Okay. Welcome, everyone, to a green channel to college.
It's nice to see so many faces at the end of eighth week while the beginning of ninth week, in fact.
So the students in the room who aren't too exhausted.
I hope you enjoyed it. I hope you enjoyed the day. I think everyone's a little bit exhausted this time of the year.
So 2016 marks the 50th anniversary of the Oxford Centre for Criminology and the Faculty of Law, along with the centre,
put together a rather exciting series of different events and activities throughout this calendar year.
So it goes across two different academic years and this is one of those events.
And these activities are really about folks sort of celebrating the last 50 years of criminology in Oxford.
Looking forward to the next 50 years. I don't think we'll be around for all of those, but at least hopefully some of them.
And to really celebrate and pause and think about where we are now, what we are now.
So this event is very generously funded by Green Templeton College and co-hosted with the college.
And I want to explain a little bit why that would be.
And Green Town College, I've been a governing body fellow here since 2000 when it was still called Green College.
And over that time, its focus on human welfare has developed quite considerably.
It has now this annual human welfare conference. It has a human welfare journal and a blog,
and a lot of its academic activity among its students and its faculty are very much connected with trying to have an impact in the real world,
have an impact on practitioners,
have an impact on policymakers and and on research in all different disciplines, but with a very broad focus on human welfare,
on really making things better for people who are perhaps in more disadvantaged positions than many of us in this room.
And also criminology, too, has an interest in human welfare again that I see defined.
And so it's perhaps not surprising that many of our students choose to come here to Green Templeton College.
And in the last 15 years only, we've had almost 50 student members of this college and and fashion high players, some very proud.
And some of them are in this room today, and some of them will be speaking in the various different sessions today.
So also criminology. Why celebrate 50 years in 2006?
It was possible to study criminology here in Oxford before 50 years ago.
In fact, my father in law was very keen to tell me that he studied criminology as a law student at Exeter College here over 60 years ago,
and he was taught then by Dr. Max Robert, who was the first reader in criminology.
But the reason why we mark the 50th anniversary this year is because 50 years ago, Max Gohmert's successor, Dr. Nigel Walker,
who unfortunately passed away at the ripe old age of about 93, just a year ago,
he set up a unit that was called the Penal Research Unit, and he set that up in 1966.
So that's where we mark the 50th anniversary from, because that was the first time we had a centre devoted to criminological research and teaching.
It was renamed the Centre for Criminological Research in 1973, when then Dr. Roger Hurd,
now Professor Roger Hurd took over as the reader in criminology and set up the centre just around the corner on Paddington Road.
It became a department at the University of the Law Faculty sorry, in 1991.
And then we moved in 2004 to our current premises in the Munroe building,
which is the Social Sciences Divisional Building now until the start of the new millennium.
Oxford Criminology was focussed very much on its research.
So we were striving for excellence in academic research that also reached out and influence policy and practice.
And we had at the time and we remain to have very good relationships with various different public and
private and third sector bodies who work in the area of criminal criminology and criminal justice,
and did research on victimisation of prisons on probation and parole and the death penalty on crime in the family,
and latterly very important work on border control and the detention of refugees and asylum seekers of which you will hear more later.
So at the same time, in 2001, we established our MSI in criminology and criminal justice,
and this coincided with the change of our name to the Centre for Criminology.
Criminology to to really reflect that shift in emphasis, not away from research,
but onto teaching as well as research and striving for the same excellence in our teaching as we think we strive for in our research.
So we have now come to 980 to 19 96 to 2016, and we think we feel very proud to celebrate 50 years of excellence for teaching and research.
We don't want to rest on our laurels.
We have with the law faculty developed a development prospectus which will find property in the packs given to you.
And this is very much about celebrating where we are now, but looking forward to the next 50 years.
And we are embarking on the very ambitious fundraising campaign to secure our continued success over the next 50 years and to secure
a global criminal justice research hub which will encompass various different ambitions around a new post new student ships,
particularly student ships for students who would not otherwise be able to come and study at Oxford.
So if you have friends or colleagues with five deep pockets,
you might want to leave that prospectus lying around on their desk and maybe buy them a drink at the same time.
So this conference, why this conference?
Well, I mentioned before the emphasis on human welfare in Green Templeton College and our own interests in this field, too.
So this conference is really aimed at trying to understand and appreciate the lived experiences of
people who are considered to be vulnerable or not having that rights in the criminal justice system.
And so it draws together a range of experts from criminology, from psychiatry, from law, and from third sector,
with enormous expertise in a range of areas that speak to these issues of
trauma and vulnerability and issues around mental health in criminal justice.
So the day will start with a plenary session and it will end with the plenary session and in the middle will have a panel sessions that really bring
together what we might call early career researchers working this area with
strong links to Oxford criminology and many of them to Green Templeton College,
to talking on various different topics around vulnerability, trauma, resilience of people in prisons,
people on immigration detention in immigration detention centres, at risk of offending people with autism, etc.
And we will have before you a very interesting and exciting day.
