Assessments Often Miss Mental Health Issues for Youth on Probation

An assessment tool used by many jurisdictions within the juvenile justice system that is intended to help recognize the effects of adversity and trauma in children’s lives is not the best means of evaluating mental health problems faced by at-risk youth, according to new study by a University at Buffalo social work researcher.

The groundbreaking research, which lead author Patricia Logan-Greene believes is among the first studies to connect the adverse childhood experience (ACE) assessment for juveniles on probation to mental health problems, could help improve the justice system’s responses to court-involved youth, especially those who have experienced maltreatment and trauma.

“The United States continues to have a massive juvenile justice system that does not, generally speaking, serve youth well,” says Logan-Greene, an assistant professor in UB’s School of Social Work. “We suspect that the way mental health is often assessed in the juvenile justice system is missing many mental health problems – in particular with disadvantaged youth.”

The number of youth on probation is a far larger group than those who are incarcerated or in treatment facilities. Yet most of the research literature is on that smaller population.

“We may have identified a gap,” says Logan-Greene. “The court assessment asks whether youth have ever been diagnosed with a mental illness.  That question makes a lot of big assumptions like equal access to health care and equal desire to access mental health care, which has a lot to do with stigma.

“A better assessment tool would address symptomology,” she says.

The problems faced by youth on probation are widespread, according to Logan-Greene. The vast majority have histories of child abuse, family dysfunction and social disadvantage.

“Only 25 percent have no history of abuse,” she says. “One of my elevator speeches argues against punitive responses for youth with histories of trauma.”

Although most jurisdictions do assess mental health, these are not necessarily good assessments – and some jurisdictions aren’t assessing for this at all. A single question to capture all aspects of mental health simply isn’t sufficient.

“While the adverse childhood experience tool has done wonderful things to help us recognize the importance of adversity and trauma in children’s lives, there is still room for improvement,” she says. “For instance, there is nothing in the ACE tool about childhood poverty, and we know from previous research that childhood poverty is deeply damaging.”

In the current study, Logan-Greene and her co-authors Robert L. Tennyson and Paula S. Nurius, both from the University of Washington, and Sharon Borja, University of Houston, divided their assessment of childhood adversity into childhood maltreatment, family dysfunction including substance abuse, family history of mental illness, physical health problems with the family, and social disadvantage, using a diverse sample of more than 5,300 youth on probation.

The findings suggest a clear connection between childhood maltreatment and mental health problems.  Although there did not appear to be a relationship between social disadvantage and mental health problems, there was a connection between mental health and the symptoms of social disadvantage such as coping problems, social isolation and what the authors call aspirations or the measure of hope for the future.

“Because social disadvantage did have a negative effect on those indicators we suspect the court assessments are not picking up what are probably undiagnosed and untreated mental health problems among disadvantaged youth,” Logan-Greene says.

Include Youth’s Commitment to Northern Ireland Care Leavers

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Located in Northern Ireland, Include Youth supports vulnerable and disadvantage youth by helping them to improve their educational and employment training outcomes, and their main objectives are to increase employment opportunities for disadvantage youth in addition to boosting their self-esteem and life skills.

According to a commissioned review by Include Youth, criminal justice reform and policing were acknowledged as two major areas of concern impacting disadvantage youth with early intervention/family support and diversion programs listed as interventions to reduce risks and increase protective factors for this vulnerable group.

Sharon Whittaker from Include Youth courteously agreed to facilitate a Q&A with us to highlight the amazing work of Include Youth.

SWH: Could you tell us about the mission and vision for Include Youth?

SW: Include Youth is an independent rights-based charity which promotes the rights of and best practice with disadvantaged and vulnerable children and young people in Northern Ireland.  In particular Include Youth supports those involved with the criminal justice system and those who need education, employment and training.

Inspired by the experiences of young people Include Youth works to ensure that their rights are being realised. Young people’s views guide us in our advocacy work to achieve social justice, change and promote a greater understanding of their lives in government and across statutory organisations and the community and voluntary sectors.

