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Welcome Preventing Suicide among Justice-Involved Youth: Newly Developed Tools, Recommendations, and Research Thursday, 17 April 2014 1:30-2:30pm EDT If.

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Presentation on theme: "Welcome Preventing Suicide among Justice-Involved Youth: Newly Developed Tools, Recommendations, and Research Thursday, 17 April 2014 1:30-2:30pm EDT If."— Presentation transcript:

1 Welcome Preventing Suicide among Justice-Involved Youth: Newly Developed Tools, Recommendations, and Research Thursday, 17 April :30-2:30pm EDT If you have technical questions, please call If you would like to submit a question to the speakers for the Q&A portion of the webinar, please click “Submit a Question” on the right side of the screen. Youth in Contact with Juvenile Justice System Task Force

2 Preventing Suicide among Justice- Involved Youth: Newly Developed Tools, Recommendations, and Research Joseph J. Cocozza, PhD – Director, National Center for Mental Health and Juvenile Justice Linda A. Teplin, PhD – Vice-Chair for Research, Department of Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University Katherine Deal, MPH – Deputy Secretary, National Action Alliance for Suicide Prevention 17 April 2014 Presenters Facilitator

3 Acknowledgments Youth in Contact with Juvenile Justice System Task Force

4 About the Action Alliance  Vision: A nation free from the tragic experience of suicide.  Mission: To advance the National Strategy for Suicide Prevention (NSSP) by: Championing suicide prevention as a national priority Catalyzing efforts to implement high-priority NSSP objectives Cultivating the resources needed to sustain progress  Goal: Save 20,000 lives over the next five years. Youth in Contact with Juvenile Justice System Task Force

5 About the Action Alliance Current initiatives:  Developing the Action Alliance Framework for Successful Messaging to change public conversation  Improving healthcare for at-risk individuals (e.g. clinical workforce preparedness, quality of care, healthcare reform)  Increasing quality, timeliness, and usefulness of surveillance data  Disseminating a first-ever prioritized research agenda  Improving support for survivors of suicide attempts and loss  Improving workplace suicide prevention (e.g. law enforcement)  Work for other populations and settings Youth in Contact with Juvenile Justice System Task Force

6 About the Speakers Joseph J. Cocozza, PhD Director – National Center for Mental Health and Juvenile Justice; Policy Research Associates, Inc. Co-lead – Youth in Contact with the Juvenile Justice System Task Force Youth in Contact with Juvenile Justice System Task Force

7 About the Speakers Linda A. Teplin, PhD Vice-Chair for Research – Department of Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University Member – Suicide Research Workgroup, Youth in Contact with the Juvenile Justice System Task Force Youth in Contact with Juvenile Justice System Task Force

8 Co-leads: Melodee Hanes, JD – Acting Administrator, Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, US Department of Justice Joseph J. Cocozza, PhD – Director, National Center for Mental Health and Juvenile Justice, Policy Research Associates Youth in Contact with the Juvenile Justice System Task Force Youth in Contact with Juvenile Justice System Task Force

9 Why Focus on this Population?  Youth involved with the juvenile justice system have a higher risk of suicide than non justice-involved youth.  Youth in juvenile justice residential facilities have nearly 3x the rate of suicide compared with their peers in the general population.  Suicide is the leading cause of death for youth in juvenile confinement.  Up to one-third of justice-involved youth report having experienced suicidal ideation in the past year. Youth in Contact with Juvenile Justice System Task Force

10 Task Force Goal The task force was established to focus attention on the unique needs of youth in the juvenile justice system and develop new suicide prevention resources for the juvenile justice field. Youth in Contact with Juvenile Justice System Task Force

11 Task Force Objectives Youth in Contact with Juvenile Justice System Task Force  Raise awareness  Review and integrate the available research  Provide guidance around suicide prevention programming and training  Encourage greater collaboration among the mental health and juvenile justice systems The task force included leading experts in the field organized into workgroups to address the four objectives.

