Criminogenic Risk and Behavioral Health Need

Transcription

1 Criminogenic Risk and Behavioral Health Need J E F F K R E T S C H M A R, F R E D B U T C H E R, P A T R I C K K A N A R Y, & R I C K S H E P L E R B E G U N C E N T E R F O R V I O L E N C E P R E V E N T I O N R E S E A R C H A N D E D U C A T I O N C A S E W E S T E R N R E S E R V E U N I V E R S I T Y

2 Criminogenic Risk and Behavioral Health Need Criminogenic risk: risk to reoffend Antisocial behavior, Antisocial personality, Family factors, Antisocial activities, Substance abuse, Negative peers Behavioral Health need: understanding of the severity of mental health and/or substance use issues

3 Risk-Need-Responsivity Model Risk - Match the intensity of individuals treatment to their level of risk for reoffending Need - Target criminogenic needs those dynamic factors that contribute to the likelihood of reoffending Responsivity - Address individuals barriers to learning in the design of treatment interventions

4 Mental health as a responsivity factor While mental health status is not considered a CR factor, it is directly related to responsivity Serious mental health challenges can cause functional impairments that may significantly affect responsivity to interventions Treatment providers may need to first deal with an individual's debilitating anxiety or mental disorder in order to free the individual to attend and participate fully in a program targeting criminogenic needs. Substance Use disorders are both a risk factor and responsivity issue Direct relationship to risk and indirect relationship to responsivity to intervention

5 Criminogenic Risk and Behavioral Health Needs National Institute of Corrections, Bureau of Justice Assistance, and the Council of State Governments

6 A National Perspective: NCMHJJ and the Northwest Juvenile Project 65-70% of JJ involved youth have a MH disorder 60% of JJ involved youth have a SA disorder 75% have had traumatic victimization Substance abuse diagnosis most common: 50% for males and 46% for females Multiple disorders are common: 57% for females and 46% for males

7 Criminogenic Risk, Behavioral Health Need, and BHJJ We have criminogenic risk (OYAS) on a sample of BHJJ youth (n = 795) Created an index of Behavioral Health need Problem Severity, Functioning, trauma symptoms, # DSM diagnoses, co-occurring disorders Created Low, Moderate, and High BH need groups using effect coding and standard deviations

8 CR & BH Need data OYAS Low OYAS Moderate OYAS High 30% 47% 23% Low BH needs Moderate BH needs High BH need 20% 40% 40%

9 OYAS Risk and BH Need Low BH Moderate BH High BH Low OYAS 20% 38% 42% Moderate OYAS 17% 34% 49% High OYAS 14% 27% 59%

10 Risk and Need Levels of BHJJ Youth Low OYAS Low BH Low OYAS Mod BH Low OYAS Hi BH Mod OYAS Low BH Mod OYAS Mod BH Mod OYAS Hi BH Hi OYAS Lo BH Hi OYAS Mod BH Hi OYAS Hi BH

11 CR and Successful Termination OYAS Low OYAS Moderate OYAS High 84% 74% 53% BH Low BH Moderate OYAS Low 71% 94% 80% OYAS Moderate 84% 79% 70% OYAS High 45% 45% 61% BH High

12 CR/BH and Felony Charges after BHJJ Enrollment OYAS Low OYAS Moderate OYAS High 16% 26% 43% BH Low BH Moderate OYAS Low 6% 20% 15% OYAS Moderate 31% 33% 20% OYAS High 50% 46% 38% BH High

13 Practice Implications Criminogenic risk is not the same as behavioral health need Different treatment recommendations for youth based on both criminogenic risk and behavioral health need More work is needed to understand how criminogenic risk and behavioral health need interact o can lead to improved shared outcomes

14 Practice Considerations Level of care decisions can be influenced by the risk comfort level of the community and decision-makers. Risk aversive or risk sensitive communities need to be cognizant of the possibility of amplifying concerns and making a larger response than what is needed Stigma plays a role is community risk aversion/sensitivity Effective management of youth presenting with both behavioral health and criminogenic risk depends in part on community availability of necessary services and supports that address their complex needs and safety concerns

15 Shared Decision-Making Shared risk, shared burden, shared decision-making: No one child serving system can or should bare the sole responsibility of managing youth, family, and community risk Assessment instruments are necessary but not sufficient in determining the most appropriate type and level of services and supports for youth, family, and community safety Utilize clinically-facilitated, shared decision-making process, with a partnership between youth, family, and community stakeholders for determining a consensus plan for services, supports, and safety. Consider utilizing Wraparound format Utilize as cross-system plan for consideration by the court

16 Policy Implications How has the presence of a BHJJ project impacted the local system of care for youth and families-from a systemic and collaborative perspective? What benefits and challenges have been experienced? What does the BH need and Criminogenic Risk data say to us?

17 Discussion Questions What challenges do you face in assessing the needs of youth involved in the Juvenile Justice system? Are there tools or techniques that you have used that provide a good balance between the risk and need aspects? What are the opportunities to reframe risk in juveniles within a broader context? Does Hi Fidelity WA provide an opportunity for this?