Juveniles with Mental Health Problems

OJJDP Videoconference to Explore Innovations and Issues 
By Michelle Gaseau, Managing Editor

Many juvenile justice systems are facing a crisis that few have been able to resolve. The dilemma is that as many as one in five youth in the juvenile justice system has a serious mental health problem and few agencies are prepared to treat and handle it.

"In terms of the kids in the system who need attention, there is a significant group and in the past we haven't paid a lot of attention to them. The US Surgeon General's recent report did a wonderful job of documenting it as a crisis in public health. We need to understand how serious it is as an issue," said Joseph Cocozza, Director of the National GAINS Center for People with Co-Occurring Disorders in the Justice System.

Cocozza is one of several national experts who will discuss this issue and potential solutions during a videoconference sponsored by the Office of Juvenile Justice and Delinquency Prevention on April 19. (See below for more information)

Also participating in the videoconference are Susan Bower, Director of Project Hope through the Rhode island Department of Children, David Heffler, Chief of Outpatient Services for the Western New York Children's Psychiatric Center, Bruce Kamradt, Director of Children's Mental health Services for the County of Milwaukee, Roslyn Holliday Moore, Public health Advisor at the Substance Abuse and Mental Health Services Administration's Center for Mental Health Services, and John Wilson, Acting Administrator for the OJJDP. 

Presenters hope to provide information about the extent of the issue in juvenile justice facilities as well as ways to address mental health problems among youth and some of the useful models that are proving to be effective across the country.

According to Cocozza, one of the starting points for addressing these issues is increasing awareness of the problem. Once the right parties understand the extent of the issue, then they can begin to formulate how they can work together both inside and outside facilities.
"Mental health agencies and social service agencies need to work together," he said.

Another point that Cocozza believes will be addressed during the conference is the importance of working on both the front and back end to divert juveniles who don't need to be in the system. "We need to learn more about keeping the kids who don't belong in the justice system out. We do such a better job with adults with diversion than with kids," 

Cocozza said working on the back end, after release, entails providing the right aftercare and reintegration for juveniles so they can return to the community and succeed.

Finally, Cocozza says, in order to address the problem fully, the field needs to conduct additional research and evaluation on how to address the problem. 

There is a growing body of strategies to deal with this issue and some of them will be highlighted during the videoconference.

Innovative Programs

"On the national and federal level with the OJJDP, they have begun and are pushing very hard on these issues. When you talk to some of the state juvenile justice directors - one of the things that comes up as the number one issue is dealing with the mental health issues the kids are having," said Cocozza.

Three programs that address juvenile issues with mental health will be presented and discussed during the videoconference: including the Wraparound Milwaukee Program, the Mobile Mental Health Teams-State of New York and Project Hope.

According to Bruce Kamradt, Director of the Milwaukee County program, officials began looking at different ways to better treat juveniles with mental health and emotional problems after steadily spending dollars on hospitalizations for the population and residential treatment. 

"What we designed was a project that uses a wrap-around philosophy. It is a problem-oriented model. We spend time building on strengths of the child and family. It gets away from categorical funding. Whatever the child needs, we can obtain. If you do this well you'll have a different plan for each kid," said Kamradt.

The program ensures the varied needs of the juvenile population are met and utilizes pools money from Medicaid and juvenile justice. "We blend $28 million for the care of 600 overall youth. We purchase all the services from psychiatric hospitalization to community services. If they are in wrap around they are not in the juvenile justice system," said Kamradt. 

Wraparound Milwaukee is responsible for, pays for and initiates the services required by the family. Because it can utilize a wide variety of funding pools that are joined together, it provides a great deal of flexibility in how it can be spent to serve the youth that need it. 

The funding partners include child welfare, juvenile justice, Medicaid and mental health agencies. The program has created a provider network of 200 agencies in which they can purchase over 80 different services.

If a child needs respite services, day treatment, music lessons, or an after school program, you would be able to put it together," said Kamradt.

Each child in the program has his/her own case manager, who carries loads no larger than eight. The case managers work to identify the individual needs of each youth and put the plan for together for service.

The program also has an evaluation component to review its successes. Since its inception, the program has been able to reduce the use of treatment and psychiatric hospitalizations for children, which has reduced the overall costs. In addition, children in the county have access to a wider range of services. The evaluation outcomes for those youthful delinquents in the program have been positive. 

"There has been a significant reduction of recidivism by delinquent youth in all types of offense categories. School attendance is up by 65 percent for those kids and school incidents have been reduced by half," said Kamradt.

To learn more about this program and others that will be discussed during the videoconference, visit the Juvenile Information Network website on Thursday to view the videoconference via this website.