A CASE FOR REFORM OF THE CHILD WELFARE SYSTEM

There are more than half a million children in our nation's foster care system. While foster care is intended to provide a temporary safe harbor for abused and neglected children, too many of these youth spend years in foster care limbo—experiencing a turbulent life in motion as they move from placement to placement, community to community, and school to school. Youth in foster care commonly fail to receive basic health and psychological care, and nearly 20,000 youth age out of foster care every year to an adult path of homelessness, unemployment, and despair. Our entire community must work together to more responsibly parent these youth. This article will address how lawyers and child advocates can advocate for new approaches and enhanced support on behalf of the voiceless and most vulnerable members of our community. It will address existing hurdles and systemic challenges that have helped to create the current disheartening status quo. The article will then discuss strategies that advocates can employ to turn the corner on behalf of these youth at risk.     

WHEN IT HAPPENS IN A FAMILY: AIDING PARENTS OF SUBSTANCE‐ABUSING ADOLESCENTS*

This article first summarizes key data on the scope of teen substance abuse and the lack of teen access to needed treatment services. It then describes how and why attorneys may be helpful to parents who discover their teen's drug or alcohol problem and seek advice and counsel about the legal implications of various actions that can or may be taken. The article explores such issues as parents finding illegal drugs in the house or on their teen's person, various modalities of treatment and how family members are involved, how parents might secure residential evaluations for their youth without the necessity of juvenile court involvement (and why this is important), concerns about placing youth in unlicensed residential treatment facilities, health insurance coverage issues, home drug testing, and how past American Bar Association (ABA) policy on youth drug and alcohol abuse is being followed up with a new ABA project to aid parents of substance‐abusing teenagers and their families.     

HELPING CLIENTS TRANSITION TO INDEPENDENT LIVING

There is growing recognition and concern that too many of the 20,000 foster youth who age out of the child welfare system each year 1 in this country do so without the basic necessities of housing, education, employment, and health care. The purpose of this article is to outline the problems facing foster youth as they leave care and to detail, as a case study, the steps taken by KidsVoice, a Pittsburgh legal services organization representing almost 5,000 dependent children each year, to help youth in foster and substitute care transition more successfully to adulthood and independent living.     

The Role of Emotional Security,Narrative, and Resilience for Youth and Families in Contexts of Armed Conflict

The far‐reaching devastation created by contemporary armed conflict puts children and families at risk. The goal of this article is to describe current research on the effects of armed conflict and political violence on families and youth with a focus on the roles of emotional insecurity and narratives of conflict that can persist long after the end of conflict. We describe how identity processes that are at the heart of many intergroup conflicts of the 20th and 21st centuries are linked with emotional insecurity and the historical and personal narratives of youth in these contexts. We conclude with general considerations for legal, medical, and mental health practitioners working with families who have experienced armed conflict.     

Exploring the Impacts of Racial Disparity Within the American Juvenile Justice System

The racial disparity in the American juvenile justice system impacts the lives of many youth of color. Youth of color constitute 34% of the U.S. population, however, they make up 62% of the youth charged in the juvenile justice system. The cycle of racial inequality and imprisonment are factors influenced by residential segregation and policing practices. Juvenile justice involvement leads to poorer physical and mental health in youth, stymied social outcomes, poorer familial relationships, decreased graduation and employment rates, increased rates in violence, and long-term negative future outcomes. The article advocates for mental health treatment and family services to be incorporated within incarcerated settings. Clinical strategies and future direction are discussed to begin to combat these various adverse impacts.     

FROM THE INSIDE OUT: CALLING ON STATES TO PROVIDE MEDICALLY NECESSARY CARE TO TRANSGENDER YOUTH IN FOSTER CARE

It is well known that transgender youth in foster care often face egregious discrimination and victimization based on their gender identities. Unfortunately, transgender youth in foster care have also been deprived of transgender-specific medical care that is vital to their health and well-being. This Note advocates that child welfare agencies adopt legislation that will demonstrate their commitment to fulfilling their constitutional duty to provide medically necessary care to transgender youth in their custody. This Note examines recent case law on the topic and addresses counterarguments to the proposal, including risks associated with treatment, high cost, and the stigma of gender identity disorder. Ultimately, this Note concludes that adopting the proposed legislation is a necessary step toward securing health care rights for transgender foster care youth.     