And what we're doing is really trying to look at the enduring aspects of trauma and mental health problems,
but not just lay out a litany of misery, rather, to try to better understand,
to better explain the experiences of people in these situations and really to
look forward to what improvements might be made to the criminal justice system.
So before I introduce our first plenary speaker, I just want to give you a couple of very tedious housekeeping points, tedious, but useful.
You might have seen as you came down the stairs coming to the lecture theatre that just behind you there's toilets.
So the rights as you go out of the gents on the left is the ladies.
And when we break for coffee and also for lunch, which we'll have coffee break this morning and a coffee break this afternoon,
as well as lunch, you will go to the stables bar for refreshments.
And it's basically, as you come out at the top of the lecture theatre building, you go straight across the grass, into the doors ahead of you.
Some Oxford colleges,
you're not allowed to walk on the grass and people will come up and shoot you or there would be landmines hidden among the grass.
Oxford French Upton College is a little bit more laid back, so you can walk round if you feel nervous or high heels,
but I think you're safe to go across if you don't know where you're going.
That just just follow the crowd almost certainly go.
I've not been given any advice on what to do if there's a firearm, so I suggest you scream and run.
But there's probably a procedure that I should tell you is that this is over.
That is probably meets outside of the grass.
And the only thing other thing to say is when you're going out, if you could just we can make as much analysis we like in this lecture theatre.
But as you go out of this building, if you could be a little bit quiet because you will pass on the right as you as you leave the building,
the library and students are preparing for exams and assessments at the moment.
So maybe we could respect that need for a bit of peace and quiet.
So you get to the staples, be as nice as you like. So our first plenary session as speaker, we're delighted to welcome Sarah Brennan.
She's the chief executive of Young Minds.
This is a national charity that promotes emotional wellbeing and mental health for children and young people.
And I think she's been that since 2008.
So she has a vast amount of experience to draw on, experience of really championing, championing the cause of young people.
And she promotes that, that the talents and services advises government ministers about mental health needs of children and young people,
and is a member of various different fora and and task forces aimed at making vulnerable young people's lives a little bit better.
So. Sarah, I'd like to invite you to the podium.
And I think everything is set up right now.
Thank you very much. Hello.
It's great to be here. And thank you, Caroline, for inviting me.
And it's interesting coming to a completely new environment because you don't know who your audience is going to be.
So I just be interested to know a little bit about you just had a little bit about me.
How many of you are connected to the university and this course you put to quite, quite a lot of you?
And are you? How many of you are MSE students or post grads?
All right, both of you and all the people who work within the criminal justice system, you know, we are to one little hand quill, a couple of hands.
I think they're getting brave enough to put their hands up. And what about in the mental health system?
Other people hear from one oh couple of hands going up there about that as well.
Brilliant. Okay. Well, thank you very much.
It's just quite nice to know and I hope that what I've got here for you is going to be interesting and hopefully a little bit different.
But that's all. And so what I'm going to do is a quick scope through.
I'll tell you a little bit about young minds and then a scope through the policy development that's happened over the last ten years.
And where we're where it's all kind of going and then much more recently where where we're at and what
the opportunities are and what the risks are and and what we'd like from you really and especially,
I think as you're coming through the, the university and about to go out there, we need your energy and we need your knowledge and brains.
And I can't make this move on. Yes. So here we are, so young minds.
First of all, as Carolyn said, we are leading charity committed to improving the emotional wellbeing and mental health in young people.
What we do, though, is very much a focus on young people's experience.
There are lots of academics in the world, there's other organisations that are very focussed on research and what we wanted to bring in was,
well, actually what's the impact on young people and families?
What are they saying about what their experiences of mental health?
And what's our what's our platform in the way of all credibility?
And it's very much about what young people are saying their lives are like, what they're saying about their experience of services,
what they're saying helps and similarly about families and parents in particular, who are generally not always,
but generally the main advocates for their children in terms of trying to get help for them.
And with that experience that we are very much driven by young people and they are involved in every element of what we do,
but in particular around our campaigns and our policy asks, it's very much driven by young people themselves.
So what's our vision? Where are we trying to get to here?
What is it that keeps us on the road? So we want to see resilient children and young people who can cope with life's adversities,
find help when it's needed and who go on themselves to create mentally healthy communities.
And I love the fact that we are young people achieving young people's organisation because the potential and the sheer energy and excitement is,
is always really exciting and inspirational to work with. But also young people are tomorrow's community, tomorrow's society.
And if we can get it right or better for young people, we will actually improve how society is tomorrow.
And so we do this by championing children, young people's mental health, wellbeing across the UK.
And as I said, driven by our experience, that's what creates momentum for change.
And I have to say, if you're talking about wanting to have policy change,
the people who are the fantastic advocates are actually young people themselves.
When we've done campaigning work, we have all the research, the statistics, you know, up your arm,
but you actually put young people in front of politicians and they describe what's happened to them and that's what makes them sit up and listen.
