|
DJC Newsletter February 2005 |
|||||||||||||||||||||||||||||||||||||||||||||||
|
Mental Health Programming
DJC Program Updates
Model County Programs
Mental Health
programming at by Dr. Michael Hagan In a manner of speaking, Ethan Allen School is the largest mental health facility for juveniles in the state of Wisconsin. The majority of youth who arrive at Ethan Allen School have a combination of problems: delinquency along with educational and mental health problems. As of this writing, there are approximately 325 youth at Ethan Allen School. Of these youth, 257 – just over 70%, have been referred to clinical services for psychological assessment and intervention. Of the total, 22 youth are in the reception cottage and are in the process of being screened for possible clinical services help. Eighty youth (approximately 25%) are presently receiving psychotropic medication. Thirteen additional youth have been prescribed psychotropic medication, and we are awaiting parental permission before they can begin taking it. In years past, Ethan Allen School housed many youth that were considered non-violent delinquents. This is no longer the case. The vast majority of youth at Ethan Allen School have long histories of violent delinquency, and most have failed in several attempts at intervention in the community before coming here. Upon arrival, a nurse in the Health Services Unit (HSU) screens each youth. If HSU staff identifies problems or concerns they can initiate clinical services intervention. The screening for mental health problems also takes place soon after being placed in the Reception Cottage, where all youth new to the institution are interviewed by a social worker, and are administered a suicide assessment inventory. Clinical services has a psychologist assigned to the Reception Cottage. Social workers and youth counselors make referrals to clinical services, and youth are given additional screening and intervention. Problems range from serious mental illness to distorted perceptions of the danger of being at Ethan Allen School. Youth present a myriad of mental health problems upon arrival at EAS. Depression and dysthymia, bipolar disorders, anxiety, chemical abuse problems, attention deficit disorders, cognitive disabilities, and post traumatic stress disorders are all present in the population. There are also some youth with severe generalized behavioral disorders and, at times, psychotic symptoms. Ethan Allen School is a juvenile correctional facility that has significant mental health services imbedded in it. Presently there is a part time psychiatrist; four full-time licensed doctoral level psychologists, and a psychologist supervisor who is also a doctoral-level, licensed psychologist. EAS is also home to the only internship in professional psychology in a juvenile correctional facility in the United States that is accredited by the American Psychological Association. There are five psychology interns at EAS who work for a year under the supervision of licensed staff providing many of the same services to youth. Interns are doctoral candidates at their respective schools, and over the years have come from as close as Waukesha and Milwaukee, and as far away as California, Hawaii, Florida, New York and Arizona. The internship receives applicants from all over the United States, and has been instrumental in the recruitment and hiring of psychologists into the entire Department of Corrections. It has also been instrumental in improving diversity among psychologists in the Department of Corrections. Since its inception in 1991, twenty-one interns have gone on to work for the State of Wisconsin Department of Corrections. Goals of Clinical Services Unit There are two important goals of Ethan Allen School's Clinical Services Unit. First, to promote mental health by treating young men who exhibit significant mental health needs or mental disorders. Secondly, to facilitate change within delinquent youth to reduce the likelihood of further involvement in delinquency and crime upon release from the institution. Clinical Services is an integrated component of the Ethan Allen School program. Psychologists are assigned to cottages, including security cottages, and attend cottage meetings. Individual Psychotherapy is shaped around the individual needs and goals of youth referred to Clinical Services. Treating mental disorders and distressing symptoms are a key purpose of individual psychotherapy. Research indicates that with juvenile delinquents, individual therapy is often needed as part of a comprehensive treatment program. Sex Offender Group Therapy is a very intensive intervention that averages one and a half to two years within the Serious Sex Offender Program at Ethan Allen School. Evaluation begins with the Sex Offender Screening Instrument: Pre-Treatment Interview. Groups are generally scheduled to meet three times a week. Groups vary in number from nine to five youth. A licensed professional counselor also is significantly involved in the provision of group psychotherapy services in