12 Public Awareness and Education Workgroup Members  Lead: Deborah Stone, ScD, MSW, MPH, Behavioral Scientist, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention  Christy (Lentz) Malik, MSW, Senior Policy Associate, National Association of State Mental Health Program Directors  Roy Praschill, Director of Operations, National Association of State Mental Health Program Directors  Steffie Rapp, LCSW-C, Program Manager, Office of Juvenile Justice and Delinquency Prevention  Kathleen Skowyra, Associate Director, National Center for Mental Health and Juvenile Justice Youth in Contact with Juvenile Justice System Task Force

13 Suicide Research Workgroup Members  Lead: Denise Juliano-Bult, MSW, Chief, Systems Research Programs and Disparities in Mental Health Research Programs, National Institutes of Health  Laurie Garduque, PhD, Director, Justice Reform John D. and Catherine T. MacArthur Foundation  Thomas Grisso, PhD, Director, National Youth Screening Assessment Project, University of Massachusetts Medical Center  Karen Stern, PhD, Social Science Analyst, National Institutes of Justice  Barbara Tatem-Kelley, MA, MEd, Program Manager, Office of Juvenile Justice and Delinquency Prevention  Linda A. Teplin, PhD, Vice Chair of Research, Director of Health Disparities and Public Policy, Northwestern University, Feinberg School of Medicine  Additional contributors include Karen M. Abram, PhD, Kathleen P. McCoy, PhD, and Marquita L. Stokes, MA, Northwestern University Youth in Contact with Juvenile Justice System Task Force

14 Prevention Programming and Training Workgroup Members  Lead: Ned Loughran, MA, Executive Director, Council of Juvenile Correctional Administrators  Karen Abram, PhD, Associate Professor, Health Disparities Program, Northwestern University, Feinberg School of Medicine  Donald Belau, PhD, Psychologist, Geneva Youth Residential Treatment Center  Lindsay Hayes, MS, Project Director, NCIA Jail Suicide Prevention and Liability Reduction, National Center for Institutions and Alternatives  Shawn Marsh, PhD, Chief Program Officer, National Council of Juvenile and Family Court Judges  Kara McDonagh, MSW, Program Manager, Office of Juvenile Justice and Delinquency Prevention  Nicholas Read, MA, Research Analyst, Human and Social Development, American Institutes for Research Youth in Contact with Juvenile Justice System Task Force

15 Collaboration Workgroup Members  Lead: Eric Trupin, PhD, Director, Division of Public and Behavioral Health and Justice Policy, University of Washington  David DeVoursney, MPP, Program Analyst, Substance Abuse and Mental Health Services Administration  Simon Gonsoulin, MEd, Principal Research Analyst, American Institutes for Research  Carl Wicklund, Executive Director, American Probation and Parole Association  James Wright, MS, LCPC, Public Health Advisor, Substance Abuse and Mental Health Services Administration Youth in Contact with Juvenile Justice System Task Force

16 Public Awareness and Education Workgroup Objective  To promote awareness among individuals who work with adjudicated youth and youth at risk of delinquency, and the public at large, that there is an increased risk for suicidal behaviors in youth involved with the juvenile justice system and that suicide for this target population is preventable. Youth in Contact with Juvenile Justice System Task Force

17 Primary Products Title: Need to Know: A Fact Sheet Series on Juvenile Suicide Overview: Provides practical information about suicide prevention to three distinct groups: 1) judges and juvenile courts, 2) juvenile detention and secure care staff, 3) juvenile probation staff. Each fact sheet includes:  Prevalence of suicide among youth in the juvenile justice system and factors that may increase suicide risk  Practical steps that staff can take to prevent suicide  Practical steps that systems (i.e., juvenile courts, detention and secure care facilities, probation departments) can take to prevent suicide Youth in Contact with Juvenile Justice System Task Force

18 Selected Key Findings  Youth involved with the juvenile justice system have increased risk of suicide.  There are factors that may increase the risk of suicide among justice-involved youth, such as mental health or substance use disorders, suicide or other death of friend or family member, social isolation, relationship problems, or separation from family.  There are steps that juvenile justice personnel and systems can take to prevent suicide. Youth in Contact with Juvenile Justice System Task Force

19 Suicide Research Workgroup Objective  To review current research on suicide and its prevention among juvenile justice- involved youth to identify gaps and make recommendations for future research. Youth in Contact with Juvenile Justice System Task Force

