1 00:00:00,480 --> 00:00:04,560 Okay. Welcome, everyone, to a green channel to college. 2 00:00:06,660 --> 00:00:11,880 It's nice to see so many faces at the end of eighth week while the beginning of ninth week, in fact. 3 00:00:11,910 --> 00:00:14,910 So the students in the room who aren't too exhausted. 4 00:00:16,050 --> 00:00:21,150 I hope you enjoyed it. I hope you enjoyed the day. I think everyone's a little bit exhausted this time of the year. 5 00:00:22,350 --> 00:00:30,419 So 2016 marks the 50th anniversary of the Oxford Centre for Criminology and the Faculty of Law, along with the centre, 6 00:00:30,420 --> 00:00:36,240 put together a rather exciting series of different events and activities throughout this calendar year. 7 00:00:36,780 --> 00:00:40,890 So it goes across two different academic years and this is one of those events. 8 00:00:41,190 --> 00:00:47,070 And these activities are really about folks sort of celebrating the last 50 years of criminology in Oxford. 9 00:00:47,370 --> 00:00:52,680 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. 10 00:00:53,100 --> 00:00:58,680 And to really celebrate and pause and think about where we are now, what we are now. 11 00:01:00,420 --> 00:01:06,930 So this event is very generously funded by Green Templeton College and co-hosted with the college. 12 00:01:07,320 --> 00:01:11,220 And I want to explain a little bit why that would be. 13 00:01:11,850 --> 00:01:19,140 And Green Town College, I've been a governing body fellow here since 2000 when it was still called Green College. 14 00:01:19,560 --> 00:01:24,930 And over that time, its focus on human welfare has developed quite considerably. 15 00:01:25,170 --> 00:01:30,420 It has now this annual human welfare conference. It has a human welfare journal and a blog, 16 00:01:30,870 --> 00:01:39,719 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, 17 00:01:39,720 --> 00:01:41,070 have an impact on practitioners, 18 00:01:41,070 --> 00:01:50,700 have an impact on policymakers and and on research in all different disciplines, but with a very broad focus on human welfare, 19 00:01:50,700 --> 00:01:57,150 on really making things better for people who are perhaps in more disadvantaged positions than many of us in this room. 20 00:01:58,460 --> 00:02:04,200 And also criminology, too, has an interest in human welfare again that I see defined. 21 00:02:05,190 --> 00:02:10,260 And so it's perhaps not surprising that many of our students choose to come here to Green Templeton College. 22 00:02:10,620 --> 00:02:19,199 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. 23 00:02:19,200 --> 00:02:25,200 And some of them are in this room today, and some of them will be speaking in the various different sessions today. 24 00:02:25,710 --> 00:02:30,750 So also criminology. Why celebrate 50 years in 2006? 25 00:02:31,560 --> 00:02:37,620 It was possible to study criminology here in Oxford before 50 years ago. 26 00:02:37,920 --> 00:02:46,590 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, 27 00:02:46,920 --> 00:02:52,560 and he was taught then by Dr. Max Robert, who was the first reader in criminology. 28 00:02:53,610 --> 00:03:03,659 But the reason why we mark the 50th anniversary this year is because 50 years ago, Max Gohmert's successor, Dr. Nigel Walker, 29 00:03:03,660 --> 00:03:07,890 who unfortunately passed away at the ripe old age of about 93, just a year ago, 30 00:03:08,820 --> 00:03:15,940 he set up a unit that was called the Penal Research Unit, and he set that up in 1966. 31 00:03:15,940 --> 00:03:23,910 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. 32 00:03:24,720 --> 00:03:31,620 It was renamed the Centre for Criminological Research in 1973, when then Dr. Roger Hurd, 33 00:03:31,620 --> 00:03:39,570 now Professor Roger Hurd took over as the reader in criminology and set up the centre just around the corner on Paddington Road. 34 00:03:40,320 --> 00:03:45,150 It became a department at the University of the Law Faculty sorry, in 1991. 35 00:03:46,110 --> 00:03:50,759 And then we moved in 2004 to our current premises in the Munroe building, 36 00:03:50,760 --> 00:03:57,810 which is the Social Sciences Divisional Building now until the start of the new millennium. 37 00:03:57,840 --> 00:04:00,780 Oxford Criminology was focussed very much on its research. 38 00:04:01,170 --> 00:04:08,280 So we were striving for excellence in academic research that also reached out and influence policy and practice. 