The provision of mental health care for young people who are in the criminal justice system has changed little in 20 years, meaning many are falling between the gaps in services, a report has found.
This is despite numerous inquiries, policy documents, expert reference groups, working parties, reports, consultations, white papers, Bills and Acts of Parliament in that time.
The report, Same Old…, by mental health charity YoungMinds and the Transition to Adulthood Alliance (T2A), in partnership with City University, and funded by the Barrow Cadbury Trust, revealed:
- Waiting lists are too long resulting in young people self-medicating with drugs and alcohol while they wait to access services. This can exacerbate their mental ill health and offending behaviour
- Rigid criteria for mental health services means young people have to be enduring a severe and debilitating mental illness before they can access any help or support
- There is still a gap in service provision between child and adult mental health services meaning many young people slip through the net and lack support at a vulnerable time in their adolescence
- If a young person manages to receive support, it is largely centred around medication. Following prescription, young people often don’t get medication reviews, support or intervention
- In occasions where intervention extends beyond medication, professionals have little time for young people and a high turnover of staff means a lack of continuity making it difficult for the young person to establish rapport or trust – a core component for positive progress.
Sarah Brennan, chief executive of YoungMinds, said: “How many more wake up calls about this problem do we need before anything changes? In order to prevent more tragedies and the waste of thousands of young people’s futures we are calling on politicians, local government, commissioners, children and young people’s mental health services, GPs, magistrates and the children’s workforce to grasp the nettle and work with young people to ensure they get the mental health support and intervention they need.
“Young people and society deserve better. We should not be writing these young people off and risking them becoming engulfed in a life of crime which will dictate their futures because they did not receive the help they desperately needed.”
Joyce Moseley OBE, chair of the T2A Alliance, added: “Why do our public services – mental health, criminal justice and children’s services – go on with the false assumption that young people in their late teens and early twenties are fully grown adults and therefore should get the same services as adults?
“At T2A we know, from the research we have done, that all young adult brains go on developing way into their 20s in ways that affect their behaviour and responses. For those with problems – and this includes all young people in the criminal justice and mental health services – their lack of maturity, in addition to their mental health needs, means they need special and often intense therapeutic help.
“By not providing appropriate and effective mental health services we are just funnelling young people into the criminal justice system with all the stigma and exclusion that brings. It doesn’t make sense for them, for their families and communities or the taxpayer. We do know what is needed – the political and professional will to deliver it.”
Key recommendations from the report include:
- Implement existing strategy, namely the Mental Health Strategy Implementation Plan and the Caldicott 2 Review (2013),which would go a long way to mitigating some of the problems
- All professionals, and specifically education professionals working with children and young people at risk of offending, should receive training to gain baseline knowledge and skills regarding the identification and awareness of mental health issues to ensure children are not written off as ‘trouble children’. Police and magistrates need training in mental health to deal with the young person appropriately and ensure appropriate sentencing. All professionals in the criminal justice system must understand any mental illness issues and not just see the crime
- Responsibility to monitor a young person’s case needs to lie with a lead professional: an individual or agency that ensures that medical case reviews take place regularly, medication is monitored and the young person is engaged in their mental and physical health care
- Health and Wellbeing Boards should ensure joint commissioning across offender mental health and local CAMHS to ensure ‘joined up services’. Clinical commissioning groups should appoint a mental health lead at senior level
- Consideration should be given as to how services can be targeted at the 16-19 year olds most at risk given the difficulty of CAMH or AMH services to respond appropriately. Contracting with local community services and co-location with other services are two ways that could help to address this
- A single point of access to services should be extended to include young people involved with the criminal justice system. CAMHS websites should develop better information, targeting this group to provide a shared point of information for young people, social workers, health professionals, criminal justice professionals, parents and police.