Over the last decade, international studies have highlighted that young people with disproportionately high and multiple needs have clustered in juvenile justice systems. Epidemiological studies suggest that the development of antisocial behaviour involves a complex interaction of risk and protective factors. Links between early adverse events and the impact of parenting, family and peer relationships on behaviour in early childhood have been found. Heritable influences contribute towards a gene-environment interaction suggesting pathways are complex and some vulnerabilities become increasingly evident in the context of other risk factors.
These young people generally experience higher levels of diagnosable mental health problems than the general population as well as facing a wide range of neurodisability such as elevated rates of ADHD, speech and communication problems, traumatic brain injury and learning needs. The association between academic problems and antisocial behaviour has been well established. Young offenders are frequently excluded from school, propelling them towards the company of other antisocial peers. Detachment from school can increase the risk of offending through reduced supervision, loss of any positive socialisation effects of school and by creating delinquent groups of young people. Many of these needs go unrecognised in the system. Lack of identification hampers opportunities for early intervention and promotion of healthy development and resilience in young people and it can undermine due process in the criminal justice system.
Policy makers in many countries have become increasingly aware of the need to work with local commissioners and services to address this over-representation of children with multiple needs in the criminal justice system. Historically, screening and assessment tools have been developed focussing on single problem areas. However, young people who offend often possess multiple problems which in aggregate undermine their mental and physical health and their life chances as well as impacting on a range of different agencies and services.
A developmental approach to understanding the needs of young people in contact with the criminal justice system can provide implications for both policy and practice.
Professor Prathiba Chitsabesan is a practising child and adolescent psychiatrist working in a large mental health and learning disability trust in Manchester, England (Pennine Care NHS Foundation Trust).
She became the Associate National Clinical Director for Children and Young People’s Mental Health in 2017 and Chair of the Tier 4 CYPMH Clinical Reference Group in 2019 (NHS England and NHS Improvement). She has an interest in the mental health and neurodevelopmental needs of children and young people in contact with the criminal justice system. Over the last 16 years she has published in peer reviewed journals and books and contributed to national reports and guidance and continues to be active in research as a Visiting Chair (Manchester Metropolitan University).
She has been involved in a number of regional and national transformation programmes including the development of the Comprehensive Health Assessment Tool across the youth justice secure estate for the Department of Health and NHS England.