this program. The Division of Juvenile Corrections is presently working to update and improve the sex offender treatment group process. The Positive Lifestyle Groups are designed for the older youth at Ethan Allen School who have a committed crimes or delinquent acts over a protracted period. The group is facilitated by a Staff Psychologist and examines group members’ delinquent behavior in the community and behavior at Ethan Allen School. The general purpose of the group is to help these individuals to establish a positive lifestyle in the community. The group uses various media and autobiographies to examine why individuals decide to change and the struggles to be faced in establishing a positive lifestyle. Anger/Stress Management Groups are planned and implemented by clinical services. The groups are facilitated by a staff psychologist or psychology intern to examine the positive and negative impact of anger, and the ways this emotion can be appropriately managed through such methods as relaxation, thought stopping, and assertiveness skills. Family Therapy is offered to residents of EAS and their families. This is a limited service because of the difficulty some families have with transportation to EAS, and the motivation to be involved in it. Psychological Assessments The clinical services unit completes approximately seventy formal psychological assessments a year. Some are done as part of a court order, some are done to assess youth to help in developing treatment plans, and some are done to assess dangerousness, including the likelihood of sexual violence. The are numerous informal evaluations completed throughout the year, many assessing the likelihood of self-harm. Consultation and Training All psychologists work within the cottages to help staff work more effectively with youth by understanding their mental health and behavioral problems. EAS clinical services is also a leader in providing formal training to staff on and off grounds resulting in CEU’s and CE’s being earned by participants. Clinical Services, along with the triage social worker, develop a plan for determining which youth need more intensive treatment programming than is available at EAS, and who would be appropriate for placement at Mendota Juvenile Treatment Center (MJTC). Some youth do well at MJTC, but unfortunately many are returned to EAS because of a lack of progress and behavioral disruptions within that program. EAS determines whom to send to MJTC, and they determine whom to send back. Contact: Dr. Michael Hagan, Ethan Allen School
Telephone: 262.646-3341 |
|||||||||||||||||||||||||||||||||||||||||||||||
|
Lincoln Hills School by Dr. Thomas Mueller LHS staff provides a variety of mental health services to youths committed to our care. When a new youth is admitted to this institution, an initial screening is conducted by a psychologist or other experienced professional before that youth is even allowed into his own room. This screening is specifically designed to assess suicide potential, presence of mental illness, developmental disability issues, acting-out potential, and other important concerns. Housing and placement decisions may be altered depending upon the result of this initial screening. This evaluation process is continued by the reception cottage social worker, who completes a detailed social history. This includes information from the youth, as well as background data from previous placements, prior evaluations, court records, etc. This evaluation focuses particularly on previous mental health services, suicide issues, physical and sexual abuse, and other important psychosexual factors. A youth counselor is assigned to be the primary counselor for each youth in the reception cottage program. This is done to assist each youth to adjust to life within an institution. In addition, these staff members monitor youths on a daily basis for any signs of mental illness, as well as unusual behavior of any kind. In fact, each youth is placed in a camera room for a period of time where he can be carefully observed to ensure that he has made a reasonable adjustment to the institution. Any staff at LHS can refer a youth to the Psychological Services Unit for assessment. A youth may be referred for a variety of reasons, including concerns about suicide potential, need for medication, potential to act out aggressively, need for ongoing therapy, etc. A psychologist is assigned to complete these evaluations in a timely fashion. Of course, emergency referrals are given priority. Currently, LHS has four psychologists on staff. Youths with particular needs may be placed in Miller Cottage, which has traditionally been known as the mental health unit. This cottage, which has room for up to 40 youth, focuses on meeting the mental health needs of youths by providing a consistent, predictable environment. Youths may be referred to this cottage while in the reception program, or they may be referred from one of the regular program cottages. Sometimes, the need for additional mental health services surfaces after the youth