The psychosocial needs of young offenders and adolescents from an inner city area

The Prospective Impact of Family Functioning and Parenting Practices on Court-Involved Youth's Substance Use and Delinquent Behavior

Court-involved youth exhibit high rates of psychiatric symptoms, substance use, and delinquency, yet little is known about the contributing roles of caregiver and family factors. The current study examined whether family functioning and parental monitoring mediate the relationship between caregiver and youth psychiatric symptoms (at first court contact) and youth substance use and delinquency (two years later). Participants were 400 first-time offending court-involved youth (M_age = 14.5 years; 57.3% male; 45.6% non-Latinx White, 42.0% Latinx) and an involved caregiver (M_age = 41.0 years; 87.2% female; 53.0% non-Latinx White, 33.8% Latinx). Structural equation modeling revealed that caregiver and youth psychiatric symptoms were prospectively associated with worse family functioning, which was in turn related to higher levels of youth delinquency and greater likelihood of substance use. The results support the notion of addressing the needs of justice-involved youth and families holistically rather than treating youth as "the problem" in isolation.

Traumatic brain injury is highly associated with self-reported childhood trauma within a juvenile offender cohort

PRIMARY OBJECTIVE

To identify correlates of past traumatic brain injury (TBI) in a population of young offenders.

RESEARCH DESIGN

Cross-sectional analyses were conducted on available data from a sample derived from the NSW Young People on Community Orders Health Survey.

PROCEDURES

Study participants were administered questionnaires to collect history relating to past TBI, childhood trauma, substance abuse, and psychological/psychiatric symptoms and underwent assessments of intellectual functioning. Information on offending history was accessed through Juvenile Justice administrative records.

OUTCOMES AND RESULTS

Analyses were undertaken on data from 788 young offenders (672 males and 116 females). A past TBI was reported in 39%. Symptoms of psychological distress were more prevalent in females. A history of TBI was associated with more symptoms on a Childhood Trauma Questionnaire, as well as higher psychological distress (K-10), and higher levels on standardized measures of anger/violence, post-traumatic stress, and substance abuse.

CONCLUSIONS

The experience of early life trauma warrants further consideration as an antecedent to both childhood TBI and offending which might account for some of the previously observed association of mild TBI with subsequent offending behavior.

Mental Health Symptoms and Parenting Stress of Parents of Court-Involved Youth

Youth involved in the juvenile justice system are at risk for emotional and behavioral problems. However, research with court-involved adolescents has neglected to examine the mental health of their parents, who may also have significant personal and parenting stress. This sample consisted of 144 parent-adolescent dyads. Adolescents (aged 11 to 17 years) identified by court officials were referred to the study to receive mental health treatment. Parents and adolescents completed surveys about their mental health diagnoses, treatment, and family relationships. Using the clinical cut-off for the global severity index of the Symptom Checklist-90-Revised, bivariate and multiple logistic regression analyses were performed to examine group differences between parents with and without significant mental health symptoms. Results indicated that 35% of parents endorsed clinically significant mental health symptoms. Parents with clinically significant symptoms, compared to those without, reported significantly greater parenting stress (p < .05), and were more likely to have received prior mental health treatment (54% vs. 25%; p < .05) and a psychiatric diagnosis (52% vs. 19%; p < .05). Our findings revealed that more than one in three parents of court-involved adolescents are currently experiencing significant mental health symptoms. Improved mental health screening and intervention that incorporates the unique needs of families is recommended, including the possible use of family-based approaches as well as individualized treatment for the parents of court-involved youth.

Exploring parents' understandings of their child's journey into offending behaviours: A narrative analysis

Parents are perhaps the best placed individuals to comment upon their child's life story, including early life experiences, transitions and their child's needs. However, research has rarely focussed on the views of parents of young people who have committed serious offences. This research aimed to explore parents' opinions of which factors may have led to their child becoming involved with the criminal justice system. Interviews were undertaken with six parents who were asked to narrate their child's life journey into offending behaviours. The data were then analysed using narrative analysis techniques, and a shared story was created which incorporated the main transitional stages in the children's journeys, as seen by the parents. The findings suggest that it is not just the child but the whole family who have been in a state of distress throughout the child's life. Systemic and environmental factors are argued to contribute to this distress, and the use of diagnosis for this population is critically evaluated. The research highlights a life story in which the child's and family's distress remains unheard and therefore unresolved. Clinical implications for working with this population are discussed.

