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The US Supreme Court's complaint in 2005 about inconsistencies in research into adolescents' decision-making capacity did not take into account the different demands placed on adolescents by controlled situations and unstructured situations. Apparent inconsistencies in research into adolescents' capacity in treatment situations and in trial situations may simply be due to methodological differences between the two bodies of research. Apparent inconsistencies in the law regarding presumptions about adolescents' capacity are related to differences in societal objectives across decision-making contexts.
Gina M. Vincent, Department of Psychiatry, University of Massachusetts Medical School 55 Lake Avenue North, WSH 8B Worcester, MA 01655 USA,
Thomas Grisso, Professor, Law and Psychiatry Program Department of Psychiatry University of Massachusetts Medical School 55 Lake Avenue North, WSH 8B Worcester, MA 01655 USA,
Anna Terry, Research Associate, Law & Psychiatry Program Department of Psychiatry University of Massachusetts Medical School 55 Lake Avenue Norh, WSH 8B Worcester, MA 01655 USA
This chapter provides a brief description of the benefits and procedures of mental health screening and assessment in juvenile justice settings. It begins with a discussion of the reasons for and benefits of identification of mental health problems in juvenile justice settings, and the developmental complications involved in this undertaking. The chapter defines and differentiates mental health screening versus assessment by describing the characteristics of both. Finally, it provides a brief review of the current mental health screening tools, which are in the public domain and have been validated for use in juvenile justice settings. The screening tools are defined along three categories: multidimensional brief screening tools, problem or needs-oriented interview schedules, and multidimensional scales identifying clinical disorder. The selection of tools must be commensurate with the purposes, demands, and constraints of the situations in which they will be used.
A new actuarial method for violence risk assessment – the Iterative Classification Tree (ICT) – has become available. It has a high degree of accuracy but can be time and resource intensive to administer.
To increase the clinical utility of the ICT method by restricting the risk factors used to generate the actuarial tool to those commonly available in hospital records or capable of being routinely assessed in clinical practice.
A total of 939 male and female civil psychiatric patients between 18 and 40 years old were assessed on 106 risk factors in the hospital and monitored for violence to others during the first 20 weeks after discharge.
The ICT classified 72.6% of the sample as either low risk (less than half of the sample's base rate of violence) or high risk (more than twice the sample's base rate of violence).
A clinically useful actuarial method exists to assist in violence risk assessment.
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