has been at the institution for a longer period of time. Youths in the other program cottages may also exhibit significant mental health problems. A psychologist is assigned to each cottage and has the responsibility to assess and treat the youths assigned to that cottage. This may involve individual or group treatment, as well as family therapy. All of the efforts of institution psychologists are designed to complement the group and individual counseling provided by social workers and other cottage staff. Mental health services are delivered as part of a comprehensive package designed to meet the needs outlined in the youth’s individual case plan. Another treatment option at LHS involves the use of psychotropic medication. If the psychologist determines that medication might be an appropriate treatment tool, a referral is made to the consulting psychiatrist. The psychiatrist will then evaluate the youth and determine whether psychotropic medication would be appropriate and beneficial. Of course, both the youth and his parent/guardian must consent to this form of treatment. Feedback to the psychiatrist is provided on a regular basis by means of treatment team meetings. Youths receiving medication are re-evaluated by the psychiatrist on a regular basis. A final option is available for those youths experiencing more extreme mental health problems. A total of 13 beds at the Mendota Juvenile Treatment Center are available for youths from LHS. Every effort is made to carefully evaluate those youths with significant problems and determine who is most likely to benefit from the combination of intensive mental health services available at MJTC. Regular consultation with that institution ensures that these beds are being utilized effectively. This is an important treatment resource which has been utilized very effectively over the years. In summary, youths are sent to LHS for a variety of reasons and often exhibit significant mental health needs. Many have long histories of mental health treatment at numerous other facilities. Staff at this institution are proud of their efforts to carefully evaluate these needs and provide the best mental health services possible to meet these needs and help youths learn to cope more effectively with the challenges in their lives. For more information contact Dr. Tom Mueller, clinical
supervisor, or Mark Bye, Unit Supervisor, at Lincoln Hills School
715-536-8386.
by Dr. Richard Miller Facility Overview Southern Oaks Girls School houses all juvenile females within the State of Wisconsin who are adjudicated delinquent and determined to be in need of a secure placement. The facility, which opened in 1994, is located in Union Grove. Historically (from 1995 through 2003), average daily population at the institution has been 84. The population has recently declined, with an average daily population of 56 in 2004. Upon arrival at Southern Oaks, students are immediately involved in a structured treatment and educational environment, with a strong focus on release planning. The facility utilizes an eclectic treatment approach, with strong cognitive, experiential, rewards-focused, and strength-based influences. Since the initiation of the 120-day short-term program in January of 2004, average length of stay at the facility has been 6 months. Girls released from Southern Oaks have evidenced a particularly low rate of criminal recidivism. Depending upon the particular time frame and definition of recidivism that is utilized, recidivism rates for youth released from Southern Oaks have ranged from 3-11%. Mental Health Needs of the Youth at Southern Oaks Numerous research studies have found that female youth involved in the juvenile justice system evidence a particularly high degree and complexity of mental health disorders. It has been speculated that this is likely related to the high level of abuse and other dysfunctional relationships in the histories of these youth. Youth admitted to Southern Oaks clearly fit the pattern described above. A typical "new admission" to Southern Oaks arrives at the facility just prior to her fifteenth birthday. She has experienced physical and/or sexual abuse at an average age of nine, and at an average age of twelve she began to engage in "consensual" sex. Arrest histories typically begin at this age as well. By the time of her arrival at Southern Oaks, she has dropped out of school; has been involved with between four and ten adult sexual partners; has been reported as a runaway at least 10 times; has become involved with alcohol and/or drugs; and has "failed" in multiple out of home placements. A 2004 survey of youth at the facility documented frequent histories of abuse, prior mental health treatment, and self-destructive behaviors among admitted youth:
General Mental Health Services For All Youth at Southern Oaks Given the prevalence and complexity of mental health disorders among the youth admitted to Southern Oaks, the institution has devoted considerable resources to meet these needs, including an enhanced staffing pattern for Psychological Services. Extensive mental health services are provided to all girls admitted to Southern Oaks:
