BMJ  2006;333:989 (11 November), doi:10.1136/bmj.39024.433356.DB

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Professional teams who deal with young offenders lack healthcare expertise

¹ Abergavenny

Many young offenders in England and Wales lack adequate access to health care, a new report says.

One in three youth offending teams, the multiagency groups designed to bring together education, health, and social care professionals, as well as the police and probation services, does not have a mental health worker, says the report from the Healthcare Commission and Her Majesty's Inspectorate of Probation.

And it says that a sixth of the teams do not have a healthcare worker, although primary care trusts have a statutory duty to provide one to their local team.

"The consequences of not providing support to these children are dire for the young person and the local community," said the Healthcare Commission's chief executive, Anna Walker.

She said, "Children and young people are responsible for 25% of all crimes in the UK, and 40% of those who commit crimes have mental health problems. The NHS clearly has a significant role to play. All primary care trusts must fulfil their statutory duty to provide healthcare workers to their local teams."

The report looked at 50 of 155 teams formed in 1998 to prevent children and young people aged between 10 and 17 years from participating in offending behaviour. It identifies several areas where improvements are needed, and its recommendations include a call for every primary care trust to provide at least one healthcare worker for their local team.

It says that 60% of teams did not have adequate involvement of a healthcare professional at a strategic or board level and that up to a third had inadequate screening for health and drug misuse problems. A third of teams also had inadequate record keeping or information sharing policies.

"Sixteen and 17 year olds are particularly disadvantaged by the provision of child and adolescent mental health services with a clear gap in services for this age group," says the report, which recommends that every child up to 18 years has access to good quality mental health services.

It says, "Child and young offenders have a range of needs that distinguish them from the non-offending population of children. They are more likely to have been in care, witnessed violence in the home or have been the victim of crime. Many young offenders often have difficulties in gaining access to mainstream health services due to a lack of parental support."

The report also identifies positive features, including greater availability of healthcare services for child and young offenders since 2003 and what it describes as a clear and consistent approach to substance misuse work across England and Wales.

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