BILL ANALYSIS
SENATE HEALTH AND HUMAN SERVICES
COMMITTEE ANALYSIS
Senator Martha M. Escutia, Chair
BILL NO: AB 2228
A
AUTHOR: Aroner
B
AMENDED: June 28, 2000
HEARING DATE: July 5, 2000
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FISCAL: Appropriations
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CONSULTANT:
8
McCarthy / ak
SUBJECT
Juvenile offenders: mental health screening
SUMMARY
The purpose of this bill is to establish the Juvenile
Probation Assessment Pilot Project, as specified.
ABSTRACT
Current law:
1.Generally, requires county probation departments to
provide care and supervision to children who have
committed an act of delinquency, and who are or may
become wards of the juvenile court (Welfare and
Institutions Code (WIC) Section 730 et seq.);
2.Directs county mental health departments that receive
funding to provide mental health screening assessment,
and other services to the extent resources are available
to children served by county social services and
probation departments.
This bill:
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1.Establishes the "Juvenile Probation Assessment Pilot
Project" to be administered by the State Department of
Mental Health (DMH);
2.Requires the pilot be conducted in three counties for
three years;
3. Requires DMH to establish minimum standards, funding
schedules, procedures for the collection of data, and
procedures for the review and approval of local plans in
pilot project counties, as specified;
4.Provides that the bill's implementation shall be
contingent on an appropriation in the annual Budget Act;
5.Requires that county probation departments involved in
the pilot to use data collected through the pilot to
identify service needs of juveniles in the county, and
work with the assessment team to develop plans for an
appropriate continuum of treatment services.
FISCAL IMPACT
Unknown at this time; bill provides that funding is
contingent on the annual Budget Act.
BACKGROUND AND DISCUSSION
1.Background: Mentally Ill Juvenile Offenders
No studies comprehensively document the level of mental
health services needs among California's juvenile
offenders. However, the following data provides some
information outlining the scope of the need. The data is
based on the quarterly juvenile detention surveys
conducted by the Board of Corrections:
Average Daily Populations of Minors Detained in
California County
Juvenile Halls and Camps Receiving Psychotropic
Medications or Requiring Mental Health Services 1999
-------------------------------------------------------
| | 1st | 2nd | 3rd | 4th |
| | Quarter | Quarter | Quarter | Quarter |
|-----------+----------+----------+----------+----------|
|Receiving | 1,018 | 1,029 | 1,396 | 1,055 |
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|Psychotropi| | | | |
|c Drugs | | | | |
|while in | | | | |
|Detention | | | | |
|-----------+----------+----------+----------+----------|
|Identified | 1,322 | 1,533 | 1,619 | 1,552 |
|as Needing | | | | |
|Mental-Heal| | | | |
|th | | | | |
|Services | | | | |
-------------------------------------------------------
The National Mental Health Association (NMHA) concludes
that although estimates of the percentage of youth with
mental disorders in the juvenile justice system vary
from study to study, a consistent picture is beginning
to emerge. Despite differences in methodology and
instrumentation, researchers from across the country
have documented high rates of mental disorder, including
substance abuse disorders and multiple co-occurring
diagnoses, among children incarcerated in juvenile
facilities.
Among a random sample of youth from the South Carolina
Department of Juvenile Justice facilities, 72% met the
full criteria for a diagnosis of at least one mental
health disorder (Atkins et al., in press). In addition,
researchers in Canada (Toronto) used a structured
diagnostic interview to evaluate adolescents in two
secure facilities and found that 63% had two or more
mental disorders, with an additional 22% meeting
diagnostic criteria for one mental disorder (Ulzen &
Hamilton, 1998 or NMHA @ www.nmha.org/children/
justjuv/prevalence.cfm).
In 1998, the federal Office of Juvenile Justice and
Delinquency Prevention (OJJDP) issued a report on mental
health disorders among juvenile offenders. OJJDP
concludes that dealing with the long-term mental health
problems in juvenile offenders is crucial:
Although the prevalence of mental health and substance
abuse disorders among youth in the juvenile justice
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system is largely unknown, recent research suggests
that these problems are significantly greater for
juvenile delinquents than for other youth. It has
been estimated that each year, of the youth who come
in contact with the juvenile justice system, 150,000
meet the diagnostic criteria for at least one mental
disorder, 225,000 suffer from a diagnosable alcohol
abuse or dependence disorder, and 95,000 may suffer
from a diagnosable substance abuse or dependence
disorder (Cocozza, 1992).
Research has also demonstrated that juvenile
delinquents tend to have both mental health disorders
and substance abuse problems, and a high percentage of
them also have conduct disorders. Finally, research
and experience demonstrate that the services available
in the juvenile justice system to alleviate these
problems are entirely inadequate. ( Mental Health
Disorders and Substance Abuse Problems Among
Juveniles , Bilchik, OJJDP Fact Sheet #82).
In addition, the National Mental Health Association has
compiled the following summary of findings concerning
prevalence of mental disorders among children in the
juvenile justice system:
Based on data obtained from site visits to a
nationally representative sample of 95 public and
private juvenile facilities, researchers found that
73% of the children in these facilities reported
mental health problems during screening (Abt
Associates, 1994). In addition, 57% of youth reported
that they have previously received treatment for
mental health problems.
In Maryland, data obtained from a representative,
random sample of youth from all 15 juvenile facilities
indicated that 57% have a history of mental illness;
53% have at least one current mental disorder
diagnosis based on structured diagnostic interviews
(Shelton, 1998).
