The blurred vision of Lady Justice for minors with mental disorders: records of the juvenile court in Belgium.

International Journal of Law and Psychiatry 37 (2014) 198–209

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International Journal of Law and Psychiatry

The blurred vision of Lady Justice for minors with mental disorders: Records of the juvenile court in Belgium Sofie Merlevede ⁎, Freya Vander Laenen, Leen Cappon Ghent University, Department of Criminal Law and Criminology, Institute of International Research on Criminal Policy (IRCP), Universiteitstraat 4, 9000 Ghent, Belgium

a r t i c l e

i n f o

Available online 20 November 2013 Keywords: Court records Juvenile court Decision-making Minors Mental disorders

a b s t r a c t Purpose: This study examined (1) the information present in juvenile court records in Belgium (Flanders) and (2) whether there are differences in information between records that mention a mental disorder and those that do not. Method: The file study sample included 107 court records, and we used a Pearson's chi-square test and a t-test to analyze the information within those records. Results: Information in juvenile court records varied considerably. This variability was evident when we compared juvenile court records with and without mention of a mental disorder. Significantly more information about school-related problems, the functioning of the minor, and the occurrence of domestic violence was included in records that mentioned a mental disorder compared with records that did not. Conclusion: The content of the juvenile court records varied, particularly with regard to the mental health status of the minor in question. We suggest guidelines to standardize the information contained in juvenile court records. © 2013 Elsevier Ltd. All rights reserved.

1. Introduction Numerous studies have examined the decision-making process of judges in juvenile courts (Bond-Maupin & Maupin, 1998; Cappon & Vander Laenen, 2011; Cauffman et al., 2007; Leiber, Johnson, Fox, & Lacks, 2007; MacDonald, 2003; Mears, 1998; Stein, Blank, Avidan, Barel, & Elizur, 1995). In such research, while different methodologies were used, file studies—close examinations of juvenile court records— were the predominant research method employed (Cappon & Vander Laenen, 2011). Using the information present in juvenile court records, file studies can identify which factors could potentially influence judges' decisionmaking (Campbell & Schmidt, 2000). The review by Cappon and Vander Laenen (2011) indicated that the following factors were most often included in decision-making research: legal (e.g., type of offense, prior juvenile court record), demographic (e.g., age, gender, ethnicity), family (e.g., family structure, family functioning, psychiatric history of parents), and school factors (e.g., school problems, truancy, suspension). However, the individual characteristics of the minor (e.g., behavior, gang involvement) were less often discussed in the decision-making studies that employed file studies. For example, the presence of mental disorders in minors was examined in only four of these studies (Cauffman et al., 2007; Gebo, 2007; Kempf-Leonard & Sontheimer, 1995; Wordes, Bynum, & Corley, 1994).

⁎ Corresponding author. Tel.: +32 92648423; fax: +32 92646971. E-mail addresses: Sofi[email protected] (S. Merlevede), [email protected] (F. Vander Laenen), [email protected] (L. Cappon). 0160-2527/$ – see front matter © 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijlp.2013.11.006

Despite the dominance of file studies in decision-making research, some researchers have criticized its use (Applegate, Turner, Sanborn, Latessa, & Moon, 2000; Kunin, Ebbesen, & Konecni, 1992; MacDonald & Chesney-Lind, 2001; Mears, 1998; Sanborn, 1996; Sheehan, 2001). Some have stated that the information in juvenile court records varies according to the author of the information, the amount of time available to prepare it, and the degree of access to family members to gather the information (Kunin et al., 1992; Sheehan, 2001). Others have argued that some potentially important influential factors cannot be researched because they are not present in the juvenile court records (Applegate et al., 2000; MacDonald & Chesney-Lind, 2001; Mears, 1998). This lack of information is especially noticeable regarding mental health information. Indeed, it has been suggested that this lack of discussion about mental health information in decision-making research might be a consequence of the overall absence of this information in juvenile court records (Breda, 2003; Herz, 2001; O'Donnell & Lurigio, 2008). Nevertheless, extracting available mental health information from juvenile court records might be especially important because many minors going through the juvenile justice system have a mental disorder. Previous studies examining juvenile courts have indicated prevalence rates ranging from 30% to more than 75%, depending on the mental disorder examined (e.g., Colins et al., 2010; Doreleijers, Moser, Thijs, van Engeland, & Beyaert, 2000; Fazel, Doll, & Langstrom, 2008; Garland et al., 2001; Vermeiren, 2003). These rates are far higher than the 6% to 16% prevalence reported in the general youth population (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003; Ford, Goodman, & Meltzer, 2003). Moreover, studies have indicated high rates of comorbidity and undiagnosed mental health problems in 50% to 75% of juvenile delinquents (Colins, Vermeiren, Schuyten, & Broekaert, 2009; Desai et al.,

S. Merlevede et al. / International Journal of Law and Psychiatry 37 (2014) 198–209

2006; Domalanta, Risser, Roberts, & Risser, 2003; Fazel et al., 2008; Vermeiren, Jespers, & Moffitt, 2006). In Flanders, Belgium, the juvenile justice system addresses two different types of cases: juvenile delinquent offenders and problematic educational situations (Grietens & Hellinckx, 2004; Put, 2010). “Juvenile delinquent offenders” are minors between the ages of 12 and 18 who have committed one or more delinquent offenses,1,2 since minors under the age of 18 have no criminal responsibility, juvenile courts handle juvenile offenses in a “protective” manner, meaning that no punishments can be imposed, only measures that aim for rehabilitation (Muncie & Goldson, 2006; Walgrave, 2002). For minors who commit crimes under penal law, which applies only to adults, the law specifies that they have committed “acts defined as offenses,” and not “offenses,” to make clear that minors do not commit offenses because they cannot be punished (Walgrave, 2002). “Problematic educational situations”3 is a term used to refer to minors between the ages of 0 and 18 who have committed “status offenses” (e.g., general misconduct, high intractability, truancy), as well as minors who are victims of child abuse or neglect (Grietens & Hellinckx, 2004; Put, 2010). Juvenile delinquency cases and problematic educational situations are both ruled by the juvenile judge. Because of the protective orientation of the law, many of the procedural rules and measures apply to both categories (Walgrave, 2002). Regarding legislation, the major difference between juvenile delinquency cases and problematic educational situations concerns which authorities are responsible. The judicial reaction to youth delinquency is a federal matter, while the communities are responsible for problematic educational situations (Van Dijk, Dumortier, & Eliaerts, 2008; Walgrave, 2002). Juvenile judges can apply similar measures to both groups in the same institutions with some additional measures and services specific to juvenile offenders (e.g., reprimands, juvenile detention, and restorative measures such as community service or mediation; Walgrave, 2002). Since the reform of the Youth Protection Act of 1965 in 2006, juvenile offenders with mental disorders in the juvenile courts have received increased attention in Belgium (Ministerial Circular concerning the reform of the Youth Protection Act of 1965, 2006). The reform provided juvenile judges with the ability to apply specific measures related to mental health to juvenile offenders with mental disorders (Rom, 2007). The applicable measures consist of ambulant counseling or placement in a hospital, mental health service, or drug or alcohol treatment service (De Smet, 2006; Ministerial Circular concerning the reform of the Youth Protection Act of 1965, 2006). However, these measures might not be applied at present, because implementation of legislation that makes a clear distinction and definition between open and closed mental health services is pending. Moreover, the reformed law requires a medical-expertise report (verifying that due to the minor's mental disorder and/or addiction, treatment is necessary to safeguard his or her integrity) before the minor can be placed in a mental health or drug treatment service. However, currently, the provision of this report has not been put into practice. Moreover, since the law regarding psychiatric expertise is pending implementation, there are no

