Actions speak louder: A second review of healthcare in ... - HMCPSI

ACTIONS SPEAK LOUDER
FINDINGS
Of the children and young people whose cases our health inspectors looked at,
nearly a quarter were assessed as having some form of disability. Half of those
related to a learning disability, a fifth had a physical impairment and the rest had
a disability linked to their mental health or emotional state. In the total number
of cases reviewed by both health inspectors and Her Majesty’s Inspectorate of
Probation inspectors in phase 4, 17% were assessed as having a disability with a
quarter of those exhibiting issues linked to their mental health or emotional state. 7
A considerable number of children and young people displaying offending behaviour
therefore have identifiable health issues. The overall number, however, may be
higher, since we also found that many health needs were not being reliably
assessed or, in the case of physical health, too often ignored.
There is still a significant percentage of children and young people who are
‘looked-after’ 8 who come into contact with YOTs. Twelve per cent of all the children
and young people (from a random sample) whose cases were investigated were
either accommodated and maintained via a care order, or remanded in local
authority accommodation.
In phase 4, we also considered what the nature of the original offence was of the
young people whose cases we examined. The highest percentage of the total (30%)
related to violence against the person, and the second highest (16%) involved theft
and handling stolen goods. Specific drug offences amounted to 4% of the total while
criminal damage was 10% overall. For those children and young people with
custodial sentences, the majority who had been released into the community on
community supervision had conditions, or an intensive supervision and surveillance
programme, attached to that order.
Prevention
In all cases relating to prevention in phase 4, there was evidence of specific physical
health needs (scoring above 3 using the YJB ‘Onset’ 9 ) in 15% of the cases. There was
additional evidence of emotional and mental health needs in 50% of the cases and
evidence of substance misuse needs in 15% of cases (out of 554 prevention cases
providing relevant data for this analysis). Less than half of these cases were
subsequently referred to mainstream health services.
The percentage of cases where there was evidence of an intervention being
delivered in relation to physical health only amounted to 9%; for emotional and
mental health, the percentage was 26%; and for substance misuse, the percentage
7
This was from a total of 3,370 cases having been examined in inspections.
8
Those children and young people who are accommodated by a local authority.
9
Onset is a YJB assessment tool used for those who may offend – the YJB indicates that an assessment score of
3 or more should lead to a referral for a more thorough assessment by a specialist health worker. The scale is
0-4 where 0 is not associated with the likelihood of offending and 4 is very strongly associated with the likelihood
of offending.
14