jmh court presentation
TRANSCRIPT
Mental Health Policy Luncheon
A special thank you to our sponsors:
WELCOME!
Robert Sanborn, Ed.D.President & CEO
&Tanya Makany-Rivera
Assistant Director of Public Policy
3
Overview
Mental illness affects At least 1 in 5 children in the U.S. 50% of juvenile justice population
Texas ranks 49th in the U.S. for mental health expenditures
4
Texas Juvenile Mental Health Courts
CHILDREN AT RISK independent evaluation, “Texas Juvenile Mental Health Courts: An Evaluation and Blueprint for the Future.”
Specialized court
Voluntary
Uses a team approach
Focuses on treatment
Wraparound services
What is a Juvenile Mental Health Court?
6
Typical Juvenile Mental Health Court Process
Goals of the Juvenile Mental Health Court
Decrease recidivism
Improve family education and involvement
Reduce repeat contacts
Effective use of resources (saving taxpayers money)
Mental Health Courts in Texas
Travis County COPE Program Austin, TX
Special Needs Diversionary Program El Paso, TX
Harris County Juvenile Mental Health Court Harris County, TX
Bexar County Crossroads Court Program San Antonio, TX
Evaluation Methodology
Direct Observation
Key Informant Interviews
Participant Outcomes Recidivism Cost Analysis
Challenges
Travis County COPE Program
First Juvenile Mental Health Court in Texas
Eligibility: Ages between 10 and 17
Pending charge other than truancy or running away
No sexual offense
No previous adjudication
Axis 1 diagnosis (ex. Bipolar 1, Dementia, Schizophrenia)
Parent/guardian agrees to participate with child
Travis County COPE Program
Services available to both participant and family Therapy
Parent coach and liaison
Respite care
Rapid re-housing
Mentoring
Access to drug education
Substance abuse education
Wrap-around services
12
Travis County COPE Program
Characteristics
13
Travis County COPE Program
Characteristics
Travis County COPE Program:
Characteristics
15
Travis County COPE Program
Characteristics $180.59 cost per day, per participant
Average length of stay is 158 days
33% recidivism rate
El Paso (SNDP)
Eligibility At risk of removal from home
Post-adjudicated boy or girl between the ages of 10 and 17
DSM-IV Axis diagnosis other than substance abuse, autism, mental retardation, pervasive developmental disorder
Global Assessment of Functioning (GAF) score below 50
17
El Paso (SNDP)
Services Counseling (Individual and Family)
Case Management • Anger management • Home organization • Educate parents on school system, advocacy
24-hour crisis hotline
Referral to community based services• School Supplies • Food vouchers
18
El Paso (SNDP)
Characteristics
19
El Paso (SNDP)
Characteristics
20
El Paso (SNDP)
Characteristics
21
El Paso (SNDP)
Characteristics
22
El Paso (SNDP)
Characteristics Average length of stay is 193 days
23
Harris County Juvenile Mental Health Court
Eligibility Mental health diagnosis
Pre-adjudicated boy or girl between the ages of 10 and17
Family participation
24
Harris County Juvenile Mental Health Court
Services Education to parent on mental illness
Counseling
Anger management
Referral and assistance in obtaining services
25
Harris County Juvenile Mental Health Court
Characteristics
26
Harris County Juvenile Mental Health Court
Characteristics Most common diagnosis - Affective Disorders
(67%)
$150 per day, per participant
Average length of stay is 243 days
33% recidivism rate
27
Bexar County Crossroads Court Program
Eligibility Pre and post-arrest, girls aged 12 to 15
Mental health diagnosis
History of substance abuse
Experienced past trauma and/or abuse
Supportive adult participation
Legally competent
28
Bexar County Crossroads Court Program
Services Anger management counseling
Family violence intervention/prevention
Adolescent counseling
Family counseling
School success services (includes mentoring)
Substance abuse treatment
29
Bexar County Crossroads Court Program
Characteristics
78% Latino
30
Bexar County Crossroads Court Program
Characteristics At the time of publication, diagnosis data was
unavailable
$105 per day, per child
Average length of stay is 212 days
10% recidivism rate
Observed Social Outcomes
Surveys in Harris County
School Performance
Attendance
Medication compliance
So what about social outcomes?
Recommendations from CHILDREN AT RISK
Conduct a follow up evaluation
Create a statewide committee for Juvenile Mental Health Courts
Sustain current funding for mental health services
Expand juvenile mental health courts across Texas
CHIP and Medicaid reimbursement
For more information…
Bob Sanborn, Ed.D.President and CEO
Tanya Makany-RiveraAssistant Director of
Public [email protected]
www.childrenatrisk.orgPhone: 713.869.7740
Harris County Mental Health Court
Olivia D. McGill, PhD
Mental Health Court Clinician
The Creation
• Community support and involvement was essential.
• MHA and the JEHT foundation assisted in getting the funding necessary to create a clinical tool to assess for mental health problems.
• Collaborative effort by the probation department, MHA, Children at Risk, and JEHT Foundation to secure funding for the mental health court.
The Development
• Visited existing juvenile mental health courts.
• Decided on our mission and goals.
• Our approach can be described as holistic, individualized, and collaborative.
• Monthly review hearings are conducted with the entire team present.
The Progress
• Since our inception in February 2009 we have had 67 youth enter into the mental health court.
• 42 youth have successfully graduated and 16 youth are currently in the program.
• Recidivism: 86% of the graduated youth had not been adjudicated for a new offense at the 6 month mark
The Youth
• Most common diagnosis is Affective Disorders (depression, anxiety & bipolar)
• Most common offense is assault.
• Several youth have had prior psychiatric hospitalizations.
• A significant number of the participants have trouble with school.
The Challenges & Lessons
• Defining success
• Path to success is often very bumpy
• Connecting families with needed resources can be difficult
• Collaborating with different agencies and different parts of the legal system can be tough, but always worth it.
The Best Practices
• Individual based treatment
• Important to meet the client where they are
• Remain flexible
• Networking and exploring available resources in the community is essential
Juvenile Mental Health Panel Discussion: Legislative Analysis, Future Outlook and
Recommendations
Dr. Curtis Mooney, President and CEO, DePelchin
Deborah Colby, LCSW, LMFT, TRIAD
Lillian Aguirre Ortiz, MSW, MHA Houston
Dr. Andrew Harper, University of Texas, Harris County Psychiatric Center