Juvenile Justice Residential Program at Hastings Juvenile Correctional Facility
A. Required 4-months rotation occurring in the second year at institution 5 and requiring 20% of the resident’s time (one day per week) during those four months.
B. University faculty consists of 1 full-time psychiatrist, and facility faculty includes a psychologist in charge of the behavioral overlay programs, eight master’s degree level therapists, eight licensed mental health technicians and intervention specialists.
C. Residents participate in bi-monthly in-services and educational staffings. On-site and off-site faculty is always available for consultation.
D. Because this is a juvenile detention facility for boys, the clinic population is 100% male of ages 13 up to and including 18. Of these, 54% are African American, 40% Caucasian; 5% Hispanic; and 1% Asian. Approximately 72% have dually diagnosed substance abuse plus other psychiatric disorders. The other diagnoses cared for include 42% conduct disorder, 10% learning disorders and ADHD, 13% depressive disorders, 3% bipolar disorder, 6% anxiety disorders, and an 9% are responding to stressful environments, i.e., family disruption, death in the family, or abuse. During 2004, the facility housed on average 120 youths per day, of which 46% had psychiatric care. Treatments consist of medication therapy, various individual therapies, and substance abuse treatment services.
E. Caseloads vary according to facility occupancy and patient needs, and averages 25 to 30 patient visits per month. Residents are responsible for patient evaluations and follow-ups, medication management and brief individual and supportive therapy, collaboration with the multidisciplinary treatment team, for providing input into comprehensive treatment planning, and record keeping. Residents also provide educational in-services for staff members and participate in weekly educational staffings.
F. Residents will receive case-by-case supervision by a faculty member present on-site, by qualified substance abuse professional on-site, as well as by their individual supervisors off site.
G. Following are the goals and objectives for this rotation:
Goal: To provide psychiatric care to adjudicated adolescents with psychiatric disorders that is of high quality, with priority on safety and use of interventions with established effectiveness.
Objectives:
Knowledge:
- To become knowledgeable of patterns of psychiatric morbidity and substance use disorders in juveniles residing in correctional facilities;
- To understand developmental, social, and cultural factors that may contribute to psychiatric morbidity and substance use disorders.
- Be knowledgeable about Court authorization procedures for psychotropic medication use in adjudicated minors.
Skills: The resident will demonstrate the ability to
- Evaluate and treat diverse adolescent populations in a culturally sensitive manner.
- Formulate a differential diagnosis for adolescents with coexisting legal problems.
- Develop comprehensive biopsychosocial management plans for adolescents in juvenile justice settings.
- Provide psychopharmacologic treatment of psychiatric disorders and functional problems in juvenile justice settings.
- Apply consultation principles to community-based facilities.
Attitudes: The resident will demonstrate:
- Attitudes conducive to successful multidisciplinary collaboration, including with substance abuse specialists and juvenile detention staff.
- Understanding of counter-transference issues relevant to juvenile detainees.
- Display professional attitudes with appropriate boundaries and empathy.
- Awareness of and sensitivity to possible cultural differences among teens, families, treatment providers, and detention staff.
