Recent advances in mental health research contributed to the founding of the Center for the Promotion of Mental Health in Juvenile Justice. Research documents rates of mental disorder as high as 65% in some juvenile justice settings compared to the 21% in the general youth population (11% are significantly impaired. Youths in the juvenile justice system have a great need for mental health resources. Compounding this need, assessment and treatment resources in juvenile justice programs are often inadequate to meet their needs.

At the same time, mental health treatment research has resulted in rapid, systematic, and reliable tools for mental health assessments, as well as in effective treatments for mental health disorders. High quality assessment tools are now available for application in settings, like juvenile justice, which were traditionally underserved. In this context the Center was created to help transfer advances from mental health research into juvenile justice practice.

The history of the Center is also linked to the evolution of the Diagnostic Interview Schedule for Children (DISC) into a psychiatric assessment tool used to screen youths in the juvenile justice system. The DISC was originally developed by the National Institute for Mental Health and Columbia University to allow a diagnostic assessment of children and adolescents by lay interviewers. A breakthrough occurred in 1999 with the release of the Voice DISC, software that plays recorded questions over headphones to youth who then respond using the keyboard. This point is of particular importance to juvenile justice settings, where youth populations may have lower literacy rates.

Recognizing the potential for the Voice DISC to help improve mental health practice in the juvenile justice system, in 1998, Dr. Gail Wasserman of Columbia University’s Department of Child Psychiatry obtained the first of a series of grants from the Office of Juvenile Justice and Delinquency Prevention (OJJDP) to study how well the Voice DISC worked in juvenile justice settings. Reported in The Journal of the American Academy of Child and Adolescent Psychiatry (March 2002), this work shows high rates of mental disorder in incarcerated youths, results which are comparable to those from prior studies using interviewer-based procedures.

In 2001 the Center for the Promotion of Mental Health in Juvenile Justice was created at Columbia University with Dr. Wasserman as its Director. The Center’s Steering Committee includes experienced and nationally prominent juvenile justice administrators, mental health researchers, and advocates. Private funding was provided by a benefactor with a passion to see that leading-edge information in child psychiatry is brought into practice for the benefit of children’s mental health.

The Center expanded from its initial feasibility sites in Illinois, New Jersey, and South Carolina into sites in Alabama, Texas, Washington State, and Wyoming. Since 1998, we have expanded our efforts to 130 sites in twenty-two states. As of the end of 2005, we have assisted in the assessment of over 15,000 youths across a variety of juvenile justice settings.

In April 2002, the Center conducted a national survey of current mental health assessment practices. Juvenile justice staff nationwide reported on mental health assessment practices in their work settings and then expressed their opinions on best practices. A paper reporting these findings (Mental health assessment practices in juvenile justice settings) was published in 2004.

Building upon the mental health assessment practices survey, in April 2002, the Center convened a national group of expert researchers and practitioners with the intent of developing recommendations to influence policy changes aimed at improving mental health care in justice settings. Following the expert consensus method, the Conference members derived six specific recommendations for best practices in conducting mental health assessments in juvenile justice settings. The Consensus Conference recommendations addressed screening for emergent risk, screening and assessment of mental health service needs, comprehensive mental health assessment components, assessment before community re-entry, need for regular re-assessment, and staff training. A paper based on the recommendations was published in the July 2003 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

In the past several years, the Center has focused its efforts on helping collaborating sites understand the prevalence of mental health disorders in their populations, and also on how to use that information as an aid in planning and programming. Among many areas of current interest, one area we are studying deals with how using different instruments impacts case identification, referral, and disposition. For example, we published a paper, Screening for emergent risk and service needs among incarcerated youth: Comparing MAYSI-2 and Voice DISC-IV), which compares the Voice DISC to a widely used screening instrument, the MAYSI-2.

Similarly, systematic examination of prevalence reports as they relate to other available information has led to recommendations regarding the integration of parent information into assessment procedures (Contribution of parent report to Voice DISC-IV diagnosis among incarcerated youth) and gender-specific mental health programming (Gender differences in psychiatric disorder for youths in juvenile probations). Such research helps juvenile justice administrators make informed decisions about which procedures are best for what purposes.

Current collaborative arrangements aid in validating a new measure, the VISA (Voiced Inventory of Self-Injurious Actions), a tool developed by the Center which inquires about self-injurious behavior in juvenile justice populations. Such an instrument is an essential component of an evaluation for a juvenile justice population because it may allow quick and reliable assessment of self-injurious behavior for the purposes of risk management and service planning. Similarly, we’re also currently validating a second measure, the SUSI-Y, an instrument that assesses different treatment plans presented to youths.

Currently, we are partnering with the New York State Office of Mental Health and the New York State Division of Probation and Correctional Alternatives (DPCA) to implement a systematic mental health and suicide screening program called Project Connect. Project Connect was designed by CPMHJJ with a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to prevent suicide. While adolescents in general are at increased risk for suicide, those in contact with the juvenile justice system are among the most at risk, and are identified as one of the two most vulnerable teen populations in the recent NY State Suicide Prevention Plan. Project Connect aims to assist probation officers in identifying youth in need of mental health services. Probation officers in cooperating sites receive training on the Project Connect curriculum which covers: mental health disorders most common in juvenile justice youth, mental health service provider information, and how probation officers can work with mental health service providers to incorporate treatment into a youth’s probation plan.

We are actively interested in collaborating with juvenile justice programs at all points in the system, and in all states. For specific information about how to become a site, please contact us.