Module 2: Screening and Assessment

5. Mental Health and Substance Abuse Assessments in the Juvenile Justice System

When screening identifies youth with possible mental health or substance use disorders, juvenile justice staff will conduct a more comprehensive assessment to determine the youth’s level of skill deficits, the need for psychotropic medications, and which forms of mental health, substance abuse, and juvenile justice interventions would be most appropriate. This type of in-depth assessment may include a clinical interview, tests of cognitive and intellectual functioning, personality tests, information from family/caretakers, and other measures of a youth’s behavioral and emotional adjustment.

Information obtained from a comprehensive assessment should be given to mental health and substance abuse professionals to help them develop an individualized treatment plan for youth in a secure facility or under community supervision. It also assists in creating a seamless transition or reentry to the community for youth who have been in secure settings.

Depending on the assessment instruments used, it is often necessary to consult mental health and substance abuse clinicians to interpret the findings before determining the need for a referral. In addition to mental health and substance abuse professionals, results of the assessment should be clearly communicated to the youth and family members.

The relationship between mental health and substance abuse disorders is complex. It could be that the disorders coexist independently, there may be an interactive relationship between them, the youth may be self-medicating, masking of either disorder may be occurring, and so forth. Assessment must be considered an ongoing, continual process covering the multiple domains that affect a youth's functioning. If symptoms of both mental health and substance use disorders are detected during screening, all follow-up assessments should explore both disorders.

The following sections provide information on mental health assessment, substance abuse assessment, drug testing, and assessment of co-occurring disorders. It is important that all three systems – mental health, substance abuse, and juvenile justice – are familiar with the approaches used by the other systems. In this way, professionals in each system can make the most of the information gained during the assessment process. Information and recommendations are provided on strength-focused assessment, culturally sensitive assessment, and important questions to ask when choosing assessment tools for co-occurring disorders.