Introduction to the Online Tutorial

Brenda

Brenda is a 16-year-old youth incarcerated at the local juvenile detention facility. She has a history of alcohol and marijuana abuse and has been taking psychiatric medication for over a year. A contracted psychiatrist works at the facility one day a week and has refilled her prescription. Staff at the facility have noticed that Brenda has been getting increasingly depressed. She also seems to get angry and assaultive after phone conversations with her aunt. Staff members are considering a referral to a community based mental health program.

Enrique

Enrique, a 17-year old youth, has a diagnosis of ADHD and was convicted after his second drug charge. Enrique was assessed, referred, and admitted to an outpatient drug and alcohol treatment program. His mother is concerned because he has been acting agitated and angry for the past two years. Staff members are considering referring Enrique back to the juvenile justice system if he is found with drugs again.

Think about What resources does your agency offer for youth with co-occurring disorders like Brenda and Enrique who are involved in the juvenile justice system? What is the best way to access those resources? Any insider tips? Who are the best "contact" people and what are the best ways to contact them?

Studies consistently show that youth in the juvenile justice system have significantly higher rates of mental illness and serious emotional disorders in comparison to youth in the general population. It is now estimated that at least 20 percent of all youth entering the juvenile justice system experience a serious mental or emotional disorder. The majority of these youth also have significant problems with the abuse of substances.

It has been unclear as to which system is responsible for youth with co-occurring mental health and substance abuse disorders. The treatment needs of youth with co-occurring disorders are different from the treatment needs of those who have a mental health or substance abuse disorder alone. Because of the complexity of their needs, these youth tend to receive inadequate treatment services and often end up in the juvenile justice system.

We know that adults with co-occurring mental health and substance abuse disorders experience a range of negative outcomes including higher rates of hospitalization, incarceration, noncompliance with medications and other treatments, housing instability/homelessness, and higher service utilization and costs. To improve the outcomes for youth, the mental health, substance abuse treatment, and juvenile justice systems must work together to address the needs of this underidentified and underserved population of youth.

The National GAINS Center for People with Co-occurring Disorders in the Justice System was created in 1995 as a national focus for the collection and dissemination of information about effective mental health and substance abuse services for people with co-occurring disorders who come in contact with the justice system. A 2-day cross-training program (Working Together for Change: Co-occurring Mental Health and Substance Use Disorders Among Youth Involved in the Juvenile Justice System) has been developed that provides an opportunity for professionals in the mental health, substance abuse treatment, and juvenile justice systems to learn more about each system and participate in learning exercises designed to enhance systems coordination and collaboration.

This online tutorial is designed to:

1. Prepare participants who have registered for the 2-day cross-training program.
   
   
2. Provide reference material for participants who have completed the 2-day cross training program.
   
   
3. Provide information for juvenile justice, mental health, and substance abuse treatment professionals who are not planning to take the 2-day cross training but would like to learn more about co-occurring mental health and substance use disorders among youth involved in the juvenile justice system.

The goal is to cover basic information so professionals from all three systems will have the same information and language. The goal is not to train a juvenile justice professional to become one in mental health or vice versa. The objective is to provide information about each system and reduce the barriers that have interfered with collaboration in the past and to provide a common ground from which to go forward.

Module 1 provides an overview of the juvenile justice, mental health, and substance abuse treatment systems.

Module 2 provides the following information:

• Basic information about mental illness and substance abuse disorders
• Prevalence of co-occurring disorders among youth in the justice system
• Interactive nature of mental illness and substance abuse
• Screening and assessment of youth with co-occurring disorders

Module 3 provides information on effective treatment strategies for youth who have co-occurring disorders.

Module 4 provides information on effective communication and systems coordination among the juvenile justice, mental health, and substance abuse treatment systems.