The Mental Health Needs of Young Offenders : Forging Paths Toward Reintegration and Rehabilitation

The majority of young people in the American juvenile justice system have diagnosable mental illnesses, including substance abuse, mental retardation and learning disorders. However, these often remain undetected and untreated. In this book, a team of experts examines the prevalence of mental disorders in this population and describes the means of screening for, diagnosing, and treating them effectively in a developmentally appropriate, culturally sensitive manner. They also examine psychopharmacologic and psychotherapeutic approaches; innovative alternatives to detention; the true costs of detaining youth; vulnerability to self-incrimination; and the alarming trend of minority confinement. Their comprehensive coverage includes discussion of ethical dilemmas and the need for preventive strategies and integrated approaches involving judicial, law enforcement, educational, and mental health professionals. This book will be of interest to both mental health and juvenile justice professionals. Cover......Page 1 Half-title......Page 3 Title......Page 5 Copyright......Page 6 Dedication......Page 7 Contents......Page 9 Contributors......Page 11 Foreword......Page 15 Acknowledgments......Page 17 1 An overview of child and adolescent mental health needs in the juvenile justice system......Page 19 Prior research......Page 25 Methods......Page 34 Psychiatric diagnoses......Page 35 Prevalence rates by sex......Page 36 Prevalence rates by race/ethnicity......Page 39 Prevalence rates by age......Page 41 Rates of substance use disorders among youth with major mental disorders......Page 52 Relative onset of major mental disorders and substance use disorders......Page 53 Discussion......Page 54 Limitations......Page 55 Future research......Page 56 Implications for juvenile justice......Page 57 Acknowledgments......Page 58 References......Page 59 3 Disproportionate minority confinement......Page 66 Literature review......Page 67 Residential placement......Page 68 Other decision-making points in the juvenile justice continuum......Page 69 National strategies to address and resolve DMC......Page 73 State strategies to reduce DMC......Page 75 References......Page 77 4 Police interrogation of youth......Page 79 Contemporary police interrogations......Page 80 Pre-interrogation interview......Page 81 Issuance of Miranda warning......Page 83 The interrogation......Page 84 Youthfulness......Page 85 Mental illness......Page 88 Conclusions and recommendations......Page 90 References......Page 92 Introduction......Page 97 Historical background: juvenile courts and due process......Page 98 Competence to stand trial......Page 100 The child’s ability to understand the interrogation process and to waive Miranda rights......Page 102 The legal test for competence to stand trial......Page 105 Competence vs. criminal capacity......Page 106 The procedure followed to determine whether a child is competent to stand trial......Page 107 The standards to be applied in deciding if a child is competent to stand trial......Page 111 Ability to cooperate with counsel......Page 112 The role of the defense lawyer......Page 113 The role of the prosecutor......Page 114 The role of the judge......Page 115 Intelligence......Page 116 Immaturity......Page 117 Conducting a fitness evaluation......Page 118 Competence of children to knowingly waive Miranda rights and to make voluntary and accurate statements during the interrogation process......Page 121 Medical and social science: research on children’s ability to understand and waive Miranda rights......Page 123 Protocol for conducting an examination regarding competence to waive Miranda rights......Page 124 Referrals to psychiatrists, psychologists, educational consultants, and social workers......Page 125 Making sure that the evaluation team has all relevant records......Page 127 Educational records......Page 128 The other side’s psychiatric and psychological evaluations......Page 129 Disclosure of data, notes, and reports......Page 130 Interaction between judges, lawyers, and expert witnesses......Page 131 Organization of expert witness report on fitness to stand trial......Page 132 Case example 1......Page 133 Case example 2......Page 134 Case example 3......Page 135 Conclusion......Page 137 References......Page 138 6 The etiology of antisocial behavior: biopsychosocial risk factors across development......Page 140 Risk factors influencing the developing brain......Page 141 Genetics......Page 142 