Examining experiences of transition, instability and coping for young offenders in the community: A qualitative analysis

This article explores experiences of transition, instability and coping using a qualitative approach with young offenders within a specialist forensic child and adolescent mental health service (CAMHS). Participants were four young people (aged 14-17 years) on community orders under the supervision of local youth offending teams (YOTs). Semi-structured interviews were conducted and data analysed using an inductive thematic analysis approach. Three main themes were identified: (i) people and places; (ii) growth; and (iii) managing difficult experiences. Findings suggest that young offenders are exposed to a wide range of challenging contextual factors including unpredictable or inadequate home environments, numerous transitions (between family members/foster placements and schools), limited engagement with educational settings and a lack of social support, supporting the findings of Paton et al. Findings also portrayed a sense of participants' 'psychological growth' with development along a trajectory from a young child 'acting out' in response to the environments in which they were living; through a more reflective stage, in which they were able to begin to consider the situations they found themselves in; before reaching a position in which they were able to look beyond their day-to-day circumstances with some hope that their lives could be different in the future. Furthermore, accounts revealed that these young people had a limited range of functional coping strategies and had largely negative experiences of services. Clinical implications and the need for further research developing professionals' understanding of the influence of early experiences on young offenders' behaviour are discussed.

Effcacy of Williams LifeSkills Training in improving psychological health of Chinese male juvenile violent offenders: a randomized controlled study

This randomized controlled study was conducted to evaluate the efficacy of Williams LifeSkills Training (WLST) as a means of improving the psychological health of Chinese male juvenile violent offenders. Sixty-six participants were assigned randomly to receive the usual intervention plus 8 weeks of WLST (study group, n = 33) or only the usual intervention (control group, n = 33). We found that the study group exhibited significantly decreased State-Trait Anxiety Inventory (STAI X-1, X-2) STAX2 scores and Trait Coping Style Questionnaire (TCSQ) negative scores, and increased Interpersonal Support Evaluation List (ISEL) tangible scores from baseline to 9 weeks later (P <0.01). In addition, a between-group difference in changes of TCSQ negative score was observed at the end of week 9 (P <0.05). These fndings suggest that WLST can improve trait anxiety, coping style, and interpersonal support in male Chinese juvenile violent offenders.

Psychopathology, symptoms of attention-deficit/hyperactivity disorder, and risk factors in juvenile offenders

BACKGROUND

The aim of this study was to assess the prevalence of potential environmental and psychopathological risk factors, with special focus on symptoms of attention-deficit/hyperactivity disorder (ADHD), in a sample of adolescent offenders in relation to the type of crime committed.

METHODS

The assessment included data collection and administration of clinical standardized scales such as the Youth Self-Report and Conners' Adolescent Self-Report Scale. A total of 135 juvenile offenders participated in the study. In relation to the type of crime committed, we identified three groups matched for age and sex (crimes against people, property crimes, and alcohol-drug-related crimes).

RESULTS

Fifty-two percent of juvenile offenders reported educational achievement problems and 34% reported a family history of psychiatric disorders. We detected a statistically significant difference between the three groups with regard to ADHD (P=0.01) and conduct problems (P=0.034). Juvenile offenders who had committed crimes against people showed more ADHD symptoms (18%) and conduct problems (20%) than adolescents who had committed property crimes and alcohol-drug-related crimes. Sixty percent of the juvenile offenders who had committed property crimes and 54% of those who had committed alcohol-drug-related crimes showed problems in academic achievement.

CONCLUSION

These findings suggest the need to implement specific interventions for prevention and treatment of specific criminal behavior.

Emotion recognition and cognitive empathy deficits in adolescent offenders revealed by context-sensitive tasks

Emotion recognition and empathy abilities require the integration of contextual information in real-life scenarios. Previous reports have explored these domains in adolescent offenders (AOs) but have not used tasks that replicate everyday situations. In this study we included ecological measures with different levels of contextual dependence to evaluate emotion recognition and empathy in AOs relative to non-offenders, controlling for the effect of demographic variables. We also explored the influence of fluid intelligence (FI) and executive functions (EFs) in the prediction of relevant deficits in these domains. Our results showed that AOs exhibit deficits in context-sensitive measures of emotion recognition and cognitive empathy. Difficulties in these tasks were neither explained by demographic variables nor predicted by FI or EFs. However, performance on measures that included simpler stimuli or could be solved by explicit knowledge was either only partially affected by demographic variables or preserved in AOs. These findings indicate that AOs show contextual social-cognition impairments which are relatively independent of basic cognitive functioning and demographic variables.

