School Disciplinepolicy Brief

School DisciplinePolicy brief

The Prevelance of Behavioral health disorders in the juvenile justice SYSTEM, A NATIONAL PROBLEM & A Coordinated Community Solution

MAIA MCCOY, MSW CANDIDATE 2016

Since the Department of Justice published a study in 2006, documenting the over-incarceration of mentally ill persons in local jails and state prisons, it has become common knowledge that our criminal justice system is a major mental healthcare provider in the United States.[i] However, the criminalization of mental illness in the juvenile justice system has received relatively little attention. While the juvenile courts were erected to rehabilitate youth, linking children to behavioral health services through the courts comes with manifold, long-term, collateral consequences, including: disruption of education, poor graduation rates and employment difficulties, potential banishment from public housing, and consequences for adult sentencing, among many other repercussions, placing a profound burden on the individual youth, our society, and economy.[ii]Treatment of behavioral health disorders through the juvenile justice system is not ethical, efficient, or cost-effective.

This policy brief seeks to 1) Bring awareness to the grossly disproportionate rates of behavioral health disorders in the juvenile justice system; 2) To focus on school-district-level disciplinary policy, specifically an experimental, multi-pronged approach in the state of Connecticut, combatting disproportionality; 3) To offer recommendations to school districts for adopting amended disciplinary policies that reduce court-involvement and increase behavioral health treatment; and 4) To call for a coordinated community response for the handling of school discipline, in order to improve outcomes for youth and communities.

THE PROBLEM: DISPROPORTIONATE RATES OF BEHAVIORAL HEALTH DISORDERS

In the United States, the majority of youth who come into contact with the juvenile justice system suffer from one or multiple behavioral health conditions, inclusive of both diagnosable mental health disorders and substance use disorders.[iii] In addition, court-involved youth are more likely to have had one or more adverse child experiences (ACES), or traumatic experiences that can then exacerbate or cause behavioral health conditions.[iv]Some key statistics:

70% of court-involved youth have a mental health disorder, compared to 20% in the general youth population.[v]
Roughly 46% of juveniles have a substance use disorder, compared to just 8% of the general youth population.[vi]
60% of juvenile delinquents have comorbid mental health and substance use disorders.[vii]
Approximately 90% of juvenile delinquents have been exposed to some of the common ACES of domestic violence, crime and gang violence, bullying, physical and sexual abuse, rape, and other abject experiences.[viii]
The majority of juveniles have experienced 6 or more ACES.[ix]
One study estimates that as many as 93% of girls in the juvenile justice system have been sexually abused.[x]

Essentially, those juveniles being charged with delinquency are themselves victims, and are coping, or not coping, with a behavioral health disorder. The interaction between trauma, mental health conditions, and substance use can be volatile, seemingly intractable, and if left untreated, can cause further delinquency.[xi] The reality is that kids without proper coping skills and without clinical support to handle their problems act out.

SCOPE & MAGNITUDE

On any given day, approximately 55,000 youth are detained in residential placement facilities, in either state or federal custody, within the juvenile justice system.[xii] To extrapolate the rates of behavioral health disorders to this daily population, approximately 38,500 children with a mental health disorder and 25,300 with a substance use disorder are locked up in a juvenile facility not conducive to their long-term treatment goals or success. One must then wonder if we are charging kids for their crimes or for having and expressing symptomology of behavioral health disorders and for living in environments which sustain and even greatly aggravate them. These youth could be better served in community settings with access to evidence-based treatments.[xiii]

The Connecticut School-Based Diversion Initiative (SBDI)

Public policy initiatives addressing the prevalence the behavioral health disorders in the juvenile justice system are still being developed. School-district-level policy to increase access to behavioral health services for youth might ultimately reduce justice system involvement and provide an entry point for disassembling the school-to-prison pipeline.

Connecticut has developed a novel public/private initiative, theSchool-Based Diversion Initiative(SBDI), to identify youth exhibiting inappropriate emotional and behavioral dysregulation when they act out at school and to divert some youth to community-based behavioral health services to address their needs, in lieu of, or in addition to disciplinary action. In tandem, the initiative implements reforms to zero-tolerance disciplinary policiesto reduce use of exclusionary disciplinary methods: out-of-school suspension, expulsion, and incarceration. SBDI relies upon close coordination of key community stakeholders to successfully implement its constellation of legal and policy instruments.