A NOT SO HAPPY BIRTHDAY: THE FOSTER YOUTH TRANSITION FROM ADOLESCENCE INTO ADULTHOOD

Every year close to 25,000 youth age out of our foster care system; without the anchor of a family, former foster youth disproportionately join the ranks of the homeless, incarcerated, and unemployed. While the average age of financial independence in America is twenty‐six years of age, we presume that foster youth can somehow attain financial and emotional independence by age eighteen. Instead, these adolescents are woefully unprepared for independent adult life, and when they falter, too often no one is there to provide support or guidance. As a result, former foster youth are ten times more likely to be arrested than youth of the same age, race, and sex and one in four youth who age out of foster care will end up in jail within the first two years after leaving care. This article will discuss strategies for changing these disheartening outcomes for transitioning foster youth, including breaking down our silos and collectively taking charge of the lives of children in our care; keeping a watchful eye on data and outcomes and using that information to guide our actions; ensuring that the voices of youth are an ever‐present part of decisions and processes that will chart their future; and educating ourselves about best practices and new approaches. This article also discusses new opportunities that now exist to support foster youth as they move into adulthood, including new federal legislation that—for the first time—will allow states to support foster youth beyond age eighteen. Finally, this article provides a backdrop for this Special Issue and summarizes the insightful articles and innovative thinking contained herein.     

ATTENTION DEFICIT HYPERACTIVITY DISORDER AND THE FAMILY COURT

A major focus of the Youth at Risk Initiative is the provision of appropriate community based mental health services to help prevent unnecessary residential placement of troubled youth and thereby reduce the risk of troubled youth becoming criminal offenders. Yet, inexplicably, one of the major factors contributing to the risk of criminal offending has received scant attention. That factor is Attention Deficit Hyperactivity Disorder (ADHD). This article established the widespread prevalence of ADHD among troubled youth and hence, the critical importance of identifying and treating ADHD as an essential component for any best practices model for the Family Court. It also examined the major mechanisms whereby ADHD increases the risk for criminal offending.     

A Qualitative Examination of the Self-Medicating Hypothesis Among Female Juvenile Offenders

Substance misuse among criminally delinquent youth has typically been described as a concurrent part of their participation in risky and delinquent behavior. Using Khantzian’s self-medication hypothesis, this article presents an alternative view by presenting qualitative data which suggests that substance misuse for female juvenile offenders may serve as self-medication for mental health problems stemming from early trauma, often at the hands of their families. Based on the narratives of 30 female juvenile offenders, this article examines the lived experiences of girls with childhood trauma and substance misuse, followed by arrest and incarceration. The paper concludes with recommendations for juvenile justice and child welfare practitioners.     

Judges’ Perceptions of Screening,Assessment, Prevention,and Treatment for Substance Use, Mental Health,and HIV among Juveniles on Community Supervision: Results of a National Survey

Juvenile Justice‐Translational Research on Interventions for Adolescents in the Legal System (JJ‐TRIALS) National Survey was funded in part to describe the current status of screening, assessment, prevention and treatment for substance use, mental health, and HIV for youth on community supervision within the US juvenile justice system. Surveys were administered to community supervision agencies and their primary behavioral healthcare providers, as well as the juvenile or family court judge with the largest caseload of youth on community supervision. This article presents the findings from the judges’ survey. Survey results indicated juvenile and family court judges were open to innovations for improving the court's performance, rated their relationships with collaborators highly, and appreciated the impact of screening, assessment, prevention, and treatment on judicial practices.     

