. If intake determines that there is not sufficient evidence to go forward, the case is dismissed. Cases may be dismissed for a variety of reasons, including insufficient legal evidence, the offense is a relatively minor one, and the juvenile is a first-time offender, the juvenile or his or her family has compensated the victim, the family background is strong, and the youth is amenable to parental supervision, or formal processing is unnecessary (Kelly & Mears, 1999).

If it is determined that there is sufficient evidence to proceed, intake will then decide if formal intervention with the juvenile court is necessary. About half of all cases referred to juvenile intake are handled informally and most informally processed cases are dismissed (OJJDP, 2004). In the other informally processed cases, the youth voluntarily agrees to specific conditions for a period of time. These conditions, which are often documented in a written contract with the youth, may include such items as restitution, community service, school attendance or participation in some sort of treatment program (OJJDP, 2004). A youth’s compliance with these conditions is typically monitored by a probation officer. As a result, this process is referred to as informal diversion or probation. If the youth successfully meets the terms of the informal disposition, the case is dismissed. If a youth does not meet the terms of the informal disposition, the intake officer can decide to formally proceed with the case and refer the youth to juvenile court for an adjudicatory hearing.

When making decisions about whether a case should be dismissed, diverted or formally referred to juvenile court, intake officers often engage in a process to collect information on which to base their decision (Torbet, 1996). This includes collecting information from the youth, his or her family, and any social service agencies involved with the youth on such factors as school attendance, behavior at home and in the community, and family and peer relationships. Emphasis is also placed on examining the circumstances of the offense and the youth’s previous record, if there is one (Torbet, 1996).

Mental Health Needs and Issues

Intake is very often viewed as the “gatekeeper” to juvenile court and, as such, represents an ideal opportunity to intervene early and identify the need for mental health or other types of rehabilitative services. Considering the potential influence that intake decisions can have on subsequent juvenile justice processing, it constitutes one of the most critical points within the juvenile justice continuum for applying prevention and early intervention strategies (Kelly & Mears, 1999). Despite this potential, there is concern that this opportunity is not fully seized to routinely collect information on a youth’s mental health status and to use this information to make effective referral or diversion recommendations.

There is a lack of mental health prevalence research on youth at intake; most studies have focused on youth in post-intake settings such as detention and corrections (Kelly & Mears, 1999). A recent study that examined gender differences in psychiatric disorders among youth at probation intake in Texas found that nearly half of the entire sample met diagnostic criteria for at least one mental health disorder (Wasserman, McReynolds, Ko, Katz, & Schwank, 2005).

There is concern that intake units, such as probation departments, are not fully prepared to adequately identify and respond to these needs. A 1999 study of juvenile intake practices in Texas found that while most jurisdictions value appropriate assessment and referral processes, not all are well positioned to provide them (Kelly & Mears, 1999). One of the most frequently cited problems was the lack of communication and collaboration between juvenile justice and other child serving systems, with the authors citing the need for improved relations in order to more effectively identify and respond to youth with mental health needs. A recent study that examined probation officers’ responses to a survey on mental health knowledge and practices when working with youth found that there are gaps between existing practice and current knowledge about mental disorders, assessment, and appropriate treatments. This lack of knowledge may, in fact, limit some probation officers from effective execution of their “gatekeeper” role (Vilhauer, Wasserman, McReynolds, & Wahl, 2004).

One of the most important strategies that can be applied at this point in the processing continuum is the standardized use of a mental health screen on all youth entering intake. The most common purpose of screening at intake is to identify those youth who are most likely to have special mental health needs that require more detailed clinical assessment or emergency referral for community mental health services (Grisso et al., 2005). Mental health screening at this point can result in a youth being diverted from the juvenile justice process, with intake officers using their discretion to arrange for appropriate community-based evaluation and services in lieu of referral to juvenile court (Grisso & Underwood, 2004).

