Gold Standard Versus Treatment as Usual: Assessment Practices in the Juvenile Justice System

Abstract

Mental health concerns are highly prevalent in the juvenile justice system (JJS). Assessment practices vary significantly across probation departments, often relying on past medical history or unstructured clinical interviews. Numerous structured and semi-structured assessment tools exist, some of which have previously been used within JJS samples. The current research compared mental health diagnosis prevalence and distribution as assigned by the current practice in a probation department versus utilizing the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) in a sample of youth involved with the JJS. Results suggested the K-SADS identified a higher variety of mental health concerns with higher precision (e.g., all diagnoses were specified rather than unspecified). However, the standard assessment practice identified a higher prevalence of ADHD diagnoses, as well as “Other Conditions That May Be a Focus of Clinical Attention.” Limitations and future directions are discussed.