The Role of Responsivity in Youth Rehabilitation: The Case of Mental Health

Mental health problems are a significant concern for justice-involved youth. Yet there is substantial variability in how mental health problems have been understood in terms of their role in offending and their significance to treatment planning and outcomes. Perspectives on mental health from a predominantly clinical literature differ from the conceptualization found in the rehabilitation-focused Risk-Need-Responsivity (RNR) literature. This dissertation consists of two papers addressing the role of mental health issues in justice system involvement, with a focus on youth. Paper 1 provides a conceptual analysis of the two literatures to elucidate points of contrast and potential for common ground. I argue that the two literatures differ in seven ways: major goals, definition of risk, predictors studied, outcomes of interest, timelines of interest, features- versus disorder- based approaches, and what is included in the category of mental health concerns. Using these identified differences as an interpretative framework, areas of concordance are then identified. Directions for research include the role of mental health in offending, especially for youth in a developmental context, and gender differences. Implications for policy and practice are reviewed. Paper 2 presents an empirical study that examined probation services and reoffending outcomes for 232 youth following comprehensive assessments of their mental health and criminogenic risk/needs. The role of mental health functioning was examined in the context of assessed and treated criminogenic needs. Youth with identified mental health needs were no more likely than youth without such needs to reoffend, regardless of whether those needs were treated. Youth who received mental health treatment were more likely than other youth to have their criminogenic needs treated, suggesting that mental health treatment was associated with intermediate treatment targets. However, criminogenic needs treatment reduced the risk of reoffending regardless of mental health; mental health treatment did not significantly moderate the effectiveness of criminogenic needs treatment. These findings are discussed in terms of possible interpretations of responsivity, reflecting either that treatment of mental health problems facilitated engagement in criminogenic needs treatment, or that youth received higher quality or more comprehensive services due to systems-level variables. Implications for theory and practice are discussed.Ph.D