1 In exceptional cases, the minor can stay under the supervision of the juvenile court until the age of 23. This can be the case when two conditions are met: (1) a minor is referred to the juvenile court because of a serious offense committed between the ages of 12 and 17 (that would be punishable with a prison sentence of 10 years when committed by an adult) and (2) when the minor has been placed in a community institution. Minors—mostly juvenile delinquents, but also those in a problematic educational situation—can be placed for both protective and educational aims in a community institution. These institutions have an obligation to admit minors. The minor can be admitted to closed or open education settings and to reception and observation units (Grietens & Hellinckx, 2004). 2 Before the age of 12, the minor is considered to be incapable of understanding his actions (De Smet, 2006; Van den Wyngaert, 2006). However, minors can be referred to the court due to an act defined as an offense before the age of 12, although in that case only a limited number of measures can be applied; namely, a reprimand, being put under the supervision of the court, and intensive educational counseling (Put, 2010). 3 In exceptional cases, minors in problematic educational situations can stay under the supervision of the juvenile court until the age of 21. For instance, this is the case when the minor is living independently under the supervision of the court.

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guidelines as to who is providing this expertise or what it comprises. Consequently, the diagnosis of a mental disorder is not systematically included in court records before a minor's referral to mental health services. The inclusion of this information depends on its availability and the decision of the author of the reports on whether to include the diagnosis. Therefore, mental health status can be included in juvenile court records to provide insight into the overall situation of the minor and his or her environment or to specifically advise the juvenile judge to apply a mental health measure. In the meantime, the juvenile judge can apply the most appropriate measure according to the needs of the minor, which does not preclude mental health measures (Put, 2010). Despite the delay in implementation of the amended law, the specific legal attention to minors with mental disorders further underscores the importance of researching this subgroup. Therefore, the purpose of this study was twofold. First, we aimed to examine the information present within juvenile court records in Belgium. Second, we sought to study the differences in juvenile court records between those that mentioned a mental disorder and those that did not.

2. Method 2.1. Setting This study gathered data from a juvenile court in Flanders, Belgium. There are two groups of minors that come into contact with the juvenile court, according to Belgian law: (1) minors who have committed delinquent offenses (juvenile delinquents) and (2) minors who have committed so-called status offenses (e.g. truancy, general misconduct, or high intractability) or were victims of child abuse or neglect (problematic educational situation cases; Grietens & Hellinckx, 2004; Put, 2010). Both groups are discussed in this study.

2.2. Selection of juvenile court records The data were collected using a file study at the juvenile court. A record is kept in the juvenile court of each minor that comes into contact with it, and each of these records consists of three parts. First, each record contains the reasons for the minor's referral to the juvenile court. This part is constructed by the public prosecutor. Second, each record contains reports by the social services investigators of the juvenile court. Specifically, these are reports of the social relationship and personality investigations4 and any treatment programs the minor has taken part in, and reports evaluating the minor's overall situation. In addition, some records contain reports from the institution where the minor resides (Put, 2010; Walgrave, 2002). Third, each record contains the decisions of the juvenile judge, which are recorded and included in the record by the office of the clerk of the juvenile court (Walgrave, 2002). The information about these decisions includes a summary of the personality or environment of the minor (or any facts) that justifies the judge's decision, a mention that the minor was heard (or an explanation for why this was not the case), a reference to one or more decisive factors in the decisionmaking process, and a specific explanation of the decision when a combination of measures have been applied (Put, 2010). In some cases, additional reports by other authors can be included in the records, such as police reports in the cases of minors who had attempted to run away, school reports, and letters from the parents. 4 In this report, information about the minor and his/her family is included. Specifically, these are descriptions and information on the development (and, optionally, a diagnosis) of the minor's situation and the reasons for the minor's reference to the juvenile court. Next, a description and evaluation of what care has been provided for the minor can be included. Finally, when necessary, a proposal/advice on appropriate measures can be included.

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Belgian law does not explicitly delineate the specific elements of these reports. Consequently, some records contain very detailed information, while others can have very limited information. In particular, since the law on the implementation of assessment by a psychiatric expert is pending, there is no legal obligation to include a report containing a psychiatric assessment of the minor, let alone guidelines as to who can provide this expertise or what the assessment entails. The file study was conducted between November 2011 and March 2012. We selected 261 juvenile court records referred by the public prosecutor to the juvenile court in 2008. For the purposes of the PhD research5 of which this study formed a part, another inclusion criterion was added: the juvenile court records had to be processed for two years or longer at the juvenile court. This resulted in 107 juvenile court records, which were then further analyzed. 2.3. Codebook The 107 juvenile court records were analyzed using the codebook developed by Franssens, Put, and Deklerck (2010). These authors used this codebook to gain insight into the decision-making process of the juvenile court in Flanders. Their codebook was adapted for this study in order to include data on mental health problems by adding the following codes: self-harm and suicidal behavior, mental disabilities and mental disorders (type of disorders, who made the diagnosis, when the diagnosis was made, and the instruments and classification systems used to make the diagnosis), and the mental health care that the minor had received. Further, codes specific to the mental health status of the parents (type of disorder and received care) were added. In the end, five categories of data were collected using this codebook: (1) juvenile court characteristics, (2) child demographics, (3) school factors, (4) functioning of the minor, and (5) family characteristics. 2.3.1. Juvenile court characteristics In this category, the following variables were obtained from the records and coded for analysis: (1) reasons for referral to the juvenile court and (2) the first applied measures. The first applied measure is the measure that the juvenile judge applies after the minor has been referred to the juvenile justice system.6 First applied measures comprise nine types of care. The first type includes residential care services for minors and parent counseling, unless the minor has no contact with his/her parents (Janssens & Deboutte, 2010). The second type is specialized care, which is the care provided to minors with special needs (intellectual disabilities; emotional, behavioral, physical, developmental, and healthrelated needs; Havlicek, 2010). The third type refers to foster homes— small institutions run by families providing a family-like environment (Grietens & Hellinckx, 2004). The fourth is home-based care, which involves (in general) a weekly home visit by care workers to support the families of the children (Janssens & Deboutte, 2010). The fifth type is a placement in an admission, orientation, and observation center. These centers admit young people either for observation purposes or because they have been arrested by the police and cannot be returned to their guardians or to the judicial authorities. These centers also admit young people living in a crisis situation or young people who cannot be sent to another facility (Grietens & Hellinckx, 2004). The sixth type included referral to a youth detention center (Colins et al., 2009) and the seventh, a school dormitory (Hawkins, Almeida, Fabry, & Reitz, 1992). The eighth type is mental health care (limited to inpatient care), and the ninth is the supervision of the juvenile court. 5 The aims of this PhD research were to (1) examine the placement moves of minors at the juvenile court by using a record study and (2) to compare the placement moves of minors with and without mental disorders at the juvenile court. The literature recommends studying placement trajectories of minors who spent an equal amount of time in care (which is in this study a two-year period) to accurately detect these placement moves (James, Landsverk, & Slymen, 2004). 6 When a minor has been followed within the juvenile justice system for some time, the judge can apply different measures.

