Lack of staff training in mental health issues and poor
relationships with child and adolescent mental health services are
responsible for the failure to diagnose and treat children and
young people in secure accommodation, according to a Community
The survey of 30 homes and units found a high prevalence of mental
health problems and disorders among detained children.
All the homes said young people in their units during the last year
had demonstrated mental health problems, including anxiety,
depression, hyperactivity, conduct disorders, and emotional and
behavioural problems. Just over half of the homes reported mental
disorders among their residents, such as schizophrenia, psychosis
or manic depression.
Forty-seven per cent of homes reported that young people in their
units had eating disorders and a similar proportion of homes
referred to suicide attempts. All homes reported incidents of
self-harming, while just under half had sectioned a young person in
the last year.
Roy Walker, chairperson of the Secure Accommodation Network and a
regional secure unit manager, said: “We are concerned that young
people are locked up because there are not other areas of
accommodation, particularly around mental health issues. Children
are sometimes placed because we don’t know what else to do with
Despite the high prevalence of mental health problems within secure
units, one-third of homes said none of their staff had received any
formal training in dealing with mental health issues.
Furthermore, although two-thirds of homes said they had access to
local CAMHS for mental health support and services, nearly half
said they had difficulties in their relationship with the service.
Services were either non-existent, poorly resourced, understaffed,
too slow, or too dependent on personal relationships.
The survey responses also highlighted possible ways forward,
including removing barriers between health and social care, quicker
access to health professionals, more screening for mental health
problems on admission to secure units, the appointment of an
individual psychiatrist or psychologist to each home, and greater
access to specialist units.
“The concept of corporate parenting is much spouted, but it always
ends up at the door of social services,” Walker said.
“What we need is more joined-up working. We need to target more
resources at children and young people with special needs.”