39 00:04:08,520 --> 00:04:14,940 And we had at the time and we remain to have very good relationships with various different public and 40 00:04:15,240 --> 00:04:20,940 private and third sector bodies who work in the area of criminal criminology and criminal justice, 41 00:04:21,240 --> 00:04:27,840 and did research on victimisation of prisons on probation and parole and the death penalty on crime in the family, 42 00:04:28,080 --> 00:04:35,610 and latterly very important work on border control and the detention of refugees and asylum seekers of which you will hear more later. 43 00:04:36,900 --> 00:04:42,060 So at the same time, in 2001, we established our MSI in criminology and criminal justice, 44 00:04:42,480 --> 00:04:45,840 and this coincided with the change of our name to the Centre for Criminology. 45 00:04:46,110 --> 00:04:52,079 Criminology to to really reflect that shift in emphasis, not away from research, 46 00:04:52,080 --> 00:04:59,190 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. 47 00:05:01,280 --> 00:05:14,660 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. 48 00:05:15,440 --> 00:05:17,180 We don't want to rest on our laurels. 49 00:05:17,510 --> 00:05:23,690 We have with the law faculty developed a development prospectus which will find property in the packs given to you. 50 00:05:24,050 --> 00:05:29,210 And this is very much about celebrating where we are now, but looking forward to the next 50 years. 51 00:05:29,480 --> 00:05:38,360 And we are embarking on the very ambitious fundraising campaign to secure our continued success over the next 50 years and to secure 52 00:05:39,110 --> 00:05:47,209 a global criminal justice research hub which will encompass various different ambitions around a new post new student ships, 53 00:05:47,210 --> 00:05:51,590 particularly student ships for students who would not otherwise be able to come and study at Oxford. 54 00:05:51,920 --> 00:05:54,620 So if you have friends or colleagues with five deep pockets, 55 00:05:54,620 --> 00:05:59,840 you might want to leave that prospectus lying around on their desk and maybe buy them a drink at the same time. 56 00:06:01,190 --> 00:06:03,860 So this conference, why this conference? 57 00:06:04,190 --> 00:06:11,780 Well, I mentioned before the emphasis on human welfare in Green Templeton College and our own interests in this field, too. 58 00:06:12,260 --> 00:06:17,809 So this conference is really aimed at trying to understand and appreciate the lived experiences of 59 00:06:17,810 --> 00:06:23,480 people who are considered to be vulnerable or not having that rights in the criminal justice system. 60 00:06:23,960 --> 00:06:29,690 And so it draws together a range of experts from criminology, from psychiatry, from law, and from third sector, 61 00:06:29,750 --> 00:06:34,489 with enormous expertise in a range of areas that speak to these issues of 62 00:06:34,490 --> 00:06:38,540 trauma and vulnerability and issues around mental health in criminal justice. 63 00:06:40,220 --> 00:06:47,990 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 64 00:06:47,990 --> 00:06:51,979 together what we might call early career researchers working this area with 65 00:06:51,980 --> 00:06:56,780 strong links to Oxford criminology and many of them to Green Templeton College, 66 00:06:56,780 --> 00:07:03,650 to talking on various different topics around vulnerability, trauma, resilience of people in prisons, 67 00:07:04,010 --> 00:07:11,329 people on immigration detention in immigration detention centres, at risk of offending people with autism, etc. 68 00:07:11,330 --> 00:07:15,080 And we will have before you a very interesting and exciting day. 69 00:07:15,560 --> 00:07:21,469 And what we're doing is really trying to look at the enduring aspects of trauma and mental health problems, 70 00:07:21,470 --> 00:07:27,470 but not just lay out a litany of misery, rather, to try to better understand, 71 00:07:27,470 --> 00:07:31,700 to better explain the experiences of people in these situations and really to 72 00:07:31,700 --> 00:07:36,230 look forward to what improvements might be made to the criminal justice system. 73 00:07:37,850 --> 00:07:46,580 So before I introduce our first plenary speaker, I just want to give you a couple of very tedious housekeeping points, tedious, but useful. 74 00:07:46,850 --> 00:07:53,000 You might have seen as you came down the stairs coming to the lecture theatre that just behind you there's toilets. 75 00:07:53,270 --> 00:07:57,620 So the rights as you go out of the gents on the left is the ladies. 