Neurotransmitters and neurochemicals......Page 143 Autonomic nervous system......Page 144 Attachment......Page 145 Temperament......Page 146 Intelligence and academic performance......Page 147 Parenting......Page 148 Child abuse and family violence......Page 150 Peer relationships......Page 151 Larger social forces: role of communities and the media......Page 152 Implications for future policy and research......Page 153 References......Page 154 Prevalence of disorders......Page 164 Risk factors......Page 165 Early intervention education programs......Page 167 Media......Page 168 Mood disorders and conduct disorders......Page 169 Anxiety disorders......Page 170 Suicide......Page 171 Genetic factors and the neurobiology of addiction......Page 172 Age of exposure to substances of abuse......Page 174 Age of exposure to interventions for learning disorders......Page 175 Adolescent neurobiological changes that increase the risk for substance abuse......Page 176 Assessment......Page 177 Screening tools......Page 179 Levels of care......Page 180 Treatment......Page 181 Motivation enhancement therapy......Page 182 Family therapy......Page 183 Cognitive behavioral therapy......Page 184 12 steps......Page 185 Psychopharmacology......Page 186 Prenatal exposure to alcohol......Page 189 References......Page 190 Introduction......Page 198 Suicide in US jails and prisons......Page 199 Other risk factors for fatal suicide in the delinquent youth population......Page 200 Hayes’ survey on juvenile suicide in confinement......Page 201 Psychiatric disorders and fatal suicide in delinquency......Page 202 Physical, sexual, emotional abuse, and fatal suicide......Page 203 Non-fatal suicidal attempts and self-harm behavior......Page 204 Mental health services in juvenile facilities......Page 206 Does suicide rate vary by the type of juvenile institution?......Page 207 Special issues and future directions......Page 208 The effectiveness of suicide prevention programs in jails......Page 209 Conclusions......Page 211 References......Page 212 Demographic data......Page 216 Etiology......Page 217 Categorization of abusers......Page 218 Very young offenders......Page 219 Risk factors......Page 220 A literary example of developmental influences in a sex offender......Page 221 Legal issues......Page 222 Registration......Page 223 Types of sex offenders and case examples......Page 224 Rape......Page 225 Sexual homicide......Page 226 Pedophilia......Page 227 Voyeurism......Page 228 Fetishism......Page 229 Zoophilia......Page 230 Zoophilia case example one......Page 231 Necrophilia......Page 232 Interview and collateral information......Page 233 Psychological and actuarial testing......Page 234 Physiological assessment......Page 235 Biological treatments......Page 236 Psychosocial therapies......Page 237 A description of psychoeducational/therapeutic modalities......Page 238 Recidivism issues......Page 239 Conclusion......Page 240 References......Page 241 Introduction and overview......Page 247 Toward improving juvenile correctional Education programs......Page 255 References......Page 257 Introduction......Page 259 History of the juvenile death penalty and Eighth Amendment jurisprudence......Page 260 Evolving standards of decency......Page 262 Evolution of science......Page 263 The role of science in the evolution of standards of decency......Page 265 Science and legal culpability......Page 267 Roper v. Simmons......Page 268 Reality......Page 269 Conclusions......Page 270 References......Page 271 Medical/organic issues that may predispose to delinquency......Page 273 Health problems resulting from delinquent behavior......Page 275 General adolescent medical problems......Page 277 Malingering......Page 280 Research......Page 281 References......Page 282 Mental health screening in juvenile justice......Page 288 Reasons for identifying youths’ mental health problems in juvenile justice......Page 289 Distinguishing screening from assessment......Page 290 The nature of mental health screening......Page 291 Selecting screening tools......Page 293 Screening tools available for juvenile justice settings......Page 294 Massachusetts Youth Screening Instrument – Version 2 (MAYSI-2)......Page 295 Global Appraisal of Individual Need – Short Screener (GAIN-SS)......Page 296 Problem-Oriented Screening Instrument for Teenagers (POSIT)......Page 297 Child and Adolescent Functional Assessment Scale (CAFAS)......Page 298 Multidimensional scales identifying clinical disorder......Page 299 Practical Adolescent Dual Diagnosis Interview (PADDI)......Page 