Adolescent Substance Abuse Treatment

To help organizations seeking a time- and cost-efficient assessment for adolescents, Inflexxion developed the Comprehensive Health Assessment for Teens, or CHAT, which has been found to be both valid and reliable in research funded by the National Institute on Drug Abuse (NIDA).
The CHAT format is based on the ASI-MV Connect, a self-administered, multimedia version of the Addiction Severity Index (ASI) developed by Dr. A. Thomas McLellan. A number of treatment centers, such as the Center for Drug-Free Living in Orlando, Florida, are using the ASI-MV Connect as part of the NIATx campaign to streamline their assessment procedures [PDF].

If it is true that dollars drive decisions and the media shape attitudes on spending for public policy, we better all get off our couches, get involved, and mobilize to make sure policy makers understand how important it is to support youth and families in recovery.
Our family has suffered for years with generations of the disease of addiction. Two of our kids have made it; two have not. But when I was channel surfing last night, I saw enough images of  “rehab” to know there’s no hope that anyone would fund youth and family recovery services, given the current public will and culture.
 
Sensationalistic depictions of addiction are sold by the media business to get ratings, the media impacts public opinion and government, and the government impacts recovery spending on our health prospects and the future.

Juvenile Justice System News (Mostly)

• Work in the juvenile justice system? Seen kids hammered for minor drug offenses because they occurred within 1,000 feet of a school? Well, those laws may not work very well. In 2008, the Prison Policy Initiative (PPI) did a thorough analysis and critique in one Massachusetts community, called The Geography of Punishment: How Huge Sentencing Enhancement Zones Harm Communities, Fail to Protect Children. (Also, if you happen to have a used Mac laptop you want to give away as a tax-deductible gift, PPI could use one for its many volunteers. Just use the contact form on the PPI website to learn more.)
• Here's a sobering Washington Post editorial on the sexual violence and exploitation endured by young girls on the margins of our society. And guess where many of these girls end up? The juvenile justice system. (Hat tip to Nancy Gannon Hornberger and the Act-4-JJ Facebook page.) Corroboration comes from a new study for the National Institute of Justice showing that poly-victimization is pervasive among girls in the juvenile justice system, based on a sample of girls in South Carolina.

One of the most difficult things for adolescent substance abuse treatment service systems to do is to support teens in recovery.
Fostering peer support has long been seen as critical in adult recovery, but duplicating that for teens raises difficult-to-solve issues of liability and concern for their safety. 
Nevertheless, there's no question that peer support could be a powerful tool for teens in recovery, and many communities are looking at ways to accomplish it. Furthermore, new technological tools, like this iPhone app for 12 Step participants, may address some common barriers.
And now the Substance Abuse and Mental Health Services Administration (SAMHSA) is offering a small number of grants to commmunities wishing to build peer-to-peer recovery support services. (It would be great if one of the grantees focused specifically on adolescents in the justice system.) Deadline is February 10, 2010. 
However, note that the grant application specifies that "peer services must be designed and delivered primarily by individuals in recovery to meet the targeted community’s recovery support needs, as the community defines them." It also draws a sharp distinction between peer recovery and aftercare. 

This report on adolescent substance abuse and mental health issues in the federal legislation governing the juvenile justice system is reprinted, with permission, from the Spring/Summer 2009 issue of The Link: Connecting Juvenile Justice and Child Welfare, published by the Child Welfare League of America. The final fact sheet, suitable for printing, can be found on the Act-4-JJ website.

 
The second part, below, contains recommendations for strengthening the Juvenile Justice and Delinquency Prevention Act; the first part lays out the justification and the key issues.

Recommendations for Strengthening JJDPA Mental Health and Substance Abuse Provisions
 

• Call for and provide federal funding for collaboration between state and local agencies, programs, and organizations that serve children, including schools, mental health and substance abuse agencies, law enforcement and probation personnel, juvenile courts, departments of corrections, child welfare, and other public health agencies. Juvenile justice agencies should involve families whenever appropriate.