Intensive MH Services for Severely Disturbed Youth at Southern Oaks Girls with more severe mental health treatment needs are identified utilizing the screening procedures noted above, and subsequently admitted to the institution’s intensive mental health unit, Stepping Up-Intensive Treatment Program (SU-ITP), which opened in January of 2000. SU-ITP provides the comprehensive, intensive, and individualized treatment needed to address the complex combination of behavioral and mental health symptoms evidenced by the most severely disturbed youth placed at Southern Oaks. The treatment approach involves a combination of behavioral management (including a modified point/level/disciplinary system), psychiatric medication management, a variety of cognitive-behavioral and skill-development treatment groups (including Skillstreaming and Dialectical Behavior Therapy groups), and intensive individual/family psychotherapy. Extensive outcome data has been collected for girls admitted to the SU-ITP program, including comparison to outcomes for a similar group of girls placed at Southern Oaks prior to the opening of SU-ITP. Relative to girls in the prior comparison group, girls admitted to SU-ITP evidenced:
To date, SU-ITP has been funded through a series of federal grants managed by the Wisconsin Office of Justice Assistance. Permanent GPR funding of the unit has been requested in the 2005-2007 DOC Budget Request and was included in the State Budget Proposal put forth by Governor Doyle in February of 2005. For further information please contact Dr. Rick Miller at Southern Oaks Girls School (262) 878-6500. Community Supervision Services Mental health services are provided to youth who are supervised in the community by DJC. Wisconsin is divided into two regions for the purposes of providing community supervision. The Southeastern Region includes Kenosha, Milwaukee, Ozaukee, Racine, Walworth, Washington and Waukesha counties. The Northwest Region includes the remaining 65 Wisconsin counties. As part of mental health services, DJC staff in both regions are currently implementing the Comprehensive Approaches to Sex Offender Management grant. The grant will enable contracted providers from the community to work with DJC institution and field staff to transition selected youth with sex offenses to residential facilities or home by meeting their clinical needs during this critical period.These services are provided during a designated Transition Phase -- a period of approximately 90 days prior to a youth’s transfer from a correctional institution to community supervision and up to 90 days in the community. During this time, a team of DJC and community-based providers put into place the services and supports the youth will need to be successful in the community. Providers will be involved in transition planning meetings, assist in developing a realistic case plan and assembling formal and informal supports in the community to aid in the youth's transition. This case plan will include very structured initial supervision that will gradually evolve into greater reliance upon informal supports. As this happens, the offender will work with trained providers to develop and live within a relapse prevention program. Progress will be monitored by the contracted treatment providers who helped to transition the youth home or to independent living.Read more about the Sex Offender Management Grant in the DJC Updates. Mental Health Services in Southeastern Region The Southeastern Regional office of the Division of Juvenile Corrections offers a variety of mental health services for DJC clients and their families. Services include:
Services delivered by community-based private providers and social service agencies allow for a continuum of treatment from the institution into the community. The Region contracts with community providers sensitive to cultural issues. Additionally, providers are available to provide in-home therapy for families needing those services. Milwaukee County is fortunate to have crisis services available through Milwaukee County's Mobile Urgent Treatment Team (MUTT). MUTT provides mobile crisis stabilization services for youth who may be experiencing suicidal ideation, threats of harm to self or others, out of control behavior, and any other psychiatric emergencies needing outside intervention. The team consists of Ph.D. level psychologists, MSW's, and RN's. The team responds immediately (with guardian consent, unless the police are involved) to help problem solve, assess and evaluate DJC clients for possible hospitalization intervention. The Southeast Region is working closely with several community agencies such as Running Rebels Community Organization and the Boys and Girls Club to meet the emotional needs of at-risk youth through culturally sensitive mentoring partnerships. Parents and families also have been involved in the mentoring process. The hope is that the relationships youth and their