2.3.2. Child demographics Three demographic characteristics were gathered from the juvenile court records: (1) gender, (2) age, and (3) ethnicity. Ethnicity referred to the ethnic origin of the parents7 and was divided into three subcategories: Belgium, other European Union (EU) countries, and non-EU countries. 2.3.3. School factors The following school data were extracted from the records: (1) current education level (special education, regular education [kindergarten, primary education, secondary education8], and not being in school), (2) repeated grades, (3) suspension,9 and (4) truancy.10 2.3.4. Functioning of the minor The following variables were included: (1) running away from home and/or an institution where the minor resided, (2) aggressive behavior, (3) disciplinary problems of the minor, (4) negative influence of peers, (5) suicidal or self-harming behavior, (6) number of mental disorders and comorbidities, (7) type of mental disorder, (8) the agent who diagnosed the mental disorder, (9) assistance received related to the mental disorder, and (10) IQ. 2.3.5. Family characteristics The following variables were obtained from the records: (1) family structure, (2) employment status of the mother and/or father, (3) psychiatric antecedents of the parents (presence of mental disorder(s), type of mental disorder(s), number of mental disorder(s), and assistance received for the mental disorder(s)), (4) presence of suicidal behavior, (5) criminal antecedents of the parents, and (6) presence of domestic violence. 2.4. Data analysis The data obtained from the juvenile court records were processed and analyzed using SPSS (version 20). Descriptive statistics were obtained to determine the presence/prevalence of the different characteristics within the five categories of information. Chi-square analyses and t-tests were then performed to detect significant differences in the available information between the records with and without mention of a mental disorder and/or intellectual disability. To analyze the information in the court records, the records were divided into three comparison groups. First, all of the records (n = 107) were examined in order to extract the information they contained. Of the sample, 15% (n = 16) of the minors were juvenile delinquents and 85% (n = 91) of the minors were referred due to a problematic educational situation. We compared the information between these two groups. 7 Considering that a difference may exist between the nationality of the minors and their ethnic origin (a minor can have Belgian nationality, but have their parents be of different ethnic origin), we chose the origin of the parents as the criterion for ethnicity in this study. 8 Secondary education in Belgium consists of the following categories. (1) General secondary education provides broad general training that mainly offers a solid foundation for attending higher education. (2) Technical secondary education focuses on general and theoretical technical subjects, after which pupils can take employment or continue their studies in higher education. (3) Similarly, artistic secondary education provides a general, broad education in conjunction with active arts practice; after this, pupils can take employment or attend higher education. (4) Vocational secondary education is practice driven, where pupils learn specific skills for a specific occupation, while also being given some more general training (Opdenakker & Van Damme, 2000). (5) Finally, part-time professional education (“sandwich courses”) is a combination of part-time education and parttime work. This type of education is possible from the age of 15 (second grade). 9 A suspension is seen as a disciplinary response by a school, which includes the suspension of a minor from attending school (Raffaele Mendez, Knoff, & Ferron, 2002). 10 Truancy at school refers, in this article, to unexcused absences, non-anxiety-based absenteeism, absenteeism linked to lack of parental knowledge about the minor's behavior, absenteeism linked to delinquency or academic problems, or absenteeism linked to social conditions such as homelessness or poverty (Kearney, 2008).


Second, a comparison was made between the records with and without mention of a mental disorder and/or intellectual disability to determine whether differences could be found between these types of records. In order to be considered as mentioning a mental disorder, the record had to mention the diagnosis of an Axis I or II (intellectual disability or personality) disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSMIV-TR; American Psychiatric Association, 2002). Intellectual disability was included in this comparison because this diagnosis was often overlooked in previous research, and due to existing reports of high comorbidity of intellectual disability with mental disorders (Dekker & Koot, 2003). Records were considered to have mentioned an intellectual disability when 1) an IQ score that is considered lower than “normal” (IQ score: 90–110; Resing & Blok, 2002) was present in the court records and 2) a mention is made in the records that the minor is following special education specific for minors with a mild or moderate mental retardation. Third, we compared the records with and without mention of a mental disorder. Records mentioning only an intellectual disability were excluded from this group. To determine statistically significant differences between the three comparison groups, Pearson's chi-square tests and t-tests were used (the significance threshold was set at .05). All p-values were two-tailed. If significant differences were found in the first comparison group— juvenile delinquents and problematic educational situation cases—the specific rates were mentioned in the results section. For the second and third comparison groups, we found no significant differences in information about mental disorders between the records of juvenile delinquents and those of problematic educational situations (χ2 = .002, df = 1, p = .961) or those mentioning an intellectual disability (χ2 = .041, df = 1, p = .839). Therefore, the juvenile delinquents and problematic educational situations are presented as one group in the results section. 2.5. Ethics The study was approved by the institutional review board of the Faculty of Law, Ghent University, and by the Belgian Commission for the Protection of Privacy. We obtained the approval of the public prosecutor before starting the file study. Finally, the juvenile judge of the juvenile court gave their consent for the file study. 3. Results In this section, we shall first describe the information that was found in all of the records that we sampled. Second, we shall discuss the information in the records that mention a mental disorder and/or intellectual disability. Third, we shall compare the information in the records with and without mention of a mental disorder. For each comparison group, the child demographics, juvenile court characteristics, school factors, functioning of the minor, and family will be discussed. 3.1. Information in the sampled records 3.1.1. Juvenile court characteristics 3.1.1.1. Reasons for referral. For minors in problematic educational situations, the main reasons for referral to the juvenile court were linked to parental behavior (64.5%; n = 69), with references to “child in danger” and/or cases of abuse/neglect. Status offenses (general misconduct and high intractability, truancy, and running away) were the reasons for referral in 20.6% (n = 22) of the records. The majority of these minors were referred after complaints of their misconduct or intractability (n = 15). In five records within this group, the reason for referral was also parental behavior. In four records, the reason for referral was truancy, and in two records the reason was that the minor had run away. One

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Table 1 First applied measures. First applied measures

Under supervision of the juvenile court Residential care Youth detention center Specialized care Admission, orientation and observation centers Foster care School dormitory Mental health care (inpatient) Home-based care Total

N (%)

32 (30%)

Problematic Juvenile educational delinquents situations 26

6

22 (20.6%) 22 10 (9.3%) 1 10 (9.3%) 10 10 (9.3%) 9

/ 9 / 1

10 (9.3%) 5 (4.7%) 4 (3.7%) 4 (3.7%) 107 (100%)

