How State, Local Communities and Universities Work Together To Implement Evidenced Based Practices and Reduce Recidivism of Juvenile Offenders Eric Shafer – Assistant Court Administrator – Montgomery County Juvenile Court Barbara Keen-Marsh, MSW, LISW-S, LICDC - South Community, Inc. Jeff M. Kretschmar, Ph.D. - Begun Center for Violence Prevention Research and Education, Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University

Montgomery County Juvenile Court Dayton, Ohio Ohio’s Behavioral Health Juvenile Justice Initiative (BHJJ) -Began in 2005 with 6 Counties -Required the introduction of Evidenced Based Practices -Funding through: Ohio Dept. of Mental Health Ohio Dept. of Youth Services 2

Montgomery County Juvenile Court Dayton, Ohio Learning Independence and Family Empowerment LIFE Program Functional Family Therapy (FFT) 3

Multiple Pathways to South Community Inc. – Function Family Therapy Ohio Department of Youth Services – Parole Nicholas Residential Treatment Center – 24 bed facility for boys – Open Setting Juvenile Cognitive Alternative Rehabilitation Effort – 18 bed program for boys housed within the Detention Center – 90 Day Stay – Aggression Replacement Training (ART) 4

Multiple Pathways to South Community Inc. – Function Family Therapy The Center for Adolescent Services – Community Correctional Facility – 44 bed facility, 34 for boys, 10 for girls MCJC Probation – 950 youth on Probation – 4 Dedicated Probation Officers MCJC Intervention Center (Diversion) – 24/7 Reception and Assessment Center – 2,900 cases diverted annually – Disproportionate Minority Contact Mediation Program 5

Montgomery County Juvenile Court Dayton, Ohio Keys to Success – Early Involvement Make a connection on day one – Opening our facilities and providing space Become true partners with providers – Constant Collaboration Line Staff Administrative staff 6

LIFE Program Learning Independence and Family Empowerment Local Partnership ADAMHS Board of Montgomery County Montgomery County Juvenile Court and Reclaiming Futures South Community, Inc. SBHI/Crisis Care

LIFE Program Learning Independence and Family Empowerment State and Federal Partners

REFERRAL STRUCTUREREFERRAL STRUCTURE Youth is Released from ODYS, JCARE, Nicholas or CAS Crisis Care Completes an Assessment LIFE Program is Recommended Parole, Probation Officer or Other Court Personnel Refer Family to Services Youth Enters Into the Juvenile Court System

LIFE PROGRAM STRUCTURELIFE PROGRAM STRUCTURE Therapist Contacts Family Within 48 Hours of Referral Services Provided: Home Based Family Therapy Psychiatric Services Intensive Probation Case Management Other Collaboration: F AMILY P ROBATION / PAROLE O FFICER I NTERVENTION C ENTER N ATURAL H ELPER C HILD W ELFARE O THER S YSTEMS C ASE W ESTERN U NIVERSITY F UNCTIONAL F AMILY T HERAPY, I NC.

Why FFT? Blueprints Model – Evidenced Based Practice Well DocumentedWell Documented Highly Successful Family Intervention Program for Juvenile OffendersHighly Successful Family Intervention Program for Juvenile Offenders Strength-based Consistent with local and state initiatives Focus on strengths and assists families to recovery

Goals: Significant and Long-Term Reduction in Youth Re-Offending and Violent Behavior Low Drop-Out and High Completion Rates Positive Impacts On Family Conflict, Family Communication, Parenting, and Youth Problem Behavior Significant Reduction in Sibling Entry into High-Risk Behaviors,

CONTINGENCY MANAGEMENT MODEL

Macro Level Macro Level Key Concepts  Top Down Cooperation and Collaboration  Ongoing Problem Solving  Attention to Customer Service—the other agencies are Our Customers too!!  Ongoing Needs Assessment  Planning for Sustainability from Day 1 and adjusting Sustainability Plan as Program Grows  Current Challenge is Ohio’s move to an IHBT Rate

Service with a Smile Weekly meetings with Probation officers to maximize collaboration and keep everyone on the same page Including Probation Officers and Administration in FFT Trainings Problem Solve any interruption in the flow of referrals– eliminate barriers and SELL SELL SELL to all links in the referral chain---Judges, Magistrates, Traditional Probation Officers, Mental Health Assessors in and out of our agency. Key Attitude is how can we make Our Process fit Your Process and Your Needs

Marketing = Matching A site is Selling Two Things – Service (Micro Level) – Results (Macro Level) You have to do both in ways that MATCH a particular customer

Demographics From 2006 through June 2013, 2,545 youth enrolled – average age at intake 15.6 years – 58.4% male – 52.3% Caucasian From July 2011 – June 2013 – 67.4% male – 42.9% Caucasian 18

Youth Characteristics QuestionFemalesMales Has the child ever been physically abused? 20.5% (n=194)** 15.3% (n=208) Has the child ever been sexually abused? 28.1% (n = 262)*** 7.1% (n = 95) Has the child ever had a problem with substance abuse, including alcohol and/ or drugs? 43.9% (n = 411) 50.3% (n = 674) ** Has the child ever talked about committing suicide? 49.6% (n = 468)*** 31.3% (n = 425) Has the child ever attempted suicide? 22.2% (n = 207)*** 9.6% (n = 129) Has the child ever been exposed to domestic violence or spousal abuse, of which the child was not the direct target? 43.8% (n = 414)* 39.4% (n = 536) 19 *p =.05, ** p <.01, *** p <.001

