Friday, 14 January 2005 - 12:00 PM
This presentation is part of: Poster Session I
Violent Juvenile Offenders with Co-existing Mental DisordersMark I. Singer, Mandel School, Case Western Reserve University and Daniel Flannery, Kent State University.
Violent Juvenile Offenders with Co-Existing Mental Health Disorders
Purpose: To evaluate the psychosocial status of violent juvenile offenders who were believed to have mental health disorders and were referred to a diversion program funded by the Ohio Department of Mental Health (ODMH). There are few studies on this population of youth; yet, studies of other populations have consistently demonstrated that the identification and treatment of mental disorders in children/adolescents can prevent or mitigate a range of problems in adulthood. It would be especially important to identify the types of mental disorders and related psychosocial problems in a population of violent juvenile offenders. Thus, a major goal of this initiative was to improve the mental health and juvenile justice systems’ knowledge of the profiles of these high-risk youth, thereby assisting the development of appropriate services.
Methods: ODHM funded three sites in Ohio to provide assessment and treatment services to juvenile offenders referred by the local juvenile courts. In 2002, 68 youths were referred to these program sites. Data were collected from the short form of the Ohio Youth Scales (scales used by ODMH to assess mental health and psychosocial functioning), the Dispositional Investigation Report (information from the Ohio juvenile justice system) and additional demographic/psychosocial data. Each youth was also evaluated using DSM IV criteria by a licensed clinician.
Results: Of the 68 subjects, 26 were African-American, 24 Caucasian, and 6 Hispanic; 60 were male. Mean age was 15.5 years. Youths demonstrated extensive offending histories with 438 current or past cases brought against them with a total of 673 charges (6.42 mean cases; 9.81 mean charges). All subjects received at least one DSM IV Axis I diagnosis, with fifty-five youth (81%) receiving two or more Axis I diagnoses (twenty-eight subjects had three or more diagnoses). The most frequent Principal Axis I diagnostic classifications were mood disorders (36) and behavior disorders (15). The mean Globalized Assessment of Functioning rating was 45, which reflects “serious symptoms and/or serious impairment in social, occupational, or school functioning” (American Psychiatric Association, 1994, p. 32). Medication use was quite high among subjects: forty-two youths (62%) were taking 1-3 psychotropic medications and an additional ten (15%) were taking more than three such medications. The most frequently used psychotropic medications were: Depakote (18) – used primarily for aggression, hyperactivity, agitation and mood symptom management; Resperidol (17) – a mood stabilizer and atypical anti-psychotic; and, Zyprexia – a relatively new antipsychotic used to control psychotic and mood symptoms. Of the 51 youths for whom we had IQ data, sixty-nine percent had IQs in the Low Average (21, 41%), Borderline (9, 18%) or Intellectually Deficient (5, 10%) ranges of intellectual functioning.
Implications for practice: Findings suggest that this population of youths have significant impairments that require substantial interventions. Subjects in this study were compromised across several domains including illegal/violent behaviors, significant and often multiple psychiatric disorders and intellectual deficits. Programs and policies should focus on the provision of adequate assessment and treatment of this vulnerable population rather than on non-therapeutic incarceration.
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