10 5 4 4 91

/ / / / 16

minor was referred for a combination of reasons: general misconduct, high intractability, truancy, and running away. For the juvenile offenders, the most frequently mentioned offenses were person offenses (n = 8) and property offenses (n = 7). The two types of person offenses were sexual assault (n = 6) and battering (n = 2). For property offenses, in four records, the property offense occurred in a group and violence or threats were used. In one case, the minor stole a motorcycle. In one record, the minor was referred because of shoplifting. One record contained only reference to the general term “theft.” One minor committed a sexual assault and was also referred for parental behavior. Finally, one juvenile delinquent was referred to the juvenile court for both a status offense (running away) and drug use. 3.1.1.2. First applied measures. Table 1 provides information on the first applied measures for the total sample. In the majority of the records, the minor was placed under the supervision of the juvenile court (30%). In 20.6% of the cases, the minor received residential care. Next, in 9.3% of the records, the first applied measure was referral to a detention center. This same percentage was found for specialized care, foster care, and admission, orientation and observation centers. Referral to a school dormitory was the first applied measure in 4.7% of the records. In the minority of the records, the first applied measure was homebased care or mental health care (inpatient; 3.7%). A significant difference has been found between juvenile delinquents and problematic educational cases concerning first applied measures. In this study, it was not possible to determine what these differences were (χ2 = 54.512, df = 8, p b .001). However, based on Table 1, we could conclude that the first applied measure for the majority of the juvenile delinquents was referral to a detention center (9 of the 16 records), while that was the case in only one problematic educational situation. 3.1.2. Child demographics In 64.5% of the juvenile court records, the juveniles were males (n = 69). Two age categories were differentiated (minors who were younger than 12 and minors who were 12 years or older when their records were opened at the juvenile court).11 More specifically 51.4% of the minors were younger than 12 and 48.6% of the minors were 12 years or older. The mean age of all the minors was 9.8 years, with a range from 0 to 16 years. Juvenile delinquents were significantly older than problematic educational situations (χ2 = 19.899, df = 1, p = .000), which can be explained by the fact that minors are seldom referred to the juvenile court as a juvenile delinquent before the age of 12. 11 These two categories were chosen because in Belgium a minor who commits a crime will seldom be referred to the juvenile court as a juvenile delinquent before the age of 12. Furthermore, in such cases, only a limited number of measures can be applied (Dumortier & Christiaens, 2006).

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The majority of the juveniles were of Belgian origin (75.7%; n = 81); 21.5% (n = 23) had at least one parent of non-European Union origin, and 2.8% (n = 3) of the juveniles had at least one parent of origin in another EU member state. The most common non-European Union country was Turkey (n = 13), followed by Russia (n = 3) and Tunisia (n = 3). The majority of the juvenile delinquents were of non-EU origin (10 of the 16), while the majority of minors in problematic educational situations were of Belgian origin (75 of the 91; χ2 = 18.870, df = 2, p = .000). 3.1.3. School factors 3.1.3.1. Current education level. In 14 records (13.1%), no information on education level was provided. This information was found, however, in 93 records. Twenty-three of these 93 minors were in special education classes: 11 minors in primary and 12 minors in secondary special education. The remaining minors were engaged in regular education (66 of 93). Seventeen of the 93 minors were in kindergarten and 11 were in primary school. Regarding secondary education, we found that three minors were in general secondary education, 11 were in professional training, and four were in technical secondary education. Two minors were in secondary art education, and 18 were engaged in part-time professional education. Four minors were not in school because they were approaching the age of majority. 3.1.3.2. School problems. Information about school problems was not always included in the court records. In this study, 11 records contain no information on repeating grades, five contained no information on suspension, four included no information on truancy, and two records did not contain information on the discipline problems of the minor. Thirty-four of the ninety-six (35.4%) minors had repeated one or more grades. Significantly more information was included on repeating grades in the records of juvenile delinquents than in those of problematic educational situations (χ2 = 9.394, df = 1, p = .002). Thirty-one of the one hundred and two (30.4%) minors had been suspended once or more times. Again, significantly more information on suspension was found in the records of juvenile delinquents compared with those of problematic educational situations (χ2 = 18.018, df = 1, p = .000). Thirty-three percent of the minors were regular truants (34 of 103 records). Again, significantly more information about truancy was found in the records of juvenile delinquents compared with those of problematic educational situations (χ2 = 8.827, df = 1, p = .003). Within the studied records, 38 minors (36.2%; 38 of the 105 records) seemed to have problems with discipline. Significantly more information about disciplinary problems was found in the records of juvenile delinquents compared with those of problematic educational situation (χ2 = 19.308, df = 1, p = .000). 3.1.4. Functioning of the minor 3.1.4.1. Mental disorders. A total of 63 mental disorders could be found in the 34 juvenile court records that explicitly mentioned a mental disorder (Table 2). The most common mental disorder was “emotional disorders” (n = 13) followed by “attachment disorders” (n = 11) and conduct disorder (CD; n = 11). 3.1.4.2. Comorbidity. In nearly half of the juvenile court records with explicit mention of a mental disorder (n = 16 of 34), only one mental disorder was mentioned. In the remaining 18 records, more than one mental disorder was noted. Of these, 10 records mentioned two mental disorders and six records mentioned three mental disorders. In one record were four different mental disorders found and also in one record five different mental disorders were found. The most common comorbidity was a combination of an externalizing and an internalizing

Table 2 Prevalence of mental disorders. Mental disorders

Frequency of mental disorders (N = 63)

Axis I Emotional disorders Attachment disorders Conduct disorder (CD) Attention deficit hyperactivity disorder (ADHD) Autism spectrum disorder (ASD) Substance abuse disorder Posttraumatic stress disorder (PTSD) Depression Attention deficit disorder (ADD) Oppositional defiant disorder (ODD) Schizophrenia Presumption dissociative disorders

13 11 11 5 6 4 3 2 1 1 1 1

Axis II Presumption personality disorders Total

4 63

mental disorder12 (n = 13). Three of these records were combined as well with an attachment disorder, a presumption of a personality disorder, or a presumption of a dissociative disorder. Two juvenile court records had a combination of an internalizing disorder (PTSD) and an autism spectrum disorder. One of these records was combined also with a presumption of a personality disorder. One record was found with a combination of an externalizing disorder (substance abuse disorder) and a presumption of a personality disorder and also an attachment disorder. Two records had a combination of attachment disorders. Namely in one record the attachment disorder was combined with a presumption of a personality disorder and in one record with schizophrenia. Nearly half of the records (16 of 34) also mentioned who made the diagnosis: in eight records, the minors were diagnosed by a psychiatrist; in seven, the diagnosis was made by a multidisciplinary team; and in one record, the diagnosis was made by a psychologist. 3.1.4.3. Received care for mental disorders. Out of the entire sample (n = 107), 30 juvenile court records contained information on received mental health care (Table 3). In 20 of the 34 records mentioning a mental disorder, information about the received mental health care was present. In the remaining 14 records mentioning a mental disorder, no information was found concerning the received mental health care. Surprisingly, in 10 records, there was information about received mental health care but no information about a mental disorder. In 8 of these records, the reason that the minor was referred to mental health care seemed to have been socalled “difficult behavior” (externalizing or internalizing). In one record, the minor received mental health care even though she/he refused to be diagnosed. Finally, in one record, the received mental health care was ordered by the juvenile judge because of the nature of the committed crime (sexual abuse). In 14 of the 30 records containing information on received mental health care, the minors received a form of combined treatment. The most prevalent combined therapies were inpatient mental health care and medication (n = 5), ambulant mental health care and medication (n = 4), and a combination of inpatient mental health care, ambulant mental health care, and medication (n = 4). In one case, the minor was given a combination of drug treatment and medication. 3.1.4.4. Self-harm and/or suicidal behavior. Almost one in five (22.4%; 24 of the 107 records) of the examined juvenile court records mentioned 12 Externalizing disorders are including ADHD (en ADD), CD, ODD, and substance abuse disorder. Internalizing disorders are including depression, PTSD, and emotional disorders.

S. Merlevede et al. / International Journal of Law and Psychiatry 37 (2014) 198–209 Table 3 Received mental health assistance.

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Table 4 IQ scores.

