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 mental health needs than the general population as well as facing a wide range of neurodevelopmental 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 and fragmented approaches across agencies hampers opportunities for early and effective intervention and promotion of healthy development and resilience in young people.
Policy makers have become increasingly aware of the need to work with local commissioners and services to address this over-representation of young people with multiple needs in the criminal justice system. Young people who offend often possess multiple problems which in aggregate undermine their mental and physical health and their life chances.
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 including the need for integrated approaches.
Prathiba Chitsabesan is a Consultant in Child and Adolescent Psychiatry working in a large mental health and learning disability trust in Greater Manchester (Pennine Care NHS Foundation Trust).
Prathiba became 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). 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 articles in peer reviewed journals and books and contributed to national reports and guidance.
She has contributed to the development of the Comprehensive Health Assessment Tool across the youth justice secure estate for the Department of Health and continues to be research active as a Visiting Professor (University College London and Manchester Metropolitan University). She has been involved in a number of regional and national transformation programmes.