And that is really been our experience dating back actually from the Mental Health Act reform back in 2010.
Was it before that 2008? Just before I started Young Minds,
it was young people describing their experience since that committee that made ministers go, We've got to change this.
We can't have young people. We've got to have children, young people being on adult wards.
That's what brought that changing. So do not underestimate your power in terms of being young people as well.
So what do we do? As I said, we do a lot of influencing work, whether it's through media, with politicians, with whether it's locally in local areas.
But we do that also with practical help. We know that this is tough.
We know life is tough. We know that delivering. Service is really hard and lots of people are doing the best they can against
what feels like a watershed to push them in the in the opposite direction.
And so we work with and support children and young people, but also parents and families and also professionals, practitioners.
We do a lot of work in schools. We do a lot of work with commissioners and local areas and helping develop local strategies.
And so we work across the UK.
Though I have to say that with the changes in the NHS from 2010,
it kind of swallowed it up and we have been very focussed on England in the last few years and now we're going, okay, enough.
We now need to think more broadly, both internationally as well as the UK.
So as I said, we need you and this is where I'm going to start because I'll come back to this at the end as well.
The best and most exciting thing that's happened is a future in mind.
I don't know if you are aware of future in mind. I will explain this a bit more in a bit.
And there are local transformation plans, which are also the most exciting thing that is happening at the moment.
So and I will talk more about that.
We need to keep raising awareness about offender mental health everywhere, if only by keeping on keeping on keeping on that.
Actually, anything is going to change. And there is awareness and there is policy developing.
But, you know, a long way from policy into practice.
And so that pressure has to be maintained. And we need you to help us do that.
We need more more resources. We need help about learning from practice, not just from research.
We need practice to develop. We need to bridge that research into practice and then back again.
It can't just be in one direction, but that needs money and we need to capture and disseminate what we're learning about practice.
And that comes from the mistakes, not just from the good stuff.
We need to be a bit more open about, you know, it is really hard and we didn't that didn't work.
So we're going to change it.
We're going to do it differently next year so that we can do things differently, that we do create learning organisations.
Do you know what we really don't? We really don't do that. And actually it's not our fault because the policy changes, the money changes,
different government comes in and everything's turned around again and people are tired.
We have to fight that. We have to keep that going at local level and often it is at local level where the exciting things are happening.
So we have to be brave and honest. So that's my call to action from the beginning.
So I will go back now to, well, what we're talking about here.
So I'm sure that this is familiar to you as well.
This comes from a book called Young Minds.
We from Professor Bailey and Professor Chuter both present at the Royal College of Psychiatry at different time, psychiatrists.
But it's where this is the groundwork.
What is our mental health? What's it made up of? It isn't any one element.
It is what we're born with. But it is also of our upbringing, the nurture.
But it is also events. Stuff happens. And we know that when those things happen, if other things aren't in place,
if other support isn't in place, it can have a major impact on the development the developing brain,
the developing heart, hardwiring in children and young people, and overall their mental health chances in life.
Well, what's been a really good phone bonus for us has been the development of brain science in the last 15 years.
It has really given credibility to what actually we've known about the impact of emotional nurturing on the development,
development both of the brain, but also the hardwiring of what gets get set in place for your emotional health later on in life.
And that is what is also particularly crucial, both these two elements,
the nurture and events around young offenders, young people at risk of offending.
So I want you to hold this in mind. I did not go into this in detail.
I mind guessing that you're familiar with risk in protective factors.
Can I just check that? Yes. Is that lots of nods around the room?
But I just want us to also this is again, the groundwork about with any young person,
there is a whole set of risk factors that is going to increase their likelihood around
mental health problems and indeed of offending as well as a number of protective factors.
And these are also crucial and it is an approach that we take very strongly within young minds around recognising the the environment,
the context that that young person is living in.
I'm sure these can be made available to you if you would like them,
but I don't want to go through these in detail because it's I'm I'm guessing that you're familiar with that.
Okay. Yeah. So. What do we know?
We know that 95% of young people aged 1620 in youth offending institutions have at least one mental health disorder.
We know that 45% of children have mild to moderate conduct.
Problems go on to commit half of all crime with the estimated cost of 37 billion.
We know that 40% of young people have been have been homeless in the six months before entering custody.
And we also know that the connection between homelessness and mental health as well, mental health problems.
We know that nearly 90% of young people in Wales have been excluded from school.
And we know that 43% of young people in prison have ADHD.
Or on the second point, 45% of children. Yet is that all crime committed by youth for all crimes?
Full stop. Very good point. I wouldn't like to say definitely because I don't know off the top of my head,
I believe that this is all crime of young people and it is it is from the Sainsbury Centre for Mental Health Research.
So it can be checked and I'm pretty sure it's of it.
I was looking at it again, loss on actually did say in the in the in the section I was reading of all crime,
but I find that a bit of a challenge so it must be able which must be children, young people, crime victims by children, young people.
And in the last ten years there has been a number of reviews and reports.
