Psychosocial needs of boys in secure care for serious or persistent offending

University of Manchester and Central Manchester and Manchester Children's Hospitals, Manchester, UK.
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 09/2005; 46(8):859-66. DOI: 10.1111/j.1469-7610.2004.00388.x
Source: PubMed


The mental health of child offenders who are detained in secure settings is a matter of great public and professional concern but there has been little systematic longitudinal research on the outcomes of these problems once the young person has returned to the community. The aims of the present study were to describe the psychosocial outcomes of boys in secure care and to establish if these outcomes were correlated with criminal outcomes.
Prospective cohort study of 97 boys whose average age was 14 years when they were admitted to secure units in the North West of England. The boys were followed up on average 2 years later, when outcome data were obtained on 81/97 (83%) cases. The main outcome measure was a standardised assessment of mental health, social and educational needs obtained by interview with the young person and corroborated in most cases by information from informants. All data were then reviewed by experienced clinicians who made best-estimate ratings of need 'blind' to the findings from the first phase of the study.
The average number of needs requiring an intervention at follow-up (mean=3.4, sd=3.0) was much lower than before admission to secure care (mean=8.2, sd=2.5) (mean difference 4.9 needs, 95% CI 4.0 to 5.7). Educational and occupational needs were particularly well dealt with. However, many mental health problems persisted or worsened. For example, 31% had a need for treatment of substance abuse, a significant increase compared with when they were in secure care (percentage difference 21%, 95% CL 9.0% to 32.7%). No mental disorder predicted subsequent offending.
Boys who have been in secure care continue to have a high rate of mental health problems. The mental health needs of this group are not, however, static but change over time and with changing circumstances. Services need to be designed to meet these changing needs.

7 Reads
  • Source
    • "Special interventions are also needed, for example, to assess and manage suicide risk (Fazel et al., 2008). On the other hand, adolescents' needs change during their time in secure treatment and this has to be taken into account in planning and providing services (Harrington et al., 2005; Kroll et al., 2002). Therefore, interventions should not be restricted to secure units but should also include parents and agencies working with the young (Kroll et al., 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: doi: 10.1080/14999013.2013.819394 AB - This study aimed to describe treatment settings and interventions provided by adolescent forensic inpatient units in four Northern European countries. Data were collected with the Monitoring Area and Phase System (MAPS). Data were analyzed using descriptive statistics and qualitative methods. Results showed that there were differences in intake criteria and in theoretical orientation between the units studied. In addition, there were differences in treatment focus. The results can be used in service planning and provision of care in adolescent forensic setting. Exchange of information cross-nationally facilitates the advancement of knowledge and sets parameters for education in the clinical forensic setting.
    International Journal of Forensic Mental Health 07/2013; 12(3):155-164. DOI:10.1080/14999013.2013.819394 · 1.05 Impact Factor
  • Source
    • "We classified the participants in recidivism subgroups by using two alternative approaches. First, and in line with previous studies (e.g., Colins et al., 2011; Harrington et al., 2005; Vermeiren et al., 2002), violent rearrests were dichotomized to indicate the presence of at least one (versus zero) violent rearrest (i.e., any violent rearrest). Second, violent recidivists differ from each other regarding the frequency of violent rearrests. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to prospectively examine whether psychotic-like symptoms (PLSs) are positively associated with violent recidivism and whether this relation is stronger when PLSs co-occur with substance use disorders (SUDs). Participants were 224 detained male adolescents from all youth detention centers in Flanders. The Diagnostic Interview Schedule for Children was used to assess PLSs and the number of SUDs. Two to 4 years later, information on official recidivism was obtained. Although hallucinations were unrelated to violent recidivism, paranoid delusions (PDs) and threat/control override delusions (TCODs) were negatively related to violent recidivism. The relation between PLSs and violent recidivism did not become stronger in the presence of SUDs. Detained youths with PLSs do not have a higher risk for violent recidivism than detained youths without PLSs. In contrast, by identifying detained youths with PDs or TCODs, clinicians are likely to identify youths with a low risk for future violent crimes.
    The Journal of nervous and mental disease 05/2013; 201(6). DOI:10.1097/NMD.0b013e3182948068 · 1.69 Impact Factor
  • Source
    • "The frequency of aggressive behavior, self-destructive/identity problems and externalizing problems were substantially closer to the controls 6 months after admission, which was also the case for delinquent behavior after 12 months. This reduction is probably due to the strict management and because many educational needs are being met [27]. All youths in detention centers must follow the rules and regulations to study, exercise, and work, which could have improved the above-mentioned mental health of these boys. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To assess the behavioral risk factors and mental health needs of adolescents in juvenile detention centers (JDC). A total of 238 boys aged 12-17 years was surveyed who had been admitted to a detention center and compared them with boys from the community (n = 238) matched for sex and age. We assessed behavioral risk factors and mental health problems by using the Youth Risk Behavior Survey questionnaire (YRBS) and the Youth Self-Report questionnaire (YSR). Young offenders had significantly higher YRBS scores than controls for drug use (odds ratio (OR) 5.16, 95% CI 2.27-7.84), sexual intercourse (OR, 2.51; 95% CI 1.55-2.90), irregular diet (4.78, 2.11-7.51), suicide attempts (1.96, 1.32-5.85), and physical fighting behavior (3.49, 1.60-7.07), but not for tobacco use, alcohol use, and high-risk cycling. Young offenders at the time of admission (6.61, 2.58-15.2), at 6 months (3.12, 1.81-10.1), and at 12 months (5.29, 1.98-13.3) reported statistically higher levels of total mental health problems than adolescents in a community sample. Young offenders have a high rate of mental and behavioral disorders. In the detention period, aggressive behavior, self-destructive/identity, and externalizing of problems improved while withdrawn, anxious or depressed, and internalizing of problems worsened.
    PLoS ONE 05/2012; 7(5):e37199. DOI:10.1371/journal.pone.0037199 · 3.23 Impact Factor
Show more

Similar Publications