Module 2: Screening and Assessment

2. Introduction to Screening and Assessment in the Juvenile Justice, Mental Health, and Substance Abuse Treatment Systems

Accurate screening and assessment of youth with co-occurring disorders in the juvenile justice system are essential if youth are to receive adequate treatment and rehabilitative services. Youth are often misdiagnosed, resulting in inappropriate programming, treatment, referral, and under- or overreliance on psychotropic medication, resulting in poor outcomes.

There are several reasons why mental health and substance use disorders may go undetected in the juvenile justice system. Staff may lack the training to identify symptoms and behaviors related to mental health and substance abuse disorders. Conduct problems and oppositional behaviors often mask more significant disorders. Some youth may underreport symptoms or behaviors out of fear of stigma and negative consequences; others may overreport symptoms to receive desired services or may be unable to report due to toxic effects of intoxication or withdrawal.

This section provides information on how the terms screening and assessment are used in the treatment systems and in the juvenile justice system. It is important that each professional recognize how others use these terms. When dealing with youth with co-occurring disorders, it is imperative to have mental health, substance abuse, and juvenile justice collaboration in the assessment process. Coordinated information gathering is efficient and results in a more positive relationship with youth. The way youth respond to treatment may well be affected by their initial encounter with the system during the initial screening and assessment phase.