We have Michael Marmot initially to really focus on the social determinants of mental health, which was very powerful and very useful.
But we've had the Bradley report, we've had around information governance review, which is has been very interesting.
We've had the No Health Without Mental Health, the first mental health strategy,
which Apple Birthday Ltd back in 2011 also focussed around the health of mental health
offenders and the Harris Review looking at death in custody of of young people as well.
I think looking at the extreme end shows a very good spotlight on the overall
experience of what's happening with young people in the criminal justice system.
And then Future Mind, which came out last March following Norman Lamb's Mental Health Taskforce for Around Children,
Young People's Mental Health and which is now coming into effect, which we will cover a bit more.
What's coming through? And I will also talk a bit more about Young Minds own research that we carried out a couple of years ago with City University,
but the message is coming through are pretty consistent and there but it is how that translates into changing practice is the challenge.
So again, the sorts of messages coming through around the, around the impact of the brain on behaviour.
So from the British Psychological Society Positioning Paper which came out last year and the fear,
the linkage there between brain trauma or other intellectual disabilities and around offending is significant and gang members.
What the connection here around the dualistic relationship about poor mental health and being drawn to gangs.
And again, what we know about the mental health of gang members,
90% will have antisocial personality disorder, 86% have conduct disorder, 59% anxiety disorders.
And so it goes on and the it is very clear you see the connections repeatedly around young people's
mental health and what their behaviour and their behaviour and where that behaviour leads them.
Now there's a very clear trajectory. I worked previously both of homeless young people for many years at Centrepoint and with young
people at risk of offending and offenders and it was like you could just see this path going.
So and, and it's like you could almost predict what was going to happen as time went on and the connections between being a looked after young person,
school exclusions and offending and also homelessness and offending and mental health problems was like completely connected.
And yet nobody was actually connecting up the dots and actually thinking, what is it that's happening here that we can do differently?
And it is still happening and has more data around mental health and gangs and around girls as well.
And about what happens here around is again behavioural problems about there.
There are signs, there are early signs and early signals of distress in all sorts of different ways which we aren't suitably picking up on in any way.
Again, coming back to Harry's review, as I mentioned earlier,
you and Lord Harris is looking at self-inflicted deaths in custody of 18 to 24 year olds over a particular period of time, 27 to 2013.
And what's interesting about this is the government response, which came out in December just before just before Christmas.
And I want to go through this in detail, but it's just painting a picture really well.
I think each one of these things around what he found with these young these young people,
overwhelmingly young men and who have chaotic lives, have histories of abuse and exposure to violence and whilst in prison,
are not engaged in purposeful activity, that they don't have norms themselves,
don't have proper means of assessing whether sufficient care is being given to young people who are vulnerable.
And also the the importance of the caring adult adult role model,
which comes through in all sorts of different research about young people's need for attachment and and positive role models and,
and care, and the gap between health care services in prison and in the community and also workforce needs around being aware and being trained.
We were asked by the prison service do some training a long time ago,
ten years ago around competencies, because then prison officers were saying we didn't know,
we didn't know what we're looking at in terms of behaviour of young people here in the in the in custody and in the in prison.
We don't know if they're swinging the legs or if it's real.
We don't know if what we're seeing is them being a bit fed up or actually really serious depression.
And we don't know if they're just acting out or actually this is distress behaviour
and the only way they know they know how to behave there is a complete loss.
And we have to remember that young people have agency.
You know, they if they think that by behaving in a certain way, it's going to get them something that is going to improve their lot.
They think, of course, we we all will.
And it was very interesting that it was actually about competencies of those of those staff and increasing their confidence as well through that.
It wasn't about they aren't good enough that they want to do a good job but didn't feel able to.
So the whole workforce training, we we hear this again and again with teachers exactly the same issues and we don't want to make things worse.
We don't know, you know, is this our job as it should be on somebody else's job?
Where do we stop? Where do we say no? This you need to come in now and help us.
We need a specialist. And what is it that we can do? So I think workforce training is a really critical issue.
And again, Lord Harris, I have one of the very strong things that comes through in that report,
is why these young people in custody in the first place.
You look at their life history and something should have been done years ago to help this young person.
What we're seeing is a life of chaos and distress and nobody has done anything.
Is it any surprise that that we are where we are with this young person,
that there were signs as well early on about the distress that this young person
was feeling before they ever got to the point of actually taking their own lives.
And that those all those opportunities were missed along the way.
And that this isn't just about criminal justice.
Youth justice system. This is actually about all parts of government working across and working better.
And of course, that is the most difficult thing you can possibly ask for.
We are all bad at working in our silos because it's very complicated to work across and to work with somebody who works in a different way.
When you talking about government departments, it's like becomes this enormous inertia that's within the system.
But actually, he's right. It is about education.
It is about social care. It is about community service.
It is about mental health services and CAMHS. But it is also about the criminal justice system.
And finally, we are talking about young people.
And young people in development are vulnerable in themselves in terms of the impact of what happens to them is dramatic and different from adults.
