Washington State Juvenile Justice Rehabilitation Administration: Echo Glen Children’s Center Mental Health Services

Principal Investigator: 
Eric Trupin, Ph.D.
Funding Source: 
WA State Juvenile Justice Rehabilitation and Recovery Administration
Project Period: 
Ongoing
PBHJP Project Faculty and Staff: 
Eric
Trupin
Director and Vice Chair, Department of Psychiatry & Behavioral Sciences
Nicholas
Weiss
Acting Instructor/Senior Fellow
Terry
Lee
Associate Professor
Project Summary: 

Echo Glen Children’s Center (EGCC) is a Washington State Juvenile Justice Rehabilitation Administration (JJRA) facility for adjudicated youth, located in Snoqualmie Ridge. The University of Washington (UW) Division of Public Behavioral Health and Justice Policy (PBHJP) provides psychiatric services and consultation to youth adjudicated to Echo Glen Children’s Center, and manages a training site at EGCC for the University of Washington General Psychiatry and Child Psychiatry Residency Programs.
 
Echo Glen Children’s Center is a medium/maximum security facility that is not fenced, but bordered by natural wetlands. EGCC is the main JJRA facility for girls and younger boys (<17-years-old). Approximately 2/3 of youth at Echo Glen have a mental health disorder beyond oppositional-defiant disorder/conduct disorder and substance use disorders, and approximately 50% have a substance use disorder. More than 50% of youth qualify for Special Education services and approximately 40% have less than a 5th grade reading level at the time of admission.
 
Echo Glen provides treatment to all youth via the Integrated Treatment Model (ITM). The ITM is based on behavior modification, cognitive-behavior therapy and Dialectical Behavior Therapy. The ITM emphasizes skills training to increase self-awareness, and more effectively communicate, solve problems and manage feelings and behavior. Youth learn ITM skills approximately 20% via group and individual sessions and 80% coaching in the milieu. ITM treatment fidelity is monitored via an Environmental Adherence measure which uses trained observer ratings on a structured instrument, and youth and staff input. In addition, some staff members are trained on Trauma-Focused Cognitive-Behavior Therapy (TF-CBT). The Issaquah School District provides Educational Services at Echo Glen. Youth also have the opportunity to participate in training future service animals in the Canine Connections program.
 
Evidence-based and best practices psychiatric services are emphasized. Psychiatric services are coordinated with psychosocial treatments and educational services. Psychiatrists communicate with families throughout a youth’s psychiatric treatment at Echo Glen, and plan transition psychiatric services. UW psychiatry also chairs the EGCC Mental Health Administration Team, which oversees mental health services and provides consultation for pertinent clinical and administrative concerns. UW psychiatry also co-chairs the JJRA Psychiatry Quality Improvement Committee.
 

Public Health Relevance: 

Youth in long-term secure detention have increased mental health needs, and are at increased risk to re-offend, as well as multiple negative quality-of-life outcomes. Placement in detention is a risk factor for completed suicide, adjustment disorders and exacerbation of existing mental health disorders. Long-term detention offers an opportunity for treatment to address mental health concerns, further develop problem-solving skills, improve youth well-being, and decrease the risk of re-offending.

Juvenile Justice
Additional Reports: 
  • Trupin E., Stewart D., Beach B., & Boesky L (2002). Effectiveness of a dialectical behaviour therapy program for incarcerated female juvenile offenders. Child and Adolescent Mental Health, 7(3), 121-127.
  • Fazel s., Doll H., & Langstrom N. (2008). Mental disorders among adolescents in juvenile detention and correctional facilities: A systemic review and metaregression analysis of 25 survey. Journal of the American Academy of Child and Adolescent Psychiatry, 47(9), 1010-1019.
  • Teplin, L., Abram, K., McClelland, G., Dulcan, M., & Mericle, A. (2002). Psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry, 59 (12), 1133-1143.
  • Cocozza, J. & Skowyra, K. (2000). Youth with mental health disorders: Issues and emerging responses. Office of Juvenile Justice and Delinquency Prevention Journal, 7 (1) 3-13.
  • Skowyra, K.R. & Cocozza, J.J. (2005).  Blueprint for Change: A Comprehensive Model for the Identification and Treatment of Youth with Mental Health Needs in Contact with the Juvenile Justice System.  National Center for Mental Health and Juvenile Justice.