OVERVIEW OF POLICY AND LEGAL INSTRUMENTS

School district level disciplinary policy.SBDI employs a Graduated Response Model for addressingmisconduct, which is a structured framework for disciplinary action, beginning with 1)classroom level intervention, 2)school administration level intervention, 3) assessment and intervention with school or community-based behavioral health services and/or other resources, including possible review by a juvenile review board or court referral, and lastly 4)police intervention, involving a school resource officer (SRO), after disciplinary strategies at the prior 3 levels have been exhausted.[xiv]Intervention by law enforcementshould only be used to address behaviors posing animminent danger to self or others or serious, criminal behavior.[xv]

Service linkage.Eligibility criteria for referral or diversion to behavioral health services for students is flexible across the levels of disciplinary intervention laid out in the graduated response model. However, Level 3 intervention requires assessment and referral to appropriate school, peer, or community resources. SBDI utilizes an existing behavioral health support infrastructure, most commonly referring students to the Emergency Mobile Psychiatric Services (EMPS) for crisis intervention.[xvi]It should be noted that acts of repetitive truancy, falling under the Level 3 infractions may only be addressed with in-school disciplinary methods and treatment. A child cannot be expelled or given out-of-school suspension for truancy, as is typical practice in public schools, to prevent worsening of academic performance and future justice-involvement.[xvii]

Capacity building.In order for students with behavioral health disorders to be appropriately identified and diverted to treatment, school personnelare trained by community-based behavioral health service providers in: adolescent development, recognizing behavioral health conditions, an overview of the behavioral health services system and available resources, evidence-based strategies for handling classroom discipline, and crisis intervention and de-escalation techniques.[xviii]

Legal instruments.In order to strengthen coordinated response and cooperation among teachers, law enforcement, and behavioral health services providers,Memorandums of Agreement (MOA) are utilized to outline policies and protocols, including those dictating police activity on campus, to be followed and understood by community stakeholders to engender appropriate responses to behavioral infractions. Participating behavioral health service agencies and local law enforcement must acknowledge and adhere to provisions in the MOA.[xix]

ANALYSIS

Strengths.SBDI was designed specifically to reduce the number of in-school arrests and referrals of students with behavioral health conditions to the juvenile justice system and to divert them to more appropriate rehabilitative services. Data evidences the effectiveness of the initiative in meeting its stated objectives:[xx]

Of 18 schools that have participated for at least 5 years, SBDI has reduced the rate of court referral by 45%,
Reduced suspension rates by 8-9%, and
Increased use of Emergency Mobile Psychiatric Services (EMPS) by 94% within the first year of implementation.
Between 2010 and 2012, calls for ambulances decreased by 22%, and
In-school arrests decreased 50-69% per school.
One inner city school reduced its court referrals by 92% in the 2012-2013 academic year.

Under the Graduated Response Model of school disciplinary policy, school administrators and law enforcement are forced to reframe “criminal behavior” as a student’s cry for help. Proper use of the model necessitates separation of behavioral incidents into serious and non-serious offenses, with non-serious offenses likesmoking, substance use, bullying, fighting not resulting in bodily injury, and chronic truancy prompting referral to treatment instead of arrest or automatic exclusion.[xxi] Even possession of marijuana has resulted in referral for substance use counseling and in-school discipline.[xxii]The overall result is that students are able to continue with their education, while still getting critical support, and discipline is no longer outsourced to the courts. Punishments are proportionate to infractions, unlike in typical school disciplinary frameworks, in which disciplinary action is largely at the discretion of the school administrator, inviting sometimes severe inconsistencies in response.

Weaknesses. At this time, SBDI has been piloted in 21 schools across 10 school districts in Connecticut. Schools demonstrate need for policy consultation and program implementation based upon poor behavioral health service utilization and high rates of suspension, expulsion, and in-school arrests.[xxiii] Statewide implementation of SBDI and its myriad components: Graduated Response Model, increased service linkage, and community coordination, has not been tested. With crisis intervention service usage increasing by 94% within the first year of SBDI implementation, it could be that even a combination of public and private resources cannot support large-scale implementation. A paucity of mental health professionals might also preclude implementation of the initiative on a larger scale.

SBDI refers the majority of students to EMPS, which offers crisis intervention but does not provide long-term counseling or other services. External community resources and partners are necessary to address ongoing treatment needs, and it is unclear as to whether students benefiting from SBDI are receiving continuous care and evidence-based treatment.