One of the things he raised was just removing a young person from home and taking them
away from all of their local community and contacts is drastic for a young person,
has all sorts of impacts upon their own emotional wellbeing and mental health,
which doesn't get recognised and that will have an impact on their behaviour.
It will have an impact, a longer term impact on on their wellbeing and on their mental health.
We need to understand that this actually has a neurological impact.
It isn't just a bit sad at the minute.
This has a much longer term and deeper impact on but on a developing person.
So Young Minds was approached by the Barrow Cadbury Trust,
who support transition to adulthood around offending in that particular age between 18 and 24.
That's the and that's what they're interested in because this is a period where young people are particularly vulnerable
and where most of all systems completely collapse because you're moving from children's services to adult services,
whether that is in education, whether that's in from cans to arms.
We've seen the justice system with that social care and looked after children get, you know, shifted around.
Things have slightly changed from that. And what is it that's actually happening?
Is that transition they're interested in but around mental health? And so we carried out a piece of research.
Absolutely. Focusing on relationships and work.
What actually is the detail of what's going on rather than numbers?
It was what is it systematically that's happening to young people that we can learn from?
There are really five critical issues that came out of that.
One was around the need for consistency of relationships for young people about building trust and empathy.
I know this seems really obvious, you know,
and I sometimes I sort of pinch myself because a lot of things seem to be really quite obvious and quite common sense.
But we don't do it. What we know that happens with this research out, we called it same old because a number of us at young minds,
you know, old in the tooth now been working with young offenders or young people at risk of offending for a long time.
And it's like can't quite believe that the same things are the case now as when I was first working in this field scary number of years
ago and it's like surely we've learnt and moved on and changed things and actually sadly we haven't or it doesn't seem to be the case.
And so young people, you start building a relationship with a young person and that with funding stops, jobs change, they get a new job.
The organ, like the organisation reorganises their structure.
It changes for that young person who's had chaos.
They are not going to then bond with the next person who comes is like, well, how long are you going to be here and why should I?
Why would I? Why would I trust you? And unless you have that trusting relationship, actually, you know what?
Nothing's going to happen. So how do we get over that one?
How do how do we do something about that? Because actually, if you are going to make change in somebody's life, we all know you need to.
That is the core for anything else to happen.
So that's number one, greater knowledge and skills through identification and awareness of mental health issues,
as I just talked about, the lack of coordination, the collaboration between services.
So not only is it about changing in terms of developing trust,
but across the piece you have a young person who goes to their GP having come out of of custody.
They have a mental health problem because you're under that psychiatrist.
I can't do anything. I'll put you on the list. So they go away.
They wait, wait, wait, wait.
And then they they might have a support worker.
And the support worker goes, oh, right. Okay, well, you're doing that. Your wait, your, your mental has been so sorted out by that person.
So I won't do anything about that because that's over there and their benefits as hair being dealt with slightly differently to all these services,
not talking to each other, bits of information held by different people in different places.
What came through really strongly in this research was that the only people who actually sat with them and kind of went
with them and advocated on their behalf was in the voluntary sector because they felt they had that was their job.
That was their job to do that and that was their job to stick by them and try and make all these other services work.
Are statutory services overwhelmed as they all tend to go?
No, this is my job and that's not my job that I'm here and information sharing, but confidentiality issues.
I can't I can't tell you that the young people were going, I don't care.
You know, tell them I'm telling my story again and again and again.
Why can't we just don't call these professionals, just talk to each other and just tell them.
And I don't know the impact of these drugs a lot on me.
They're not telling me, you know, how often or what what I might have to manage alongside it.
One young person who ended up overdosing because they weren't they weren't kind
of engaged with what the that how they should be taking these this medication.
I think what's going to make it better? We'll have more young people because they weren't seeing getting the kind of coordinated care,
self-medicating with drugs and alcohol as a way of just coping and feeling a bit better
because they were scared about how they how they're about their own mental state.
So we actually make things worse all the time so easily.
And so it comes down to this who holds the ring?
It's never very clear who it is who actually should be saying, okay, you're mine, right?
You do that, you do that and you do that. Have you done that?
Have you done that? Nobody does that.
For young people coming out of custody, there isn't a clear kind of person around their mental health care who has got that responsibility,
not just to see them once every three months and just check that they're taking
the medication to actually ensure that the different elements are being chased up,
all happening. And you know how good we are about not not following up one things again, everyone's busy.
So what's happening around that? That policy management. Who is it?
Who who should be doing that? And the other bit was just about access to accurate information for everyone.
The young people didn't know what the system was or who they should be seeing, when they should be seeing them.
Who they saw for what if they were on drugs?
Whether what? What the impact of those drugs might be on them?
What combination it might be. And also that the treatment,
the mental health treatment tends to focus on medication and not on any other kind of either talking therapy or other kind of support.
And again, with vulnerable young people, we also know that that isn't going to be enough.
We need both elements. But they didn't know that either.