Received assistance

N

IQ scores

N (%)

Ambulant mental health care Inpatient mental health care Medication Drug treatment Combined care Total

8 5 2 1 14 30

Mild mental retardation (50–69) Borderline intellectual functioning (70–79) Dull normal (80–89) Normal (90–110) Bright normal (111–120) No explicit IQ-score in file Total

5 (4.7%) 8 (7.5%) 5 (4.7%) 2 (1.9%) 1 (0.9%) 86 (80.4%) 107

self-destructive behavior (n = 7) and/or suicidal thoughts (n = 16) and suicide attempts (n = 1). 3.1.4.5. IQ scores. IQ scores were not included in 80.4% of the records (n = 86). Explicit IQ scores were found in 21 of the 107 juvenile court records (Table 4). These IQ scores were classified using the classification criteria of Resing and Blok (2002), as this classification is more specific than the DSM-IV categories. Of these 21 records, eight minors fell within the category of borderline mental retardation, followed by five in the “dull normal” category. Another five minors had scores corresponding to mild mental retardation. Two minors had IQ scores categorized as normal IQ and one minor had a score categorized as “bright normal.” In total, 18 minors had an IQ score lower than “normal”.13 3.1.4.6. Running away, aggression, and negative influence of peers. Information on running away, aggression, and the negative influence of peers could be retrieved from nearly all records. Only in one record no information could be retrieved on aggression; similarly, one record contained no information about the negative influence of peers, three contained no information on whether the minor had run away from home, and four records did not contain information about running away from the institution. In 25% of the records, it was mentioned that the minor had ran away from home at some point in time (26 of 104 records). Information about running away from home was found significantly more within the records of juvenile delinquents compared with those of problematic educational situations (χ2 = 16.230, df = 1, p = .000). For the total sample, a slightly higher percentage (27.2%; n = 28 of the 103 records) was found for running away from an institution where they were staying while they were facing the juvenile court. Again, information about running away from an institution was found significantly more within the records of juvenile delinquents than within those of problematic educational situations (χ2 = 6.065, df = 1, p = .014). In almost half of these records (49%, 52 of 106) the aggression of the minor was reported. Information about aggression was found significantly more within the records of juvenile delinquents compared with those of problematic educational situations (χ2 = 9.890, df = 1, p = .002). In 33% of the records, information about negative peer influence was reported (35 of the 106 records). Again, information about this influence was found significantly more in the records of juvenile delinquents compared with those of problematic educational situations (χ2 = 35.444, df = 1, p = .000). 3.1.5. Socio-demographic characteristics 3.1.5.1. Family characteristics. In all the court records, there was information about the family structure of the minor. Half of the minors (50.5%) had divorced or separated parents (54 of the 107 records) and 15% lived 13 In six records it was mentioned that the minor followed special education specific for minors with a mild or moderate mental retardation (without a mention of an IQ score in the record), which indicated also an intellectual disability. So, in total 24 of the records seemed to have a mention of an intellectual disability (18 records with a mention of an IQ lower than “normal” and six records with a mention of special education specific form minors with a mild or moderate mental retardation).

Table 5 Psychiatric antecedents of parents. Psychiatric disorder

Parents (N = 86)

Substance abuse Comorbidity Depression Postnatal depression Autism spectrum disorder Bipolar disorder Mental health problems (no further specification) Total

36 20 9 2 1 1 17 86

in a reconstituted family (16 of the 107 records). In 20.6% of the records, the minors lived with their two biological parents (22 of the 107 records). In 7.5% of the juvenile court records, at least one of the parents had died (8 records), and in two of these records the other parent was in detention. Next, in 6.5%, one of the parents did not claim paternity (7 records). With regard to the work situation of the parents, information was missing in 27% of the records (29 of the 107 records). For the fathers, we found that 48.6% (n = 52) worked on a regular basis, while 10.3% (n = 11) were unemployed. For mothers, 21.5% were unemployed (n = 23) and 20.6% were working (n = 22). 3.1.5.2. Psychiatric antecedents of parents. In 103 of the 107 records, information on the mental health status of the parents could be found. In four records, it was not possible to retrieve any information about the mental health status of the parents. Information about the presence of suicidal behavior in the parents could not be retrieved from two records. In 70.9% of the juvenile court records, mental health problems were mentioned in one of the parents (73 of the 103 records, 86 parents in total; Table 5). In 51,4% of these records (53 of the 103 records), one parent had a mental disorder and in 19,4% of the records (20 of the 103 records) both parents had a mental disorder. The most common mental disorder diagnosed in parents was substance abuse (n = 36). For nine parents, depression was mentioned. Two mothers had postnatal depression, one parent had autism spectrum disorder, and one parent had bipolar disorder. Seventeen parents were mentioned as having some type of “mental health problems,” without further specification. Sixty-six of the eighty-six (76.7%) parents had only one diagnosis, while 23.3% (n = 20) were mentioned as having more than one mental disorder. In most of these parents, except for two, the disorder was comorbid with substance abuse. The majority of these parents had a combination of substance abuse with depression (n = 6) or with other mental health problems (n = 6). Two parents had comorbidity of three disorders: (1) bipolar disorder, psychotic disorder, and substance abuse; and (2) substance abuse, psychotic disorder, and depression. In 40 of the total 107 records (37.4%), information was found on all of the mental health care that the parents had ever received.14 The 14 The juvenile court records made differentiation between current and past mental health care impossible. Therefore, we referred to care they had received throughout their entire life.

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majority of the received care (37.5%, 15 of 40 records) was inpatient mental health care. Drug treatment was found in six records (15%). In five records, the parents used medication (12.5%) and four (10%) mentioned that the parents received ambulant mental health care. In nine records (22.5%), the parents received a combination of different mental health care services. The combinations were as follows: inpatient mental health care and medication (n = 3), ambulant mental health care and medication (n = 3), and (alternating between) ambulant mental health care and inpatient care (n = 3). One parent was interned.15 In 21% of all the records (22 of the 105 records) the presence of suicidal behavior was mentioned. 3.1.5.3. Criminal antecedents of parents and domestic violence. In four records, information about the criminal antecedents of the parents was missing. In 103 records, there was some information about previous detentions of the parents. In 18.4% of the records (19 of 103), it was mentioned that a parent was in detention. In 62 records (57.9%; 62 of the 107 records), domestic violence was mentioned. 3.2. Differences in characteristics To meet the second purpose of our study, a comparison was made between the information found in juvenile court records with and without mention of a mental disorder and/or an intellectual disability (Table 6). In addition, a more specific comparison is made between the information found in the records with and those without mention of a mental disorder (Table 7).16 3.2.1. Mental disorder or/and intellectual disability In this study, we found that 51 of the 107 records (47.8%) mentioned a mental disorder or/and an intellectual disability. In 27 records, only a mental disorder was mentioned; in 17, only an IQ score was mentioned; and in 7, both a mental disorder and an intellectual disability were mentioned. 3.2.1.1. Child demographics. Concerning gender (χ2 = .202, df = 1, p = .653) and the ethnic origin (χ2 = 2.247, df = 2, p = .325) no significant differences were found. Next, according to a t-test, in records with mention of a mental disorder and/or an intellectual disability the mean age of the minors was significantly higher than that in the records without mention of a mental disorder and/or intellectual disability (t = −2.364, p = .020).