20 Primary Products Title: Suicidal Ideation and Behavior Among Youth in the Juvenile Justice System: A Review of the Literature Overview: Summarizes relevant peer-reviewed literature on suicide in the juvenile justice system and identifies gaps and needed research directions. Literature-Review.pdf Title: Screening and Assessment for Suicide Prevention: Tools and Procedures for Risk Identification and Risk Reduction Among Youth Overview: Examines the juvenile justice system’s responsibilities for identifying youth at risk of suicide, the contexts in which screening and assessment instruments are used, and specific instruments available to advance suicide prevention efforts. Screening-Assessment.pdf Youth in Contact with Juvenile Justice System Task Force

21 Selected Key Findings  New research studies must be conducted to determine a current and reliable rate of suicide prevalence among youth involved in the juvenile justice system.  Information on the number of attempts, preparatory acts, method of attempts, etc. remains scant, which hinders the development of research-based suicide prevention programming.  Little has been done to-date to empirically test the effectiveness of preventative interventions and programs in reducing suicide risk among justice-involved youth.  Juvenile justice providers should implement currently available tools for detecting and intervening with youth at risk for suicide. Youth in Contact with Juvenile Justice System Task Force

22 Suicide Prevention Training and Programs Workgroup Objective  To develop a national strategy for implementing accepted guidelines for juvenile suicide prevention at each critical intervention point within the juvenile justice processing continuum. Youth in Contact with Juvenile Justice System Task Force

23 Primary Product Title: Guide to Developing and Revising Suicide Prevention Protocols for Youth in Contact with the Juvenile Justice System Overview: Describes eight critical components of a sound juvenile suicide prevention program and strategies for implementing components across all points of contact within the juvenile justice system. -7-P1-ProtocolGuidelines.pdf Youth in Contact with Juvenile Justice System Task Force

24 Selected Key Findings  Suicide prevention programs should include strategies at all points of contact within the juvenile justice system, including: referral/arrest, courts, probation, detention and secure/non-secure care facilities, and aftercare.  Critical components of a comprehensive juvenile suicide prevention program – such as training, identification, housing, and treatment planning – should be incorporated at each point of contact. Youth in Contact with Juvenile Justice System Task Force

25 Mental Health and Juvenile Justice System Collaboration Workgroup Objective  To identify strategies for improving the level and quality of collaboration between the juvenile justice and mental health systems around juvenile suicide prevention and offer recommendations for promoting greater collaboration. Youth in Contact with Juvenile Justice System Task Force

26 Primary Product Title: Preventing Juvenile Suicide through Improved Collaboration: Strategies for Mental Health and Juvenile Justice Agencies Overview: Recommends priorities and strategies that mental health and juvenile justice agencies at the state and local levels can pursue to inform joint policy and budgeting decisions associated with suicide prevention for youth involved in juvenile justice. Provides an environmental scan tool with which jurisdictions can assess strengths, weaknesses, opportunities, and threats across priority areas. CollaborationFullVersion.pdf Youth in Contact with Juvenile Justice System Task Force

27 Selected Key Findings  Thoughtfully planned collaboration across all levels of government and jurisdiction is strongly urged.  Overarching collaborative priorities and strategies are offered to foster joint policy and budgeting decisions associated with suicide prevention for justice-involved youth. Youth in Contact with Juvenile Justice System Task Force

28 Suicide Research Workgroup Youth in Contact with Juvenile Justice System Task Force

29 Goals 1)Estimate prevalence of recent and past suicidal ideation and attempts 2)Examine gender and racial/ethnic differences 3)Identify associated risk factors 4)Suggest future directions for research Youth in Contact with Juvenile Justice System Task Force

30 Method  2 independent reviewers  Databases: MEDLINE/PubMed, PsycINFO, PsycARTICLES  Search and inclusion criteria: Epidemiologic studies, conducted in US Published since 1990 Empirical studies Examined suicidal ideation or attempts Youth in Contact with Juvenile Justice System Task Force

31 Study Selection Identified 27 studies Omitted 3 studies because they reported scale means, not prevalence Final database: 24 studies Youth in Contact with Juvenile Justice System Task Force

32 How Did Studies Vary?  Point of contact and adjudication status  Measures of suicidal behavior  Recall periods (“recent,” past year, lifetime) Youth in Contact with Juvenile Justice System Task Force