This report on adolescent substance abuse and mental health issues in the federal legislation governing the juvenile justice system is reprinted, with permission, from the Spring/Summer 2009 issue of The Link: Connecting Juvenile Justice and Child Welfare, published by the Child Welfare League of America. The final fact sheet, suitable for printing, can be found on the Act-4-JJ website. 

 
The first part, below, describes the justification and the key issues; the second part contains recommendations for strengthening the Juvenile Justice and Delinquency Prevention Act.

When Congress considers legislation later this year to reauthorize the Juvenile Justice and Delinquency Prevention Act (JJDPA), mental health and substance abuse issues will be a top priority.
 
Available data from single site and multisite studies indicate that 70% or more of youth who are securely detained in a juvenile justice facility may suffer with mental health and related disorders; rates of mental health and substance abuse disorders appear to be somewhat higher for girls than boys; and more than 20% of such youth suffer disorders so severe that their ability to function is significantly impaired (Abram, Teplin, McClelland, & Dulcan, 2003; Skowyra & Cocozza, 2007; Teplin, Abram, McClelland, Dulcan, & Mericle, 2002).
 
Among youth under nonresidential court supervision (e.g., on probation), the rate of diagnosable mental health and substance abuse disorders is approximately 50%.
 
By comparison, in the general youth population, approximately 20% of youth suffer with mental health and substance abuse disorders. In addition, justice system involved youth may experience behavioral/emotional disorders for the first time because of contact with the juvenile justice system.

Parents of teens with alcohol or drug problems often feel terribly isolated. In the last week or two, however, I've found three resources that might help, from parents who've been there. (Two, incidentally, are from Intervene, an excellent blog for parents run by the Partnership for a Drug-Free America.) 

• "7 Truths about My Addict that Took 5 Years to Learn." A father writes about the seven hard lessons he and his wife learned in five years of dealing with their addicted son, who is now 21. 

Your Juvenile Justice System: Share Local Needs with OJJDP

• What training and technical assistance does your system need?  The Office of Juvenile Justice and Delinquency Prevention (OJJDP) wants to know. Complete their online needs assessment for your juvenile justice system, and help them improve their understanding of local needs to build capacity and sustainability among juvenile justice organizations. 

 
Juvenile Justice System and Adolescent Substance Abuse Treatment News

• Laurence Steinberg, co-author of Rethinking Juvenile Justice, was just awarded $1 million for his work on adolescent developmental psychology -- work that has made him an expert on juvenile justice. Steinberg is the first winner of the Klaus J. Jacobs Research Prize, believed to be one of the largest prizes given in the social sciences.

What is NIATX?

NIATx helps behavioral health providers improve access to and retention in treatment for all of their clients. It's a process improvement collaborative based at the University of Wisconsin-Madison. (The acronym stands for The Network for the Improvement of Addiction Treatment. However, since NIATx has moved into mental health other areas of behavioral health, we now go by the acronym only.)
NIATx began in 2003 as a grant project funded by the Robert Wood Johnson Foundation and the Center for Substance Abuse Treatment. The 39 provider sites involved in the grant applied the NIATx model of process improvement, making dramatic improvements in access to and retention in treatment. Today, we work with more than 1500 providers in all states.

Juvenile Justice Reform News

• The Coalition for Juvenile Justice has an update on the Congressional reauthorization of the federal Juvenile Justice and Delinquency Prevention Act (JJDPA), one of the key engines of juvenile justice reform. (Thanks to the Coalition for Juvenile Justice for sharing its slide deck.)
• Big news from Luzerne County, Pennsylvania, in the juvenile "kids for cash" case. The state Supreme Court overturned thousands of juvenile adjudications made by former Judge Mark A. Ciavarella, Jr., because he consistently failed to inform juveniles of their right to representation. Only the cases of youth still under court supervision would be eligible for retrial. (Hat tip to Youth Today.)