The Office of the Children’s Commissioner has undertaken an investigation into the provision of mental health services in the youth justice system. Whilst the report recognises that there has been a significant reduction in the number of children and young people (children) going into custody, with a reduction of a third in a year, it also found a wide variation in the consistency and quality of measures put in place to support mental health and emotional well being of children in custody. Its findings included:

  • commissioning arrangements for health services for children in the youth justice system were complex and variable,
  • a lack of understanding by staff of children’s emotional well being and mental health problems and a lack of training for staff;
  • systemic problems and poor communication between professionals;
  • a focus on physical controls to deal with challenging behaviour rather than through building relationships;
  • children in specialist units and some Local Authority secure children’s homes were more positive about their experiences than those in mainstream units.

The recommendations include the following:

  • commissioning of health services for children in detention should be regarded as a specialist function undertaken by the DH through the management of the National Commissioning Board, provided that it includes people with specialist knowledge of child health and child health commissioning;
  • the DH should ensure there is an efficient health screening process for all children entering custody and all those with identified risks regarding mental or physical health should receive access to appropriate services;
  • professionals from all disciplines working with detained children should have shared training;
  • a shared protocol should be developed between the DH, Ministry of Defence, Department of Education and local government in relation to sharing health, education and social care information about children in the youth justice system;
  • the Ministry of Justice should make sure the commissioning specification of the secure estates ensures that children are accommodated in small units of no more than 150 children;
  • training in mental health and child development should be compulsory for those working with children in the youth justice system;
  • governors and senior management should have basic training in emotional health, well being and mental health and child and adolescent development;
  • there should be a statutory duty on local authorities to provide support services to children leaving custody;
  • legislation should be amended to ensure that children accommodated under section 20 of the 1989 Children Act immediately prior to a custodial sentence should continue to receive services from the local uuthority children’s services, as if they were still accommodated;
  • There should be a single inspection body with appropriate expertise.