76 00:07:58,120 --> 00:08:04,999 And when we break for coffee and also for lunch, which we'll have coffee break this morning and a coffee break this afternoon, 77 00:08:05,000 --> 00:08:10,010 as well as lunch, you will go to the stables bar for refreshments. 78 00:08:10,130 --> 00:08:17,780 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. 79 00:08:18,080 --> 00:08:19,340 Some Oxford colleges, 80 00:08:19,340 --> 00:08:24,200 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. 81 00:08:24,480 --> 00:08:30,800 Oxford French Upton College is a little bit more laid back, so you can walk round if you feel nervous or high heels, 82 00:08:31,130 --> 00:08:35,090 but I think you're safe to go across if you don't know where you're going. 83 00:08:35,090 --> 00:08:37,690 That just just follow the crowd almost certainly go. 84 00:08:37,910 --> 00:08:42,740 I've not been given any advice on what to do if there's a firearm, so I suggest you scream and run. 85 00:08:44,480 --> 00:08:47,560 But there's probably a procedure that I should tell you is that this is over. 86 00:08:47,570 --> 00:08:50,480 That is probably meets outside of the grass. 87 00:08:52,340 --> 00:08:59,270 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. 88 00:08:59,270 --> 00:09:06,290 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, 89 00:09:06,500 --> 00:09:12,350 the library and students are preparing for exams and assessments at the moment. 90 00:09:12,350 --> 00:09:16,160 So maybe we could respect that need for a bit of peace and quiet. 91 00:09:16,280 --> 00:09:24,229 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. 92 00:09:24,230 --> 00:09:26,330 She's the chief executive of Young Minds. 93 00:09:26,630 --> 00:09:31,970 This is a national charity that promotes emotional wellbeing and mental health for children and young people. 94 00:09:32,780 --> 00:09:35,179 And I think she's been that since 2008. 95 00:09:35,180 --> 00:09:42,380 So she has a vast amount of experience to draw on, experience of really championing, championing the cause of young people. 96 00:09:42,890 --> 00:09:51,530 And she promotes that, that the talents and services advises government ministers about mental health needs of children and young people, 97 00:09:51,920 --> 00:10:00,079 and is a member of various different fora and and task forces aimed at making vulnerable young people's lives a little bit better. 98 00:10:00,080 --> 00:10:03,459 So. Sarah, I'd like to invite you to the podium. 99 00:10:03,460 --> 00:10:07,180 And I think everything is set up right now. 100 00:10:08,050 --> 00:10:40,110 Thank you very much. Hello. 101 00:10:40,830 --> 00:10:45,120 It's great to be here. And thank you, Caroline, for inviting me. 102 00:10:45,610 --> 00:10:52,230 And it's interesting coming to a completely new environment because you don't know who your audience is going to be. 103 00:10:52,240 --> 00:10:57,450 So I just be interested to know a little bit about you just had a little bit about me. 104 00:10:58,200 --> 00:11:05,399 How many of you are connected to the university and this course you put to quite, quite a lot of you? 105 00:11:05,400 --> 00:11:09,390 And are you? How many of you are MSE students or post grads? 106 00:11:09,420 --> 00:11:18,719 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. 107 00:11:18,720 --> 00:11:23,340 I think they're getting brave enough to put their hands up. And what about in the mental health system? 108 00:11:23,340 --> 00:11:28,230 Other people hear from one oh couple of hands going up there about that as well. 109 00:11:28,260 --> 00:11:30,270 Brilliant. Okay. Well, thank you very much. 110 00:11:30,270 --> 00:11:39,360 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. 111 00:11:39,420 --> 00:11:47,729 But that's all. And so what I'm going to do is a quick scope through. 112 00:11:47,730 --> 00:11:55,230 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. 113 00:11:55,230 --> 00:12:01,530 And where we're where it's all kind of going and then much more recently where where we're at and what 114 00:12:01,530 --> 00:12:09,719 the opportunities are and what the risks are and and what we'd like from you really and especially, 115 00:12:09,720 --> 00:12:19,530 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. 116 00:12:19,530 --> 00:12:23,759 And I can't make this move on. Yes. So here we are, so young minds. 117 00:12:23,760 --> 00:12:31,200 First of all, as Carolyn said, we are leading charity committed to improving the emotional wellbeing and mental health in young people. 118 00:12:32,550 --> 00:12:36,990 What we do, though, is very much a focus on young people's experience. 