300 Global Appraisal of Individual Needs (GAIN-Q)......Page 301 References......Page 302 Introduction......Page 306 Relationship of conduct problems to ADHD......Page 308 Life-course persistent vs. adolescent onset conduct disorder......Page 310 General intelligence tests......Page 311 Tests of non-verbal intelligence......Page 314 Tests of language functioning......Page 315 Tests of executive functioning ability......Page 316 Tests of memory and learning......Page 317 Tests of academic achievement......Page 318 Personality questionnaires......Page 319 Behavioral questionnaires......Page 321 References......Page 322 Introduction......Page 326 Aggression and juvenile delinquency......Page 328 Subtyping of aggression: aiming at causal processes......Page 329 Evaluation and assessment for psychopharmacology......Page 330 Pharmacotherapy for conduct disorder......Page 332 Antidepressants......Page 343 Benzodiazepines......Page 344 Mood stabilizers......Page 345 Suicidality......Page 346 Integrated treatment planning......Page 347 Conclusion......Page 349 References......Page 350 16 Evidence–based treatment for justice–involved youth......Page 358 Key intervention strategies and targets for change......Page 360 Predictors and correlates of success......Page 361 Key intervention strategies and targets for change......Page 362 Predictors and correlates of success......Page 363 Key intervention strategies and targets for change......Page 364 Functional family therapy......Page 365 Evaluation......Page 366 Key intervention strategies and targets for change......Page 367 Family integrated therapy......Page 368 Dialectical behavior therapy......Page 369 Predictors and correlates of success......Page 370 Clinical supervision......Page 374 Conclusions......Page 375 Policy recommendations and future direction......Page 376 References......Page 383 Introduction......Page 386 Meta-analytic studies on the efficacy of delinquency interventions......Page 387 Individual interventions......Page 390 Family interventions......Page 392 Programs with minimal or negative effects......Page 394 Special issues and future directions......Page 395 References......Page 397 18 Innovative problem–solving court models for justice–involved youth......Page 403 Youth courts......Page 404 Restorative justice conferences......Page 407 Juvenile mental health courts......Page 408 Juvenile drug courts......Page 412 References......Page 416 Introduction......Page 419 Confidentiality......Page 420 Confidentiality in the child/adolescent forensic evaluation setting......Page 422 Consent......Page 427 Competency – mature minor......Page 429 Right to treatment......Page 431 Right to refuse treatment......Page 433 Guidelines and policies......Page 435 Indications and contraindications......Page 436 Implications for youths with histories of abuse, trauma and PTSD......Page 437 References......Page 438 Introduction......Page 441 Court referral and structure of the evaluation......Page 443 Factors that affect disposition......Page 444 Residential and community facilities......Page 445 The evaluation......Page 449 References......Page 452 Index......Page 455 "The majority of young people in the American juvenile justice system have diagnosable mental illnesses, including substance abuse, mental retardation and learning disorders. However, these often remain undetected and untreated. In this book, a team of experts examines the prevalence of mental disorders in this population and describes the means of screening for, diagnosing, and treating them effectively in a developmentally appropriate, culturally sensitive manner. They also examine psychopharmacologic and psychotherapeutic approaches; innovative alternatives to detention; the true costs of detaining youth; vulnerability to self-incrimination; and the alarming trend of minority confinement. Their comprehensive coverage includes discussion of ethical dilemmas and the need for preventive strategies and integrated approaches involving judicial, law enforcement, educational, and mental health professionals. This book will be of interest to both mental health and juvenile justice professionals."--Publisher's website The majority of young people in the American juvenile justice system have diagnosable mental illnesses, but these often remain undetected and untreated. In this book, a team of experts examines epidemiology, screening, diagnosis and treatment. They also cover innovative alternatives to detention; ethical dilemmas; preventive strategies; and integrated cross-disciplinary approaches.