This study examined juvenile justice-involved youths' understanding and appreciation of the Miranda warnings' rights to silence and legal counsel using the Miranda Rights Comprehension Instruments (Goldstein, Zelle, & Grisso, 2012). It also examined the relationships between totality of circumstances factors and understanding and appreciation of rights. Data were collected from 183 youths (140 boys) in pre- and postadjudication facilities in 2 states. Overall, youths demonstrated greater difficulty on measures of appreciation than understanding, with particular deficits in their abilities to comprehend the abstract concept of the right to silence. Results varied slightly by instrument, highlighting the importance of a multimodal assessment of these complex abilities. Examination of totality of circumstances factors identified relationships between some factors (e.g., age, verbal IQ, academic achievement) and Miranda comprehension, but revealed that other factors (e.g., gender, number of previous arrests) were not significantly related to Miranda understanding or appreciation. The findings support a nuanced conceptualization of Miranda rights comprehension that acknowledges the complexity of understanding and appreciating the warnings. Empirical analyses also support the continued use of some totality of circumstances factors and abandonment of others. Findings underscore the necessity of multimodal assessment and interpretation when conducting capacity to waive Miranda rights evaluations.

For people with serious mental illness, research demonstrates the potential positive effects of having an advance directive with specific instructions for mental health care. The Commonwealth of Virginia has undertaken efforts to incorporate the completion of psychiatric advance directives into routine mental health services for individuals with serious mental illness. The inherent complexities of advance directives-a single legal tool for use by a heterogeneous array of consumers, providers, and organizations-have led to more barriers than had been anticipated. This article describes challenges encountered in the first three years of implementation efforts. Data are from feedback on early training attempts and experiences of staff at pilot sites and work groups convened for the implementation project. The authors describe a range of challenges, such as how to present a complete and clear message about the nature, purposes, and potential advantages of psychiatric advance directives to various audiences, in particular their use in recovery-oriented care; how to promote cross-system collaboration among potential users of these directives; and how to overcome resource constraints and sustain interest in the process. Virginia's experience reinforces the importance of developing multifaceted implementation strategies, such as the creation of informational and training tools to spread implementation more effectively, the identification of "champions" or staff members who are invested in implementation, and the development of multiple approaches to facilitating completion of advance directives by consumers.

This article describes the psychometric properties of the Miranda Rights Comprehension Instruments, the revised version of Grisso's Miranda instruments. The original instruments demonstrated good reliability and validity in a normative sample. The revised instruments updated the content of the original instruments and were administered to a sample of 183 youth in pre- and postadjudication facilities. Analyses were conducted to establish the psychometric properties of the revised instruments and included similar analyses to those conducted by Grisso, as well as additional calculations (e.g., standard errors of measurement, intraclass correlation coefficients, Kappa coefficients). Results revealed sound psychometric properties, similar to those observed for the original instruments.

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