Table 6 Differences in information between juvenile court records with and without mention of a mental disorder/intellectual disability. Information in the juvenile court records Chi square

Gender Ethnic origin Repeating grades Suspension Truancy Running away from home Running away from an institution Aggression Discipline problems Negative influence of peers Self-destructive behavior of the minor Received mental health care of the minor Psychiatric antecedents of the parents Received mental health care of the parents Self-destructive behavior of the parents Detention of the parents Domestic violence

Value

dfa

p

.202 2.247 .533 4.844 8.200 2.894 8.062 9.632 5.072 2.957 6.658 14.058 .741 2.529 .398 .091 10.974

1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

.653 .325 .466 .028⁎ .004⁎

t

df

p

−2.364

104.645

.020

.089 .005⁎ .002⁎ .024⁎ .085 .010⁎ .000⁎ .389 .112 .528 .763 .001

T-test

Age ⁎ p b .05. a Degrees of freedom.

references to self-destructive behavior (χ2 = 6.658, df = 1, p = .010). There was no significant difference in information between the types of records concerning the negative influence of peers (χ2 = 2.957, df = 1, p = .085). As could be expected, significantly more records referred to received mental health care if they mentioned a mental disorder and/or intellectual disability compared with those not mentioning a mental disorder or intellectual disability (χ2 = 14.058, df = 1, p = .000).

Table 7 Differences in information between records with and without mention of a mental disorder. Bold: p b .05 Information in the juvenile court records

3.2.1.2. School factors. Concerning the minors' behavior at school, records mentioning a mental disorder and/or intellectual disability referred to suspension (χ2 = 4.844, df = 1, p = .028) and truancy (χ2 = 8.200, df = 1, p b .004) significantly more than the records not mentioning a mental disorder or intellectual disability. No significant differences were found between both types of records for repeated grades (χ2 = 533, df = 1, p = .466). 3.2.1.3. Functioning of the minor. Records mentioning a mental disorder and/or intellectual disability were significantly more likely to refer to aggression (χ2 = 9.632, df = 1, p = .002), discipline problems (χ2 = 5.072, df = 1, p = .024), and running away from an institution (χ2 = 8.062, df = 1, p = .005) compared with the other type of records. Furthermore, records with mention of a mental disorder and/or intellectual disability were significantly more likely to contain 15 In Belgium, mentally ill offenders can be interned. Internment is regulated by the Act on the Protection of Society against Abnormal and Recidivist Offenders of 1 July 1964. Internment is considered a safety measure (not a punishment) to prevent harm to society and to provide medical treatment (Vandevelde et al., 2011). 16 The chi-square test was not applied to: reason for referral, first applied measure, current education level, family composition, and work situation of the parents because the categories within these factors were too wide (more than 3) and had too many degrees of freedom.

Chi square

Gender Ethnic origins Repeating grades Suspension Truancy Running away from home Running away from an institution Aggression Discipline problems Negative influence of peers Self-destructive behavior of the minor Received mental health care of the minor Psychiatric antecedents of parents Received mental health care of the parents Self-destructive behavior of the parents Detention of the parents Domestic violence

Value

dfa

p

.161 1.507 .349 6.697 6.625 3.852 14.522 6.922 6.109 4.461 10.066 23.410 .383 .061 .004 .872 12.184

1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

.688 .471 .555 .010⁎ .010⁎ .050 .000⁎ .009⁎ .013⁎ .035⁎ .002⁎ .000⁎ .536 .805 .949 .351 .000⁎

T-test

Age ⁎ p b .05. a Degrees of freedom.

T

df

p

−1.724

74.169

.089


3.2.1.4. Family characteristics. No significant differences were found concerning the parents' mental health problems (χ2 = .741, df: 1, p = .389), and in line with this, no significant differences were found for parents' received mental health care (χ2 = 2.529, df = 1, p = .112), detention (χ2 = .091, df = 1, p = .763), or self-destructive behavior (χ2 = .398, df = 1, p = .528). However, references to domestic violence were significantly more likely to be found in records mentioning a mental disorder and/or a mental disability (χ2 = 10.974, df = 1, p = .001). 3.2.2. Mental disorders A more specific subgroup was then examined, namely those juvenile court records mentioning only a mental disorder, thus excluding the records mentioning only an intellectual disability. 34 records (31.78%) of the total 107 met this criterion. These records were compared with the records of minors without a mental disorder (n = 73; Table 7). 3.2.2.1. Child demographics. No significant differences were found between the types of records concerning gender (χ2 = .161, df = 1, p = .688) and ethnic origin (χ2 = 1.507, df = 1, p = .471). Furthermore, according to a t-test, no significant differences could be found concerning the mean ages of the minors between the types of records (t = −1.724; p = .089). 3.2.2.2. School factors. Concerning the minor's behavior at school, juvenile court records with mention of a mental disorder were significantly more likely to contain information on suspensions (χ2 = 6.697, df = 1, p = .010) and truancy (χ2 = 6.625, df = 1, p = .010) compared with records without mention of a mental disorder. No significant differences were found between both types of records for repeating grades (χ2 = .349, df = 1, p = .555). 3.2.2.3. Functioning of the minor. Records mentioning a mental disorder were significantly more likely to contain information about aggression (χ2 = 6.922, df = 1, p = .009), negative peer influence (χ2 = 4.461, df = 1, p = .035), discipline problems (χ2 = 6.109, df = 1, p = .013) and running away from an institution (χ2 = 14.522, df = 1, p = .000) compared with records not mentioning a mental disorder. No significant differences were found between the groups for running away from home (χ2 = 3.852, df = 1, p = .050). Minors' self-destructive behavior was significantly more likely to be mentioned in records that referenced a mental disorder than in those that did not reference a mental disorder (χ2 = 10.066, df = 1, p = .002). Received mental health care was also more significantly likely to be reported in the records with a mention of a mental disorder than in the other type of records (χ2 = 23.410, df = 1, p = .000). 3.2.2.4. Family characteristics. No significant differences were found concerning the parents' mental health problems (χ2 = .383, df = 1, p = .536); in line with this, no significant differences were found in parents' received mental health care (χ2 = .061, df = 1, p = .805), detention (χ2 = .872, df = 1, p = .351), or self-destructive behavior (χ2 = .004, df = 1, p = .949). Records mentioning a mental disorder were significantly more likely to refer to domestic violence compared with those not mentioning a mental disorder (χ2 = 12.184, df = 1, p = .000). In summary, the records of minors mentioning a mental disorder were significantly more likely to contain information about suspension, aggression, truancy, discipline problems, running away from an institution, self-destructive behavior of the minor, domestic violence, and the received mental health care of the minor, compared with the records of minors not mentioning a mental disorder.