We provide direct services to support young people to develop their employability and life skills, which are based on working at the young person’s pace and understanding their needs.

SWH: What are the main barriers affecting young people in Northern Ireland?

SW: Overall youth unemployment remains consistently high at 17.5 per cent in Northern Ireland, this is three times that of the adult population.  There are high levels of suicide and self-harm among young people generally, as well as other recognised mental health issues, including severe depression and anxiety.  Almost half of children in care or placed in custody at the Juvenile Justice Centre have serious mental health concerns.

We work specifically with 16-24 year olds from socially disadvantaged areas, have had poor educational experiences, have committed or are at risk of committing crime, misuse drugs and/or alcohol, engage in unsafe or harmful sexual behaviour or at risk of being harmed themselves.   All of the young people we work with are not in education, employment or training and many will have experience of the care system.

Education and employment is a huge barrier for young people in care.  Almost 3,000 children are in the care of the state here and only a quarter will go on to achieve five GCSE’s (grade A*-C) compared with more than 80 per cent of the general school population.  More than 350 young people aged 16 to 21 in care here are not in education, employment or training at any one time.  The unemployment rate for care leavers is double that of young people who grew up in the community.

SWH: What types of challenges have you run into?

SW: How children and young people are perceived in their community is a real challenge for Include Youth. A simple thing like how a young person might be portrayed in the media can impact on social policy is made and on how services to children and young people are delivered.

The young people we work are often most in need or at risk, yet do not have their voices heard and acted upon by organisational representatives and decision-makers.  This means the most vulnerable young people in society are more likely to suffer the consequences of inadequate policies and poor services.

Piecemeal and short-term funding is a challenge for our organisation, as to address the long-term needs of children in care a more sustained and cohesive approach is needed.  There is funding available for short-term projects, which will only ever help long-term goals to an extent.

SWH: Do you think enough is being done to help children in care?

SW: Too many young people from a care background are being detained in the Juvenile Justice Centre under PACE because suitable accommodation cannot be found.  Custody should only be used as a last resort, so not enough is being done to redress the overrepresentation of looked after children within the justice system.

In figures supplied to us by the Youth Justice Agency looked after children represented 40% of individual young people admitted under PACE, between October 2014-September 2015.  Up to 50% of these young people did not receive a custodial sentence, evidence that custody is not being used as a last resort.

We also continually look to Scotland to see what is happening there, as they tend to have more positive policies and practices around their responsibility to children and young people in care.  However some progress has been made to increase labour market opportunities for young people in care.  Business in the Community and Include Youth run targeted initiatives and the Employability Services run by all five health and social care trusts.  Each health and social care trust has employability and guidance schemes in place to help prepare young people for employment and have developed a range of service models, for example, ring-fenced posts and social clause provision in partnership with a number of companies.

SWH: What other vulnerable groups of young people does Include Youth support?

SW: We work in partnership with community-based organisations to deliver cross-community or employability programmes to young people aged 16-24.  Most of these young people won’t have experience of care, therefore their needs vary from young parents, to carers, substance abuse issues to early school leavers.

We also lobby on behalf of children and young people in our formal youth justice system.  Currently 10 year olds living in Northern Ireland can be arrested, prosecuted, get a criminal record and even be locked up however we’re seeking legislative change so that 10 and 11 year olds who commit crime are dealt with in a much more effective way.

SWH: Is there any way people can support Include Youth?

SW: There are a number of different ways people can support our work.  If you’re an employer, public, private or charity sector you may be able to provide a workplace tour or experience for the young people on our programmes or you may wish to join our Board of Directors.  We’re also always on the lookout for volunteer mentors who can support a young person in their area on a one to one basis.  Finally, you can get involved in our Raise the Age campaign and help us raise the age of criminal responsibility in Northern Ireland.

SWH: What is next for Include Youth?

SW: To continually improve our services for the young people we work with.

You can keep up-to-date with Include Youth on Facebook, Twitter and their website on the latest services they offer young people in Northern Ireland.

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