Correlates of traumatic brain injury among juvenile offenders: a multi-site study

BACKGROUND

There is some evidence that antisocial individuals, including young delinquents, are significantly more likely than people in the general population to incur a traumatic brain injury (TBI). Extant studies are hampered by methodological limitations, such as small sample sizes, lack of control for confounding effects, and use of single sites and may lack representativeness.

HYPOTHESIS

The hypothesis for this study is that young offenders with a history of TBI will not only be at higher risk of impulsivity and negative emotionality than their non-injured peers but also that those with TBI will have had more previous victimisation experiences.

METHODS

Data from two sites (Philadelphia, PA and Phoenix, AZ) in a substantial longitudinal, prospective study - the Pathways to Desistance Study - were used to compare young people (average age 16 years) who reported TBI with those who did not. Independent variables were behavioural, criminogenic and psychosocial measures.

RESULTS

Male youths were about twice as likely as young females to report TBI. Such injury was associated with higher impulsivity and negative emotion ratings, even after allowing for potentially confounding factors, including sex. In addition, TBI was independently associated with self-reported experience of victimisation.

CONCLUSIONS/IMPLICATIONS

This extends the generalisability of earlier suggestions of a relationship between TBI and offending, and various factors thought likely to mediate the relationship. The implications are, thus, that it is likely to be of practical value to screen young people who get into the criminal justice system for a history of TBI, and thus to allow for more specific tailoring of interventions to reduce the range of associated problems, including likely reoffending.

High impulsivity as a risk factor for the development of internalizing disorders in detained juvenile offenders

BACKGROUND

Whilst impulsivity is most commonly linked to the development of internalizing disorders, high levels of impulsivity, anxiety, and depression have been found in detained juvenile offenders. We therefore sought to determine whether impulsivity is associated with the development of self-reported anxiety or depression in a sample of detained juvenile offenders.

METHODS

323 male juvenile offenders and 86 typically developing controls, aged 15-17 were assessed. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (SADS-PL) was used to assess psychiatric diagnoses, the Barratt Impulsivity Scale (BIS-11) was used to measure impulsivity, and the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Birleson Depression Self-Rating Scale (DSRS) were used to assess self-reported anxiety and depression respectively.

RESULTS

Compared to controls, juvenile offenders had significantly higher scores on the BIS-11 total, as well as on the motor and nonplanning subscales (all p values <0.001), as well as higher DSRS (p<0.001) and SCARED (p<0.05) scores. Within the juvenile offender group, scores on the SCARED correlated positively with BIS-11 total, attention subscale, motor subscale, and total DSRS (all p values <0.01). DSRS scores correlated positively with BIS-11 total, attention subscale, nonplanning subscale, and total SCARED scores (all p values <0.01). Participants were then categorized low, middle or high impulsivity according to scores on the BIS-11. One-way ANOVAs demonstrated a significant difference between these tertiles on DSRS [F(2,320)=4.862, p<0.05] and SCARED total scores [F(2,320)=3.581, p<0.05]. Specifically, post-hoc analyses found that the high impulsivity tertile scored significant higher than the remaining tertiles on both DSRS (16.1 ± 0.3 vs. 14.0 ± 0.6, p<0.05) and SCARED (23.3 ± 0.9 vs. 18.4 ± 1.4, p<0.05) scores. Using multiple linear regression, BIS-11 attention scores, number of months served in custody, age, and BIS-11 nonplanning scores predicted higher levels of anxiety, whilst only BIS-11 attention and nonplanning scores predicted higher levels of depression.

CONCLUSIONS

In detained juvenile offenders, high impulsivity may be an important risk factor not only for the externalizing disorders, but also for anxiety and depression. Results of this study, therefore, suggest that specific facets of impulsivity may represent one mechanism underlying the emergence of anxiety and depression in this population.

Internalizing and externalizing problems, depression, and self-esteem in non-detained male juvenile offenders

BACKGROUND

High rates of mental disorders have been found in detained juvenile offenders, whereas the role of psychopathology in non-detained offenders is less clear. Therefore, the present study compared psychopathology in male non-detained delinquent juveniles and two matched samples from the community and an adolescent psychiatric clinic.