families form with community agencies will continue after discharge from community supervision. The Southeast Region has many other services and treatment options available in the community for DJC youth. For more information please contact Rebecca Winner, Purchase of Service Coordinator for the Southeast Regional DJC office. Telephone (414) 229-0911. Mental Health Services in Northwest Region The Northwest Region of the Division of Juvenile Corrections is committed to working closely with each of the area communities to transition offenders with mental health concerns to their home community via the resources located there. The Division of Juvenile Corrections is using the Case Management model of guiding the offender through the course of placement within the Juvenile Correctional Institution and his ultimate return to the community. Recommended services are identified as part of the case plan for the offender and his family. Expectations are clearly outlined. The services that are commonly identified are: psychiatric follow up and medication management; family counseling; psychological assessments; AODA individual treatment/groups; sex offender individual therapy and groups; and in-home therapy. The family and/or the DJC agent contact the provider(s) to arrange for the service(s) to be delivered. The DJC agent then explores how these services will be provided via the family HMO, Medical Assistance or funding through the Youth Corrective Sanctions Program, Serious Juvenile Offender Program or Aftercare Purchase of Services monies. The Northwest Region is committed to working with the providers, offenders and their families to develop a network of support for a successful reintegration to the community. We hope that these resources will help sustain the offender after he or she completes DJC supervision. The Northwest Region has other Community resources and supervision options available to youth committed to DJC. For more information please contact Mark Frost, (715-241-8890), Sue Boeke, (608-288-3350) or Tammy Muller, (920-729-3900).
In the summer of 2003, the Division of Juvenile Corrections (DJC) received a federal grant for just under $250,000 to implement areas of service for juvenile sex offender (JSO) management. JSO management was identified as an area needing enhancement in the Wisconsin Juvenile Correctional System. This Juvenile Sex Offender Management Grant follows a $2 million federal grant that was received in January 2003 for implementing a "Serious and Violent Offender Reentry Initiative". Titled the Going Home Project, this initiative is based on a three-phase model which demonstrates best practices related to successful reentry of offenders to the community. The first phase, Institution, begins during a youth’s placement at a secured juvenile correctional facility. The second phase, Transition, starts approximately three months prior to a youth’s return to the community and continues for about three months in the community. The third phase, Stabilization, takes place during ongoing community supervision of the youth for an average of six to nine months. The Next Step - Transitional services for juveniles with sexual offenses One of the objectives of the JSO Management grant is to provide aftercare services for older youth who are released into the community and are in need of transitional services that are not currently available to those over 18 years of age (housing startup costs, job training, etc.). To accomplish this objective, the DJC is following the three-phase model of the Going Home Project. In December 2004, the DJC began to identify youth with sexual offenses in juvenile correctional institutions that meet the criteria for a 90-day transition program and who require specialized aftercare services. Forty-four youth were identified as meeting initial eligibility criteria under the JSO grant. Of these forty-four youth, there are ten county-supervised youth who meet the institution criteria. DJC is working with Chippewa, Oneida, Racine, Rock, Menominee, Fond du Lac, and Marinette Counties to confirm eligibility, enroll these youth in the 90-day Transition Phase, and establish needed services for the youth upon release. The identified services may include individual sex offender therapy and family therapy, housing assistance, and individual transitional needs (work related items, independent living supplies, employment training, bus passes, books, etc.) DJC is excited about the opportunity to work with counties that provide their own aftercare in an effort to improve the transitional services for these, and all youth, being released from a Juvenile Correctional Institution back into their home communities. Other accomplishments under the grant:
Grant objective: to create a 90-day transition phase back into the community for all JSOs upon release from a correctional institution
Grant objective: to coordinate with the Wisconsin Chapter of the Association for the Treatment of Sexual Abusers (ATSA) to fund several training events to expand community treatment providers.
