Effectiveness Of Mental Health Provision for Young Offenders Mental Health Services of Salford and t

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Effectiveness Of Mental Health Provision for
Young OffendersMental Health Services of Salford
and the University of ManchesterFunded by the
Youth Justice Board

• Research Team
• Dr.P.Chitsabesan, S.Sneider, G.Taylor, C.Kenning
  and W.Macdonald
• Principal Investigators
• Professor.R. Harrington, Professor.S.Bailey and
  Dr.L.Kroll

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Overview

• Almost 2 million crimes are committed by young
  people each year
• Strong continuity of antisocial behaviour into
  adulthood
• Services patchy and lack of continuity of care
• Providing services requires an integrated
  approach from agencies involved in their care
• High levels of co-morbidity

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Methods of Assessment

• Problems with Previous Studies
• Small or in specific geographical locations
• Unrepresentative of the juvenile offending
  population
• Males only
• Few from ethnic minorities
• Secure or community sites only
• Mainly cross-sectional data
• Psychiatric diagnosis only

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Needs Assessment

• Definition
• Capacity to benefit
• Significant problem that can benefit from an
  intervention that is not being offered

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Needs Assessment

• Standardised measures for needs assessments for
  adults well established
• Includes client and carers views, availability
  of effective interventions, clients perception
  and motivation
• S.NASA (Salford Needs Assessment Schedule for
  Adolescents)
• Reliability studies (Kroll et al., 1999)

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S.NASA

• Covers 17 areas of need (mental health,
  educational and social)
• Interview gathers information on symptom
  severity, client co-operation and key worker
  stress in addition to interventions offered
• S.NASA computer algorithm generates significant
  problems (problem requiring intervention)
• Significant problems rated by clinicians into
• Unmet need
• Suspended Need (ongoing intervention)
• Persistent needs despite interventions (PDI)

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Effectiveness of Mental Health Provision to Young
Offenders
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Aims

• Question 1
• What is the level of mental health need among
  young offenders in the community and in secure
  facilities
• Question 2
• Do needs change for those discharged from secure
  facilities

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Study Design
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Study Design
Cross-sectional Survey 300 Young Offenders (150
in custody and 150 in the community)
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Pre-liminaryFindings
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Results

• Subjects
• Site 151 secure care and 150 - community
• Sex Male n234 (78) Female n67 (23)
• Age Mean age 15.7yrs (range 13-18yrs)
• Ethnicity
• White (83)
• Afro-Caribbean (9)
• Asian (2)
• Other Eastern European (1)
• Mixed Race (5)

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ResultsPrevalence of Significant Problems
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Mental Health Needs

• Rates of Mental Health Problems
• Depression - 18
• Anxiety - 10
• PTSD - 9
• Hyperactivity - 7
• Psychosis - 5
• Alcohol Abuse- 11
• Drug Abuse - 20
• Self-harm - 9

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Mental Health Needs At Follow-up

• Rates of Mental Health Problems
• Depression - 27
• Anxiety - 13
• PTSD - 13
• Hyperactivity - 8
• Psychosis - 5
• Alcohol Abuse- 23
• Drug Abuse - 24
• Self-harm - 7

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Correlates of Need

• Baseline
• Sex (MgtF but not significantly different)
• Ethnicity (not significantly different)
• Site (Communitygtsecure significantly different)
• Follow-up
• Needs increased at follow-up

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Reasons for Unmet Need

• Many of these needs were unmet
• 1) Problems with screening
• Inadequate training
• Transfer without documents
• Static assessments on referral/admission
• 2) Reasons for non-referral
• Lack of services locally and long waiting lists
• Concerns about the imminent transfer of the young
  person disrupting an intervention
• 3) Young person refused any intervention

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Reasons for Unmet NeedExample drug abuse and
mental health

• Unmet need at baseline and reasons identified
  during follow-up drug abuse (n53) and mental
  health (n73)
• Screening Problems
• Drug abuse -52 and mental health 78
• Service Problems
• Drug abuse 12 and mental health 10
• Young Person Refuses/DNA
• Drug abuse 32 and mental health 7
• Missing/lost to follow-up
• Drug abuse 4 and mental health 5

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Conclusions

• Young offenders have high levels of need,
  including mental health
• The most significant correlate of need is
  location
• Young offenders in secure estates had lower
  levels of need compared with those in the
  community
• Needs increased on discharge from secure estates
• Many of these needs were unmet