Diversion programs and strategies are employed at intake in communities throughout the country. Some programs aim to divert status and other low level offenders to community treatment; other diversion programs specifically target youth with more serious offenses or with more complicated treatment histories and needs. When implementing a diversion strategy, there are a number of questions that need to be considered. How early should a youth be identified and diverted into services? Should the decision to divert be made at intake, prior to the case being referred to court, or should diversion occur after a petition is filed but before adjudication? If a pre-adjudication diversion strategy is employed, does the Probation department have linkages with community-based mental health service providers to accept these youth? Are there evidence-based services available in the community for these youth? Does the probation department have the capacity to provide supervision to youth who are diverted into treatment?

Communities have responded to the issue of early identification and diversion for youth with mental health needs in a variety of ways. The Family Intervention Resource Services Team (FIRST) in Lexington, Kentucky is a county diversion program for first-time status offenders in grades 6 through 8 who have mental health and substance abuse problems and who appear for adjudication in juvenile court. The goal of the program is to connect youth with effective, community-based interventions as an alternative to further (and more formal) court processing. A Court Designated Worker (CDW) makes referrals to the program based on referrals to the court from probation intake. The CDW administers the Problem Oriented Screening Instrument (POSIT) to determine mental health status and shares the results of this evaluation with the FIRST program. The FIRST case manager then meets with the family (either at their home or at the court office) to do the formal program intake and begin the development of a family service plan. The case manager provides referrals and linkages to a range of community services, including mental health and substance abuse services, as well as case management to the family. The family case manager regularly reports to the CDW on how the case is progressing, and if a youth meets the goals included in the individual service plan, the case is closed successfully.

Jefferson County, Alabama, operates Diagnostic and Assessment Units that serve to identify youth with mental health disorders who are at-risk of out of home placement. Four units are in place—one in family court, two in the schools, and one in the child welfare agency. Referrals to the court unit come from Probation intake or the family court judge. After an evaluation, the youth goes before the judge, and if the youth agrees to the diversion program, they are linked to services, which can include outpatient mental health care, psychiatric care, respite services, case management, medication management, and tutoring. Most services are provided to the youth and family in their home or in locations that are convenient to the family. Probation staff are involved with all cases to monitor and report back to the judge on progress.

Some communities have created diversion programs that link youth in need of mental health services with evidence-based services at both the pre- or post- adjudication stage of case processing. The Indiana Family project of Bloomington, Indiana, uses Functional Family Therapy as a diversion intervention. Referrals come from the probation intake unit if the youth is diverted pre-adjudication, or from the family court judge if the youth is diverted post-adjudication. An FFT family preservation team is assigned to work with the youth and family and provides treatment in standardized phases. Reintegration planning begins on day one so that a plan is in place upon a youth’s discharge from the program.

Family Intervention Specialists (FIS) of Georgia provides intensive family intervention services to youth with a known or suspected mental health disorder, who are at risk of out of home placement or are currently in out of home placement with reunification imminent. The majority of referrals come from probation intake or the juvenile court. Specialized probation officers, who are trained to identify mental health and substance use disorders among youth, use the MAYSI-2 to screen all youth at intake. Youth referred to the program undergo further evaluation and receive Brief Strategic Family Therapy (BSFT) as the primary intervention. Services are provided by FIS staff, and there is strong collaboration between FIS and justice staff, including probation officers and the court, throughout the period of involvement.

The New York State PINS Diversion program, created in 1986 as way to reduce unnecessary court intervention on behalf of persons (alleged) to be in need of supervision (PINS), gives juvenile probation departments the authority to deny access to court to potential petitioners by engaging in a comprehensive assessment and diversion effort for these youth. An interagency designated assessment service (DAS) provides comprehensive assessments and services (either directly or under contract with community-based providers) to youth and their families in an effort to address the issues that brought the youth to the attention of juvenile probation. Successful completion of the service plan results in the case being closed with no formal court intervention.

The Texas Special Needs Diversionary program is a probation-intake based diversion program that targets youth with specific mental health needs by diverting youth into wraparound community services, many of which are provided to the youth and families in their homes or in school. Co-located teams of probation and mental health staff provide joint case management, service delivery, and supervision to youth involved with the program. Each team has a caseload of 12 to 15 youth. These teams are responsible for jointly securing, providing or supervising the provision of services to youth on their caseload. Program compliance and progress is monitored through weekly unscheduled home visits by the youth’s probation officer and the team therapist. Participating families also have three to five program contacts per week, at least two of which are in the home.