Mapping an agenda for the study of youth sexual aggression in Europe: assessment,principles of good practice,and the multilevel analysis of risk factors

ABSTRACT

Sexual aggression is a serious threat to young people's sexual health in Europe, but establishing the exact scale of the problem has been hampered by a variety of conceptual and methodological problems. This article presents a framework for studying youth sexual aggression that addresses both prevalence and risk factors of victimisation and perpetration. It proposes a research tool to comprehensively assess the perpetration of, and victimisation by, sexual aggression that captures different coercive strategies, sexual acts, victim–perpetrator relations, and gender constellations. The instrument is rooted in a clear conceptual definition of sexual aggression and was pilot-tested in 10 countries of the European Union (EU). Furthermore, a list of good practice criteria is proposed to promote the quality and comparability of research on youth sexual aggression in Europe. A multilevel approach combining individual-level and country-level predictors of sexual aggression is outlined and illustrated with data from the pilot study in 10 countries.     

Child maltreatment profiles and adjustment problems in high-risk adolescents

The purpose of this article is to identify profiles of maltreatment experiences in a sample of high-risk adolescents and to investigate the relationship between the derived profiles and psychological adjustment. Participants are 1,131 youth between the ages of 12 and 18 years involved with publicly funded mental health and social services. Information on physical, sexual, and emotional maltreatment and psychological symptoms are obtained in interviews with adolescents and their primary caregivers. Using latent profile analysis, three maltreatment profiles are identified: "sexual+physical+emotional maltreatment," "physical+emotional maltreatment," and "low maltreatment." Adolescents in the two maltreatment profiles generally have significantly higher scores on symptom scales compared with those in the "low maltreatment" profile, but scores in the two maltreatment profiles do not differ. Findings highlight the need for agencies to identify and provide appropriate intervention for youth who experience multiple types of maltreatment.     

Conclusion: Mental health and legal responses to the adolescent mental health crisis: Raising the bar on best interests and promoting family connectedness in divorcing families

We are currently facing an unprecedented increase in adolescent mental health problems resulting in alarmingly high levels of depression, anxiety, and suicidality. Significant mental health problems among youth pose unique challenges to families in the process of separation and divorce, as well as to family law professionals across all disciplines. The current adolescent mental health crisis calls for new ways of approaching our work with high conflict families to promote family connectedness and shift away from adversarial approaches that may exacerbate conflict and further destabilize families. As a conclusion to the special issue on adolescent mental health needs, the authors make multidisciplinary best practices recommendations and advocate for systems level changes in recognition of the needs of youth in crisis at this pivotal developmental stage.     

Mental Health Services for Incarcerated Youth: Report from a Statewide Survey

The need for mental health care has been steadily increasing for youth coming into contact with the juvenile probation system. This paper presents the results of a statewide survey of juvenile probation departments and associated mental health, health care, court, and education personnel in California. The intent of the survey was to better understand the costs and associated contexts of caring for youth with suspected mental disorders in juvenile detention facilities. The burden of caring for these youth on detention facilities and their staffs is substantial. Implications for courts, policy planning, training, and further research are discussed.     

Southeast Asian Refugee Youth: Implications for Juvenile Justice

Abstract Southeast Asian refugees have been arriving in the U.S. in significant numbers since 1975. While they have had a history of a seemingly smooth resettlement and acculturation to this country, the number of Southeast Asian youthful offenders has increased dramatically since 1984. Factors common among refugee youth which have contributed to this rise include: problems of acculturation; role reversal with parents; lack of shared values, parental guidance and school success; and mental health problems often stemming from their history of war, traumatization, and loss before coming to this country. This article will discuss these factors and the implications for the juvenile justice system. The discussion will also highlight culturally appropriate intervention strategies for personnel working with these youth and their families.     

