Assessment Of The Mental Health Needs Of Juvenile Offenders
COMMONWEALTH OF VIRGINIACommission on YouthAssessment of the Mental HealthNeeds of Juvenile OffendersSeptember 17, 2013Leah Mills
Study Mandate During the 2013 General Assembly Session, Senator Jill HolzmanVogel introduced Senate Bill 928. This bill would require an interdisciplinaryteam to evaluate the service needs of a juvenile when the Commonwealthis seeking the juvenile’s commitment. Such an evaluation would be orderedwhen the juvenile has been:placed in a secure facility;‒ identified with a mental health need from the mental health assessmentconducted by the secure facility; and‒ adjudicated delinquent and the attorney for the Commonwealth is seekingcommitment.‒The interdisciplinary committee would evaluate the juvenile’s service needsand submit a report to the juvenile and domestic relations (JDR) court . The JDR court would consider the evaluation when determining whetherthe juvenile would be committed to the Department of Juvenile Justice(DJJ). VIRGINIA COMMISSION ON YOUTH2
Study Mandate The Senate Courts of Justice Committee reviewed Senate Bill 928and determined further study would be appropriate The Committee passed Senate Bill 928 by indefinitely andrequested the Commission on Youth to study the issues set forthin the legislation. On April 2, 2013, the Commission on Youth adopted the studyplan.VIRGINIA COMMISSION ON YOUTH3
Study Activities Identify Concerns with SB 928Site visits and stakeholder interviewsLiterature reviewReview federal legislation/statutesReview Virginia laws, regulations, and policiesTwo informal surveysPrepare draft findings and recommendationsVIRGINIA COMMISSION ON YOUTH4
Study Activities Identify Concerns with SB 928‒The screening conducted at the juvenile detention centers does notidentify a mental health diagnosis.‒This bill may increase the juvenile’s length of stay at a juveniledetention center.‒The bill requires Commonwealth Attorneys to reveal whether theyare seeking commitment.‒The bill raises concerns about information-sharing and workload.‒The bill provides the judge with existing dispositional options.‒This bill raises concerns about self-incrimination.‒Adequate mental health services may not be in place in somelocalities of the Commonwealth.VIRGINIA COMMISSION ON YOUTHs5
Site Visit Interviews RoanokeCulpeperWinchesterFairfaxChesapeakeVirginia Beach29th CSU (Bland, Buchanan, Dickenson, Giles, Russell, &Tazewell)ChesterfieldHenricoHanoverCity of RichmondVIRGINIA COMMISSION ON YOUTH6
Stakeholder Interviews DJJ officialsDepartment of Behavioral Healthand Developmental Services(DBHDS)Community Services Board (CSB)representativesCommonwealth Center for Childrenand Adolescents (CCCA)Local Comprehensive Services Act(CSA) representativesCourt Services Unit (CSU) DirectorsLocal Family Assessment andPlanning Teams (FAPTs)Local Departments of Social Services(DSS) representativesMental health clinicians & serviceprovidersVIRGINIA COMMISSION ON YOUTH Virginia Supreme Court/Office ofthe Executive SecretaryJuvenile Detention CenterrepresentativesProbation/Parole officersLaw Enforcement officialsGuardians Ad LitemDefense AttorneysJuvenile Court Judges/CourtrepresentativesAdvocacy organizationsFamily Members/ParentsCommonwealth Attorneys(pending)Department of Criminal JusticeServices (pending)7
Literature Review Other states’ initiatives and policies‒‒‒‒‒‒National Conference of State LegislaturesMacArthur Foundation Model for Change ProgramAnnie E. Casey Juvenile Detention AlternativeInitiatives (JDAI)Office of Juvenile Justice and Delinquency PreventionModel Programs GuideBlueprints for Healthy Youth DevelopmentSAMHSA’s National Registry of Evidence-basedPrograms and PracticesVIRGINIA COMMISSION ON YOUTH8