119 00:12:37,230 --> 00:12:46,290 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, 120 00:12:46,290 --> 00:12:49,410 well, actually what's the impact on young people and families? 121 00:12:49,980 --> 00:12:53,400 What are they saying about what their experiences of mental health? 122 00:12:54,210 --> 00:12:58,080 And what's our what's our platform in the way of all credibility? 123 00:12:58,080 --> 00:13:05,490 And it's very much about what young people are saying their lives are like, what they're saying about their experience of services, 124 00:13:05,700 --> 00:13:12,870 what they're saying helps and similarly about families and parents in particular, who are generally not always, 125 00:13:12,870 --> 00:13:18,450 but generally the main advocates for their children in terms of trying to get help for them. 126 00:13:18,870 --> 00:13:24,780 And with that experience that we are very much driven by young people and they are involved in every element of what we do, 127 00:13:25,620 --> 00:13:33,270 but in particular around our campaigns and our policy asks, it's very much driven by young people themselves. 128 00:13:34,530 --> 00:13:38,250 So what's our vision? Where are we trying to get to here? 129 00:13:38,880 --> 00:13:45,840 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, 130 00:13:45,840 --> 00:13:51,320 find help when it's needed and who go on themselves to create mentally healthy communities. 131 00:13:51,630 --> 00:14:01,920 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, 132 00:14:01,920 --> 00:14:09,210 is always really exciting and inspirational to work with. But also young people are tomorrow's community, tomorrow's society. 133 00:14:09,510 --> 00:14:15,450 And if we can get it right or better for young people, we will actually improve how society is tomorrow. 134 00:14:15,990 --> 00:14:20,460 And so we do this by championing children, young people's mental health, wellbeing across the UK. 135 00:14:21,150 --> 00:14:25,110 And as I said, driven by our experience, that's what creates momentum for change. 136 00:14:25,410 --> 00:14:29,880 And I have to say, if you're talking about wanting to have policy change, 137 00:14:30,180 --> 00:14:34,890 the people who are the fantastic advocates are actually young people themselves. 138 00:14:35,280 --> 00:14:40,320 When we've done campaigning work, we have all the research, the statistics, you know, up your arm, 139 00:14:40,560 --> 00:14:48,660 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. 140 00:14:48,930 --> 00:14:58,050 And that is really been our experience dating back actually from the Mental Health Act reform back in 2010. 141 00:14:58,230 --> 00:15:01,170 Was it before that 2008? Just before I started Young Minds, 142 00:15:01,710 --> 00:15:08,550 it was young people describing their experience since that committee that made ministers go, We've got to change this. 143 00:15:08,550 --> 00:15:12,720 We can't have young people. We've got to have children, young people being on adult wards. 144 00:15:12,720 --> 00:15:20,490 That's what brought that changing. So do not underestimate your power in terms of being young people as well. 145 00:15:21,330 --> 00:15:30,840 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. 146 00:15:31,320 --> 00:15:35,370 But we do that also with practical help. We know that this is tough. 147 00:15:35,370 --> 00:15:41,879 We know life is tough. We know that delivering. Service is really hard and lots of people are doing the best they can against 148 00:15:41,880 --> 00:15:45,420 what feels like a watershed to push them in the in the opposite direction. 149 00:15:46,410 --> 00:15:53,700 And so we work with and support children and young people, but also parents and families and also professionals, practitioners. 150 00:15:54,060 --> 00:16:02,700 We do a lot of work in schools. We do a lot of work with commissioners and local areas and helping develop local strategies. 151 00:16:03,240 --> 00:16:07,320 And so we work across the UK. 152 00:16:07,530 --> 00:16:12,240 Though I have to say that with the changes in the NHS from 2010, 153 00:16:12,420 --> 00:16:20,399 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. 154 00:16:20,400 --> 00:16:25,080 We now need to think more broadly, both internationally as well as the UK. 155 00:16:26,580 --> 00:16:32,550 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. 156 00:16:34,170 --> 00:16:37,200 The best and most exciting thing that's happened is a future in mind. 157 00:16:37,860 --> 00:16:41,850 I don't know if you are aware of future in mind. I will explain this a bit more in a bit. 158 00:16:42,690 --> 00:16:48,810 And there are local transformation plans, which are also the most exciting thing that is happening at the moment. 