Background to the Research

• The Health and Social Services Boards in NI were concerned with the numbers of young people who were assessed as requiring a 'restriction of their liberty' and the lack of alternative services to manage the risks these young people posed. They commissioned this study to provide an assessment of:
  • Numbers of children and young people in NI who require secure care;
  • The level and range of services currently available to meet the needs of these young people;
  • Possible alternative ways in which their needs can be met.
    

Research Approach

• Staff in Trusts identified 63 young people who had been assessed as needing a secure care placement in the period April 1 2005-March 31 2006. Of these 63 young people 45 moved to secure care, following assessment.
• Information was gathered in 2 main ways:
  • Detailed examination of the case files of the young people;
  • Ascertaining, by questionnaire, interview and group discussion, the views of social workers, mangers at Board and trust level, staff at the secure facility, Guardians ad litem, VOYPIC and young people who had experience of secure care.
    

Main Findings

The needs of young people and the services provided

• The profile of the young people in this sample is similar to that of other studies of secure care. There were similar numbers of boys and girls, most aged 14-15 years. All have multiple and often complex needs, many with long standing unresolved issues. Almost all had long been known to social services and other agencies; entry in to care was usually after 11 years of age.
• The case files reveal increasingly risky or anti-social behaviours by the young people over the previous year. Managing the crisis that these behaviours generated deflected efforts to deal with the inherent underlying causes of the behaviours.
• As the challenges posed by the young people increased, so did the use of residential care. By the time of assessment for a secure placement 71% of the young people were living in residential care and 84% returned to a residential setting.
• The case files also reveal that the young people had been offered many services by a range of agencies. These are fragmented and lack continuity; accessing CAMHS posed real difficulty. There is limited or non-engagement by young people with professionals and services. This failure to engage or communicate effectively with young people limits the possibility of working with them to bring about lasting change.
• Eighteen of the young people who were assessed as needing secure care were not allocated a place because of lack of capacity. Compared to the group that had a secure placement, these young people received a smaller range and fewer services.
  

Secure Care System

• Most staff members are satisfied with the assessment process for determining whether a young person requires a secure placement and think it is effective; coupled with oversight by the courts, this leads to the right decisions being made.
• The involvement of children and their families in the process is not as meaningful as it should be, reflecting the lack of effective communication and engagement with young people.
• Managing the challenges posed by these young people calls for staff with high levels of skill, especially: ability to really listen, understand and communicate well with young people; understanding the child, for example attachment theory; process skills especially around assessment and management of risk; and the skill to think creatively about alternatives to secure care.
• Despite positive assertions about the value multi-agency, translating the concept into practice is not as effective as it could be. There is a need for structural and cultural shift that will bring greater commitment, with all agencies taking seriously their obligations towards looked after children.
• There are enormous expectations of a secure placement. Some Lakewood clearly delivers. In the short term it keeps young people safe and meets their basic needs for food, shelter and security. It provides structure and an opportunity to break a destructive cycle of behaviour.
• Containment and the experience and skill of the staff in building relationships brought greater engagement by the young people, at least in the short term.
• It is less evident that secure care can achieve all that is expected in the longer term, especially in bringing about lasting behaviour change that will alter the young people's care trajectory and transform their life chances.

Alternatives and additions to the child welfare system

• Reflections on the strengths and challenges of the current secure care system highlight the roles alternative services need to fulfil if they are to help meet the needs of young people who are a risk to themselves to others, and do so without restricting their liberty. These include:
  • Preventative work, providing more intensive inputs to families at an earlier stage; o Management of the high level of risk that the young people present;
  • Building the trust of young people, providing continuity of support and communicating effectively with them, so they engage with services;
  • Recognising that for some young people, the group dynamics and communal nature of residential care exasperates their problems;
  • Dealing with deep-seated, underlying and unresolved issues facing young people;
  • Working with the family to address dysfunctional or destructive relationships which impact negatively on the young person.
• Addressing these tasks requires a range of additional or alternative services that, if available with sufficient intensity and working well together, could reduce the need for young people to be placed in secure care or to return there subsequently. These include:
  • Family support services, providing preventative services with sufficient intensity to address the problems of families;
  • Specialist community support services, with skill and experience in dealing with adolescents and their problems;
  • More differentiation in the residential sector with specialist units, perhaps with smaller occupancy, and with staff who have the high level of skill and commitment needed to engage positively with challenging young people;
  • Services that provide long term and intensive therapeutic input;
  • More one-to one work, especially for young people with a history of non-engagement with agencies and whose problems are compounded by the dynamics of communal living;
  • Specialist foster placements with well trained and supported carers who can provide intensive one-to one engagement with the young people.