METHODS

125 male adolescents aged 11 to 19 years (m = 16.2 years, SD = 1.5 years) from an outpatient adolescent forensic clinic were compared to a community sample from the Zurich Adolescent Psychology and Psychopathology Study (ZAPPS) and a referred sample from a psychiatric clinic matched for age and nationality. All subjects responded to questionnaires measuring internalizing and externalizing problems, depressive symptoms and self-esteem.

RESULTS

The sample of non-detained juvenile offenders showed similar rates of self-reported internalizing and externalizing problems when compared to the community sample, whereas the clinic sample displayed an increased rate of various disturbances. Similar results were found also for self-esteem. In agreement with these findings, non-detained juvenile offenders less frequently had a psychiatric diagnosis after full clinical assessment when compared to the clinical sample. However, a diagnosis of conduct disorders and a lower IQ range was found more frequently in non-detained juvenile offenders. Offenders with serious delinquent acts and involving weapons showed higher depression scores than the rest of the offenders.

CONCLUSION

In non-detained assessment situations before court examination, juvenile offenders present rather normal behaviour. Their lack of awareness of potential behavioural problems should be considered during assessment and treatment of this group of offenders.

Youth Justice staff attitudes towards screening for self-harm

Young offenders are recognised as a high-risk group for suicidal behaviour. It is essential that the screening used to identify those at risk and refer them to mental health services is effective, especially in community settings where service utilisation is low. Staff attitudes towards screening for suicide and self-harm are likely to influence how a young offender engages with the screening process. Our study is the first to explore community youth justice staff attitudes towards, and perceptions of, screening for self-harmful behaviour. Eight semi-structured interviews were conducted at an English Youth Offending Team in June 2006 with staff who had used the suicide screening tool with young offenders. Data were analysed using Interpretative Phenomenological Analysis. Staff attitudes towards working within the screening system varied along two dimensions. The first 'active/passive' dimension related to perceived confidence in dealing with self-harm. The second 'positive/negative' dimension related to perceptions of the benefits of screening and the effectiveness of mental health provision for young offenders. Results indicate that barriers to effective screening must be tackled at both individual and organisational levels. The model of attitudes presented here could be used to increase understanding of how staff can be supported to engage effectively with the screening system.

The risk behaviors and mental health of detained adolescents: a controlled, prospective longitudinal study

Background

To assess the behavioral risk factors and mental health needs of adolescents in juvenile detention centers (JDC).

Method

A total of 238 boys aged 12–17 years was surveyed who had been admitted to a detention center and compared them with boys from the community (n = 238) matched for sex and age. We assessed behavioral risk factors and mental health problems by using the Youth Risk Behavior Survey questionnaire (YRBS) and the Youth Self-Report questionnaire (YSR).

Results

Young offenders had significantly higher YRBS scores than controls for drug use (odds ratio (OR) 5.16, 95% CI 2.27–7.84), sexual intercourse (OR, 2.51; 95% CI 1.55–2.90), irregular diet (4.78, 2.11–7.51), suicide attempts (1.96, 1.32–5.85), and physical fighting behavior (3.49, 1.60–7.07), but not for tobacco use, alcohol use, and high–risk cycling. Young offenders at the time of admission (6.61, 2.58–15.2), at 6 months (3.12, 1.81–10.1), and at 12 months (5.29, 1.98–13.3) reported statistically higher levels of total mental health problems than adolescents in a community sample.

Conclusions

Young offenders have a high rate of mental and behavioral disorders. In the detention period, aggressive behavior, self–destructive/identity, and externalizing of problems improved while withdrawn, anxious or depressed, and internalizing of problems worsened.

Prevalence of traumatic brain injury in juvenile offenders: a meta-analysis

Studies of traumatic brain injury (TBI) among adult populations demonstrate that such injuries can lead to aggressive behaviors. Related findings suggest that incarcerated individuals have high rates of brain injuries. Such studies suggest that traumatic brain injury may be related to the etiology and recidivism of criminal behavior. Relatively few studies have examined the prevalence of TBI using a delinquent juvenile sample. In order to assess the relationship between TBI and juvenile offender status, the current study used meta-analytic techniques to examine the odds of having a TBI among juvenile offenders. Across 9 studies, we found that approximately 30% of juvenile offenders have sustained a previous brain injury. Across 5 studies that used a control group, a calculated summary odds ratio of 3.37 suggests that juvenile offenders are significantly more likely to have a TBI compared to controls. Results suggest that the rate of TBIs within the juvenile offender population is significant and that there may be a relationship between TBIs and juvenile criminal behavior.

