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Huikko E, Santalahti P, Aalto-Setälä T, Ahlgrén-Rimpiläinen A, Lämsä R. Discontinuities in and Perceptions of Mental Health Service Path of Violent Young Offenders: A Qualitative Descriptive Study. Community Ment Health J 2024:10.1007/s10597-024-01330-2. [PMID: 39088153 DOI: 10.1007/s10597-024-01330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 07/17/2024] [Indexed: 08/02/2024]
Abstract
Studies on mental health service use among juvenile violent offenders prior to their acts of violence are sparse. Mostly, their service use seems to be short-term, although there may have been several service periods. Little is known about how they have perceived those services. Using a qualitative content analysis on data from forensic psychiatric examination statements, we studied discontinuities in the use of mental health services of 15-22-year-old violent Finnish offenders and descriptions of their perceptions of those services. There were several types of discontinuities: limited youth engagement and subsequent dropping out from services, or partial or total refusal of the proposed examinations or treatments. Most discontinuations were instigated by the youth themselves, followed by the parents and the service system. The subjects had perceived mental health services to be not beneficial for the most part, although some experienced benefits from medication. When treating children and adolescents with behavioral symptoms clinicians should identify the early signs of the process of disengagement from treatment and pay attention to the perceptions of the treatment of both the youth and their parents. Also, more research is needed on the user experience of mental health services among violent offenders, as well as factors relating to discontinuities along their mental health service path.
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Affiliation(s)
- Eeva Huikko
- Mental Health, The Equality Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland.
| | - Päivi Santalahti
- Mental Health, The Equality Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland
- Child Psychiatry, University of Turku, Turku, Finland
| | - Terhi Aalto-Setälä
- Mental Health, The Equality Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland
| | | | - Riikka Lämsä
- Mental Health, The Equality Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland
- Public Health, University of Helsinki, Helsinki, Finland
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Tzoumakis S, Whitten T, Laurens KR, Dean K, Harris F, Carr VJ, Green MJ. Levels of Involvement with Child Protection Services Associated with Early Adolescent Police Contact as a Victim and Person of Interest. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2708-2732. [PMID: 38254307 PMCID: PMC11071604 DOI: 10.1177/08862605231223468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
The relationship between childhood maltreatment and subsequent offending/victimization is well established. However, the magnitude of this relationship for different levels of child protection services (CPS) involvement is poorly understood, due to measurement issues, lack of longitudinal data, and reliance on reports of substantiated maltreatment, which can underestimate the impact of maltreatment. This study examined associations between CPS involvement during childhood (ages 0 to <11 years) and police services contact (as a victim and/or a person of interest) for criminal incidents in early adolescence (11 to ~14 years), differentiated according to levels of CPS involvement (i.e., no risk of significant harm [non-ROSH], unsubstantiated ROSH, substantiated ROSH, and out-of-home care; each examined relative to no CPS contact). Data for 71,465 children were drawn from the New South Wales Child Development Study, an intergenerational, longitudinal investigation that uses administrative records from CPS and police alongside other health, justice, and education data. Multinomial regression analyses were conducted to determine associations between increasing levels of CPS involvement and police contact as a victim only, a person of interest only, and as both victim and person of interest while accounting for covariates (i.e., child's sex, Aboriginal, and/or Torres Strait Islander background, socioeconomic status, maternal age at child's birth, and parental offending history). Children exposed to any of the four levels of CPS involvement had higher odds of police contact, relative to children with no CPS involvement. Odds ratios were higher for contact with police as both a victim and a person of interest, compared to police contact as a victim or a person of interest only. These findings highlight that children with even unsubstantiated CPS reports (i.e., non-ROSH and unsubstantiated ROSH reports) are at heightened risk of police contact compared to children who are unknown to CPS, underlining the need to support all families in contact with CPS.
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Affiliation(s)
- Stacy Tzoumakis
- School of Criminology and Criminal Justice, Griffith University, Southport, QLD, Australia
- Griffith Criminology Institute, Mt Gravatt, QLD, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Tyson Whitten
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Centre for Law and Justice, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Kristin R. Laurens
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Network, Matraville, NSW, Australia
| | - Felicity Harris
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Vaughan J. Carr
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Melissa J. Green
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
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Girling M, Le Couteur A, Finch T. Experience-based co-design (EBCD) with young people who offend: Innovating methodology to reach marginalised groups. PLoS One 2022; 17:e0270782. [PMID: 35819945 PMCID: PMC9275718 DOI: 10.1371/journal.pone.0270782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
The mental health needs of young people who offend have become more widely recognised and attempting to meet these needs is now a global priority for governments and health agencies. Young people who offend experience a range of complex difficulties and have significantly worse health and social outcomes than their mainstream counterparts. These problems usually persist and often increase in severity through adolescence and into later life. There is growing acceptance of the potential value of co-designing services that recognise and address problems to improve the outcomes of young people with mental health problems yet to date, this methodological approach remains relatively unexplored in forensic service provision. Experience-based co-design (EBCD) is an approach to healthcare improvement that enables staff and service users to jointly co-design services. Central to the approach is the idea that understanding the experiences of service users and the ‘touchpoints’ (e.g., critical points or moments) in their journey through a service are integral to service improvement. The aim of this study was to explore whether EBCD could be applied to facilitate recognition of, and service developments for, young people presenting in community forensic settings. Qualitative methods used in this study included: observational fieldwork in four police custody suites (n = 30 hours), in-depth interviews with staff in community forensic services (n = 13) and researcher staff (n = 7). In this paper, the challenges of applying EBCD in community forensic settings with this population were: working with and across agencies; gaining access to participants; understanding knowledge and power dimensions amongst participants and understanding the context. This paper argues that innovative approaches to discovering the touchpoints for young people who offend – a key component of the EBCD approach - through combining analyses of secondary data and direct observations in community forensic settings can facilitate engagement with these specialist services and so provide access to relevant information about a group (i.e., young people who offend) who may be unable to participate directly in the EBCD process.
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Affiliation(s)
- Melissa Girling
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
- * E-mail:
| | - Ann Le Couteur
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Tracy Finch
- Department of Nursing, Midwifery & Health, Faculty of Health & Life Sciences, Northumbria University, Newcastle, United Kingdom
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