Transitioning Youth with Mental Health Needs Out of Detention: Strategies from Multnomah County David Koch Multnomah County Juvenile Services Division 1401 NE 68 th Avenue Portland, OR 97213

Objectives Give data on the prevalence of mental health issues for youth brought to juvenile detention. Look at promising strategies to facilitate their transition to more appropriate resources. Discuss some of the obstacles to helping such youth.

Prevalence Data Suicide attempts among high school students ranges from 3.5 percent to 9 percent. Actual deaths due to suicide in juvenile detention facilities have been estimated to be 5 times higher. Depressive symptoms, other psychiatric illness, and alcohol and drug abuse/dependence are common with youth in incarceration.

Care Coordination in Detention Multnomah County has an outstanding “sorting process.” We ensure that the only youth who end up in detention are those who are highest risk. There have been some unintended consequences of our success. Some detained youth are “high risk” as well as extremely high need.

Care Coordinator Positions Ensure mental health care is arranged for detained youth Transition and Release Planning Liaison with County Mental Health Services Liaison with Private and Community Providers to increase “ownership” of detained clients Custody Staff Education Intern supervision

Regular Multidisciplinary Staffings Involve mental health, child welfare, developmental disabilities, treatment providers, probation/parole. Develop transition and placement plans for complicated youth.

Obstacles Community based service providers are reluctant to work with “conduct disordered” youth. Lack of culturally specific services. Youth are served in multiple systems with sometimes conflicting mandates.