Identification and Referral for Mental Health Services in Juvenile Detention.

Rogers, Kenneth M.; Pumariega, Andres J.; Cuffe, Steven P. Identification and Referral for Mental Health Services in Juvenile Detention. University of South Florida, Tampa. Research and Training Center for Children's Mental Health. National Inst. on Disability and Rehabilitation Research (ED/OSERS), Washington, DC. 2001-00-00 7p.; In: A System of Care for Children's Mental Health: Expanding the Research Base. Proceedings of the Annual Research Conference (14th, Tampa, FL, February 25-28, 2001). H133B90022 For full text: http: //www. fmhi .usf .edu/institute/pubs/pdf/cfs/rtc/l4thproce edings/l4thchap4.htm. Reports Research (143) Speeches/Meeting Papers (150) MFO~/PCO~ Plus Postage. Adolescent Behavior; Adolescents; Behavior Disorders; Delinquency; Delinquent Rehabilitation; *Disability Identification; Disproportionate Representation; *Emotional Disturbances; Emotional Problems; *Juvenile Courts; Juvenile Justice; Mental Disorders; *Mental Health Programs; *Racial Differences; Racial Discrimination; *Referral South Carolina This report discusses the outcomes of a study that examined the mental health referral patterns of youth referred to a public sector mental health system as the result of a judicial consent decree. The study included two samples of youth ages 13-17 from the entire state of South Carolina. The first group included incarcerated youth recruited from the South Carolina Department of Juvenile Justice (SCDJJ) central detention facility in Columbia (n=120). The second group included youth referred to South Carolina Department of Mental Health (SCDMH) facilities as part of a judicial consent decree (n=120). Data were collected on both samples. between January 1997 and December 1997. Findings from the study indicate there is a substantial.leve1 of need for mental health services among detained youth. Ninety-six percent of referred youth and 69 percent of incarcerated youth met criteria for a psychiatric disorder. The most common diagnostic category was disruptive disorder for both referred and detained youth. Referred youth were more likely to have affective diagnoses than detained youth; however, they were less likely to have a substance abuse disorder. Consistent with prior studies, African-American youth were referred for mental health services less often than were Caucasian youth. (Contains 16 references.) (CR) Reproductions supplied by EDRS are the best that can be made from the original document. o\ dc\l v, \o da w 0 Minor changes have been made to improve reproduction quality. Points Of View or opinions Stated in this document do not necessarily represent official OERl position or policy. Identification and Referral for Mental Health Services in Juvenile Detention Kenneth M. Roners Introduction Andres J. Pumiriega Steven P. Cuffe South Carolina is one of a number of states that have been sued in federal court and are currently functioning under a consent decree that mandates mental health treatment for youth with serious emotional disability (SED) The premise of the South Carolina lawsuit is that youth with SED were receiving inadequate mental health services as well as being housed in overcrowded and inadequate facilities (Alexander v. Boyd. 1990/1997). The prevalence of mental illness in juvenile detention facilities is estimated to be as high as 60% (Otto, Greenstein, Johnson, & Friedman, 1992). However, many juvenile correction facilities lack adequate mental health personnel and/or screening procedures for identifying and referring youth with emotional disturbances, and few facilities have the resources in place to address the needs of such youth (Anno, 1984). The level of emotional and behavioral disturbance in detained youth is similar to levels found in an outpatient community mental health center population (Atkins et al., 1999). The determination of whether a youth will be detained in the juvenile justice system or treated in the mental health system is not always made at the level of psychopathology, but is influenced by demographic variables such as ethnicity, gender, and age (Westendorp, Brink, Roberson, & Ortiz. 1986; Shanok & Lewis, 1977). These same variables, in addition to recidivism and family environment, determine which youth will be referred for mental health services once detained in the justice system (Barton, 1976). This study examined the mental health referral patterns of youth referred to a public sector mental health system as the result of a judicial consent decree. The purpose of this article is threefold: 1) to compare the prevalence rates of emotional disturbance in youth referred for mental health services as a result of a judicial consent decree with youth incarcerated but not referred for mental health services; 2) to investigate the behavioral symptomatology as measured by the Child Behavior Checklist (CBCL; Achenbach. 1991b) and Youth Self Report (YSR; Achenbach, 1991a) between these groups of youth; and 3) to investigate the impact of sociodemographic, criminal history, and service use on referral for mental health services. Method This study included two samples of youth ages 13-17 from the entire state of South Carolina. The first group included incarcerated youth recruited from the South Carolina Department of Juvenile Justice (SCDJJ) central detention facility in Columbia (n = 120). These youth were selected from the monthly rosters of the ScDJJ facility. The second group included youth referred to South Carolina Department of Mental Health (SCDMH) facilities as part of a judicial consent decree (n = 120). Data were collected on both samples between January 1997 and December. 1997. Three instruments were used in this study. The first was the Diagnostic Interview Schedule for Children, version 2.3 (DISC 2.3; Shaffer, Fisher, Dukan, & Davies, 1996) which assessed major diagnoses found under the Diagnostic and Statistical Manual of the American Psychiatric Association, Third Edition. Revised (DSM-111-R; American Psychiatric Association, 1994). The DSM includes modules for anxiety disorders, mood disorders, psychosis, disruptive disorders, substance abuse disorders, and miscellaneous disorders such as eating disorders, tics, and elimination disorders. The frequency of diagnostic categories, the number of diagnoses, and the number of symptoms that contributed to meeting diagnostic criteria were analyzed. w e did not include psychotic symptoms in the total symptom count since the psychosis module was designed as a screen and not a diagnostic module, and many of the symptoms could overlap with symptoms in other modules. As mentioned,