For years, the Ohio court system has been mindful of substance abuse problems inherent in the adult and juvenile population. As a result, many offenders have been sentenced to alternative programs to treat their addictions. But when Judge Linda Tucci Teodosio realized that juvenile offenders needed more, she developed The Crossroads Program (The Program).

According to recent research by the National Center for Mental Health and Juvenile Justice, 75% of the youths involved in the juvenile justice system suffer from one or more mental illnesses. Teodosio felt that substance abuse and mental illness problems needed to be addressed simultaneously in order to truly rehabilitate juvenile offenders.

“We saw a value in early mental health assessment, identification, intervention and services for these juveniles,” Teodosio said in a recent GAINS/TAPA Teleconference. “The Program is designed to treat both substance abuse and mental illness at the same time – and provide the most appropriate treatment possible for each individual.”

Before 2003, Ohio courts had used a program called The Drug Court as an alternative to simply incarcerating adult and juvenile drug offenders. The Drug Court often sentenced offenders to rehabilitation clinics or used other forms of punishment. But Teodosio believed that The Drug Court had a negative stigma that came along with its name. She thought that stigma influenced the participants of the program negatively because it constantly reminded them of their substance issues.

In 2003, Teodosio, who is a Juvenile Court Judge for Summit County, renamed The Drug Court and reworked its focus to include mental health issues – and The Crossroads Program was born.

“Studies have indicated that substance abusers likely suffer mental health issues that either create or exacerbate the problem,” Teodosio said. “With the help of The Program, we can become more pro-active and innovative in our approach – and further educate children and their families.”

Reinforcement and Support

The Program is an intense 12- to 18-week program for juveniles from the ages 12 to 17. Juveniles are referred to the program by either a judge or a magistrate dealing with their case - but there are certain eligibility requirements that must be met by the participants of Crossroads. For instance, the juveniles cannot face current charges, must not be guilty of a first- or second-degree felony and cannot have been convicted of drug trafficking or gang activity. In order to address the most pressing mental health issues, participants must have a mental health diagnosis in major affective disorder categories such as schizophrenia, depression or bi-polar disorder.

“We have eligibility criteria not to exclude any juveniles, but to make sure the juveniles we are gearing The Program towards actually benefit from it,” Teodosio said. “Obviously, putting convicted drug traffickers into a rehabilitation program with other juveniles could pose a problem. We want to rehabilitate these children, so we needed to eliminate that risk.”

Crossroads also reinforces the idea that juveniles should not be separated from their families, because family support is a key component to success. The Program is set up so that the parents of enrolled juveniles are just as active in the rehabilitation process as the participants. And while the Program is voluntary, but it does require both juveniles and their families have to agree to a year-long commitment. Once they have enrolled they must finish their year-long enrollment or face traditional sentences – such as house arrest or incarceration at a juvenile facility.

In addition to involving family, Teodosio also aimed to have as many different kinds of support as possible – including probation officers that were heavily invested in each case.

“Juveniles in The Program meet with their assigned probation officers two or three times a week; they submit to frequent urine screenings for drugs, and they have access to individual and group counseling,” Teodosio said. “This is a program built around the idea that each child is an individual with different strengths or weaknesses – we want to develop the best plan we can for each child.”

In order to ensure that each juvenile is making progress, Crossroads provides a probation officer to each juvenile, and that officer also serves as a case manager. These managers help each juvenile follow through with the program, and also ensure that weekly drug screenings are completed.

The court also reviews both the juveniles and their parents periodically, and requires each to develop a contract that documents their goals and progress while in The Program.

Five Phase Treatment

The continued commitment of the participants and their family is crucial for the juveniles to be successful in this intense program. Crossroads requires dedication because it is set up in five phases and each of these phases requires the devotion of participants – and their families.

The first phase of Crossroads lasts for a minimum of 30 days. During the first phase, juveniles are assessed for substance abuse and required to attend Alcoholics Anonymous or Narcotics Anonymous meetings. The first phase also requires juveniles to attend school, complete a wellness plan, and comply with all case plans and complete goal sheet requirements. Juveniles are also required to attend weekly court reviews.

During the second phase of The Program, juveniles participate in counseling for both mental health and substance abuse issues. Each juvenile must pass urine screenings, and continue to comply with their case plan and goal sheets. Court reviews are bi-weekly during phase two.

Phase three is dedicated to mental health issues – participants are required to partake in counseling and comply with medication requirements for their treatment. Juveniles must also find an additional sponsor, who becomes another source of support. Court reviews are then reduced to every three weeks.

Phases four and five require that the juveniles obtain and maintain employment, abide by curfews, complete a relapse prevention program and attend a monthly court review.

The Program is set up so that as juveniles move through the phases, their responsibility for their own behavior increases, while contact with the court begins to decrease. Family support, however, is considered a crucial aspect of The Program once they have completed the five phases. 

The Program, and its five phases, offers a chance to address substance abuse and mental illness issues at the same time – and help juveniles work through those issues. So far, The Crossroads Program has been successful, with over half of the participants enrolled graduating from the program.

“We have seen success in terms of creating a program that truly requires participation from each juvenile,” Teodosio said. “The phases of The Program are efficient because each phase continues to address both mental health issues and substance abuse issues. We needed to address these issues, and so far, I think we have created an excellent way to help these juveniles.”