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4. Discussion 4.1. Information in the juvenile court records The decision-making process of the juvenile judge is partly based on court records, and what information is available in these records influences how judges make their decisions (Campbell & Schmidt, 2000). Our findings showed that some types of information were consistent among all juvenile court records. First, each juvenile court record included all of the necessary administrative information (e.g., juvenile judge involved, individual identification numbers, the names of involved parties, date of referral). Additionally, the reasons for referral and the first measures applied were likewise mentioned in each record. Finally, each record contained demographic information on the minor (e.g., gender, nationality, residence, date of birth) and the parents (e.g., residence, background, and family structure). This type of information has been extensively researched in quantitative studies of juvenile judge decision-making (Bond-Maupin & Maupin, 1998; Cappon & Vander Laenen, 2011; Cauffman et al., 2007; Leiber et al., 2007; MacDonald, 2003; Mears, 1998; Stein et al., 1995). However, for several characteristics, information was missing and consequently not included in the juvenile court records. The highest rates of missing values were found for IQ scores (80,4%), the employment situation of the parents (27.1%), and current level of education (13.1%). On the other hand, low rates of missing values were found for discipline problems (1.9%), aggression (0.9%), and negative influence of peers (0.9%). These percentages of missing values indicate that the content of juvenile court records varies considerably. We identified three explanations for this variability, as follows. First, while the law states which reports should be included in court records, it does not provide details on the required content of these reports. For example, juvenile judges might order an investigation by the social service of the juvenile court to examine the personality and environment of the minor, but there are no concrete, consistent details of what this investigation entails. Therefore, the differences found in the records might be explained by the differences in the opinions of the social workers who conducted the investigations; previous research has found some support for the notion that court record information is often colored by the social worker responsible for collecting it (Nuytiens, Christiaens, & Eliaerts, 2005). Indeed, previous studies have also found that the information present in reports can be biased by their authors, such as the social workers or counselors of the institution in which the minor resides, and these records are often constructed from a certain perspective (Baarda, De Goede, & Teunissen, 1997). Second, the record might lack information merely because that information is not available, such as in cases where the IQ of the minor has never been tested. Finally, the variability can be due to the inherent lack of clarity in the court's ability to receive information. Specifically, in discussions of a minor's mental health status in juvenile court, there is a tension between imperatives for sharing information in the interest of the mental health needs of the minor and imperatives for withholding information to protect the confidentiality and the privacy of the minor (Richardson & Asthana, 2006). Thus, there is a fundamental tension between practice driven by the needs of the individuals and practice driven by the demands of risk management (Seddon, 2007). Previous decision-making research based its conclusions, for the most part, on information that was present in the majority of records. Consequently, information that is inconsistently included has been less often researched (Bond-Maupin & Maupin, 1998; Cappon & Vander Laenen, 2011; Cauffman et al., 2007; Leiber et al., 2007; MacDonald, 2003; Mears, 1998; Stein et al., 1995). Therefore, current quantitative research on decision-making, which examines juvenile court records, depends on the information that is always present in those records. This study showed some of the information present in juvenile court records that has rarely been examined in previous decision-making

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studies, such as family background (domestic violence) and the functioning of the minor (e.g., aggression, discipline problems). In Belgian records, information on family background and the functioning of the minor was frequently present. One reason for this might be the Belgian protective orientation (Muncie & Goldson, 2006). Muncie and Goldson (2006) stated that, in Europe, Belgium is focused primarily on protection within its juvenile justice system. This focus on protection might require more information on family background and how the minor functions in everyday life. Overall, this study shows that information present in juvenile court records varies considerably, and that there is more relevant information that can be investigated than has been included in previous decisionmaking studies. Furthermore, the variability within these juvenile court records reaffirms the question of their quality (Baarda et al., 1997; Nuytiens et al., 2005). The variability is certainly shown when we compared juvenile court records that included information on the presence of a mental disorder or intellectual disability with those that did not. As became clear in the results, our study revealed no significant differences in the information in records that only mentioned mental disorders and the records that mentioned both mental disorders and intellectual disabilities; thus, the results for these groups are discussed together (except for the mean ages of minors). We found that there was significantly more information included in these records on the functioning of the minor (aggression, discipline problems, negative influence of peers, whether they had run away from an institution, self-destructive behavior, received mental health care), family characteristics (presence of domestic violence), and school-related factors (suspension and truancy). Each of these differences will be discussed in the following paragraphs.

4.1.1. Child demographics. A significant difference was found between the mean ages of minors in the records with and without any mention of a mental disorder and/or intellectual disability. More specifically, minors were older in records that mentioned a mental disorder and/or intellectual disability than in records without such a mention. When we excluded records that only mentioned an intellectual disability, no significant difference in age was found between records that mentioned a mental disorder and records that did not. An explanation for this difference is that the mental disorder diagnoses found in some records could have had an onset only during adolescence (e.g., schizophrenia, personality disorders; First, Frances, & Pincus, 2004). The fact that we observed a significant age difference only when we included records that mentioned only an intellectual disability might be explained by the fact that intellectual disabilities can be diagnosed at early ages.

4.1.2. Functioning of the minor. First, within this category, juvenile court records mentioning a mental disorder contained more information on past mental health care than records not mentioning a mental disorder. This indicates that when records mention a mental disorder, the authors seemed to focus more on previous mental health treatment. These authors seemed to highlight previous efforts to help the minor in question with his or her mental disorder. Second, records that mentioned a mental disorder referred more to the minor's destructive behavior toward others (aggression) and themselves (self-harm, suicidal thoughts and attempts). The attention to both types of destructive behavior might be related to minors' diagnoses. Aggressive behavior and suicidal behavior are both diagnostic criteria for some externalizing and internalizing disorders (American Psychiatric Association, 2002; Vermeiren, 2003). Vermeiren (2003) also found a high comorbidity between suicidal behaviors and conduct disorder (CD). This relationship between destructive behavior and mental disorders might explain the more frequent reference to this type of behavior in records that mention a mental disorder.

4.1.3. Family characteristics. For family characteristics, only one difference was found between the types of records: domestic violence was more often referred to in records that mentioned a mental disorder than in those that did not. Previous research has shown that domestic violence might be associated with PTSD (Burge, 2007). This association can explain the higher reference to domestic violence in records that mention a mental disorder. Remarkably, despite the notion of intergenerational transmission of mental disorders mentioned in previous research (Beardslee, Gladstone, & O'Connor, 2011), no differences were found between the two types of records regarding mental health problems in the parents. This might indicate that record authors always pay attention to mental health problems in the parents and not only when a mental disorder has been diagnosed in the minor. 4.1.4. School-related factors. The last category in which differences between the juvenile court records were found was for school-related factors. Within this category, suspension and truancy were noted more often in the records that mentioned a mental disorder. An explanation for this might be that the mental disorder has an additional negative impact on the school experience of the minor, which might lead to frequent absences and even to suspension from school. A mental disorder might cause a higher level of behavioral impairment in minors, and this impairment might lead to additional problems when attending school (Moldavsky et al., 2002). Another explanation might be linked to the high percentage of minors with disorders enrolled in special education. Minors diagnosed with behavioral and emotional disorders can be referred to special education classes; special educators might pay more attention to school-related problems, which means that this information will be more available to the juvenile judge and consequently added to the juvenile court record. All of these differences between records that mentioned a mental disorder and those that did not indicate that the record authors seem to pay more attention to the factors mentioned above when a minor has been diagnosed with a mental disorder. This raises an important question as to whether minors with mental disorders are more vulnerable on both the individual and family levels than minors without mental disorders. However, we cannot adequately address this question because we do not know if this overrepresentation indicates greater vulnerability or a greater focus on this type of information by record authors when the minor in question has been diagnosed with a disorder. This focus might be a consequence of the 2006 law reform that detailed specific measures for minors with mental disorders. Additionally, this focus might be a consequence of the stigma associated with minors with mental disorders; any misperceptions of the record authors about mental disorders might lead to greater attention being paid to certain aspects of the minor's functioning and family environment (Cappon & Vander Laenen, 2010). However, in addition to our study, previous research has revealed that minors who encounter the juvenile court are vulnerable on both the individual and family levels (Devaney, 2009; Moldavsky et al., 2002; Paradise, Rose, Sleeper, & Nathanson, 1994). For example, the majority of the minors in this study had divorced or separated parents (50.5%), which is similar to the rates found in previous research concerning juvenile courts (36%–62%; Barnes & O'Gorman, 1995; Daley & Onwuegbuzie, 2001; Lederman, Dakof, Larrea, & Li, 2004; Livaditis et al., 2000; Van Der Geest & Bijleveld, 2008). In 18.4% of the records in our study, one of the parents was in a criminal detention center; in previous research, rates between 16% and 60% were found (Barnes & O'Gorman, 1995; Bryant et al., 1995; Dale, Baker, Anastasio, & Purcell, 2007). Furthermore, the minors themselves seem to be vulnerable. In our study, 24.7% of minors were in special education. Notwithstanding the fact that these rates were lower than those found in previous research on juvenile courts (28%–48%; Daley & Onwuegbuzie, 2001; Lenssen, Doreleijers, van Dijk, & Harman, 2000; Vreugdenhil, Doreleijers, Vermeiren, Wouters, & Van Den Brink, 2004), minors going through the juvenile court seemed to be at higher risk for