A comparison of the effectiveness of three parenting programmes in improving parenting skills, parent mental-well being and children's behaviour when implemented on a large scale in community settings in 18 English local authorities: the parenting early intervention pathfinder (PEIP)

BACKGROUND

There is growing evidence that parenting programmes can improve parenting skills and thereby the behaviour of children exhibiting or at risk of developing antisocial behaviour. Given the high prevalence of childhood behaviour problems the task is to develop large scale application of effective programmes. The aim of this study was to evaluate the UK government funded implementation of the Parenting Early Intervention Pathfinder (PEIP). This involved the large scale rolling out of three programmes to parents of children 8-13 years in 18 local authorities (LAs) over a 2 year period.

METHODS

The UK government's Department for Education allocated each programme (Incredible Years, Triple P and Strengthening Families Strengthening Communities) to six LAs which then developed systems to intervene using parenting groups. Implementation fidelity was supported by the training of group facilitators by staff of the appropriate parenting programme supplemented by supervision. Parents completed measures of parenting style, efficacy, satisfaction, and mental well-being, and also child behaviour.

RESULTS

A total of 1121 parents completed pre- and post-course measures. There were significant improvements on all measures for each programme; effect sizes (Cohen's d) ranged across the programmes from 0.57 to 0.93 for parenting style; 0.33 to 0.77 for parenting satisfaction and self-efficacy; and from 0.49 to 0.88 for parental mental well-being. Effectiveness varied between programmes: Strengthening Families Strengthening Communities was significantly less effective than both the other two programmes in improving parental efficacy, satisfaction and mental well-being. Improvements in child behaviour were found for all programmes: effect sizes for reduction in conduct problems ranged from -0.44 to -0.71 across programmes, with Strengthening Families Strengthening Communities again having significantly lower reductions than Incredible Years.

CONCLUSIONS

Evidence-based parenting programmes can be implemented successfully on a large scale in community settings despite the lack of concentrated and sustained support available during a controlled trial.

Individual, family and offence characteristics of high risk childhood offenders: comparing non-offending, one-time offending and re-offending Dutch-Moroccan migrant children in the Netherlands

BACKGROUND

Childhood offenders are at an increased risk for developing mental health, social and educational problems later in life. An early onset of offending is a strong predictor for future persistent offending. Childhood offenders from ethnic minority groups are a vulnerable at-risk group. However, up until now, no studies have focused on them.

AIMS

To investigate which risk factors are associated with (re-)offending of childhood offenders from an ethnic minority.

METHOD

Dutch-Moroccan boys, who were registered by the police in the year 2006-2007, and their parents as well as a control group (n = 40) were interviewed regarding their individual and family characteristics. Two years later a follow-up analysis of police data was conducted to identify one-time offenders (n = 65) and re-offenders (n = 35).

RESULTS

All groups, including the controls, showed substantial problems. Single parenthood (OR 6.0) and financial problems (OR 3.9) distinguished one-time offenders from controls. Reading problems (OR 3.8), having an older brother (OR 5.5) and a parent having Dutch friends (OR 4.3) distinguished re-offenders from one-time offenders. First offence characteristics were not predictive for re-offending. The control group reported high levels of emotional problems (33.3%). Parents reported not needing help for their children but half of the re-offender's families were known to the Child Welfare Agency, mostly in a juridical framework.

CONCLUSION

The Moroccan subgroup of childhood offenders has substantial problems that might hamper healthy development. Interventions should focus on reaching these families tailored to their needs and expectations using a multi-system approach.

Injuries and risk-taking behaviours in Portuguese adolescents: Highlights from the health behaviour in school-aged children survey

AIM

Injuries in adolescence are an important public health problem and a major cause of morbidity and mortality in this age group. This study aimed to determine the behaviour profile associated to risk of injury and the differences between genders, region and ethnic origin.

METHODS

A cross-sectional study design of a nationally representative sample of 1581 adolescents of the Portuguese Health Behaviour in School-Aged Children study.

RESULTS

An occurrence of one injury-related event in the previous year was reported by 21.4% of the respondents and 5.9% referred having more than one injury-related event. Boys reported higher frequency of those events when compared to girls, and non-Portuguese subjects referred higher frequency of events. Scoring higher in violence-related behaviour and psychosomatic complaints was associated to higher chances of referring more than one injury-related event.

