Sponsored by the National GAINS Center and the National Mental Health Association

There is growing recognition of the high numbers of youth involved with the juvenile justice system with co-occurring mental health and substance abuse problems. More than two million youth under the age of 18 are arrested each year, and more than 100,000 of these youth will be placed in juvenile detention and correction facilities on any day. Available research indicates that approximately twenty percent of all youths who enter the juvenile justice system experience serious mental disorders, with a much higher percentage experiencing some level of mental health problems. Studies have consistently found the rate of mental disorders to be higher among juvenile justice population than among youths in the general population. There is also a growing recognition that many of these youths nearly 50 to 75 percent, have serious substance abuse problems. The growing awareness of the unmet needs of these youth had led to a joint effort by the National Mental Health Association and the GAINS Center, known as the Justice for Juveniles Initiative.

The GAINS Center, which is federally supported by the Center for Mental Health Services, the Center for Substance Abuse Treatment, and the National Institute of Corrections, provides information and practical assistance to communities, to promote systemic change and improve service delivery for individuals with both substance abuse and mental disorders in contact with the justice system. The National Mental Health Association, with its 340 affiliates nationwide, is dedicated to improving care and treatment for children and adults with mental health problems. NMHA's mission includes advocacy, public education, research and community aid for people with mental illnesses and their families.

The goal of the JFJ initiative is to highlight, at both the local and national levels, the issues and service needs of youth with co-occurring mental health and substance abuse disorders in contact with the juvenile justice system. The JFJ represents an important first step to identify these youth, their needs, the services available in communities around the country, and ways to improve how systems respond to treatment needs of youth.

Information for the JFJ assessment was collected in communities through a series of interviews with key stakeholders at both the state and local level, including: directors of mental health, substance abuse, and juvenile justice agencies; family members; police; key service providers; judges; and advocacy groups. These interviews were conducted by self-selected Mental Health Association and Federation of Families affiliates who volunteered to collect data in their community. The community assessment asked respondents about the policies and programs in place to address the treatment needs of youth in the juvenile justice system in their respective communities, and their perspective on how well services are provided to youth. The final sample of communities included 15 counties and 9 states. A list of communities that participated in the JFJ initiative is attached.

The report represents a summary of the cross-site findings from the community assessments. Due to issues surrounding the collection of data, and the nature of the information collected, there are a number of limitations to the information in this report. The limitations include:

• while we had hoped to have both state and local data for all communities participating in the initiative, information for both levels was not collected in all sites;
  
• while we had hoped to have consistency in the types of individuals interviewed across the sites, the respondents in communities are not consistent;
  
• there are differences in the depth and quality of responses between sites;
  
• the information gathered is based on respondents' perceptions.

The discrepancies between sites and limitations of the data make it difficult to make comparisons between sites regarding the systems and types of services. Therefore, the report does not make any conclusions or generalizations about individual sites; comparisons or generalizations by state or county; or comparisons by the type of respondent. The report is a general cross-site summary of all 111 interviews completed by the 24 sites participating in the initiative. While this report cannot give a complete picture of the how communities respond to the mental health and substance abuse needs of youth involved in the juvenile justice system, it does provide a critical first step in an area where little or no information exists.

Some of the main findings concerning the mental health and substance abuse services provided to youth involved in the juvenile justice system include:

• There is a general absence of information on the prevalence of youth with mental health and/or substance abuse problems involved in the juvenile justice system.

  Few communities are aware of the number of youth with mental health and/or substance abuse problems involved in their juvenile justice system. Less than half of the sites collect some data on youth, only a third of the sites can estimate the number of youth, and in only four sites is there a formal analysis of juvenile justice data. The little to no information provided by sites indicates that few communities actually identify youth with mental health and/or substance abuse problems.

• Across sites there is a failure to provide routine standardized screening and assessments.

  For the majority of communities participating in the initiative, there are no routine screening or assessments for youth involved in the justice system. Respondents indicated that identification is provided in a hit or miss fashion and youth are not generally identified until the problems result in a crisis and can no longer be ignored.

• There are inadequate and fragmented services for youth with mental health and substance abuse problems involved with the juvenile justice system.

  There are few specific services or programs in place for youth with mental health and/or substance abuse problems involved with the juvenile justice system. Further, in communities where services for youth are available, these are often provided in a piecemeal fashion. In some communities there are programs that target youth in the juvenile justice system, however these programs generally address only a piece of the system. Additionally, there are few programs specifically targeting the needs of juvenile justice youth, and even fewer communities have programming for co-occurring mental health and substance abuse disorders.

• There is a general lack of communication and coordination across the involved systems.

  Across the sites, it is clear that there is a lack of communication and coordination between the involved systems. In a few sites there are joint endeavors in the form of collaboratively funded programs and interagency committees, however, for most communities this is clearly lacking. The absence of good communication means restricted access to services and programs, duplication of services, missed identification of youth, and philosophical barriers.

The community assessments illustrate that there are many steps that need to be taken by communities to better meet the treatment needs of youth involved in the juvenile justice system. The strategies to improve services that were most frequently identified in the community assessments, include:

• Communities need to formalize screening and assessment for mental health and ubstance abuse disorders for youth at all points of contact of the juvenile justice system.

  A critical piece in any community that seeks to respond to the mental health and substance abuse needs of youth in the juvenile justice system is a routine, formalized screen and assessment. Sites identified this as a critical gap in serving youth and recognized the necessity of this piece in any system that hopes to respond to the treatment needs of youth.

• Communities need to provide the full range of services to youth.

  In order to meet the treatment needs of youth involved in the juvenile justice system, targeted mental health and substance services must be available at all phases of involvement with the juvenile justice system. Respondents indicated that communities cannot continue to provide services to youth in the piece meal, stop gap approach that currently exists. Sites felt that communities need to develop and implement new services that target this population of youth, from early intervention and prevention programs, diversion programs, services in detention, to aftercare treatment.

• Communities need to establish a coordinating body or task force that focuses on this population of youth.

  It is clear from the community assessments that agencies need to collaborate and integrate services in order to better meet the needs of these multi-system youth. Respondents identified the development of a task force or coordinating body as a strategy to involve all relevant systems and agencies, and jointly address the needs of youth with mental health and substance abuse problems involved in the juvenile justice system.

Justice for Juveniles Initiative Participating Communities:

Jefferson County, Colorado; Colorado State; Metro Atlanta, Georgia; Georgia State; Marion County, Indiana; Jefferson County, Kentucky; Kentucky State; Jefferson Parish, Louisiana; New Orleans Parish, Louisiana; Louisiana State; Maryland State; Orange County, New York; Albany County, New York; Niagara County, New York; New York State; Charleston, South Carolina; Lexington, South Carolina; Oconee, South Carolina; South Carolina State; Houston/Harris County, Texas; Tarrant County, Texas; Texas State; Central Virginia; Washington State.