Children in jail with mental health problems

Shareen* was sexually abused over several years from the age of seven. Her behaviour at school became increasingly aggressive, resulting in multiple exclusions, and she regularly self-harmed.

Shareen started to drink heavily, building up a string of drunken public order offences. Eventually, she was made the subject of an antisocial behaviour order, which she breached repeatedly. She ended up in custody where she continued to self-harm and was diagnosed with a borderline personality disorder. But no intervention was available to support this diagnosis.

At 17, she was fearful of release and wanted intensive support. Yet, despite a letter written by her psychiatrist outlining her diagnosis of borderline personality disorder, no link-up had been made with community mental health workers at the point of her release.

Sadly, cases like Shareen’s are not uncommon. A lack of joined up, accessible and attractive community services has meant that young people and their carers have struggled to access mental health provision. Problems and behaviour have been left to worsen, creating challenges for local communities and resulting in contact with youth justice agencies, which are themselves often ill-equipped to provide the support young people with mental health issues need.

Over the past 10 years, the number of young people in custody has doubled, and research suggests that under-18s in the criminal justice system are three times more likely to have mental health problems than their non-offending counterparts. Almost a quarter of young people in the criminal justice system have been identified with IQ levels indicative of learning disabilities, with another third falling within a range associated with borderline learning disabilities.

All this evidence suggests that young offender institutions are being regularly used to manage and “treat” young people with complex mental health difficulties, in spite of the deleterious effect of custodial sentences on young people’s emotional well-being.

For most young people, incarceration neither offers the best chance of reducing reconviction nor of addressing mental health needs effectively. Keeping young people with mental health difficulties in custody is also expensive (costs range from £50,800 to £164,750 a year for each child) and latest figures indicate that nearly 70% of young people are reconvicted on release.

Action is therefore required to address young people’s emotional vulnerabilities and mental health needs more effectively – and largely in the community.

The wish to avoid premature labelling, coupled with the greater number of adolescents likely to have emerging or unclear mental health difficulties, has made it easier for early signs to be construed simply as bad behaviour requiring punishment. From schools to police stations, there remains extremely limited systematic and proactive activity to identify and divert young people with mental health difficulties into more suitable care packages.

Working in partnership with the Department of Health and the Youth Justice Board, the Sainsbury Centre for Mental Health (SCMH) aims to identify and spread the key findings from promising emerging practice in this important area of work with young people. Only then can the trend of using YOIs as default health service providers for young people with complex mental health needs effectively be reversed.

*Not her real name

Lorraine Khan is a senior development worker at the Sainsbury Centre for Mental Health. For more information about young people in jail contact lorraine.khan@scmh.org.uk

This article appeared in the 21 February issue under the headline “Stop passing the parcel”