CONCLUSION

Gender, social background and behaviour profile are factors that seem to influence the risk of injuries. This information should guide those involved in the planning of injuries prevention programs in youth.

Neurocriminology

In the past several decades there has been an explosion of research into the biological correlates to antisocial behavior. This chapter reviews the state of current research on the topic, including a review of the genetics, neuroimaging, neuropsychological, and electrophysiological studies in delinquent and antisocial populations. Special attention is paid to the biopsychosocial model and gene-environment interactions in producing antisocial behavior.

Systematic review and meta-analysis of interventions relevant for young offenders with mood disorders, anxiety disorders, or self-harm

Background Mood and anxiety disorders, and problems with self-harm are significant and serious issues that are common in young people in the Criminal Justice System. Aims To examine whether interventions relevant to young offenders with mood or anxiety disorders, or problems with self-harm are effective. Method Systematic review and meta-analysis of data from randomised controlled trials relevant to young offenders experiencing these problems. Results An exhaustive search of the worldwide literature (published and unpublished) yielded 10 studies suitable for inclusion in this review. Meta-analysis of data from three studies (with a total population of 171 individuals) revealed that group-based Cognitive Behaviour Therapy (CBT) may help to reduce symptoms of depression in young offenders. Conclusions These preliminary findings suggest that group-based CBT may be useful for young offenders with such mental health problems, but larger high quality RCTs are now needed to bolster the evidence-base.

Young offenders' experiences of traumatic life events: a qualitative investigation

This investigation aimed to look at how a group of young offenders attending an inner-city youth offending team experienced adverse and traumatic life events. A qualitative approach was used and semi-structured interviews were conducted with eight young offenders about their perceptions of difficult experiences and the effects of such events. The interviews were analysed using Interpretative Phenomenological Analysis (Smith, Jarman, & Osborn, 1999). Analysis of the accounts yielded a number of themes. Young offenders experienced violence at home, in the community and in custody. Instability and transitions emerged as important themes in relation to school and home. Deprivation was experienced both in terms of poverty and the literal and emotional absence of parents. A variety of cognitive, emotional and behavioural responses to adverse/traumatic experiences were identified, including a blocking out of painful experience and aggression to self and others. There were barriers to seeking or making use of professional support. Custody appeared to offer an opportunity to reflect on and re-evaluate life trajectory. The study concluded that greater consideration of trauma when carrying out assessments would enable ;at risk' young offenders to be identified using clinical interviewing along side standardized measures to aid assessment of the complexity and uniqueness of the response to trauma.

Reintegrating young offenders into the community through discharge planning: a review of interventions and needs of youth in secure care

The health status of young offenders is often poorer than similar aged non-offenders. Addressing young offender needs is a key priority for their rehabilitation and reintegration into the community. The objectives were to identify programs and interventions that assist detained youth through focussed discharge planning by a systematic review of the literature. In addition, this review examined the identified health needs of young offenders in secure care. Our systematic review searched electronic databases using the keyword terms youth, secure care, health assessment and primary health care. Keyword browser terms were also entered as search strings, and only literature from 1997 onwards was retained. Twenty-two pieces of published literature were retained, and these documented the needs and service utilisation of young offenders. Mental health problems and trauma exposure were commonly identified in the literature, as was general physical health deficits and social and familial problems. Retrieved articles also made recommendations for health assessments and discharge planning, and some provided discharge planning models. Young offenders have diverse needs that can be ascertained from quality assessment measures. Effective discharge planning is important to attend to ongoing health issues and aid rehabilitation and reintegration into the community. By administering a comprehensive multidimensional screening measure upon admission to secure care, individualised care plans can be formulated with discharge planning measures. Recommendations for further study include the development and implementation of a needs assessment tool in youth secure-care facilities that complements the existing assessments and helps reintegrate young offenders to primary health care and community services.

Prevalence and correlates of traumatic brain injury among delinquent youths

BACKGROUND

Delinquent youth frequently exhibit high-risk behaviours that can result in serious injury. However, little is known about traumatic brain injuries (TBIs) and their correlates in this population.

AIMS

To examine the period prevalence and correlates of TBIs in delinquent youths.

