SPECIAL COMMUNICATION
Mental Health Assessments in Juvenile Justice: Report on the Consensus Conference

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ABSTRACT

Objective

At national, state, and local levels, there is increasing recognition of the importance of identifying and responding to the mental health needs of youths in the juvenile justice system, as policymakers and practitioners struggle to find ways to address causes and correlates of juvenile crime and delinquency. The proposed guidelines for mental health assessment provide explicit information about how, why, and when to obtain mental health information on justice youths at each important juncture in processing.

Method

A national group of expert researchers and practitioners convened in April 2002. Experts derived six recommendations, following the expert consensus method, for conducting mental health assessments in juvenile justice settings. Experts had broad experience creating collaborations between juvenile justice, mental health, and child welfare systems and understood the policy and health implications of conducting such assessments in juvenile justice settings.

Results

Consensus Conference recommendations regarding screening for emergent risk, screening and assessment of mental health service needs, comprehensive mental health assessment components, assessment before community re-entry, need for periodic reassessment, and staff training are presented.

Conclusion

Deriving specific recommendations that can be implemented systematically is a necessary first step toward policy changes that will optimize the standard of care for this vulnerable population. J. Am. Acad. Child Adolesc. Psychiatry, 2003, 42(7):752-761.

Section snippets

METHOD

We followed the RAND Corporation expert consensus guidelines approach (Brook et al., 1986). We first developed a survey, administered in paper and Internet formats, in which juvenile justice staff (clinical and nonclinical) nationwide reported on assessment practices in their work settings and then expressed their opinions on best practices for such assessments (Evans et al., 2003). We then held a Consensus Conference on “Mental Health Assessments in Juvenile Justice Settings,” sponsored by the

SCREENING AND ASSESSMENT

Mental health information should inform identification of both emergent risk and mental health service needs. Screening can be an efficient mechanism for gathering either type of information, at several points in the youth's contact with the system. Screening is the identification of unrecognized problems in apparently well persons via procedures that can be applied rapidly and inexpensively. Screening is not intended to be definitive; persons who screen positive should receive further

DISCUSSION

As noted, several groups have developed guidelines and standards for management of youths in detention and corrections facilities. More recent publications, and those whose focus is mental health, have addressed the present recommendations more explicitly. Of the groups providing guidelines, none provides explicit information for all six recommendations, although the CJMHC Project (Council of State Governments, 2002), pertaining only to adults, comes closest. Currently, practitioners seeking

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    The authors gratefully acknowledge the input of the participants in the conference; they are listed at the end of the text.

    Participants: Gregory L. Fricchione, M.D., is with the Division of Psychiatry and Medicine, Massachusetts General Hospital; Ralph E. Kelly, Ed.D., is former Commissioner of the Kentucky Department of Juvenile Justice; Chris Koyanagi is with the Bazelon Center for Mental Health Law; Edward J. Loughran is with the Council of Juvenile Correctional Administrators; Howard Snyder, Ph.D., is with the National Center for Juvenile Justice; Tom Stokes is with the National Juvenile Detention Association; Ray Wahl is with the American Probation and Parole Association; Prudence Fisher, Ph.D., Laurence Greenhill, M.D., Kimberly Hoagwood, Ph.D., Laura Mufson, Ph.D., Bruce Waslick, M.D., and Larkin S. McReynolds, M.P.H., are all with the Department of Child Psychiatry, Columbia University; William Arroyo, M.D., is with Children's Services, Los Angeles County Department of Mental Health; Michael Bigley, M.S.S., C.S.W., and Lois Shapiro, Ph.D., are with the New York State Office of Mental Health; Joyce Burrell is with the American Institutes for Research; Larry Faison, Ph.D., is with Mobile County Juvenile Court; Kathi Grasso is with the Office of Juvenile Justice and Delinquency Prevention; William Haxton, Ph.D., is with Clinical Services, South Carolina Department of Juvenile Justice; Diana Quintana, Ph.D., is with the Texas Juvenile Probation Commission; Lee Underwood, Psy.D., is with the National Center for Mental Health and Juvenile Justice.

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