RECOMMENDATIONS & CONCLUSION

School districts should adopt the full array of SBDI policy and legal instruments, prioritizing adoption of the Graduated Response Model in order to reduce use of overly harsh and exclusionarydisciplinary methods. The private non-profit agency Child Health and Development Institute of Connecticut (CHDI), which spearheads the initiative, has developed a multitude of resources available to school districts at no cost to facilitate adoption of the policies.

School districts should partner with Master of Social Work (MSW) programs to bolster behavioral health services in schools. Connecticut sustains a complex array of behavioral health services, however other states may not support the same level of state-funded services and community programs to address child and adolescent behavioral health needs. MSW interns could help to fill this dearth in human resources andensure that quality assessments and evidence-based interventions are being administered, as university students have access to research literature and libraries.

SBDI reframes misconduct as symptomatic of ACES and underlying behavioral health conditions, employing a paradigmatic and cultural shift. In order to gain stakeholder buy-in, political lobbying may be necessary to convey the need for preventative methods over incarceration.Juvenile court judges will also need be consulted to interpret state laws surrounding handling of criminal matters outside of the courts. Ultimately, a strong coordinated community response is necessary to ensure our children receive mental health treatment to contribute meaningfully in society and to disassemble the school-to-prison pipeline.

Endnotes

[i]Kristof, N. (2014, February 8). Inside a mental hospital called jail. The New York Times. Retrieved from

[ii]Nellis, A. (2011). Juvenile justice: Addressing the collateral consequences of convictions for young offenders [PDF document]. Retrieved from The Sentencing Project Website:

[iii]National Center for Mental Health and Juvenile Justice. (2016). Strengthening our future: Key elements to developing a trauma-informed juvenile justice diversion program for youth with behavioral health conditions [PDF document]. Retrieved from

[iv]Office of Juvenile Justice and Delinquency Prevention. (2013). Juvenile justice bulletin: PTSD, trauma, and comorbid psychiatric disorders in detained youth[PDF document]. Retrieved from

[v]National Center for Mental Health and Juvenile Justice. (2016).

[vi] Ibid.

[vii] Ibid.

[viii] Ibid.

[ix] Ibid.

[x]Smith, D. K., & Saldana, L. (2013). Trauma, delinquency, and substance use: Co-occurring problems for adolescent girls in the juvenile justice system.Journal of Child & Adolescent Substance Abuse,22(5), 450-465. doi:10.1080/1067828X.2013.788895

[xi]Kutcher, S., & McDougall, A. (2009). Problems with access to adolescent mental health care can lead to dealings with the criminal justice system. Paediatrics & Child Health,14(1), 15–18. Retrieved from

[xii]Child Trends. (2013). Adolescent health highlight: Access to mental healthcare [PDF document]. Retrieved from

[xiii]National Center for Mental Health and Juvenile Justice (2014). Better solutions for youth with mental health needs in the juvenile justice system [PDF document]. Retrieved from

[xiv] Center for Effective Practice of the Child Health and Development Institute of Connecticut (CHDI). (2013). The SBDI toolkit: A community resource for reducing school-based arrests [PDF document]. Retrieved from the Child Health and Development Institute of Connecticut, Inc. website:

[xv] Ibid.

[xvi] Ibid.

[xvii] Ibid.

[xviii]Vanderploeg, J. J., Hayling, C. C., Bracey, J. R., & Franks, R. P. (2009) Connecticut School-Based Diversion Initiative manual [PDF document]. Retrieved from

[xix] Ibid.

[xx]Bracey, J. R., Arzubi, E. R., Vanderploeg, J. J., & Franks, R. P. (2013). Impact: Improving outcomes for children in schools: Expanded school mental health [PDF document]. Retrieved from the Child Health and Development Institute of Connecticut, Inc. website:

[xxi] Center for Effective Practice of the Child Health and Development Institute of Connecticut (CHDI). (2013).

[xxii] Bracey, J. R., Geib, C. F., Plant, R., O'Leary,J. R., Anderson,A., Herscovitch,L., O'Connell, M., & Vanderploeg, J. J. (2013). Connecticut's comprehensive approach to reducing in-school arrests: Changes in statewide policy, systems coordination and school practices. Family Court Review, 51(3), 427-434. doi:10.1111/fcre.12039

[xxiii] Center for Effective Practice of the Child Health and Development Institute of Connecticut (CHDI). (2013).