The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV; Nicholls, Viljoen, Cruise, Desmarais, & Webster, 2010; Viljoen, Cruise, Nicholls, Desmarais, & Webster, in preparation) is a clinical guide designed to assist in the assessment and management of adolescents’ risk for adverse events (e.g., violence, general offending, suicide, victimization). In this initial validation study, START:AV assessments were conducted on 90 adolescent offenders (62 male, 28 female), who were prospectively followed for a 3-month period. START:AV assessments had good to excellent inter-rater reliability and strong concurrent validity with Structured Assessment of Violence Risk in Youth assessments (SAVRY; Borum, Bartel, & Forth, 2006). START:AV risk estimates and Vulnerability total scores predicted multiple adverse outcomes, including violence towards others, offending, victimization, suicidal ideation, and substance abuse. In addition, Strength total scores inversely predicted violence, offending, and street drug use. During the 3-month follow-up, risk estimates changed in at least one domain for 92% of youth, and 27% of youth showed reliable changes in Strength and/or Vulnerability total scores (reliable change index, 90% confidence interval; Jacobsen & Truax, 1991). While these findings are promising, a strong need exists for further research on the START:AV, the measurement of change, and on the role of strengths in risk assessment and treatment-planning.

Suicide-related behavior (SRB), defined as any behavior undertaken with the deliberate intent to end life (e.g., plans, attempts, completed suicide), and non-suicidal self-injury (NSSI), defined as any self-destructive behavior undertaken to damage or harm oneself without the intention of dying (e.g., cutting, burning, biting; Nock, Joiner, Gordon, Lloyd-Richardson, & Prinstein, 2006), are major health concerns among justice-involved youth (Dixon-Gordon, Harrison & Roesch, 2012; Hayes, 2004). SRB and NSSI among justice-involved youth have been attributed, in part, to elevated rates of mental disorder and emotional distress (Teplin, Abram, McClelland, Dulcan, & Mericle, 2002). Compared to the general population of adolescents, justice-involved youth have higher prevalence rates of depression, anxiety, anger problems, somatic complains, trauma, substance use, and borderline personality traits. Features of these disorders, such as suicidal ideation, hopelessness, emotional dysregulation, and impulsivity, can lead to SRB (Hayes, 2004) or NSSI (Dixon-Gordon et al., 2012). In addition, comorbid disorders are common (Teplin et al., 2002), with the risk for SRB and NSSI increasing with multiple diagnoses (Fleischmann et al., 2005). The evaluation of mental health needs on entry to the youth justice system may assist in identification of youth at risk for SRB or NSSI. However, it is unclear how justice agencies should best identify mental health needs in adolescents. Although clinician-administered tools are available for assessing mental health problems in youth (e.g., the Diagnostic Interview Schedule for Children, Version Four, Shaffer et al., 2000), these tools may be inappropriate for routine use in youth justice settings (National Action Alliance for Suicide Prevention, 2013). For instance, comprehensive clinician-rated measures require trained and experienced clinical staff with expertise in scoring and interpretation. Moreover, clinician-rated measures can be timeconsuming to administer and score and therefore may be difficult or impractical to implement for every youth. Although briefer assessment tools have been developed (e.g., the Beck Depression Inventory-II; Beck, Steer, & Brown, 1996), these tools often focus on a single problem area and thus are too limited in scope to identify the full range of mental health problems that can occur in adolescence. To address these concerns, standardized, multidimensional self-report screening measures of mental health have been developed. These measures are intended to identify adolescents in need of a more comprehensive clinician-administered evaluation, or to screen out relatively lower risk adolescents who do not require resource-intensive assessments. In addition, these measures can assist in determining whether monitoring (e.g., suicide monitoring) is required. Some of these tools, such as the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2; Grisso & Barnum, 2006), a 15-minute screening measure of mental health, were specifically developed for use wi...

BackgroundThe Canadian Hospitals Injury Reporting Prevention Program (CHIRPP) is a sentinel surveillance program that collects and analyzes data on injuries and poisonings of people presenting to emergency departments (EDs) at 11 pediatric and eight general hospitals (currently) across Canada. To date, CHIRPP is an understudied source of child maltreatment (CM) surveillance data. This study: (1) describes CM cases identified in the CHIRPP database between1997/98 to 2010/11; (2) assesses the level of CM case capture over the 14-year period and; (3) uses content analysis to identify additional information captured in text fields.MethodsWe reviewed cases of children under 16 whose injuries were reported as resulting from CM from 1997/98 to 2010/11. A time trend analysis of cases to assess capture was conducted and content analysis was applied to develop a codebook to assess information from text fields in CHIRPP. The frequency of types of CM and other variables identified from text fields were calculated. Finally, the frequency of types of CM were presented by age and gender.ResultsA total of 2200 CM cases were identified. There was a significant decrease in the capture of CM cases between 1999 and 2005. Physical abuse was the most prevalent type (57%), followed by sexual assault (31%), unspecified maltreatment (7%), injury as the result of exposure to family violence (3%) and neglect (2%). Text fields provided additional information including perpetrator characteristics, the use of drugs and/or alcohol during the injury event, information regarding the involvement of non-health care professionals, whether maltreatment occurred during a visitation period with a parent and, whether the child was removed from their home.ConclusionsThe findings from this initial study indicate that CHIRPP could be a complimentary source of CM data. As an injury surveillance system, physical abuse and sexual assault were better captured than other types of CM. Text field data provided unique information on a number of additional details surrounding the injury event, including risk factors.

Background: The Canadian Hospitals Injury Reporting Prevention Program (CHIRPP) is a sentinel surveillance program that collects and analyzes data on injuries and poisonings of people presenting to emergency departments (EDs) at 11 pediatric and eight general hospitals (currently) across Canada. To date, CHIRPP is an understudied source of child maltreatment (CM) surveillance data. This study: (1) describes CM cases identified in the CHIRPP database between1997/98 to 2010/11; (2) assesses the level of CM case capture over the 14-year period and; (3) uses content analysis to identify additional information captured in text fields. Methods: We reviewed cases of children under 16 whose injuries were reported as resulting from CM from 1997/98 to 2010/11. A time trend analysis of cases to assess capture was conducted and content analysis was applied to develop a codebook to assess information from text fields in CHIRPP. The frequency of types of CM and other variables identified from text fields were calculated. Finally, the frequency of types of CM were presented by age and gender. Results: A total of 2 200 CM cases were identified. There was a significant decrease in the capture of CM cases between 1999 and 2005. Physical abuse was the most prevalent type (57%), followed by sexual assault (31%), unspecified maltreatment (7%), injury as the result of exposure to family violence (3%) and neglect (2%). Text fields provided additional information including perpetrator characteristics, the use of drugs and/or alcohol during the injury event, information regarding the involvement of non-health care professionals, whether maltreatment occurred during a visitation period with a parent and, whether the child was removed from their home. Conclusions: The findings from this initial study indicate that CHIRPP could be a complimentary source of CM data. As an injury surveillance system, physical abuse and sexual assault were better captured than other types of CM. Text field data provided unique information on a number of additional details surrounding the injury event, including risk factors.

No abstract