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Program addresses health care needs of youngsters leaving juvenile justice system

By Jane Shaskan - August 29, 2005

A program designed to bridge the gap between detention and home is filling a need for youngsters moving through the juvenile justice system by providing psychiatric evaluation, short-term medication management, and case support.

The community-based program, HomeCare, provides transitional medical management for juveniles waiting for long-term, comprehensive service plans to begin. Youngsters aged 10 to 16 currently or recently in detention and those ready to be released and in need of immediate medication management are eligible.

The program is run by nurse practitioners Geraldine Pearson, program director and assistant professor, and Beth Muller, instructor, both staff of the Health Center’s Department of Psychiatry. They practice at program sites in Hartford, Middletown, Bridgeport, and New Haven.

“We have 50 years of nursing experience between us, and the freedom to provide high quality care to meet the needs of these young people,” says Pearson. “When a youngster walks in, we acknowledge the crime that has been committed, but we put it aside. We look at the youngster’s behavioral health and family dynamics to determine their needs and what we can do to help them return home.”

Established to meet the terms of the Emily J court order settlement mandating specific services for youths in the juvenile justice system, the first clinic opened in Hartford in September 2003. The HomeCare program is supported by the Department of Children and Families and the Court Support Services Division of the Connecticut Judicial Branch.

Youngsters are referred by probation and parole officers. During the past two years, 250 youngsters have been referred to the program.

Services available include psychiatric assessment, medication management, help negotiating medical care systems, and opportunities for individual, group, and family counseling.

“Our goal is to maintain the youngsters within the community,” says Muller. “We keep the pieces together. The mission of HomeCare is to hold these chidren in our program while the most appropriate, comprehensive, long-term plan is arranged.”

A plan of care is defined for each youngster and Pearson and Muller arrange mental health and clinical services at a participating federally qualified health center close to the youngster’s home.

“We are treating indigent kids, who would otherwise not receive care from a psychiatrist,” says Pearson. “Beth and I have found nearly every youngster we meet has had a loss or traumatic event in their lives that needs to be treated. Many have ADHD or are depressed. We regularly learn these kids are acting out because of traumatic events in their lives.”

A model designed especially for traumatized youngsters was developed at the Health Center’s Joint Institute for Public Psychiatry. Called TARGET-AV, Trauma Adaptive Recovery Group Education and Therapy, Adolescent Version, Pearson says the goal is to integrate individual and group treatment for a select population of severely traumatized HomeCare patients. The model is now in a pilot phase at the Middletown Clinic.

The HomeCare program has been well received by DCF and the court system, and other agencies have inquired about it. The program is growing, including a research component.

“We are gathering information from each youngster we see to learn how effective our program is,” says Pearson. “We strongly believe the HomeCare program is extremely valuable not only to the youngsters involved but to their families and to the community at large.”

Pearson and Muller plan to submit grant proposals to continue and expand their work.

Says Pearson, There are so many kids who need help.”

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