Youth Characteristics QuestionFemalesMales Has anyone in the child’s biological family ever been diagnosed with depression or shown signs of depression? 68.2% (n = 626)*** 60.3% (n = 793) Has anyone in the child’s biological family had a mental illness, other than depression? 47.8% (n = 440)*** 39.7% (n = 511) Has the child ever lived in a household in which someone was convicted of a crime? 40.6% (n = 372) 40.9% (n = 540) Has anyone in the child’s biological family had a drinking or drug problem? 43.9% (n = 439)** 57.2% (n = 480) 20 *p =.05, ** p <.01, *** p <.001

Juvenile Court History County Youth with Felony Charges in the 12 Months prior to BHJJ Enrollment Cuyahoga (Cleveland)35/156 (22.4%) Franklin (Columbus)147/221 (66.5%) Montgomery (Dayton)124/634 (19.6%) Hamilton (Cincinnati)30/90 (33.3%) Lucas (Toledo)33/59 (55.9%) Summit (Akron)46/49 (93.9%) Total415/1209 (34.3%) 21

OYAS Risk Ohio Youth Assessment System (OYAS) – Criminogenic risk tool designed to assist juvenile court staff with placement and treatment decisions – Helps identify likelihood to re-offend 22 Risk LevelLowModerateHigh 24% (n = 59)48% (n = 118)28% (n = 67)

DSM Axis I Diagnoses DSM-IV Axis I DiagnosisFemalesMales Oppositional Defiant Disorder41.3% (n = 419)38.9% (n = 553) Cannabis-related Disorders27.5% (n = 279)35.3% (n = 501) *** Attention Deficit Hyperactivity Disorder26.5% (n = 269)42.5% (n = 604) *** Depressive Disorders23.0% (n = 233) *** 12.5% (n = 178) Alcohol-related Disorders13.3% (n = 135) ** 9.9% (n = 140) Bipolar Disorder10.3% (n = 105) * 7.5% (n = 106) Conduct Disorder9.7% (n = 98)21.2% (n = 301) *** Post-traumatic Stress Disorder9.4% (n = 95) *** 5.3% (n = 75) Adjustment Disorder7.2% (n = 73) * 5.1% (n = 72) Mood Disorder11.1% (n = 113)9.1% (n = 130) Disruptive Behavior Disorder6.6% (n = 67)7.8% (n = 111) 23 *p <.05, ** p <.01, *** p <.001

Trauma 24 * all comparisons significant at the p <.01 level; effect sizes between

Ohio Scales Problem Severity

Ohio Scales Functioning

Substance Use 27

Substance Use Self-Reported Previous 6 Month Substance Use from Intake to Termination for Females

Termination Information Termination ReasonAll Youth Youth Enrolled from July 2011 through June 2013 Successfully Completed Services 65.1% (n = 1315)71.9% (n = 323) Client Did Not Return/Rejected Services 6.2% (n = 125)2.9% (n = 13) Out of Home Placement7.3% (n = 148)8.0% (n = 36) Client/Family Moved3.0% (n = 60)2.4% (n = 11) Client Withdrawn6.9% (n = 139)5.6% (n = 25) Client AWOL2.9% (n = 58)3.6% (n = 16) Client Incarcerated3.2% (n = 65)3.6% (n = 16) Other5.4% (n = 109)2.0% (n = 9) 29

Termination Information 2,019 youth terminated from BHJJ services (918 from Montgomery) ALOS = 209 days (147 days in Montgomery) – 224 days successful completers – 180 days for unsuccessful completers ALOS from July 2011 – June 2013 = 163 days (131 days in Montgomery) – 174 days for successful completers – 135 days for unsuccessful completers At intake, 47.9% of youth were identified as at risk for out of home placement At termination, 24.0% of youth were identified as at risk for out of home placement – 7.3% of successful completers – 56.7% of unsuccessful completers 30

Recidivism At termination, police contacts for 68% of youth had been reduced – Police contacts for 24% of youth remained the same One year after termination, 10% of successful completers and 19% of unsuccessful completers had new felony charges Eighty-nine (89) youth (3.5%) enrolled in BHJJ for whom we had recidivism data were sent to an ODYS facility at any time following their enrollment in BHJJ, including after a youth’s termination from BHJJ. – 24/1040 (2.3%) in Montgomery County 31

Financial Considerations Using only the direct State contribution to BHJJ of $8.4 million from , the average cost per youth enrolled in BHJJ was $4778. The FY11 per diem to house a youth at an ODYS institution was $442 and the average length of stay was 12.6 months. Based on these numbers, the estimated cost of housing the average youth at an ODYS facility in FY11 was $167,

Contact Information Eric Shafer Montgomery County Juvenile Court Jeff Kretschmar Begun Center for Violence Prevention Research and Education Case Western Reserve University Barbara Keen-Marsh South Community, Inc