So those are really critical issues. And it's about this is much more about the practical human delivery of service and
the human relationships rather than necessarily that which is about the systems too.
But it's about how those systems work in practice.
So the conclusions from that research was that this was trying to offer effective help can in fact exacerbate already problematic circumstances.
Too often the result for young people is increased cynicism, further loss of self-esteem, motivation, confidence and basic skills.
For the state. It can mean spiralling costs of welfare dependence, health problems,
policing and custodial sentences, as well as the loss of an active working citizen.
We were a bit fed up and we tend to the end of that research. So is it all bad?
Is this is this the situation? It isn't. And you always have to be optimistic and hopeful.
But what actually is happening so this always looks very complicated to start with, but it isn't.
I'm going to just tell you what's going to work. And for those of you in mental health, that's you'll be you'll know this so well.
But why is it all so hard for young people in general accessing accessing CAMHS?
But it's just made ten times harder for young offenders.
So this is this is can and I would say comes from as it was maybe last September, things are beginning to shift.
So we have universal services here, young people with mental health or emotional needs.
What should happen is as mental health problems may, may emerge,
that they're able to access universal services out of the community should they need something
a bit a bit more structured that they're able to access what is known as Tier two services.
So these are the when you haven't got militarily a diagnosable mental health disorder.
Often these are all sorts of things like youth counselling. They might be all sorts of other things as well.
There are things like, for instance, one might be anger management, it might be group work.
They often called step up, step down services generally in the local community.
What's happening? Actually, tier two services have been decimated.
Local authority. These were said to be generally funded by local authorities.
And with the local authority cuts from since 2010, they have practically disappeared.
And so they young people wanting to access services are being rejected.
So there isn't anything and they come back out into universal services.
What should happen again is those young people who had access to this kind of thing of of get what they need.
And often they're okay or they need further help.
They have access to Specialist CAMHS, which is what we traditionally know is as CAMHS,
which then tends to be much more pathway orientated there and is around more about diagnosed mental health problems.
And you get, you get a setting like a just a few times, but you are able to access the care you need for it for the period of time that you need.
And then from that you come out of those services, you may then have set down services.
You may come back out into into the community and not need further help.
Should you need further help or should it be a much more serious mental health problem?
Mental illness there is inpatient care, crisis care, urgent care teams.
So either inpatient care in a clinic, hospital or urgent care teams, crisis teams locally in the community.
And again, you should be able to get what you need and you come back to that service, often getting some kind of ongoing steps.
Step up, sit down, services, what's happening? You are having access to this service.
You come back out. What happens? Young people become sicker because they aren't able to access on this service or indeed this service waiting
list for tier three for specialist care has gone up and because of community services being decimated,
the thresholds, the way that council has coped is by saying, okay, you actually have to be this will now roll.
This is before we're able to offer you a service. And we've heard all sorts of awful stories of young people being told, sorry,
your BMI isn't low enough yet and, you know, so we can't offer you any help.
And so we've got these very weird and disincentives for getting better.
What we're creating are incentives. We're getting worse in need to get any help at all.
And indeed that has been what has been happening. And and councils have been absolutely stressed,
completely stressed because what they are then dealing with is much more complex cases, much greater need,
and so are then also restricting the services even more so in this kind of spiral and the allowance
element and like how these often young people aren't even getting 2 to 3 services back out again,
getting ill and the first time they get care is going into inpatient care because
they have become a crisis point and inpatient care has also been at crisis point.
And you will have heard in the news all sorts of things around young people being sent all over the country.
And we know and we know the impact that has about being cut off from your community and friendship networks and support networks.
So it's a system under huge amounts of stress.
So then when you have young people who are also going into custody, coming back out of custody.
So how they are tracked and supported within the system is an impossibility.
You have a system already under huge pressure.
And when you have young people who aren't necessarily in your area.
One of the other things is, well, who has responsibility? Who is it?
Who should be making sure linking that young person back into the services locally?
And do they then have to go to the GP to go through the whole system of referral all over again,
even though they may be seen by Cairns before they went into custody, going go, go into prison, come back out and have to start all over again.
And we're seeing waiting, waiting lists of, you know, six months is fairly normal, can be much longer, can be up to a year.
And you're talking about a young person who's coming out of prison who's already very vulnerable.
You're talking about a very serious situation that you're setting up.
Was this is this really familiar to you? Is it? Yeah.
So in last March after work by Norman LAMB,
who was then K minister and set up the taskforce for John People's Mental Health and the report
that came out of it was to remind which had 49 proposals and there was I co-chaired the work,
the task group on vulnerable young people. And one of these groups, of course, is young offenders.
One of the things that we had big debates in this task group about vulnerability,
because everyone was chipping in that particular vulnerable group that they wanted to to fight for.
And hang on a minute.
If we do this, we're going to have a list, you know, from the floor to the ceiling of young people with different vulnerabilities.
What is it? Was the common denominator here. What's underneath that all of these young people had are experiencing that we could actually
do something about because we can't do something about every every single particular group.
