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Monday 16th of July 2018

Press Room

IJJO Interviews- Dr. Thomas Grisso. University of Massachusetts Medical School. United States

Wednesday 25th of July 2012 | National, United States

In this interview, the Director of Psychology department and the Law-Psychiatry Program at the University of Massachusetts Medical School talk about the program he manages in the USA providing technical assistance to juvenile justice systems.
Dr. Grisso underlines, that there is very little research evidence that screening and assessment lead to successful and effective treatment. He also presents his new area of study aiming at finding ways to improve mental health screening in juvenile justice for young people with diverse cultural backgrounds.

Thomas Grisso since 1987 works as a Professor at the Department of Psychiatry at the University of Massachusetts Medical School, where he also performs the function of the Director of Psychology as well as of the Law and Psychiatry Program. He holds a PhD in Clinical Psychology from University of Arizona and he has also been given the title of a honorary Doctor of Law at John Jay College of Criminal Justice, City University of New York. T.Grisso is a professional member of the American Psychological Association and the American Academy of Forensic Psychology, and he is certified in forensic psychology by the American Board of Professional Psychology. His professional experience in the field of juvenile justice includes conducting clinical forensic assessment of criminal and juvenile cases, analysis of mental health needs of youth in the juvenile justice system or of risk of violence among adults and youth with mental disorders. Currently he has focused his research on the forensic mental health issues in juvenile justice, publishing and co-editing many books and articles. Recent books include Evaluating Juveniles’ Adjudicative Competence (2005), Double Jeopardy: Adolescent Offenders with Mental Disorders (2004), and Specialty Competencies in Forensic Psychology (2011).

Can you please provide us a short description of your main activities at the Department of Psychiatry of the University of Massachusetts Medical School, in relation to young offenders and mental health?

I have several roles at my university in relation to young offenders and mental health. First, I direct a research lab of four faculty and several research assistants. We do research that seeks to improve screening and assessment for mental health problems, substance use problems, and risk of re-offending among youth in juvenile justice. We are funded with grants from several U.S. federal research agencies and private foundations. Second, I oversee a program that educates and certifies all public-sector mental health professionals in the state of Massachusetts who do forensic evaluations of juveniles in our state’s juvenile courts. Third, I direct a program that provides technical assistance to juvenile justice systems throughout the U.S. and other countries that seek to improve their screening and assessment of young people with mental health disorders in their juvenile justice programs. Our technical assistance includes research that evaluates the results of mental health screening when it is actually used in juvenile justice programs.

Do you consider mental health disorders to be a contributing factor to juvenile crime? If yes, to what extent and how does it contribute? What strategies are advisable and recommended to prevent offending among youth with or at risk of mental health problems?

Yes. There are several general risk factors for offending, like impulsiveness and anger. Mental disorders contribute to offending when they involve symptoms that increase these risk factors. For example, ADHD increases the risk of offending because ADHD includes symptoms of impulsiveness, and a youth who is impulsive (whether it is due to mental disorder or not) has an increased risk of offending. In other words, mental disorders in general do not cause offending, but some mental disorders include symptoms that increase the risk of offending. Any “strategy” (e.g., treatment) that reduces impulsivity in ADHD youth, or decreases symptoms of depression and anger in depressed youth, reduce the risk of offending.

As a result of the MHYO Recommendations, which stated the necessity to develop effective measures for prompt screening and assessing mental health problems, have there been successful and effective treatment results following an in-depth screening and assessment of mental health issues for young offenders?

I am sure that many clinicians can describe cases in which proper assessment led to successful treatment for some youths and a reduction in offending. But as a researcher, I should answer based on research evidence. At this time, there is very little research evidence that screening and assessment lead to successful and effective treatment. We do have evidence that screening in juvenile justice programs leads to more attention to youths’ mental health needs, to more referrals for mental health services, and to more treatment for those young people. That is all that screening and assessment can do. They cannot guarantee that the treatment that youth receive will be “successful and effective.” To get the results you describe, we must have successful and effective screening methods (which we have) and successful and effective treatments (which unfortunately many communities do not have).

Diversion measures and restorative justice are shown to be more successful in rehabilitating youth than detention measures. Which ones do you consider being the most appropriate and effective, taking into account the seriousness of the crime and the presence of mental health problems?

Diversion and restorative justice appear to be more successful in rehabilitating youth than placing young people in detention and corrections programs. But the research evidence suggests that this is true because detention actually does harm to youth. That is, there is evidence that on average, placing youth in secure detention and corrections programs somewhat increases the number who re-offend compared to those who are diverted. Detention makes them worse, but we are not sure that diversion makes them better; it simply doesn’t make them worse. In that sense, diversion is “more successful” than detention.

The MAYSI-2 is a reliable and valid screening tool to assist juvenile justice staff in identifying youths who may need an immediate response to mental or emotional problems. What are the main difficulties and risk factors for its implementation as a good practices resource and instrument in the youth justice system?

The MAYSI-2 (and any other valid tool) is valid only if it is implemented and used properly. If it is not implemented properly, the tool is no longer valid in actual practice. Those who administer it should be trained to do so as described in the manual; if they do not, the results can no longer be considered valid. MAYSI-2 is a screening tool, which means that it should be used to determine which young people do and do not need further assessment. It is inappropriate to use mental health screening tools as though they provide diagnosis or a prescription for treatment.

As a distinguished researcher in the field of juvenile justice, what are your research plans for the near future in this field, specifically in relation to mental health and young offenders? How do you hope your efforts will contribute to the well-being of young offenders with mental health issues?

At this point in my career, my research plans are primarily to help younger researchers develop their own research plans. The one new plan that I have begun, however, is to determine ways to improve mental health screening in juvenile justice for young people with diverse cultural backgrounds. Throughout European nations, many young people in juvenile justice are not of the same culture as the nations in which they are living. This is beginning to be more common in the U.S. as well, with increasing immigration of families to the U.S. seeking refuge from conditions in their countries of origin. Young people coming from very different cultures are likely to have different forms of mental disorder. They also have entirely different cultural backgrounds from the young people on whom our screening tools were validated. We cannot assume that our screening tools will be as effective in identifying their mental health problems. These are the problems that I am beginning to study, with the help and collaboration of a new group of researchers we have formed in Europe. The group, called the International Forensic Screening and Assessment Network for Adolescents (InForSANA), includes researchers in nine European countries who are working together to do cross-national and cross-cultural comparisons of mental health problems among young people in their juvenile justice programs. The European coordinating center for this group is the Curium at Leiden University in the Netherlands.

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