An At‐Risk Profile of Probation Supervised Youthful Offenders in a Rural,Midwest County: Significant Gender and Race Differences

There have been multiple risk factors identified that lead to youth delinquent behaviors and activities. These risks are family, school, peer, disability, and neighborhood related, though the studies to date have primarily focused on larger urban juvenile court jurisdictions. This exploratory study of one rural juvenile court (in Ashtabula County, Ohio) furthers these risk factor investigations through the evaluation of 91 randomly selected, adjudicated delinquent youth (supervised in 2008 and 2009). Data on 23 risk factors was collected, with further analysis of significant gender and race differences. Key results were that a majority of youth experienced poverty and lived in a one‐parent family; 40% had a mental health or substance abuse problem; 25% were in need of special education disability services; males were much more likely to have school‐related difficulties and to commit felony offenses; females had significantly more mental health and substance abuse problems; and minority youth successfully completed probation more often.     

Canadian "medical necessity" and the right to health

In this article, Kathryn Garforth examines legal claims to health care in South Africa and Canada. Both countries face rising costs of health care that put a great strain on publicly funded systems, albeit in radically different contexts. Kathryn argues that despite these differences there are similarities in how litigants in South Africa and Canada have framed their claims to healthcare services, in how governments have responded, and in the factors courts have analyzed in reaching decisions. In South Africa, the leading case is Treatment Action Campaign (TAC) et al v Minister of Health et al, a constitutional challenge, while in Canada the relevant jurisprudence concerns the interpretation of the concept of medical necessity, articulated for the most part in non-constitutional cases.     

The red herring of adolescent mental health

An increase in adolescent distress and mental health symptoms has been clearly documented since the COVID-19 pandemic, as has increased exposure to adverse childhood experiences. Layer on top of these stressors being a youth of divorcing or separating high conflict families, and adolescent symptomatology can suddenly become a flashpoint for parental attention, division and conflict. Approaching cases using an ecological and family systems framework is necessary for accurate conceptualization and assessment of best interests in the context of child custody evaluations. Doing so ensures that adolescent mental health does not become a red herring in high conflict cases, leading to undue focus on the adolescent's mental health without considering other salient factors in the case, such as the broader parent conflict. Programs offered at the Center of Excellence for Children, Families & the Law at William James College designed to improve the lives of youth by addressing parental conflict are described.     

WE NEVER CALL THE COPS AND HERE IS WHY: A QUALITATIVE EXAMINATION OF LEGAL CYNICISM IN THREE PHILADELPHIA NEIGHBORHOODS*

This article presents data from the completed first wave of a multiwave comparative study of crime, danger, and informal social control that focuses on youth living in three high‐crime neighborhoods in Philadelphia, PA (N= 147). The study is a purposive sample of delinquent and nondelinquent young men and women in one predominantly African‐American, one predominantly Latino, and one predominantly white neighborhood, and researchers have completed in‐depth interviews and self‐reports with each subject. This article focuses on the narratives that youth living in high‐crime neighborhoods build around their contact with police and the strategies the young people propose for crime reduction in their communities. The data illustrate that most youth in each neighborhood are negatively disposed toward police and that this is grounded in the lived experience of negative encounters with law enforcement. However, when youth expounded on what they thought would reduce crime, they overwhelmingly chose increased and tougher law enforcement. We analyze these findings to determine whether support exists for a subcultural approach or a cultural attenuation/procedural justice argument, and we explore the implications of our findings for community‐based crime control.     

Global risk factors and the prediction of recidivism rates in a sample of first-time misdemeanant offenders

This article examines the prediction of recidivism using the Global Risk Assessment Device (GRAD), a reliable and valid measure of dynamic factors associated with family characteristics, peers, mental health, substance abuse, trauma exposure, educational concerns, accountability, and health risks. Using a sample of adult caregivers of first-time misdemeanant offenders, two factors-education and accountability-were significantly associated with recidivistic behavior, supporting the use of GRAD data in correctly identifying first-time offenders who have the greatest and the least likelihood for future offending behavior. Additional analyses utilizing parent reports on African American males indicate that the GRAD provides discrimination in the prediction of recidivism in a group typically seen as being high risk simply because of their gender and race. The assessment drives intervention approach of the GRAD is discussed in terms of using reports from adults to accurately place youth into appropriate levels of supervision and treatment.