And also, we are very good at splitting young people up into, you know, fragmenting them into different needs.
And we're talking about a whole young person. What is it about their experiences of vulnerability that is impacting on their mental
health that we can actually do something about and what we did come to agreement with?
And that's why it's really interesting that in the title of this conference was about the experience of trauma both in early years and bar is.
It could be a thing that happens bereavement is often kind of a of a key person
can often be one of those things or it might be cumulative over a period of time,
through an exposure, through childhood and adolescence.
This is quite contentious, this idea. And some people really pooh poohed it.
And we said we're not talking about trauma as in necessarily PTSD.
We're talking about trauma is having an impact at absolute concrete impact on that person,
that child's development and their neurological and emotional development, so much broader sense and terminology.
The traumatic impact of violence, abuse loss is not always taken into account nor reflected in the case management or therapy.
So as an example here is that serious behaviour issues being referred for anger management rather than therapy for trauma and loss.
One of the things that's come through really loud and clear is that young people, if we take looked after young people as a kind of category,
if you like, who they are, have one of the highest incidences of mental health problems, yet they don't get access to services.
And it was like when we were going, Well, why is this? What's going on here?
And where we got to is that what those young people are presenting to?
CAMHS is not a classic mental health disorder, so they can't be put into a clear pathway for care.
What they're coming is with a complexity of issues and come this is coming from their
experiences and just through their experience of of family breakdown and loss can be enough.
But because that isn't understood in that way, they are being looked at more through a more medical lens.
Those that's being lost and they're being seen as only there's nothing we can do for you.
But actually there's lots that could be done. It just needs a different type of questioning and finding out and discovery and because
actually if we can get in there early before the mental health disorders do develop,
we actually can can do much more for that young person and much more for their lives and in terms of outcomes have a much greater impact.
So this, I think, is a really important part where where we're at in terms of cans.
And what's interesting is that the Home Office in the their response to Harris and in response to future mines have
also endorsed this and also endorsed the point about asking these questions again around gangs in particular.
And the other part I think that we should want to really focus on is around sharing information,
because this is so often such an enormous block in our in our care for young people,
for everybody, but in particular around young people and mental health and the Caldicott Review.
Number two has absolutely focussed on this and that we must review and change our paranoia around
sharing information and in the medical profession and our whole approach to data protection,
it can be, can be, can be different.
We all know that there is a paranoia around this rather than a healthy use of respecting people's confidentiality when,
when wanted and when, when necessary, and that it is important to share information.
Of course, respecting safeguards, of course respecting confidentiality appropriately, but doing that appropriately.
But it is a very challenging. So I don't want to go on about this where we've covered this already, but about for young offenders,
all these aspects really, really build up to actually creating a worse situation and more offending.
We've talked about some of these recommendations that I will take out to have time for discussion.
So and this is what we came through, came out with in from our same old report around.
That is some good policy. There's some good policy and good strategy that's been well implemented.
Training we know about talked about there is something about the senior clinicians role where lots of people
are very unconfident and we have got some really excellent clinicians and what can we not bridge this better?
Can I not be providing advice and leadership around around care management and building confidence and skills within the more generic workforce?
Can we not have somebody who actually does hold the ring, please?
Can we not also make sure our commissioning works much better so that we are working across departments locally?
And can we not do something about access to services and information?
And we within talking about a single point of access, what's really exciting is that in future in mind.
Of the recommendations going through. A lot of these actually have been picked up not because of us, but because everybody.
It's common sense. And this is actually the fusion mine has a massive workforce, a task group.
I think there was about 40 people in it. It wasn't it wasn't a no, a small select group.
And there was real there was a real consensus about what we need to do, which is very exciting.
And it's the first time I've experienced it in, in this field.
And and there were some specific elements as well around young offenders.
So the transition times was really recognised as being we have really got to do something about this integrated working
with and about between mental health services and youth justice assessments really needs to tie up much more strongly.
And I was talking to the magistrates last year and they were also saying what we do,
we're having so many young people coming in with very clear mental health problems,
but if we do a community order, then actually there aren't the services there to to deliver them.
So then what happens actually may be going having some time in prison is will be a
much safer option than just leaving them back out in the community with nothing.
So that we've actually got to tie this up much better designated lead professional to act coordinate the care and
inter-agency working around a young person in the youth justice system which could be the carrot that is now talked about.
And these have all been supported in the government response.
These these have all been supported, which is great.
The single point of access is coming through and now a number of camps are introducing a single point of access and a triage system
as being an efficient way of of speeding up access and actually helping young people get the help they need much more quickly.
And what was talked about in future in mind is that as the liaison mental health model and what this picks up on is this this
role of the senior clinician and how they can be somebody locally who others can turn to for some advice and help and like,
should this person be referred to cans? What should we be doing here?
That there is huge amounts of expertise sitting in some clinics which is not accessible to others,
and we need to open that up and make it make make those people much more available.
And there are good models of practice where this is happening. So it's not that it's impossible more accessible in engaging settings.