Department of Juvenile JusticeTrendsThe Virginia Commission on YouthSeptember 17, 2013Prepared by:The Department of Juvenile JusticeLegislative and Research Unit
Court Service Units Intake Trends
National Arrest DataNumber of Juveniles Arrested Per 100,000 ,0404,5744,8894,2664,0003,0002,0001,000- 200220032004200520062007200820092010National 4,266On average, from FY 2000 - FY 2010 there were 1,787 fewer juvenilesarrested per 100,000 juveniles in Virginia compared to the nationalaverage.In FY 2010, there were 623 fewer in Virginia.11
Juvenile IntakesJuvenile Intake Cases & 00020,00010,00020022003200420052006Intake Cases2007200820092010201120122013Intake Complaints Over the reporting period, there have been between 1.2 to 1.4 juvenile intake complaints perjuvenile intake case.12
Juvenile Intake Cases by MostSerious Offense Category2013 Most Serious Offense at 03,5283,0002,0001,000Status OffenseAssaultLarcenyProbation Violation Contempt of Court The top five most serious offenses of juvenile intake cases accounted for58.6% of all intake cases in FY 2013.13
Court-Involved Youth Trends
Intakes by Petitioned Casesand 47,53944,02843,77141,56234,374Intake Cases31,543Intake Complaints30,00020,00010,0002002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 201315
520062007200820092010 A detainment is the first admission of a continuous detention stay.16
Average Length of Stay –Detention DispositionDetention Length of Stay: 004200520062007200820092010LOS (Days)17
Average Length of Stay –Detention DispositionDetention Length of Stay: Post-D (No 32004200520062007200820092010201120122013LOS (Days)18
Average Length of Stay –Detention DispositionDetention Length of Stay: Post-D 0052006LOS (Days)19
Detention ADP byDispositionAverage Daily Population : Pre-D, Post-D (No Programs), andPost-D ost-D(No Program)Post-D(Program)20
Probation TrendsProbation Placements, Releases & 01120122013ADP21
Probation TrendsProbation Length of 003200420052006LOS (Days)22
Parole TrendsParole Placements, Releases & 326200012345Placements6Releases7891011ADP23
Parole TrendsParole Length of 200420052006LOS (Days)24
Juvenile Correctional Center Trends
Admissions & ReleasesJCC Admissions & 092010201120122013Releases26
Direct Care Average DailyPopulationJCC Average Daily 52006200720082009201020112012201327
Actual Length of Stay –Average (Months)Average Actual Length of Stay in 10.08.06.04.02.00.020052006200720102011Actual LOS28
Juvenile Demographics
Average Age at JCCAdmissionAverage Age at JCC 22002200520062007200820092010201120122013Average Age at Admission30
JCC Admissions by AgeCategoryAgeUnder 14141516171819 or 6%37.7%7.0%0.8%AgeUnder 14141516171819 or 3.0%43.7%11.2%1.8%31
Average Age at JCCReleaseAverage Age at JCC 009201017.417.217.016.820042005200620072011Average Age at Release32
JCC Admissions by SexJCC Admissions by 006200720082009201020112012201302002MaleFemale In FY 2013, 90% of JCC admissions were male and 10% were female.33
JCC Admissions by 4%3.7%100.0%201365.1%29.2%0.5%5.2%100.0%34
Most Serious CommittingOffense by CategoryAssaultBurglaryLarcenyNarcoticsRobberySex OffenseAssaultBurglaryLarcenyNarcoticsRobberySex 4%24.3%21.5%22.5%7.9%6.3%8.8%9.7%9.9%7.7% The charts above shows the six most serious committingoffenses that were committed most frequently each year.35
Most Serious CommittingOffense by Severity*Offense SeverityFelony Against PersonsFelony Weapons/NarcoticsOther FelonyC1 Misdemeanor Against PersonsOther C1 MisdemeanorParole ViolationOffense SeverityFelony Against PersonsFelony Weapons/NarcoticsOther FelonyC1 Misdemeanor Against PersonsOther C1 MisdemeanorParole .6%36.0%5.5%7.3%5.9%36* Percentages do not add to 100% because categories with small percentages are not displayed.
