By Tina Marroquin
As 27 families dropped their children off at hospitals after the implementation of Nebraska’s safe-haven law, it became apparent that Nebraska is not meeting the mental health care needs of its children. In the aftermath of the safe-haven legislation, health care professionals and children’s advocates identified the need for one-stop crisis centers, more respite care beds, and more funding for outpatient and residential treatment programs for children(1) as well as a single access point for mental health services.(2) The court system, also should consider its role in addressing mental health issues for juveniles.
As a juvenile court practitioner, it is apparent that our Nebraska juvenile justice system is impacted by the lack of front-end recourses for families. Families that are unable to access necessary mental health care for their children often find themselves appearing in juvenile court. Too often a child’s behavior escalates to the point where they are uncontrollable by the parent. In other instances, the child’s mental health condition may contribute to a violation of the law. These situations can result in a juvenile court filing by the State of Nebraska. The juvenile then comes into the jurisdiction of the Nebraska juvenile court system. Increasingly, states are implementing a new approach in addressing the mental health needs of children. In several jurisdictions, juvenile courts are conducting “Mental Health Court.”
At a conference hosted by the National Association of Counsel for Children (August 2009) researcher Monic Behnken presented an overview of the Mental Health Court model and an outcome-based evaluation of its effectiveness. According to Behnken this specialty court model has a specific offender population, places an emphasis on psychiatric treatment, and conforms to Therapeutic Jurisprudence principles.
The practice of a Mental Health Court started in Santa Clara County, California, in 2001. This project was led by the Honorable Leonard Edwards. The premise of the court is simple: this court is for minors who have mental health disorders and break the law. According to the Santa Clara County website “The juvenile justice system is not the right answer for most cases when the minor has a serious mental disorder. Some minors go back to Juvenile Justice Court over and over because of their mental problem.” (3) A survey conducted at the Santa Clara County Juvenile Justice Court, found that in one day 215 out of 303 miners were already getting some kind of mental health services and half of them needed medicine for their condition. A recent study of Douglas County’s Juvenile Detention Center suggests that mental health issues are also a concern to Nebraska youth: 25% of the youth detained were identified as having a psychological impairment. (4)
Eligibility for Mental Health Court varies by jurisdiction. In Santa Clara County, the minor is evaluated for a mental health disorder. Disorders include, but are not limited to, major depression, bipolar, schizophrenia, severe anxiety, developmental disability and autism. The minor must be charged with a property or drug crime, which cannot include selling drugs. Once these criteria are met, participation in the Court is voluntary. The juvenile has to admit the charges in order to be accepted into the Court.
The structure of the Court is significantly different from the traditional hierarchical juvenile court. The Court adheres to the CITA (Court for the Individualized Treatment of Adolescents)structure which incorporates a team of individuals focused on the treatment needs of the juvenile. The team consists of the judge, probation officer, mental health practitioner, district attorney, defense counsel, family, school and an advocate. This team conducts Mental Health Court regularly with the juvenile in attendance. The team reviews services, medication, and support to ensure treatment needs are being met. This structure promotes a child-centered, multidisciplinary, and family focused approach to treatment.
Intervention services are comprehensive and fall into four categories. Psychoeducation interventions include programming such as domestic violence/teen batterers programming, anger management, parenting, job training, independent living skills, problem solving, victim awareness and substance abuse. There are also medical interventions which include neurological, psychiatric, medication and medical/dental evaluations. The school is the third area of intervention which creates individualized education programs and oversees regular school attendance. Finally, the Court may introduce sanctions such as drug testing, restraining order, restitution, community service, electronic monitoring and home detention.
The success of this specialized court is demonstrated by Behnken and her team’s research examining recidivism rates. Two of the most common offenses among Santa Clara County’s juvenile offenders were assault/battery and theft. While many other offenses were included in the research, you can observe the impact on recidivism by comparing pre and post admission offenses of these crimes:
Assault/Battery: Pre-admission=34 (53.13%), Post-admission=7(10.94%)
Theft: Pre-admission=18 (28.13%), Post-admission= 5 (7.81%)
The conclusion of Behnken’s research was that the Mental Health Court reduced recidivism in the areas of assault & battery, violent threats, possession of a dangerous weapon, theft and vandalism. She further concluded that Mental Health Court reduced recidivism in other offenses as well.
While the Mental Health Court does not solve the problem of access to services prior to entering the juvenile justice system, it does offer a model to address mental health needs and lower the frequency of re-entry into the juvenile system. Several other jurisdictions have implemented juvenile Mental Health Courts with variations from the Santa Clara County model (Texas, Washington).
Nebraska law provides a specific section for the filing of a juvenile petition in instances where there are mental health needs (see Neb. Rev. Stat. §43-247(3c).) These filings tend to be rare in comparison to the law violations and uncontrollable filings that are generally the source of adjudications in Nebraska. Considering the likelihood that mental health issues underlie these incidences, a specialized court to meet children’s mental health needs may be of great value to our current juvenile justice system and the Santa Clara County Mental Health Court may serve as a model for Nebraska as they work to improve outcomes for youth in our juvenile justice system.
(1) Hansen, Matthew. “1-stop help urged for families in crisis” Omaha World Herald. Sunday, November 23, 2008.
(2) “Idea might help mental health system” Lincoln Journal Star. Saturday, December 27, 2008.
(3) www.scselfservice.og/juvdel/specialized.htm
(4) Kalmanoff, Alan. Douglas County Secure Juvenile Detention: A Study of Crowding. Final Report May 26, 2008.
Tina Marroquin is a Guardian ad Litem practicing in Lancaster, Seward, Butler and York Counties. She may be reached at 402-476-7474 or tina_marroquin@yahoo.com.
