In this regard, psychiatric nurses stand to play a critical role in all aspects of JMHCs from design and implementation to program evaluation and advising on future directions. Child and adolescent psychiatric nursing is a profession focused on working with youth, families, and communities to support the proper assessment, diagnosis, treatment, and nursing care that youth and families need.
According to the American Psychiatric Nurses Association, psychiatric nurses, at both the basic and advanced levels, provide a continuum of care for individuals and families with mental health concerns American Psychiatric Nurses Association, As there are multiple points of contact for youth referred to JMHCs including Juvenile Hall admissions, acceptance into the mental health court, and community aftercare , child and adolescent psychiatric nurses can play a critical role in unique and diverse areas International Society of Psychiatric-Mental Health Nurses, Below, we provide a detailed description of the multiple roles that psychiatric nurses can play in reducing health disparities for adjudicated youth as they progress through the CITA or similar JMHC.
We believe that this is one of the first critical entry points where psychiatric nurses should be included to assist in the proper assessment of youth with mental health concerns brought to the attention of juvenile justice.
Burriss, personal communication, August 30, In the Santa Clara Juvenile Mental Health Court system, as youth move from the initial screening stage to the disposition of their cases, those meeting screening criteria for JMHC-recognized mental health diagnoses are often provided with a more comprehensive battery of psychological assessments.
At this stage, psychiatric nurses might work in conjunction with child and adolescent, forensic, or court psychologists to support amore comprehensive review of the full body of psychosocial, familial, and neurological concerns presented by youth referred to JMHCs.
For youth who are subsequently referred to and accepted into JMHCs, like CITA, the court is charged with ensuring that a comprehensive team of professionals is available to work closely with the youth and families in ensuring appropriate mental health care. Once youth have successfully fulfilled their agreed upon obligations to the JMHC, they may have their cases disposed to community aftercare, including wraparound treatment, residential facilities, and traditional outpatient services.
These community-based resources are designed to provide counseling and therapy; evidence-based approaches to care and behavioral modifications to help strengthen family bonds; retrain youth in making sound choices and resolving emotional and behavioral trauma. In each of these settings, psychiatric nurses can support service integrity in a child-centered, family focused, culturally competent, and unrestrictive treatment format.
We therefore offer the following ideas regarding how the field of psychiatric nursing can best prepare practitioners to assume the roles described, and the areas of research necessary to support the greater inclusion of psychiatric nurse practitioners in JMHCs. Delaney outlined the five educational trajectories for nurse practitioners who wish to provide clinical care to children and adolescents, and further describes the evolution of these programs over the years.
In particular, she notes the recent rise of programs specifically designed to train nurse practitioners in the use of pharmacotherapies. In addition, the training of advanced practice nurses would also potentially support the development of a cadre of investigators with the expertise to direct combined therapy clinical trials for youth given the paucity of research regarding the risks and benefits associated with specific psychotropic medication use in children and adolescents Breland-Noble et al.
Our assessment of the benefits and costs associated with diversion interventions for adjudicated youth supports this idea. We believe that psychiatric nurse practitioners can play an essential role in reducing mental health disparities for adjudicated youth via the mental health court system. Their knowledge of the psychological problems faced by youth in general, coupled with their ability to quickly assess, stabilize, and develop treatment plans for acutely ill youth, make them well equipped for the fast-paced juvenile justice environment.
The inclusion of psychiatric nurse practitioners in the JMHC system will provide much needed support to youth and family needs for mental health care.
Contributor Information F. Alfiee M. Joe L. Jose A. Comorbid psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry. Juvenile mental health court: Rationale and protocols.
Juvenile and Family Court Journal. Californian Journal of Health Promotion. Reduction in recidivism in a juvenile mental health court: A pre- and post-treatment outcome study.
Affect regulation and prevention of risky behaviors. Journal of the American Medical Association. Rahimi S, editor. Adolescent mental health and the juvenile justice system. Journal of Pediatric Nursing. Mental healthcare disparities affect treatment of black adolescents.
Psychiatric Annals. Use of psychotropic medications by youths in therapeutic foster care and group homes. Psychiatric Services. A cure for crime: Can mental health treatment diversion reduce crime among youth? Journal of Policy Analysis and Management. Journal of Child and Adolescent Psychiatric Nursing.
Mental disorders among adolescents in juvenile detention and correctional facilities: A systematic review and metaregression analysis of 25 surveys [Reviews] Journal of the American Academy of Child and Adolescent Psychiatry. Journal of Psychopathology and Behavioral Assessment. Waters, Nicole L. As formal mental health courts MHCs enter their third decade in existence, policymakers are increasingly looking to distill the best of research and practice into state standards that foster high-quality programming and accountability for MHCs in their states.
This resources describes states' approaches to conveying these MHC standards. Leifman, Hon. Future Trends in State Courts. This article discusses the Criminal Mental Health Project CMHP of the 11th Judicial Circuit, which diverts individuals with serious mental health or substance abuse disorders into community-based treatment and support services.
Lederman, Judge Cindy. The screening process is intense and involves a behavioral health assessment or psychological evaluation, application, interview and consent of the SOAR treatment team. Once a child and family are admitted into SOAR, they will begin a journey involving individual and group therapy, family therapy, parenting classes, assessment and reassessment, participation in programs to develop social and self-advocacy skills, educational assistance and the responsibility of appearing in open court to articulate challenges and successes.
Incentives and sanctions are handed out in this open court setting. Such incentives and sanctions have been discussed and agreed upon in advance during a treatment team meeting. The treatment team consists of Ms. Examples of incentives include lessening of restrictions, praise by the team and the court, expansion of privileges and receipt of certificates of accomplishment. Extra community service, essay writing, restricted curfews and, as a last resort and sparingly used, detention are examples of sanctions.
SOAR consists of four phases. The first is orientation, assessment, rapport building and treatment planning. The treatment plans devised by our probation officer and caseworker are something to behold: very much individualized, intense and subject to review as the child and family progress. Stabilization comprises phase two of SOAR, followed by phase three, a transition phase wherein court involvement, probation and caseworker contact, and the intensity of services and counseling is reduced.
Subscribe to Ideas and Opinions Over two decades ago, as a favor to a friend, I walked into the very juvenile courtroom that I now have the privilege of presiding over on a daily basis.
A lack of resources and training has led to poor methods of treatment, especially for those with mental illness or substance abuse problems. The treatment team consists of Ms.
However, it is all worth the effort. The last phase is our aftercare and maintenance phase. In each of these settings, psychiatric nurses can support service integrity in a child-centered, family focused, culturally competent, and unrestrictive treatment format.
The Future of Children. For some, findings like those mentioned previously beg the question of whether profits belie the goal of rehabilitation for juvenile offenders. The rationale of the mental health court approach, per Arredondo and colleagues, is that a system designed primarily to reform poor behaviors and assign accountability cannot do so effectively in the absence of addressing the root causes of the problematic behaviors. We need new ideas that honor the humanity of individuals and remind us of the potential all youth hold when they are healthy and supported.
Eligibility criteria for youth in mental health courts generally include being between the ages of 12 and 17 and demonstrating mental health need as evidenced by meeting criteria for significant or serious mental illness. Pablo spent more than 8 months trying to complete a 4-month program.
In sum, our incarcerated youth need a new solution.