2.AB 2228
This bill, in addition to the provisions described in the
Abstract above, contains the following provisions:
DMH would be required to develop a funding schedule
that includes "a set rate allocated to counties for
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screening and for assessing minors identified in this
section, and an allocation for staff training and
administration;"
DMH would be required to "integrate information
obtained from the pilot project and make it available
to the statewide chief probation officers
organization" upon the pilot's completion.
Eligibility
To be eligible for this program, county probation
departments would be required to comply with guidelines
set out by DMH, and to develop a local plan for
assessing the service needs of delinquent minors in the
county who have been arrested or cited for criminal
charges, as specified. Local plans would be required to
provide all of the following:
a)uniform screening and needs assessment instruments and
protocols, as specified;
b) identified timing for screenings and referrals, as
specified;
c)a county probation assessment team, with enumerated
minimum and multi-disciplinary representation
requirements;
d)referral protocols for screened minors who need
additional assessments, as specified;
e)staff for screening and assessment, and minimum
requirements for the prior education and training of
those staff members.
Screening and Assessment Instruments and Protocols; DMH
Technical Assistance
a)DMH would be required to develop minimum screening and
assessment instruments and protocols to be used by
pilot counties in consultation with the pilot counties
and other expert individuals or organizations, as
specified.
b)DMH would be required to provide technical assistance
to the pilot counties, including training.
Data collection and sharing
This bill would authorize county probation departments
involved in this pilot project to release information to
DMH regarding minors involved in the program for purposes
of oversight and evaluation.
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Evaluation
This bill would require that the pilot "be evaluated
independently to judge the effectiveness of the screening
and assessment protocol and processes used to implement
the programs, including whether the assessments and
screenings provide adequate background data on the minor
and the minor's family unit, improve achievement of case
plan goals, are judged useful to counties and service
providers, and can be applied with ease."
3.Stated need for this bill
The author states that between one-third and two-thirds
of youth in the juvenile delinquency system suffer from
mental health problems, according to various estimates;
in addition, a significant proportion of these youth have
substance abuse problems. The author states that
California currently has no structured procedure for the
assessment of youth when they enter the delinquency
system in order to identify mental health, health, or
substance abuse problems, or educational needs; services
to address the youth's problems in these areas are often
not provided until a crisis point is reached. The author
asserts that "Early assessment and identification of
youth's problems will enable county probation departments
to identify the services that will directly address the
reasons youth are in the delinquency system in the first
place."
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4.Recent public hearing
In December 1999, the Assembly Human Services Committee
held a hearing in Oakland on "Improving Services to
Delinquents with Serious Mental Health Problems." At the
hearing, testimony was received from a variety of
juvenile justice professionals, educators, mental health
professionals, parents, service providers, and advocates.
The testimony generally expressed the concern that in
the past decade, the treatment needs of juvenile
offenders have become increasingly complex with many
youth requiring treatment services that are often
unavailable.
According to the author, the clear intent of existing law
is to assess the service needs of youth in the dependency
and delinquency systems. Existing law, established in
the early 1990s and contingent upon funding in the annual
budget act, directs DMH to establish a service needs
assessment tool and develop a screening instrument for
youth. However, this provision of law has not been
implemented because of the combined obstacles of lack of
funding and the fact that a screening instrument has not
been developed.
5.Arguments of supporters
The California Healthcare Association writing in support of
this bill, states that,
"?our state currently has no structured process for
the assessment of youth when they enter the
delinquency system to determine whether they have
mental health, health, or substance abuse problems.
We believe that early identification of these problems
would enable county probation departments to identify
the services that would directly address the reasons
youth are in the juvenile justice system in the first
place. It is simply common sense that early
identification, assessment and treatment will help to
break the cycle of incarceration among youth that
often continues into adulthood."
The Juvenile Court Judges of California state that, "the
information gathered under this program would be
invaluable in assessing the treatment needs of juvenile
delinquents."
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6.Arguments of opponents
The Sacramento Citizens Commission on Human Rights states
that:
g."?In most cases [treatment] it will be mind-altering
psychiatric drugs that are not approved for use on
minors by the FDA. These drugs include iminprimine,
thorazine, melaril, lithium, haldol, and others which
are known by actual scientific testing to cause liver
damage, brain damage, violence by people with no
previous history of violent behavior, and death."
h."Since handling illiteracy is the single most
effective tool for stopping juvenile recidivism,
according to a study commissioned by the US Department
of Justice, it would make more sense to give these
juvenile offenders a reading test and put them into a
literacy program if they do poorly."
7.Related Legislation
This Committee passed related legislation, (5-0) SB 2062
(Perata), which would establish competitive grants for
mentally ill juvenile offender treatment. However funds
for that program were not included in the final budget
for FY 00-01. This Committee, previously this year,
heard AB 2104 (Strom-Martin), which would establish
demonstration, regional facilities for severely
emotionally disturbed juvenile offenders.
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Also, on June 28, 2000, this Committee passed out AB 2069
(Steinberg) that encouraged the University of California
to develop a mental health screening instrument to
facilitate early intervention.
This bill requires that county probation departments
release to DMH information regarding minors involved in
the pilot program for purposes of oversight and
evaluation. Should the bill be amended to add provisions
to ensure the confidentiality of any information provided
by county probation departments to DMH?
PRIOR ACTIONS
Senate Public Safety: 5- 0Do Pass
Assembly Floor: 58-19Pass
Assembly Appropriations: 14- 7Do Pass as
Amended
Assembly Human Services: 7- 0Do Pass as
Amended
POSITIONS
Support: Chief Probation Officers of California
(sponsor)
California Healthcare association
Commonweal
Juvenile Court Judges of California
Los Angeles Probation union, AFSCME, Local
685
NAMI California
Protection and Advocacy, Inc.
Oppose: Sacramento Citizens Commission on Human Rights
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