33 Overall Prevalence Rates Recent a Past YearLifetime Suicidal Ideation 3 – 52% (n = 12) b 10 – 29.2% (n = 4) 11.8 – 58% (n = 7) Suicide Attempts 1.4 – 8.5% (n = 9) 7.6 – 24% (n = 5) 10 – 31% (n = 17) a Recent assessment period ranges from “current” up to 6 months b n=Number of studies Youth in Contact with Juvenile Justice System Task Force

34 Gender Differences RecentPast YearLifetime Suicidal Ideation Females > Males (n = 5) Females > Males (n = 1) Females > Males (n = 2) Suicide Attempts 1.4 – 8.5% (n = 3) Females > Males (n = 2) Females > Males (n = 8) Youth in Contact with Juvenile Justice System Task Force

35 Racial/Ethnic Differences RecentPast YearLifetime Suicidal Ideation W > AA, H (n = 2) Females: H > AA W > AA, H (n = 1) ---- Suicide Attempts W > AA, H (n = 3) W > AA, H (n = 1) W > AA, H (n = 3) W & H > AA (n = 1) Males: W > AA & H Females: W & H > AA Youth in Contact with Juvenile Justice System Task Force

36 Suicidal Ideation: Point Of Contact RecentPast YearLifetime YOUTH IN THE COMMUNITY Pre-Adjudication 8 – 12.7% (n = 2) % (n = 1) Post-Adjudication 29.5% (n = 1) % (n = 1) YOUTH IN SECURE FACILITIES DETENTION Intake to detention 3 – 21% (n = 4) 10% (n = 1) 13.9 – 36% (n = 3) During detention 36.2 – 52% (n = 2) --- POST-DISPOSITION Intake to post-disposition facility 9.6% (n = 1) --- During stay at post-disposition facility 7.7% (n = 1) – 58% (n = 2) YOUTH AT MULTIPLE POINTS OF CONTACT Combined samples 18% (n = 1) 19 – 29.2% (n=3) --- Youth in Contact with Juvenile Justice System Task Force

37 Suicide Attempts: Point Of Contact RecentPast YearLifetime YOUTH IN THE COMMUNITY Pre-Adjudication 1.4 – 2.9% (n = 3) – 13.2% (n = 3) Post-Adjudication 2.5% (n = 1) 7.6 – 24% (n =2) 12.2 – 16.3% (n = 2) YOUTH IN SECURE FACILITIES DETENTION Intake to detention 3 – 3.7% (n = 2) – 27% (n = 5) During detention 8.5% (n = 1) 9.5% (n = 1) 15.5 – 31% (n = 2) POST-DISPOSITION Intake to post-disposition facility 3.1% (n = 1) % (n=1) During stay at post-disposition facility % (n = 1) 25.5% (n = 1) YOUTH AT MULTIPLE POINTS OF CONTACT Combined samples 2.4% (n = 1) 15.5% (n = 1) 12.4 – 14.4% (n = 3) Youth in Contact with Juvenile Justice System Task Force

38 Risk Factors  Psychopathology Depression  Substance abuse  History of sexual abuse  History of physical abuse Youth in Contact with Juvenile Justice System Task Force

39 Overall Limitations  Inconsistency in measures  Little information on where in the process samples were drawn  Few statistics on completed suicides  Few data on Hispanics  Insufficient information on females Youth in Contact with Juvenile Justice System Task Force

40 Recommendations For Future Research  Study different points of contact  Studies of females and racial/ethnic minorities, e.g., Hispanics  Examine additional risk and protective factors  Evaluate screening tools and procedures  Evaluate effectiveness of preventive interventions Youth in Contact with Juvenile Justice System Task Force

41 Improve Current Practices  Routinely screen for suicidal ideation  Provide interventions during in facilities  Provide referrals when youth return to their communities Youth in Contact with Juvenile Justice System Task Force

42 Q&A Please use “Submit a Question” on the right side of the screen to send your question to the speakers. Youth in Contact with Juvenile Justice System Task Force

43 Thank You  Visit the Action Alliance website: – more information about the Action Alliance and the NSSP force/juvenilejustice – more information about the task force  Contact: Youth in Contact with Juvenile Justice System Task Force


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