Grant objective: to create a directory of treatment providers for JSOs
The grant period began in October 2003 and will end in September 2005. For additional information please contact:
(Support, Perseverance, Respect, Initiative, Teamwork and Education) is a short term, high impact, adventure-based education program designed to teach delinquent youth the skills necessary for successful reintegration into their home communities. SPRITE students learn pro-social behavior, independent living skills, and responsibility through problem-solving activities, wilderness expeditions, rock climbing, community service and urban exploration. SPRITE differs from a recreation program in that emphasis is placed not on learning new recreational activities, but rather on the process by which responsible decisions are made and by the acceptance of consequences for inappropriate decisions or behaviors. DIRECT COUNTY REFERRAL PROCESS The SPRITE program is available to all counties in Wisconsin as a diversion to an institutional placement. The referral is to be made by the county social worker that is responsible for the youth. To start a referral, call (608) 288-3356 to find out about openings for the session you are interested in. (Generally we can accommodate placement within a month.) During this first contact the Program Director will discuss the appropriateness of the youth. If approved, a packet of information is requested. The new 2005 Referral Packet reflects changes in the required health information and eligibility criteria for youth with prescribed psychotropic medications. You may download the referral packet.To receive a referral packet in the mail, contact: Mike Kass, Program Director (608) 288-3356 fax: (608) 288-3378 michael.kass@doc.state.wi.state .
SEEKING INTAKE TRAINING INSTRUCTORS The Division of Juvenile Corrections administers Basic Court Intake Training pursuant to DOC Administrative Rule 399 and state statutes. The WI Juvenile Court Intake Association coordinates the training sessions via contract with the division. Intake Training is a five-day, 30-hour training held in locations across the state. It is designed to provide a newly assigned intake worker with the basic knowledge to perform the job functions of an intake worker. Training requirements include chapters 48 and 938, sections of chapters 51, 118 and 895, and an overview of chapters 939 to 948, the Criminal Code. At this time, we are seeking professionals that are knowledgeable and experienced in children’s/juvenile court and have an interest and experience in training in an adult educational setting. We are interested in discussing training requirements and proposals with a team that consists of a practicing social worker/intake worker and an attorney. If you are interested in learning more about this opportunity, or know someone that may be interested, please contact Pamela Eitland at the Division of Juvenile Corrections at (608) 240-5914 or via email at Pamela.Eitland@doc.state.wi.us. Southern Oaks Girls School Southern Oaks thanks all those who have sent Wisconsin Yellow Page books for use in the transitioning services program. If you have Yellow Pages from your area to contribute, please send them to Southern Oaks Girls School, Attention: Patricia Ogren, 21425B Spring Street, Union Grove, WI 53182-9707. Investigation Results Released The results of an Independent Review Committee, finding no
evidence to support an assertion of rampant sexual activity among residents of
Southern Oaks Girls School, were released on January 21, 2005. All County directors of Human/Social Service Departments and county judges received a full copy of the report. If you want to read the full report, please ask your County director for a copy. If the report is unavailable, you may contact Judy Barbian at the Division of Juvenile Corrections, 608.240.5932. Informational item With the shift to WiSACWIS for entering child support referrals for children and youth placed in out-of-home care, DOC and DHFS were asked what form counties should use to make a child support referral in the case of a youth being placed out-of-home when the placement is not documented on WiSACWIS, such as a juvenile correctional placement. If any human/social service agency needs a paper referral for a child placed in a correctional facility, the agency may download the Department of Workforce Development "Referral to Child Support" form, number DWSW 3080, through the DWD web site. http://www.dwd.state.wi.us/dwd/forms/dws/DWSW_3080.htm New Grant Coordinator at DJC The Division is pleased to welcome Gretchen Kubnick as the Division's Coordinator for its Juvenile Sex Offender Management Grant. Gretchen is a 2001 graduate of the University of Wisconsin - Madison where she attained her Bachelor of Arts in Behavioral Science and Law, Psychology, Sociology, and the Criminal Justice Certificate Program. Her internship with Probation and Parole here in Madison was spent working with and supervising adult sexual offenders in the community, facilitating sex offender treatment groups, developing pre-sentence investigations and conducting both offender and victim interviews. Gretchen can be reached at (608) 240-5915 and through email at gretchen.kubnick@doc.state.wi.us . |
|||||||||||||||||||||||||||||||||||||||||||||||
Click
underlined links to navigate through the newsletter.