Risk-Need-Responsivity Meets Mental Health: Implementation Challenges in Probation Case Planning

• Published date: 01 September 2021
• DOI: 10.1177/00938548211008491
• Date: 01 September 2021
• Subject Matter: Articles

CRIMINAL JUSTICE AND BEHAVIOR, 2021, Vol. 48, No. 9, September 2021, 1187 –1207.

DOI: https://doi.org/10.1177/00938548211008491

Article reuse guidelines: sagepub.com/journals-permissions

© 2021 International Association for Correctional and Forensic Psychology

1187

RISK-NEED-RESPONSIVITY MEETS MENTAL

HEALTH

Implementation Challenges in Probation Case

Planning

GINA M. VINCENT

RACHAEL T. PERRAULT

University of Massachusetts Medical School

DARA C. DRAWBRIDGE

Fitchburg State University

GRETCHEN O. LANDRY

William James College

THOMAS GRISSO

University of Massachusetts Medical School

This study examined the feasibility of and fidelity to risk/needs assessment, mental health screening, and risk-need-respon-

sivity (RNR)-based case planning within juvenile probation in two states. The researcher-guided implementation effort

included the Massachusetts Youth Screening Instrument-2 (MAYSI-2), Structured Assessment of Violence Risk in Youth

(SAVRY), and policies to prioritize criminogenic needs while using mental health services only when warranted. Data from

53 probation officers (POs) and 553 youths indicated three of five offices had high fidelity to administration and case plan-

ning policies. The interrater reliability (n = 85; intraclass correlation coefficient [ICC][A, 1] = .92 [Northern state] and .80

[Southern state]) and predictive validity (n = 455; Exp[B] = 1.83) of SAVRY risk ratings were significant. There was an

overreliance on mental health services; 48% of youth received these referrals when only 20% screened as having mental

health needs. Barriers to fidelity to RNR practices in some offices included assessments not being conducted before disposi-

tion, lack of service availability, and limited buy-in from a few stakeholders.

Keywords: juvenile justice; risk/needs assessment; risk-need-responsivity; mental health; SAVRY

Considerable attention has been directed toward advancing juvenile justice reform by

translating the evidence for reducing delinquent offending into practice (National

Research Council, 2013). Case planning is a particularly important area for translating

AUTHORS’ NOTE: The authors thank the administrators, probation supervisors, and officers at the study

sites, who shall remain unnamed to preserve confidentiality. We also thank our research associates, Cassandra

Beinemann, Christina DeSimone, Max Christensen, Andrew Nickerson, and Kathryn Riddinger. This research

was funded by the Office of Juvenile Justice and Delinquency Prevention (PI: Vincent, 2014-JF-FX-0001) and

the John D. and Catherine T. MacArthur Foundation as an extension of the Models for Change Initiative

Research Network (105740-0). Correspondence concerning this article should be addressed to Gina M.

Vincent, Department of Psychiatry, University of Massachusetts Medical School, 222 Maple Avenue,

Shrewsbury, MA 01545; e-mail: Gina.Vincent@umassmed.edu.

1008491CJBXXX10.1177/00938548211008491Criminal Justice and BehaviorVincent et al. / Risk-Need-Responsivity Meets Mental Health

research-article2021

1188 CRIMINAL JUSTICE AND BEHAVIOR

research evidence into practice. Quality case planning can improve the chances of justice-

involved individuals’ success, whereas poor quality planning can set them up for failure.

Case planning involves a series of interrelated functions to provide coordination, including

assessment, planning, linking, monitoring, and advocacy (Monchick et al., 2006). In justice

settings, the most widely tested model for individualizing case planning in a manner that

will reduce recidivism has been risk-need-responsivity (RNR; Andrews & Bonta, 2010;

Gendreau et al., 2006). The RNR model emphasizes use of services that target individuals’

malleable risk factors.

In juvenile justice settings, mental health needs are another critical area for consideration

in case planning due to the high prevalence rates of these needs (e.g., Drerup et al., 2008;

Teplin et al., 2002). A recent study of juvenile probation case planning found mental health

services frequently took precedence over other risk-related services (Haqanee et al., 2014),

which is contrary to the existing evidence about how to reduce recidivism (e.g., McCormick

et al., 2017) and highlights challenges with implementing best practice. To address these

challenges and better integrate risk and mental health needs into case plans, researchers

assisted juvenile probation agencies with implementing risk/needs assessment and mental

health screening procedures, along with RNR-based case planning practices. The purpose of

this study was to examine the implementation outcomes (feasibility and fidelity) of this

RNR-driven, researcher-guided, case planning process in multiple juvenile probation offices.

RNR AND MENTAL HEALTH

The RNR framework suggests intensive programming should be reserved for higher risk

cases because lower risk cases do as well or better with minimal intervention (risk principle;

Hoge & Andrews, 2011). Programming should target an individual’s dynamic risk factors

influencing their offending (need principle) to achieve the largest reduction in recidivism.

Programming also should consider how well the styles and modes of service are matched to

an individual’s attributes that may affect treatment response (responsivity principle). To

accomplish this, agencies must first conduct a valid risk/needs assessment that accurately

identifies each individual’s risk level and dynamic risk factors to which the case plan will

be tailored. Dynamic risk factors, also referred to as criminogenic needs, are malleable

characteristics that strongly influence youth offending behavior. Examples of youth crimi-

nogenic needs include negative peer associations, personality traits (e.g., impulsivity, poor

anger control, lack of empathy), and procriminal thinking. Decades of longitudinal and

epidemiological research (e.g., Farrington, 1989; Lipsey & Derzon, 1998) has documented

significant associations between dynamic risk factors and reoffending.

Mental health needs and diagnoses generally are viewed within the RNR model as non-

criminogenic needs (and not relevant to case planning unless symptoms are severe) or as

responsivity factors. Mental health needs can be an important factor in case planning

because symptoms moderate the benefits a youth would otherwise receive from services

that target criminogenic needs (responsivity factor). However, with the exce ption of some

specific circumstances (e.g., symptoms of attention-deficit hyperactivity disorder), men-

tal health needs are not considered risk factors for recidivism. Indeed, Andrews and

Bonta (2010) maintained that criminogenic needs were sufficient for prediction of recid-

ivism without considering formal diagnoses. Several studies of youth have supported

this sentiment by demonstrating that neither youths’ mental health diagnoses nor their