159 00:16:49,140 --> 00:16:50,850 So and I will talk more about that. 160 00:16:51,480 --> 00:16:59,340 We need to keep raising awareness about offender mental health everywhere, if only by keeping on keeping on keeping on that. 161 00:16:59,340 --> 00:17:04,320 Actually, anything is going to change. And there is awareness and there is policy developing. 162 00:17:04,500 --> 00:17:08,460 But, you know, a long way from policy into practice. 163 00:17:08,790 --> 00:17:13,290 And so that pressure has to be maintained. And we need you to help us do that. 164 00:17:14,040 --> 00:17:21,119 We need more more resources. We need help about learning from practice, not just from research. 165 00:17:21,120 --> 00:17:27,540 We need practice to develop. We need to bridge that research into practice and then back again. 166 00:17:28,470 --> 00:17:36,900 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. 167 00:17:37,140 --> 00:17:40,350 And that comes from the mistakes, not just from the good stuff. 168 00:17:40,770 --> 00:17:46,490 We need to be a bit more open about, you know, it is really hard and we didn't that didn't work. 169 00:17:46,500 --> 00:17:47,370 So we're going to change it. 170 00:17:47,550 --> 00:17:54,090 We're going to do it differently next year so that we can do things differently, that we do create learning organisations. 171 00:17:54,330 --> 00:18:03,030 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, 172 00:18:03,630 --> 00:18:08,640 different government comes in and everything's turned around again and people are tired. 173 00:18:09,630 --> 00:18:16,770 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. 174 00:18:17,190 --> 00:18:21,509 So we have to be brave and honest. So that's my call to action from the beginning. 175 00:18:21,510 --> 00:18:25,110 So I will go back now to, well, what we're talking about here. 176 00:18:26,430 --> 00:18:30,260 So I'm sure that this is familiar to you as well. 177 00:18:30,270 --> 00:18:33,050 This comes from a book called Young Minds. 178 00:18:33,060 --> 00:18:43,380 We from Professor Bailey and Professor Chuter both present at the Royal College of Psychiatry at different time, psychiatrists. 179 00:18:44,010 --> 00:18:47,280 But it's where this is the groundwork. 180 00:18:48,000 --> 00:18:52,170 What is our mental health? What's it made up of? It isn't any one element. 181 00:18:52,320 --> 00:18:56,820 It is what we're born with. But it is also of our upbringing, the nurture. 182 00:18:57,090 --> 00:19:04,979 But it is also events. Stuff happens. And we know that when those things happen, if other things aren't in place, 183 00:19:04,980 --> 00:19:10,650 if other support isn't in place, it can have a major impact on the development the developing brain, 184 00:19:10,950 --> 00:19:17,520 the developing heart, hardwiring in children and young people, and overall their mental health chances in life. 185 00:19:18,620 --> 00:19:25,290 Well, what's been a really good phone bonus for us has been the development of brain science in the last 15 years. 186 00:19:26,070 --> 00:19:37,770 It has really given credibility to what actually we've known about the impact of emotional nurturing on the development, 187 00:19:37,770 --> 00:19:46,470 development both of the brain, but also the hardwiring of what gets get set in place for your emotional health later on in life. 188 00:19:46,920 --> 00:19:50,729 And that is what is also particularly crucial, both these two elements, 189 00:19:50,730 --> 00:19:55,980 the nurture and events around young offenders, young people at risk of offending. 190 00:19:56,310 --> 00:20:02,049 So I want you to hold this in mind. I did not go into this in detail. 191 00:20:02,050 --> 00:20:05,710 I mind guessing that you're familiar with risk in protective factors. 192 00:20:06,040 --> 00:20:09,550 Can I just check that? Yes. Is that lots of nods around the room? 193 00:20:10,780 --> 00:20:15,550 But I just want us to also this is again, the groundwork about with any young person, 194 00:20:15,760 --> 00:20:21,010 there is a whole set of risk factors that is going to increase their likelihood around 195 00:20:21,010 --> 00:20:28,150 mental health problems and indeed of offending as well as a number of protective factors. 196 00:20:28,660 --> 00:20:38,350 And these are also crucial and it is an approach that we take very strongly within young minds around recognising the the environment, 197 00:20:38,540 --> 00:20:42,640 the context that that young person is living in. 198 00:20:43,270 --> 00:20:46,180 I'm sure these can be made available to you if you would like them, 199 00:20:47,350 --> 00:20:51,820 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. 