JCC Admissions – LastGrade CompletedPercent of Admissions by Last Grade 0%K-7Grade 8Grade 9Grade 1012Grade 1137
JCC AdmissionsFull Scale IQPercent of Admissions with FSIQ Range Below 90 20092010201120122013Percent of Admissions with FSIQ range below 9038
Frequency of ScoresJCC Educational Evaluation:Intelligence QuotientJCC Admissions,FY 2010-2012IQ ScoresGeneralPopulation JCC Average IQ: 87 General Population Average IQ: 10039
Mental Health Trends
JCC Admissions byPsychotropic Med HistoryAdmissions by Psychotropic Medication male20122013Male41
Direct Care Residents TakingPsychotropic Medications ug-10 Oct-10Feb-11Apr-11Jan-12Apr-12Jul-1242
JCC Admissions by MentalHealth DisorderJCC Admissions by Mental Health %20102011201221%10%0%2004ADHD/ADD2005Conduct DisorderSubstance Abuse2013Other MH Disorder43
JCC Admissions –Psychiatric Services HistoryAdmissions by History of Outpatient Services or Outof Home atient Services201120122013Out of Home Placement This slide shows the percentage of JCC admissions with a history of Outpatient Services OR group homeplacement, psychiatric inpatient placement, residential treatment, therapeutic foster placement, or inpatient substanceabuse rehabilitation placement.44
Percent of Juveniles with a MHSTPAlert within 8 Weeks of Admission*and at 8%57%54%50%48%56%58%54%53%50%59% 59%53%47%57%53%46%40%30%20%10%0%Alert within 8 weeks of JCC AdmissionReleased with Alert* Includes MHSTP alerts given to new commitments and MHSTP alerts that have carried over from prior commitment.45
Identified Issues &Recommendations46
Juvenile Offenders & Mental Health Needs JCC Commitments – FY 2012‒ 60% of males and 80% of females committed to DJJ showedsignificant symptoms of a mental health disorder.‒63% of males and 58% of females had a history of psychotropicmedication use prior to their commitment.‒47% of males and 77% of females had a history of outpatient servicesor group home placement, psychiatric inpatient placement,residential treatment, therapeutic foster placement, or inpatientsubstance abuse rehabilitation placement.Juveniles in Detention – FY 2012‒45% of juveniles in detention have at least one mental healthdisorder and almost 25% are on psychotropic medication.Sources: Virginia Department of Juvenile Justice, 2013 and Virginia Council on Juvenile Detention, 2012.47
Mental Health Screening & Assessment Screening at Intake‒In 2008, DJJ adopted the Youth Assessment ScreeningInstrument (YASI).‒The YASI is a validated tool that assesses risk, needs, andprotective factors to help develop case plans for juveniles.‒Mental health and substance use are two domains included onthe YASI.‒The YASI includes a brief “pre-screening” version that generatesa risk score. This score assists with early decision-makingregarding the appropriateness for diversion or detention.48
Mental Health Screening & Assessment(cont). Screening at Detention‒Virginia utilizes the Massachusetts Youth Screening Inventory, secondedition (MAYSI-2) for youth held in detention.oooo‒Designed to identify potential mental health & substance use needs ofjuvenilesValidated mental health screening toolActs as early warning for emergenciesAssists in deciding need for a more detailed and individualizedassessmentThe MAYSI-2 is effective in the initial identification of juveniles withmental health treatment needs and/or those at risk for homicidal orsuicidal behavior in order to determine if a temporary detentionorder (TDO) should be filed.49
Social History Report A social history is a report which may be ordered by the court following theadjudication of a juvenile. Pursuant to DJJ regulations, a social history report must be prepared when:‒ ordered by the court;‒ for each juvenile placed on probation supervision with the unit;‒ for each juvenile committed to DJJ;‒ for each juvenile placed in a post-dispositional detention program for morethan 30 days (pursuant to §16.1-284.1); or‒ upon written request from another unit, when accompanied by a courtorder.* When a juvenile is committed to DJJ, a social history report must be completedwithin fifteen days (pursuant to §16.1-278.7). For those reports completed prior to disposition, the information contained in thesocial history is used at the dispositional hearing to assist the judge in determiningappropriate services and sanctions.*6VAC35-150-33650
