To prevent and reduce juvenile delinquency, it is necessary to address not only the offenses that bring youth to the attention of the juvenile justice system but also the underlying problems these youth face, including mental health problems. Such problems affect many of the approximately 1.8 million youth who enter the juvenile justice system each year, yet very little is known about the mental health needs of these youth. OJJDP recognizes the critical importance of mental health problems in the lives of youth involved in the juvenile justice system and has been working for several years on a number of projects to increase knowledge and improve services in this area.

During FY 2000, the Office supported research projects examining alcohol, drug, and mental disorders among juvenile offenders and the relationship of attention deficit and hyperactivity disorder in children to delinquency. The Office is expanding a longitudinal study to investigate the development of antisocial behavior across three generations. OJJDP also developed and solicited competitive applications for two new programs: one will lead to the development of a comprehensive model program to address the mental health needs of youth at every point in the juvenile justice system, and the other (discussed in Tribal Youth Mental Health Initiative) will help American Indian and Alaska Native communities address the mental health needs of native youth. This chapter highlights these and other OJJDP activities undertaken to promote better understanding of the mental health problems and needs of juveniles and to help communities meet those needs.

Assessing Alcohol, Drug, and Mental Disorders Among Juvenile Detainees

Researchers at Northwestern University Medical School in Chicago, IL, have been studying alcohol, drug, and mental disorders among juvenile detainees in the Cook County Detention Center in Chicago since November 1995. The investigators have conducted psychiatric interviews with male and female youth in detention and have collected extensive archival data. With funding from OJJDP, other Federal agencies, and private foundations, a longitudinal component was added to this study in November 1998.

This project is unique because the sample is so large: it includes 1,830 Chicago youth who were arrested and interviewed between 1995 and 1998. The sample is stratified by gender, race-ethnicity (African American, Hispanic, non-Hispanic white), and age. Initial interviews have been completed, and extensive data have been collected on each youth, including information on arrest and incarceration history, health and mental health treatment, and other records. The investigators have tracked the youth and are now conducting the first set of followup interviews. Several deaths, virtually all of them linked to violence (e.g., gunshot wounds), have already occurred. Because of their extensive and thorough tracking procedures, the investigators will be able to reinterview members of the original sample, regardless of whether they have returned to the community, remain incarcerated, or have left the immediate area. The large sample size also will provide sufficient statistical power to study rarer disorders (including co-occurring conditions), patterns of drug use, and risky, life-threatening behaviors.

The longitudinal study is allowing researchers to assess the developmental course of substance abuse and mental disorders among juvenile detainees; examine service availability, service use, and barriers to service access among juvenile detainees; and identify patterns of risky behavior in the areas of violence, substance use, and HIV/AIDS. An OJJDP Fact Sheet, Assessing Alcohol, Drug, and Mental Disorders in Juvenile Detainees, describes this research project and is available from the Juvenile Justice Clearinghouse.

Intergenerational Transmission of Antisocial Behavior

Researchers at the University at Albany, State University of New York, are examining the development of childhood antisocial behavior in a three-generation prospective panel study. The focus of this study is on the children of current participants in OJJDP�s Rochester (NY) Youth Development Study, a longitudinal study of 1,000 Rochester youth (who were in the seventh grade when the study began in 1987�88) and their parents. By the time they reached age 21, 40 percent of the original Rochester youth participants were parents. The intergenerational study will combine data obtained from the original study of the Rochester participants and their parents with new data on the children of the original participants. This approach provides a unique opportunity to examine and track the development of delinquent behavior in a particularly high-risk sample across three generations. Such an opportunity is rare in social science research. The results of the study should provide very useful findings with policy implications for prevention programs. OJJDP is funding the program under an interagency agreement with the National Institute of Mental Health.

Mental Health Issue of OJJDP�s Journal

Recognizing the need to address the mental health problems that face so many youth in the juvenile justice system, OJJDP devoted an issue of its journal, Juvenile Justice, to this subject in FY 2000. Journal articles discuss youth with mental health disorders and emerging responses to them; Wraparound Milwaukee, a program that has successfully integrated a broad array of services to better meet the mental health needs of youth who have been adjudicated delinquent; and suicide prevention in juvenile facilities. Copies of Juvenile Justice (Volume VII, Number 1) are available from the Juvenile Justice Clearinghouse.

Multisite, Multimodal Treatment Study of Children With Attention Deficit/Hyperactivity Disorder

In 1992, the National Institute of Mental Health began a study of the long-term efficacy of stimulant medication and intensive behavioral and educational treatment for children with attention deficit/hyperactivity disorder (ADHD). Although ADHD is classified as a childhood disorder, up to 70 percent of affected children continue to experience symptoms in adolescence and adulthood. The treatment phase of the project has been completed, and researchers are now following the children who received treatment to determine the long-term impacts of the different treatment strategies. OJJDP�s participation, which began in FY 1998, is helping fund continued investigations into the children�s delinquent behavior and contact with the legal system, including arrests and court referrals. During FY 2000, OJJDP staff helped researchers significantly revise one of their data collection instruments to capture information that would be of interest to juvenile justice researchers and practitioners. Some of the children involved in the study, who currently range in age from 9 to 13, have already begun coming into contact with the juvenile justice system for behaviors such as truancy, fighting, and stealing.

Pathways to Desistance: A Prospective Study of Serious Adolescent Offenders

OJJDP awarded a research grant in FY 2000 to the University of Pittsburgh to follow 1,200 serious adolescent offenders from Phoenix, AZ, and Philadelphia, PA, for 3 years following their involvement with the juvenile justice system. At system intake, disposition, and release points, researchers will recruit youth with substantial offending histories and serious offenses. Researchers will then interview each youth twice annually for a minimum of 3 years. Once each year, researchers also will interview an individual who knows the youth. Official records (e.g., arrest records, institutional records, treatment summaries) also will be reviewed. The study also will document background characteristics (e.g., service and sanction histories), mediating factors (e.g., vocational opportunities), changes in functioning (e.g., antisocial/prosocial behavior), and involvement with interventions and sanctions during the followup period. Data analysis will focus on identifying subgroups of offenders and evaluating the impact of life events, treatment interventions, and sanctions on patterns of antisocial and prosocial behavior, mental health, psychological development, and social functioning. Researchers pilot tested their data collection procedures in FY 2000 and will begin the study in 2001.

On the Horizon

To help improve knowledge about and responses to mental health issues among juvenile offenders, OJJDP developed and solicited applications for the following two new programs in FY 2000:

• Mental Health and Juvenile Justice: Building a Model for Effective Service Delivery. This program is a multiyear research initiative designed to substantially improve knowledge about the nature and prevalence of mental health problems and co-occurring substance abuse disorders among youth in the juvenile justice system. Researchers will review what is known about theory and best practices, examine prevalence in a sample of youth, document available services, and incorporate existing theory and best practices in a model to provide comprehensive mental health services to youth in the juvenile justice system. The model will subsequently be replicated and evaluated at several sites. OJJDP will make an award in FY 2001.

• Tribal Youth Program Mental Health Initiative. This initiative is providing funds to six American Indian and Alaska Native tribal communities to improve mental health services for tribal at-risk youth and juvenile offenders. The initiative is described in greater detail in chapter 9.