Program Description

Bernalillo County Juvenile Detention Center (BCJDC), Albuquerque, New Mexico

Overview

The director of the Bernalillo County Juvenile Detention Center (BCJDC) created an innovative response to the increasing number of youth with mental health disorders entering the juvenile detention center. The BCJDC developed an intake process that uniformly identifies youth with mental health needs and diverts these youth to a community mental health clinic, the Children’s Community Mental Health Clinic (CCMHC), which is located near the detention facility and fully funded by Medicaid.

The initiative began in 1999 when the BCJDC Director, Tom Swisstack, launched a system reform effort designed to reduce the detention center population, increase diversion to community programs, and provide mental health services to youth in the community or stabilize them until placement in an appropriate facility or program was possible. With the support of local elected officials, judges, the probation department, and community providers, a two-pronged approach was developed to first identify, through intake screening, youth with mental health needs, and second, provide them with an array of services.

Youth brought to the detention center undergo a comprehensive intake screening process. The first part involves a brief screen to determine the youth’s immediate placement—either in juvenile detention; in the community custody program, which is a probation monitored diversion program; or release home. The second portion of the process involves a medical intake screen, administered by a nurse who is at the detention center 24 hours a day, seven days a week. Both of these intake screens are conducted immediately when a youth arrives at the detention facility, and the accompanying police officers are required to wait until the detention center staff has determined the youth’s placement. The nursing staff at the detention center and the mental health clinic rotate between the two buildings, allowing for consistent, high quality screening and knowledgeable referrals as well as familiarity with the youth. Youth identified through the screening as needing immediate mental health services are walked from the detention center to the mental health clinic located about 200 yards away. Other youth are given an appointment for a follow-up assessment, usually the next day.

The CCMHC serves all youth in Bernalillo County who would benefit from the services provided by a mental health treatment team. Referrals to the clinic can be made by the juvenile detention center, care providers, parents or patients, thereby reducing any incentive to refer youth to the detention center simply to access mental health services. Staff at the clinic include two part-time child psychiatrists, nurses, social workers, a licensed alcohol and drug abuse counselor, and case managers. Services provided to youth include evaluation and assessment, individual and group therapy, medication management, substance abuse treatment, case management, and crisis management. Clinical services are provided to youth in detention as well as youth in the community. Further, the CCMHC receives a daily list of youth released from detention. Clinic staff provide outreach services and continue to provide services to all youth released from detention, even if a youth is placed by a judge in a residential setting. Clinic nurses provide training to BCJDC staff on the basic signs and symptoms of mental illness and the possible side effects of certain medications.

Three of New Mexico’s Medicaid providers contributed funding to open the mental health clinic. Each provider contributed an amount based on the number of members in their Medicaid plans. It is estimated that about 75 percent  of youth in the detention center are Medicaid eligible. Clinic staff work to enroll eligible youth in Medicaid and also work with third-party insurers as necessary.

Since the initiative has been in place, the BCJDC has seen a 37 percent reduction in its population with a reduced length of stay from 33 days in 1999 to about 12 in 2001. Money saved by reducing the population at the detention center, combined with Medicaid reimbursement, keeps the clinic operating without any additional funding. Staff no longer needed at the detention center were trained and re-assigned as case mangers for the clinic.

Reference

Bernalillo County Juvenile Detention Center. Retrieved from http://www.bernco.gov/live/departments.asp?dept=2337&submenuid=2751

Program Contact

Tom Swisstack, Director
Bernalillo County Juvenile Detention Center
5100 Second Street NW
Albuquerque, NM 87107
Phone: 505-761-6600