Social History Report (cont.) Judges report social histories as being very helpful and beneficial whenmaking a dispositional decision. They want, and need, as muchinformation as possible to make appropriate dispositional decisions. Despite the noted value of a completed social history, judges may notalways have a completed social history prior to disposition. In FY 2012, 3,067 social histories were completed before disposition and2,542 were completed post-disposition.* Reasons for this may include:––––plea agreements;judges dispose of cases incrementally and have entered initial orders;delay in getting records from other jurisdictions; andadjudication and disposition occurring on the same day, narrowingconsiderably the window in which a social history can be completed.*This may be after any court disposition including status offenses.51
Social History Report (cont.) Court Service Units (CSUs) strive to complete social histories prior todisposition. An informal survey of 22 CSUs conducted by DJJ found that in 14 of those CSUs,the court does not commit a juvenile without a social history.‒In Chesapeake, Culpeper, and Winchester, there is no disposition without asocial history; similarly in Culpeper, there is no probation without a socialhistory.‒Fairfax reports judges receive social histories 100% of the time prior tocommitting a juvenile is committed.52
Social History Report (cont.) The timing of social histories, or predisposition reports, varies in otherstates. In Florida, Louisiana, and Pennsylvania, a social history may only becompleted post-adjudication. North Carolina requires a social history be completed “prior to adisposition hearing,” but provides an exception that allows a disposition tooccur without the report where the court makes a written finding that oneis not required. In Texas, a probation officer is required to begin a social history report assoon as charges are filed against a juvenile. Similarly, in Maryland, thecourt may direct a social history report after a petition or citation has beenfiled with the juvenile court.53
Social History Report (cont.)Social Histories/Predispositional ReportsSelected StatesStateMay or ShallWhenFloridaMay – unless a residentialcommitment disposition isanticipated or recommended by anofficer of the court or thedepartment, in which case nMarylandMayAfter a petition or citation has beenfiled with the courtNorth CarolinaShallPennsylvaniaMayPrior to disposition hearing –unless the court makes a writtenfinding that a predisposition reportis not requiredPost-adjudicationTexasShallWhen charges are filed against thejuvenile54
Social History Report (cont.) DJJ has established policies and procedures as to what must be includedin a social history. Social histories are supposed to include thefollowing:‒ identifying and demographic information on the juvenile;‒ current offense and prior court involvement;‒ social, medical, psychological, and educational information about thejuvenile;‒ information about the family; and‒ dispositional recommendations, if permitted by the court. An issue that often arises as localities attempt to work together isvariability of the information included in social histories. For some, a checklist may be sufficient, whereas others provide lengthynarratives.55
Social History Report RecommendationsDraft Options1. Amend §16.1 273 of the Code of Virginia to clarify that social historiesmay be completed sooner in the process rather than followingadjudication.2. Amend §16.1-278.8 the Code of Virginia to ensure judges have acompleted social history prior to disposition for juveniles who may becommitted to DJJ.3. Amend §16.1-278.7 of the Code of Virginia to state that a commitmentorder will be supported by a determination that the interests of thejuvenile and community require that the juvenile be committed.4. Request DJJ to create a model social history and guidelines for CSUs to usein assisting the courts in making informed dispositional decisions. Themodel social history and guidelines may include information on obtainingIEP assessments and acknowledge exposure to trauma of a juvenile’s socialhistory report.56