200 00:20:51,850 --> 00:20:57,480 Okay. Yeah. So. What do we know? 201 00:20:58,710 --> 00:21:05,400 We know that 95% of young people aged 1620 in youth offending institutions have at least one mental health disorder. 202 00:21:06,960 --> 00:21:10,530 We know that 45% of children have mild to moderate conduct. 203 00:21:10,530 --> 00:21:16,260 Problems go on to commit half of all crime with the estimated cost of 37 billion. 204 00:21:17,460 --> 00:21:23,150 We know that 40% of young people have been have been homeless in the six months before entering custody. 205 00:21:23,760 --> 00:21:28,860 And we also know that the connection between homelessness and mental health as well, mental health problems. 206 00:21:29,400 --> 00:21:34,800 We know that nearly 90% of young people in Wales have been excluded from school. 207 00:21:35,730 --> 00:21:39,090 And we know that 43% of young people in prison have ADHD. 208 00:21:40,680 --> 00:21:48,480 Or on the second point, 45% of children. Yet is that all crime committed by youth for all crimes? 209 00:21:49,600 --> 00:21:56,230 Full stop. Very good point. I wouldn't like to say definitely because I don't know off the top of my head, 210 00:21:56,560 --> 00:22:05,530 I believe that this is all crime of young people and it is it is from the Sainsbury Centre for Mental Health Research. 211 00:22:05,890 --> 00:22:09,040 So it can be checked and I'm pretty sure it's of it. 212 00:22:09,370 --> 00:22:16,810 I was looking at it again, loss on actually did say in the in the in the section I was reading of all crime, 213 00:22:16,990 --> 00:22:23,140 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. 214 00:22:23,890 --> 00:22:29,620 And in the last ten years there has been a number of reviews and reports. 215 00:22:31,090 --> 00:22:39,850 We have Michael Marmot initially to really focus on the social determinants of mental health, which was very powerful and very useful. 216 00:22:40,090 --> 00:22:46,600 But we've had the Bradley report, we've had around information governance review, which is has been very interesting. 217 00:22:46,990 --> 00:22:50,590 We've had the No Health Without Mental Health, the first mental health strategy, 218 00:22:50,590 --> 00:22:57,430 which Apple Birthday Ltd back in 2011 also focussed around the health of mental health 219 00:22:57,430 --> 00:23:05,050 offenders and the Harris Review looking at death in custody of of young people as well. 220 00:23:05,230 --> 00:23:10,059 I think looking at the extreme end shows a very good spotlight on the overall 221 00:23:10,060 --> 00:23:14,110 experience of what's happening with young people in the criminal justice system. 222 00:23:15,160 --> 00:23:23,410 And then Future Mind, which came out last March following Norman Lamb's Mental Health Taskforce for Around Children, 223 00:23:23,410 --> 00:23:28,960 Young People's Mental Health and which is now coming into effect, which we will cover a bit more. 224 00:23:29,620 --> 00:23:36,250 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, 225 00:23:36,880 --> 00:23:45,340 but the message is coming through are pretty consistent and there but it is how that translates into changing practice is the challenge. 226 00:23:46,030 --> 00:23:52,660 So again, the sorts of messages coming through around the, around the impact of the brain on behaviour. 227 00:23:53,050 --> 00:24:00,260 So from the British Psychological Society Positioning Paper which came out last year and the fear, 228 00:24:00,340 --> 00:24:14,590 the linkage there between brain trauma or other intellectual disabilities and around offending is significant and gang members. 229 00:24:14,590 --> 00:24:20,830 What the connection here around the dualistic relationship about poor mental health and being drawn to gangs. 230 00:24:21,190 --> 00:24:24,460 And again, what we know about the mental health of gang members, 231 00:24:24,790 --> 00:24:32,530 90% will have antisocial personality disorder, 86% have conduct disorder, 59% anxiety disorders. 232 00:24:32,860 --> 00:24:43,959 And so it goes on and the it is very clear you see the connections repeatedly around young people's 233 00:24:43,960 --> 00:24:49,750 mental health and what their behaviour and their behaviour and where that behaviour leads them. 234 00:24:50,110 --> 00:24:57,939 Now there's a very clear trajectory. I worked previously both of homeless young people for many years at Centrepoint and with young 235 00:24:57,940 --> 00:25:03,720 people at risk of offending and offenders and it was like you could just see this path going. 