Again from our work with failed and what we gain we know is that young people want to
make it a bit intimidating and they find GP surgeries also can be quite intimidating.
Let us put services where that, where that, where young people will go and also where they feel comfortable.
And I think the Youth Information Advice Centres is a really good role model for these
which are supported by youth access to the there are youth centres if you like,
but that which provide housing support, benefits advice, employment advice,
all sorts of things as well as often having a nurse on site, providing youth counsel, linking in to into cans.
And these have been now supported much more through the local CCGs and that is really good news.
And there again are some lots now or models across the country where they are
developing and becoming much more closely tied into the local can service.
And finally, about multidisciplinary multi-agency pathways, and this is the local transformation.
This is embodied in the local transformation plans.
So every local area must have their local plan about how they're going to address and meet the needs,
the mental health needs of the local young people,
and what the role is of schools, local authorities and youth justice as well as mental health services.
So this and this is where the additional money. So the 1.25 billion that has been agreed and is starting to be spent,
is it the local transformation plans is the passport and they also great news for the for us is that the local
areas have to give a financial account of that funds back to NHS England each year so we can it's for us,
it gives us an opportunity to monitor that this is actually being delivered because the trouble with that money is it kind of evaporates.
You know, we're very good in block contracts and so actually identifying where that money is going has been incredibly hard in the past.
So I've just talked about this other good. I wouldn't say that again. I've actually covered that one.
And this one was about young people and about and the the example I gave around when a young
people needing to have the consistency of contact and this is from a professional who said,
you know, I remember more than one in personal. How long are you going to be here for?
Young people do want to access support, but the trust is a massive, massive issue.
And and if they open up and trust them when they get and they disappear, they become mistrusting and they don't.
And they're not going to actually do any work. And for us as professionals, that's really quite difficult.
So what we need to do is do things differently, re-orientate services and programmes, stop the problem.
Developing early on is absolutely the key. Look at the individual in their context and look at the social and community factors.
Tackle those other determinants.
So you're working with the whole young person, not just a thing you're thinking about what is it that's going on here?
Not just is there a diagnosable mental health problem?
And also, let's just keep being good about measuring out because let's look at the practice.
What are the outcomes of this practice isn't working. If it's not working well, how do we change it?
Let's do it better. And keeping it sanguine about early intervention,
the trusted adults building resilience is think about all of those aspects about how this young person's going to cope in
the in the in the future and increase the workforce depend and skills and there are some really good examples of practice.
So Mac UK are you aware of Mac UK founded eight years ago of by a psychologist but that working with gangs
on the streets going out great where young people are really interesting with a really exciting way about
delivering services and and it's the and the staff you know working in in in risky ways well for the normal
practice risky ways but actually been really successfully engaging with young people working in gangs.
They focus on on gangs and young people on streets and beat the adolescent mental ization based in terms of treatment.
I'm sorry, I have a real thing,
but this is a fantastic program and it adolescent mental isolation based in terms of treatment was a young person going,
I think when they're being told that's the kind of service they're getting and Anna from Frye's
fantastic organisation and doing and this is a fantastic model but please can we just call these
sensible things and I have it is my thing about the mystification that we are very keen on doing the
I said this only is one of the examples of the youth information advice and counselling centres.
Youth Access is the is the umbrella organisation due to the means and fantastic organisations.
This the is one of them. GP's are now coming out and being allocated in co-located with those.
It's, it's some really good stuff. And finally red threads that are King's youth violence projects and they are
working in accident and emergency and so picking up when young because that's
often where young people first hit it's you know hit the where they hit up in terms of accessing a service especially when connected around violence.
So do do look at those if you if you're interested and I'm just coming back to this again about what you can do.
And what I'd like to focus on is the last point in this one we are picking up in the work from
the Vulnerable Working Group and we're very interested around this trauma focussed care.
We are being approached now suddenly everyone's interest in junior people's mental health,
which is great, but it does mean that everyone's fighting from their particular corner.
So here we go again, fragmenting young people and talking about, you know,
looked after children, adopted children, young offenders, sexual abuse and poverty.
And all of those things are right and important. We don't want it.
We don't want to take away from any of that. But we do also need to look at that young person as a whole and what's going on underneath.
And so we are doing a piece of let's you look literature review at the moment and to then think about and holding a summit with practitioners
because we think that's where the answer is going to lie in actually making things happen and change around how do we do this,
how do we bring these elements together and what it where are some good practices and
what can we learn and what does this mean about doing it and actually on the ground?
So we will be holding a bit of a launch of it and discussion in the spring, late spring with a summit in autumn.
And it would be great if you were interested in that because again, unless we keep a focus on this, it will slip away.
And that's why we're we're picking this up because otherwise everyone's going to fight for their particular cause, and there's nothing wrong in that.
But we do need to we need to work holistically.
We need to work together. We need to. Young people as whole people as well.
We also run some training. If you if anybody's interested.
And finally, this. That's that's us. Thank you all very much.