Court Service Units In Virginia, each juvenile and domestic relations court is served by a courtservices unit (CSU). DJJ operates 32 CSUs. In addition, there are 3 CSUswhich function as locally operated entities.* CSU juvenile servicesinclude intake, screening, diversion, placement, preand post-adjudicatory case management, supervision, parole planningand coordination, and a variety of specialized services. Juvenileintake services are provided 24-hours a day, and the intakeofficer has the authority to receive, review, and process complaints. The investigations and reports primarily completed by CSU personnel aresocial history reports, but also include case summaries to the FAPTs,commitment packets for the Reception and Diagnostic Center (RDC),interstate compact reports, transfer reports, parole transition reports,ongoing case documentation, and transitional services referral packets.* The three exceptions are Fairfax, Falls Church, and Arlington.57
Court Service Units (cont.) Because of the number of juveniles with mental health disorders enteringthe juvenile justice system, it would be extremely valuable to have aperson within the CSU to conduct mental health and substance abusescreenings, assessments, and evaluations. Assessing juveniles earlier in the process would enable judges to moveforward with dispositional and other decisions, equipped with moreinformation and a more complete understanding of what might be theappropriate action to take for the juvenile.‒‒The 31st CSU (Manassas, Manassas City, & Prince William) has a court psychologist whoadministers, scores, and interprets psychological and behavioral tests, reports on findingsand makes recommendation for treatment plans. The court psychologist also conductsfield visits to facilities pending court hearings or placements in treatment facilities andtestifies in court to present the results of interviews and evaluations. The court psychologistattends FAPT meetings and assists in the development of service and treatmentstrategies.The 29th CSU covering the counties of Bland, Buchanan, Dickenson, Giles, Russell, andTazewell have a psychologist on staff. Attorneys will request a psychological evaluation ifthey feel that it is necessary. Usually, a mental health evaluation has been completedbefore commitment is recommended.58
Court Service Units RecommendationsDraft Options1. Introduce a budget amendment to fund up to one qualified mental healthprofessional (QHMP) for each CSU that best suits their particular needs,including conducting mental health, substance abuse, and/or traumascreenings, assessments, and evaluations. Provide the CSU with theflexibility to hire the position or to enter into a Memorandum ofUnderstanding with their local CSB.OR2. Introduce a budget amendment authorizing CSUs to contract with a QHMPfor the provision of mental health, substance abuse, and/or traumascreenings, assessments, and evaluations. Provide the CSU with theflexibility to hire the position, to contract with the local CSB, or to contractwith a private provider.59
CSB Services in Juvenile Detention Centers In FY 2008, the General Assembly appropriated 110,000 state general funds forCSBs affiliated with a local detention facility so that CSBs could provide mentalhealth screening, assessment services, and community-based referrals forjuveniles in detention.‒ These programs began in 2003 with federal grant funds provided by theDepartment of Criminal Justice Services (DCJS) for approximately 500,000.00. A 10% cash match from the grantee was required.‒ Federal funds from DCJS were discontinued in 2008. The Department ofBehavioral Health and Developmental Services (DBHDS) assumed the costsusing state general funds. A licensed mental health therapist and a case manager employed by the CSB,housed at the juvenile detention facility are present at each program site. The CSB’s role is the provision of consultation and mental health services forjuveniles with mental health disorders and/or co-occurring substance usedisorders who are detained in the center.60
CSB Services in Juvenile Detention Centers(cont.)Service Sites and Funding Years.Funded in FY 03 (Federal Juvenile Accountability Block Grant/State Funds as of FY 08)1.Chesapeake CSBChesapeake Juvenile Justice Center2.Crossroads CSBPiedmont Juvenile Detention Home3.Planning District 1 BHAHighlands Juvenile Detention Home4.Richmond Beh. HealthRichmond Juvenile Detention Home5.Valley CSBShenandoah Juvenile Detention CenterFunded in FY 06 (State General Funds)6.Central VA CSBLynchburg Juvenile Detention Home7.Chesterfield CSBChesterfield Juvenile Detention Home8.Norfolk CSBNorfolk Juvenile Detention CenterFunded in FY 07 (State General Funds)9.Alexandria CSBNorthern VA Juvenile Detention Home10. Blue Ridge Beh. HealthRoanoke Juvenile Detention Home11. Region 10Blue Ridge