attending special education (Grietens & Hellinckx, 2004; Van Borsel et al., 2006). In addition, we found high rates of minors running away from their institution or home, although this was lower than the rates found in previous research (44%–64.5%; Dale et al., 2007; Lederman et al., 2004; Wolf & Hartney, 2005; Zabel & Nigro, 1999). 4.2. Limitations This study has some limitations that should be discussed. First, we must note that examining juvenile court records is not the same as examining the minor's actual situation (Bryant et al., 1995). Second, the “best interests of the minor” (Article 3 of the Convention on the Rights of the Child) should be the basis for the decision-making of juvenile judges. Belgian law states that juvenile judges must personally hear juveniles aged 12 years or older before any measure can be imposed (Put, 2010; Walgrave, 2002). However, including the transcripts of these hearings in the records is not legally required. Indeed, these transcripts were not included in any of the records we studied. A hearing for the parents is also possible, but not obligated (Put, 2010); the transcripts of these hearings are also not a legal obligation and we found none in the records of our study. Therefore, the use of records alone precludes insight into the voices of these minors and parents (Devaney, 2009). This bias should be taken into account when discussing information included in juvenile court records. Third, in view of the research design, this file study excluded records that had been processed for less than two years at the juvenile court. Thus, we focused on minors whose cases were processed for a long time by the juvenile judge (Usher, Randolph, & Gogan, 1999). The final limitation is related to the criterion that we used, which differentiated juvenile court records according to whether they mentioned a mental disorder or not. This criterion required an explicit diagnosis of a mental disorder to be present in the record in order for it to be included. This was quite strict and might have excluded some minors with mental disorders who had not been explicitly diagnosed in their juvenile court record. Therefore, the subgroup of minors with mental disorders might have been underestimated (Colins et al., 2010; Fazel et al., 2008). However, as we were interested in the information included in the records, this criterion fit our focus. Despite these limitations, records can be considered important repositories of information about a minor while also providing insight into the contemporary practice of deciding which information is collected for court records (Devaney, 2009). 4.3. Implications for practice The decision-making process of juvenile judges should be based on the “best interests of the minor” (Put, 2010). In considering what the best interests of the minor are, juvenile judges must understand the overall picture of the minor and his or her environment. This is particularly important for minors who require mental health care, because they often do not receive it (Abram, Paskar, Washburn, & Teplin, 2008; Stiffman, Chen, Elze, Dore, & Cheng, 1997). This study found that information about several aspects of minors' lives was not included in the juvenile court records. This variability obscures the overall picture that judges require, and as a result, juvenile judges must base their decisions on fragmented pictures of the minor and his or her environment. In order to achieve the inclusion of sufficient information in these records, we recommend establishing minimum standards for the content of social and personality investigations. These standards can be based on information that has been identified in previous research as risk and protective factors for juvenile offenders and problematic educational situations (Andrews, Bonta, & Wormith, 2006; Tarolla, Wagner, Rabinowitz, & Tuban, 2002; Vieira, Skilling, & Peterson-Badali, 2009). In addition, in order to address the needs of minors requiring mental health care, we recommend a systematic screening of each minor with regard to their disorder, IQ, and the presence of suicidal behavior. This

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screening would help give juvenile judges enough information to make decisions in the best interests of the minors (Grietens & Hellinckx, 2004). In view of the tension between practice driven by the needs of the individuals and practice driven by the demand of risk management (Seddon, 2007), screening for mental health problems in a juvenile justice context, in particular as part of a juvenile justice procedure, should be based upon judicial provisions. Although we do acknowledge that this tension is unlikely to be resolved by introducing new legislation (Six, Bellamy, Raab, Warren, & Heeney, 2007), a clear demarcation of the aims, boundaries, and responsibilities, including an agreement on information exchange, are essential preconditions to allow for interagency cooperation (Vandam, Colman, Vander Laenen, & De Ruyver, 2010). These judicial provisions should clearly delineate the goals and extent of the screening and the mental health professionals who should be in charge of the screening. This should include provisions for the exchange of information between the mental health services involved and the juvenile justice system. In this respect, a distinction should be made between the mental health professional conducting the screening as an expert and the mental health professional providing the actual treatment. The latter is essential to enable the minor's trust that present (and future) mental health care providers will not breach confidentiality. Indeed, a body of research conducted over the past decades has found that privacy is a significant concern for adolescents, and that adolescents have identified a lack of confidentiality as a major barrier to seeking healthcare (Deneyer et al., 2011). This is particularly important for minors in contact with the juvenile justice system and for very vulnerable young people who distrust professionals (Vander Laenen, 2009). Even when a screening leads to a diagnosis, a holistic approach remains necessary (MacKinnon-Lewis, Kaufman, & Frabutt, 2002). The diagnosis of a mental disorder does not imply that the juvenile judge should apply a mental health measure for that minor. To fully meet the needs of the minor, it is important to engage young people in the decision-making process (Abram et al., 2008). Previous research has shown that children's views are largely accurate or predictive about their own mental health situation (Hawley & Weisz, 2003). Moreover, juvenile judges should take into account the willingness of young people to engage in mental health care (Abram et al., 2008), because a positive mental health experience is related to more effective care (Day, Michelson, & Hassan, 2011). 4.4. Implications for research In view of the lack of clarity about what should be included in court records and social relationship and personality investigations, future research might study the ideas and input of the social workers conducting these investigations to gain insight into how information is collected and what the primary focus is and should be. Second, this study was conducted in one juvenile court in Flanders, Belgium, which has implications for the generalizability of the results to other juvenile courts. For further research, we recommend investigating juvenile courts in other countries. In this study, a court record was defined as mentioning a mental disorder only when a clear diagnosis was found in the record. As discussed above, this can lead to an underestimation of the actual prevalence of mental disorders. Thus, further research should incorporate other research methods (e.g., diagnostic interviews and mental health assessment procedures). Finally, since this study was based on 107 court records, future studies should include a larger sample size. References Abram, K. M., Paskar, L. D., Washburn, J. J., & Teplin, L. A. (2008). Perceived barriers to mental health services among youths in detention. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 301–308. American Psychiatric Association (2002). Diagnostic and statistical manual of mental disorders (4th ed. Text Revision )Washington DC: Author. Andrews, D. A., Bonta, J., & Wormith, S. J. (2006). The recent past and near future of risk and/or need assessment. Crime & Delinquency, 52, 7–27.

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