Encyclopedia of Psychology and Law

stand trial). Mental disorders may lead to impairments

in competence-related legal capacities for some youths.

For instance, a youth with a thought disorder may have

a paranoid delusion that her or his attorney is conspir-

ing against her or him and thus refuse to tell her or his

attorney critical information regarding her or his case,

or a youth with a depressive disorder may be unmoti-

vated to adequately defend herself or himself due to

feelings of worthlessness. In some jurisdictions, youths

with mental disorders may also raise the insanity

defense and can be found “not guilty by reason of

insanity” (not guilty by reason of mental disorder) if

mental disorders interfered with their ability to under-

stand that their illegal behavior was wrong and/or ren-

dered them unable to control their behavior.

Finally, the justice system has a responsibility to

protect the public to the extent possible. While mental

disorders are not the primary cause of most youth vio-

lence, there is some preliminary evidence that violent

behaviors perpetrated by youths with mental disorders

may sometimes relate to mental health issues, such as

attention deficit/hyperactivity disorder, substance use

disorders, and possibly even some internalizing types

of disorders. To the extent that mental health issues

contribute to youth violence, the youth justice system

has a responsibility to treat and manage psychopathol-

ogy so as to help prevent violence.

Assessment of Mental Health

Issues in Juvenile Offenders

In 2003, an expert panel including Gail Wasserman

and colleagues developed a consensus statement with

best practice recommendations for assessing mental

health issues among adolescent offenders. The panel

recommended that the assessment process involve

multiple steps. The first step is to screen all adolescent

offenders who are admitted to detention and custody

centers using an evidence-based tool. Ideally, this

screening should occur within 24 hours of the youth

being admitted to the facility and should focus on

issues such as short-term risk of harm to self and oth-

ers, active substance abuse, current medications, and

mental health history.

If a youth is identified as having mental health

needs through this screening process, a more compre-

hensive assessment may be necessary. This compre-

hensive mental health assessment should cover a broad

range of mental health issues, including Axis I disor-

ders and suicidality, and ideally should be conducted

prior to the determination of disposition so as to guide

dispositions and service delivery. Those youths who

are identified as having significant mental health needs

should continue to be reassessed periodically through-

out their detention, as youths’ mental health needs may

change considerably over the course of detention.

Also, to help facilitate youths’ transition back to the

community, Wasserman and colleagues recommend

that secure facilities assess all youths who are prepar-

ing to return to their communities.

A number of jurisdictions have recently made sig-

nificant efforts to implement a mental health screen-

ing process for detained youths. These efforts

have been advanced by the development of the

Massachusetts Youth Screening Instrument–Version 2

(MAYSI–2) by Thomas Grisso and Richard Barnum.

The MAYSI–2 is a brief self-report mental health

screening tool that has received empirical support. In

2006, this tool was routinely administered in more

than 35 states. A number of other tools may also be

useful in assessing adolescent offenders’ mental

health needs, including more comprehensive instru-

ments, such as the Diagnostic Interview Schedule for

Children–IV (Voice Version).

Despite the progress in the screening process for

adolescent offenders, there are a number of issues that

still need to be addressed. Most jurisdictions do not

routinely reassess youths who are being reintegrated

into the community to ensure that service continues.

In addition, many youth justice staff who screen ado-

lescent offenders are frontline staff, who do not neces-

sarily have adequate training in this area.

Treating and Managing the Mental

Health Needs of Juvenile Offenders

Due to the high cost of providing treatment services for

offenders, the primary focus of research and interven-

tions in the juvenile justice system has traditionally

been on reducing recidivism rather than improving

mental health outcomes. Research regarding treatment

that is specifically aimed at addressing the mental

health needs of juvenile offenders is scarce. However, it

is clear that juvenile offenders do not receive adequate

treatment services for their mental disorders, particu-

larly in the case of minority youths. Less than a quarter

of offenders with mental disorders in the juvenile jus-

tice system receive the services they need.

Recognizing that the juvenile justice system may

not be the optimal setting for youths with mental

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