Juvenile Detention Center12. Colonial CSBMerrimac Juvenile Justice Center13. Danville CSBW.W. Moore Juvenile Detention Center14. New River Valley CSNew River Valley Juvenile Detention HomeFunded in FY 08 (State General Funds)15. Henrico CSBJames River Juvenile Detention Home16. Fairfax CSBFairfax County Juvenile Detention Center17. Loudoun CSBLoudoun Juvenile Detention Home18. NWCSBNorthwestern Juvenile Detention Home19. PWCSBPrince William Juvenile Detention Home20. VA Beach CSBVA Beach Juvenile Detention Center21. District 19 CSBCrater Juvenile Detention22. Rappahannock CSBRappahannock Juvenile Detention Center23. Hampton NN CSBHampton NN Juvenile Detention Center61
CSB Services in Juvenile Detention Centers(cont.) Detention Home Survey‒ Six detention homes indicated that their CSB’s clinicians' hours had beenreduced and/or diverted to perform duties at the CSB.‒ Data provided by the DBHDS reveals that, overall, state funds to CSBs fordetention center services had not been significantly reduced.o The state general funds distributed by DBHDS for CSB services in localdetention homes were originally designated as “restricted”.o These funds were later classified as “earmarked” meaning CSBs must spendthe funds for the identified purpose but CSBs do not have to reportexpenditures tied specifically to those funds.‒‒‒In FY 2012, total juvenile detention center costs for the 23 CSBs was 3,552,897.The state general fund appropriation for these services was 2,569,652.Local funds comprised the difference.62
CSB Services in Juvenile Detention Centers(cont.) Based on FY 2014 Letters of Notification to the 23 CSBs,DBHDS will disburse 2,401,656 for mental health services injuvenile detention centers. Of the 23 CSBs, 17 will each receive approximately 111,724 6 CSB will receive lesser amounts. If all 23 CSBs received the full amount ( 111,724), the totaldisbursed would be 2,569,652. Subtracting the total amount for the 23 CSBs ( 2,401,656)from the amount above ( 2,569,652) leaves reduction of 167,996 that would need to be offset.63
CSB Services in Juvenile Detention Centers(cont.)Feedback from Site Visits/Survey – Detention Centers Some detention home representatives expressed concerns because theirclinicians’ hours have been reduced/diverted to perform duties at theCSB.‒One detention center representative is considering hiring its ownclinician since the localities are so territorial and some Post-Dresidents receive no services depending on their jurisdiction. Another common response was that executive directors at the CSBs didnot fully understand or support the mandate and the rationale for theseservices. Several detention center representatives stated that there was effectivecollaboration between their detention center and CSB but worried thismay change in the future should existing CSB staff leave or retire.64
CSB Services in Juvenile Detention Centers(cont.)Feedback from Site Visits/Survey – CSBs CSB representatives emphasized the need for flexibility. On average,there has been a decline of detention admissions. There should beagreements in place to maximize mental health services for juvenileoffenders. CSB representatives also noted the level of intensity for the juvenilesthey serve has also increased significantly.‒One locality has two full-time clinicians in their detention center.While the level of intensity and service need has escalated, theMemorandum of Understanding between the CSB and the detentioncenter has not been revised to address this.65
CSB Services in Juvenile Detention CentersRecommendationsDraft Options1. Request the DBHDS to work with Virginia’s detention home superintendents and CSBexecutive directors to facilitate a quantifiable agreement for the provision of mentalhealth and substance use screening, assessment, and other services identified asnecessary for juveniles in detention. DBHDS will provide guidance and technicalassistance and assist in the creation of a model memorandum of understanding or otherquantifiable arrangements between the detention homes and the CSBs. The agreementmay include, but is not limited to, the
The interdisciplinary committee would evaluate the juvenile’s service needs and submit a report to the juvenile and domestic relations (JDR) court . The JDR court would consider the evaluation when determining whether the juvenile would be committed to the Department of Juveni
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