mental health needs in the children detention schools siobhan young ([email protected]) 17 november...
TRANSCRIPT
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Mental Health Needs in the Children Detention Schools
Siobhan Young ([email protected])17 November 2010
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Overview
1. Review of mental health needs-Tool
-Team
-Training
2. Example of proposed model for team
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Policy, Legislative and Research Framework
United Nations Convention on the Rights of the Child
Agenda for Children’s Services National Youth Justice Strategy Legislation Research
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Mental Health Service Provision within the CDS
Oberstown Boys’ School (OBS) Oberstown Girls’ School (OGS) Trinity House School (THS)
Review included the Finglas Child and Adolescent Centre (FCAC)
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Questions
Previous involvement with Child and Adolescent Mental Health Services (CAMHS)
Screening/Non-Clinical Assessment Access to Specialist Mental Health
Assessment and Intervention during Detention
Linkages with CAMHS in Preparation for Discharge
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Methodology
File Review Staff Interviews Limitations
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School Number of Files Reviewed
OBS 9
THS 14
OGS 5
FCAC 3
Number of Files Reviewed
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File Review: How Mental Health Needs are Addressed
School Previous
CAMHS
Assessment on Admission
Access to
Specialist
Assessment
Access to
Programmes (i.e. mental health)
Linkages
to
CAMHS
OBS 55% 0 55% 0 0
THS 42% 0 100% 0 0
OGS 80% 20% 60% 0 0
FCAC 100% 66% 100% 0 66%
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File Review: Other Themes
School Presence of Intellectual
Disability
Presence of Specific Learning
Difficulties
Experience of Substance Misuse
Experience of Significant Loss
OBS 44% 55 66% 77%
THS 27% 0 64% 35%
OGS 20% 20% 60% 100%
FCAC 33% 33% 33% 66%
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Interviews
Main Mental Health Problems How Mental Health Problems are
Addressed• Assessment on Admission (Non-Clinical)
• Access to Specialist Assessment
• Linkages to CAMHS
• Access to Programmes
What Staff Think Should Happen
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Interviews: Main Mental Health Problems
ADHD Depression Schizophrenia Personality Disorders Conduct Disorders Psychosis
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Interviews: How Mental Health Problems are Addressed
Assessment on Admission (Non-Clinical)• “To profile young offenders”
• “It doesn’t necessarily inform about mental health” Access to Specialist Assessment
• “We use the psychiatrist more but that’s usually for the court, it doesn’t feed into anything practical here”
• “We have two in at the moment who are not here for assessment but both have mental health difficulties. That’s where we’re running into difficulties – the only option is to call the GP”
• “The young person presenting to an external person coming in is very different to how they present to someone who is here the whole time. A lot of reports are that the young person presented very well. Well, he did for an hour”
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Interviews: How Mental Health Problems are Addressed
Linkages to CAMHS• “They’re gone by the time the young person gets here”
• “A lot of time they are seen when they are younger but by the time they get here, all those bridges are burned”
• “A dumping ground for all the special care units”
• “The minute they enter juvenile justice the case is closed with the HSE. Everything else shuts down and off you go”
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Interviews: How Mental Health Problems are Addressed
Access to Intervention / Evidence Based Programmes• “There are programmes but not specifically for
mental health, they’re more generic”
• “We did have a drugs counsellor on campus, he was staff but he left. Now that would have to be bought in”
• “I mean surely when you get into that kind of important place with a young person that you would be able to offer a lot”
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Interviews: What Staff Think Should Happen
Onsite Mental Health Professionals• “They don’t get the whole picture”
• “Gathering information”
• “Someone qualified on campus”
• “Gut Instinct” … “Winging it”
• “Very effective… with the right guidance”
• “Sometimes when it’s all mixed up behaviours, what you actually need is someone to give clarity so people can understand”
• “What’s going to change?”
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Interviews: What Staff Think Should Happen
Training• “Incorporates some aspect of psychiatric
training but it would be a small part”
• “Techniques on how to talk to children”
• “Some type of basic training would be valuable”
• “Everyone knows that unless you are properly informed or trained you can sometimes do more damage than good with these kids”
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Recommendations
1. All young people should be screened for the presence of mental health problems on admission.
2. All young people identified as having mental health problems should have access to evidence based assessment and intervention with a clinical team.
3. All staff should have training in basic mental health awareness and positive mental health promotion.
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Commission to Inquire into Child Abuse Report (2009)
Office of the Minister for Children and Youth Affairs (2009)• Action 12 of the Ryan Implementation Plan
states that the HSE will develop a national specialist team for children in special care and detention in consultation with the Irish Youth Justice Service.
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Example of Model
Forensic CAMHS
National Manager
Oberstown Team
St Patrick's Institution
Dublin Team
Limerick Team
Cork Team
.
National Assessment, Consultation and Therapy Service