METHOD

Interviews were conducted with 720 (97.3%) residents of 27 Missouri Division of Youth Services rehabilitation facilities between March 1 and May 31, 2003. Participants [mean age (M age) = 15.5, standard deviation (SD) = 1.2, 87% male] completed measures assessing TBI, substance use, psychiatric symptoms, and antisocial traits/behaviours. TBI was defined as ever having sustained a head injury causing unconsciousness for more than 20 minutes.

RESULTS

Nearly one-in-five youths (18.3%) reported a lifetime TBI. Youths with TBIs were significantly more likely than youths without to be male, have received a psychiatric diagnosis, report an earlier onset of criminal behaviour/substance use and more lifetime substance use problems and past-year criminal acts, evidence psychiatric symptoms, report lifetime suicidality, be impulsive, fearless, and external in locus of control and criminally victimized in the year preceding incarceration. Male gender and frequency of own criminal victimization were important predictors of TBI in multivariate analyses. Regression analyses adjusted for demographic factors, indicated that youths with TBIs were at significantly elevated risk for current depressive/anxious symptoms, antisocial behaviour, and substance abuse problems.

CONCLUSIONS

TBI is common among delinquent youth and associated with wide ranging psychiatric dysfunction; however, the causal role of TBIs in the pathogenesis of co-morbid conditions remains unclear.

Planning primary health-care services for South Australian young offenders: A preliminary study

Although many young offenders receive health care during periods of detention, addressing their health needs after release from secure care is a key strategy for successful rehabilitation and reintegration into the community. The purpose of this preliminary study was to examine current discharge planning practices for young offenders in Youth Training Centres in South Australia with a view to improving offenders' connection with primary health-care services on discharge. To determine the strengths and weaknesses of current discharge planning practices, this exploratory study involved in-depth review of literature and a semistructured focus group of stakeholders. Findings were discussed with an expert advisory group before final recommendations were made. This study identified a service model approach to discharge planning that recommended a nurse located within the Divisions of General Practice as the coordinator. The study found that trusted staff in detention centres, with an awareness of services available in the location of release, influence young offenders' decision-making in relation to health-care services. Awareness and recognition of young offenders' health beyond periods of juvenile detention and into their adult lives is valuable in that it has the potential to establish lifelong healthy behaviours. Bonding with young offenders and gaining their trust increases their likelihood of attending primary health-care services.

Recent advances in the development of screening tools for mental health in young offenders

PURPOSE OF REVIEW

To describe recent advances in the development of mental health needs screening tools for use with young offenders and implications for this vulnerable group.

RECENT FINDINGS

The literature shows that young offenders in North America and Europe have high levels of diverse needs that often go unmet because of lack of methods for recognizing and assessing them. Effective screening could play an important role in improving recognition of these needs. Substantial developments have been occurring in the United States, England and Wales and the Netherlands in developing screening tools for this purpose and for this population. Now, the literature is beginning to provide a broad understanding of the optimal psychometric properties, utility and limitations of the screening tools that are required.

SUMMARY

Several centres are engaged in work to construct mental health screening and assessment tools for use with young offenders. Psychometric measures are being used to determine their validity and reliability. The work has highlighted deficiencies in the healthcare of young persons involved in criminal justice systems but should assist policymakers, healthcare strategists, planners and commissioners to come to better informed decisions about how to utilize most appropriately the limited mental health expertise that is available and how to enhance awareness of nonhealth professionals of basic mental health risks, problems and disorders.

Mental health, educational and social needs of young offenders in custody and in the community

PURPOSE OF REVIEW

The purpose of this review is to highlight recent findings from research on mental health, educational and social needs of young offenders and the implications for key agencies that commission or provide services.

RECENT FINDINGS

Young offenders have high levels of morbidity in a number of areas, including mental health. A substantial number of young offenders have learning disabilities, which has implications for educational provision and delivering interventions. Other learning problems, such as low reading and comprehension ages, also have consequences for society in a number of areas, including occupational functioning and the associated development of a skilled workforce. There is some evidence that female offenders and persistent offenders are particularly at risk of psychosocial problems. Need is often unmet due to the lack of adequate assessment. Other reasons include inaccessibility of services and difficulties experienced in engaging young people in treatment. Young offenders in the community and those from ethnic minorities are particularly at risk of having poor access to services.

SUMMARY

Providing services for young offenders requires investment from all the agencies in prioritising their needs. Research can continue to contribute by informing policy and practice, although further understanding of the developmental trajectories of high-risk groups is still needed.