Who is Served: Youth up to age 16 involved in Family Court at the pre-adjustment stage (post-arrest but before a decision has been made to file charges)
Early involvement in the criminal justice system, especially for youth with un-diagnosed behavioral health needs, is a significant risk factor for future crime and poor education and life outcomes. These negative outcomes are strongly associated with the detention of youth in correctional facilities, a process that can be particularly harmful for youth with behavioral health treatment needs.1 Studies have found that more than half of the youth detained at Rikers Island have a mental health and/or substance use disorder.2 For these young people, early diagnosis can be critical. A 2005 national survey found that one-half of all chronic mental illness begins by age 14. However, the average lag from the initial onset of symptoms to the receipt of treatment is nine years. Nationally, more than 50% of individuals hospitalized for first-episode psychosis have a previous history of arrest and/or incarceration.3 Given the high incidence of mental illness and the overrepresentation of low-income and minority youth, involvement in the criminal justice system presents a critical opportunity to identify and engage underserved young people who have mental illness and other behavioral health needs in early treatment.
The CASES Approach
In 2014, in partnership with the NYC Department of Probation, CASES began providing clinical screening for Family Court-involved youth following arrest but before a decision has been made to file charges (the pre-adjustment stage of the Family Court process). Youth with indications of a behavioral health need are referred by Probation staff for screening by CASES clinicians. If a need for behavioral health services is identified, CASES staff refer clients to one of two CASES programs:
- Adolescent Portable Therapy, providing short-term, in-home family therapy incorporating principles of cognitive behavioral therapy
- The Nathaniel Clinic, providing State-licensed outpatient mental health treatment
If a young person’s needs fall outside the scope of these programs or if he or she would be better served by another provider from within CASES’ extensive network of community referral partners, our staff provide a brokered linkage including follow-up to ensure the youth remains engaged in ongoing treatment.
In its first year of implementation, CASES Family Court Mental Health Screening assessed 47 youth, with 33 referred to treatment or services and 21 successfully linked, an engagement rate of 64% despite no court mandate dictating that a young person engage in these linkages. In addition to ensuring that at the earliest stage possible these youth access the treatment they need, the program design supports the adjustment of youth cases so that they do not unnecessarily face the consequences of a criminal record.