health needs, some jurisdictions strive to divert men-
tally ill youths from the youth justice system. At vari-
ous stages after arrest, youths may be referred out to
community-based agencies for counseling or inter-
vention services. Though the focus of diversion pro-
grams has also tended to be on reducing recidivism,
some recent research has examined the impact of
diversion programs as well as other types of programs
on mental health outcomes.
Treatment programs using a “wraparound”
approach, which focuses on strong interagency col-
laboration to address youths’ individualized treatment
needs, have shown reduced emotional problems and
mental health symptoms in referred youths, in addi-
tion to improved social and school functioning, and
reduced rearrest rates. Some preliminary research has
also reported that postrelease treatment services con-
tributed to improved outcomes. Finally, researchers
have found that multisystematic treatment, a leading
treatment for high-risk youths, is associated with
reduced psychiatric symptomatology as well as
decreased recidivism.
As another alternative to the juvenile justice sys-
tem, some jurisdictions have developed specialized
mental health courts and drug courts. While there is
preliminary evidence that juvenile drug courts are
sometimes associated with reduced substance abuse
among adolescent offenders, there is an absence of
research on juvenile mental health courts. Like many
of the treatment options for juvenile offenders, mental
health courts and drug courts are downward exten-
sions of adult treatment strategies. It is important for
these treatment strategies to be empirically investi-
gated for youths as juvenile offenders may experience
unique barriers to treatment not faced by adults.
Furthermore, approaches that have been found to be
effective with youths in community mental health set-
tings may not easily generalize to youths in juvenile
justice settings. For instance, adolescent offenders
have high rates of cognitive deficits, which may inter-
fere with their ability to engage in complex cognitive
processes that are central to some therapeutic modali-
ties. Also, the youth justice system is not an ideal treat-
ment environment. Interventions administered within
the youth justice system are often ordered by the court,
and youths who receive interventions may experience
considerable stigma. As such, adolescent offenders
may be resistant to comply with interventions.
Though research is finally moving from evaluating
criminal outcomes to mental health outcomes, there isstill a dearth of evidence supporting mental health
treatment services for juvenile offenders. Given the
significant mental health needs of adolescent offend-
ers, it is critical that future research continue to inves-
tigate effective strategies to manage and treat mentally
ill adolescent offenders.Jodi L. Viljoen and Sarah MordellSee alsoAdjudicative Competence of Youth; Juvenile
Offenders; Massachusetts Youth Screening Instrument–
Version 2 (MAYSI–2)Further Readings
Grisso, T. (2004). Double jeopardy: Adolescent offenders
with mental disorders.Chicago: University of Chicago
Press.
Grisso, T., Vincent, G. M., & Seagrave, D. (Eds.). (2005).
Mental health screening and assessment in juvenile
justice.New York: Guilford Press.
Teplin, L. A., Abram, K. M., McClelland, G. M.,
Dulcan, M. K., & Mericle, A. A. (2002). Psychiatric
disorders in youth in juvenile detention. Archives of
General Psychiatry, 59,1133–1143.
Teplin, L. A., Abram, K. M., McClelland, G. M., Washburn,
J. J., & Pikus, A. K. (2005). Detecting mental disorder in
juvenile detainees: Who receives services. American
Journal of Public Health, 95,1773–1780.
Wasserman, G. A., Jensen, P. S., Ko, S. J., Cocozza, J.,
Trupin, E., Angold, A., et al. (2003). Mental health
assessments in juvenile justice: Report on the consensus
conference. Journal of Child and Adolescent Psychiatry,
42,751–761.MENTAL ILLNESS AND
THEDEATHPENALTY
Executing mentally ill prisoners has been a controver-
sial topic for decades. The U.S. Supreme Court has
found that such executions are unconstitutional.
Although public opinion is somewhat mixed and
understudied, national societies such as the American
Psychological Association oppose executing the men-
tally ill. The legal system asks mental health profes-
sionals to determine a prisoner’s competency for
execution. Incompetent prisoners can be medicated so
that they can become competent and thus be executed.
Many professionals find this practice unethical.496 ———Mental Illness and the Death PenaltyM-Cutler (Encyc)-45463.qxd 11/18/2007 12:43 PM Page 496