236 00:25:03,770 --> 00:25:13,330 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, 237 00:25:13,840 --> 00:25:22,750 school exclusions and offending and also homelessness and offending and mental health problems was like completely connected. 238 00:25:22,990 --> 00:25:29,530 And yet nobody was actually connecting up the dots and actually thinking, what is it that's happening here that we can do differently? 239 00:25:30,040 --> 00:25:39,609 And it is still happening and has more data around mental health and gangs and around girls as well. 240 00:25:39,610 --> 00:25:44,379 And about what happens here around is again behavioural problems about there. 241 00:25:44,380 --> 00:25:55,300 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. 242 00:25:58,300 --> 00:26:00,940 Again, coming back to Harry's review, as I mentioned earlier, 243 00:26:01,810 --> 00:26:11,710 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. 244 00:26:12,730 --> 00:26:19,720 And what's interesting about this is the government response, which came out in December just before just before Christmas. 245 00:26:20,530 --> 00:26:25,020 And I want to go through this in detail, but it's just painting a picture really well. 246 00:26:25,030 --> 00:26:30,939 I think each one of these things around what he found with these young these young people, 247 00:26:30,940 --> 00:26:40,209 overwhelmingly young men and who have chaotic lives, have histories of abuse and exposure to violence and whilst in prison, 248 00:26:40,210 --> 00:26:46,580 are not engaged in purposeful activity, that they don't have norms themselves, 249 00:26:46,580 --> 00:26:53,230 don't have proper means of assessing whether sufficient care is being given to young people who are vulnerable. 250 00:26:53,590 --> 00:27:00,910 And also the the importance of the caring adult adult role model, 251 00:27:01,210 --> 00:27:09,790 which comes through in all sorts of different research about young people's need for attachment and and positive role models and, 252 00:27:10,240 --> 00:27:23,440 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. 253 00:27:24,160 --> 00:27:28,569 We were asked by the prison service do some training a long time ago, 254 00:27:28,570 --> 00:27:35,350 ten years ago around competencies, because then prison officers were saying we didn't know, 255 00:27:35,440 --> 00:27:43,420 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. 256 00:27:43,750 --> 00:27:46,760 We don't know if they're swinging the legs or if it's real. 257 00:27:47,140 --> 00:27:52,630 We don't know if what we're seeing is them being a bit fed up or actually really serious depression. 258 00:27:53,050 --> 00:27:57,700 And we don't know if they're just acting out or actually this is distress behaviour 259 00:27:57,700 --> 00:28:01,750 and the only way they know they know how to behave there is a complete loss. 260 00:28:02,630 --> 00:28:05,110 And we have to remember that young people have agency. 261 00:28:05,230 --> 00:28:11,530 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. 262 00:28:11,530 --> 00:28:13,240 They think, of course, we we all will. 263 00:28:13,780 --> 00:28:22,080 And it was very interesting that it was actually about competencies of those of those staff and increasing their confidence as well through that. 264 00:28:22,100 --> 00:28:27,250 It wasn't about they aren't good enough that they want to do a good job but didn't feel able to. 265 00:28:27,490 --> 00:28:35,620 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. 266 00:28:35,920 --> 00:28:39,280 We don't know, you know, is this our job as it should be on somebody else's job? 267 00:28:39,390 --> 00:28:44,200 Where do we stop? Where do we say no? This you need to come in now and help us. 268 00:28:44,200 --> 00:28:50,230 We need a specialist. And what is it that we can do? So I think workforce training is a really critical issue. 269 00:28:52,200 --> 00:28:56,969 And again, Lord Harris, I have one of the very strong things that comes through in that report, 270 00:28:56,970 --> 00:29:01,020 is why these young people in custody in the first place. 271 00:29:01,350 --> 00:29:07,500 You look at their life history and something should have been done years ago to help this young person. 272 00:29:07,800 --> 00:29:13,140 What we're seeing is a life of chaos and distress and nobody has done anything. 273 00:29:13,320 --> 00:29:16,950 Is it any surprise that that we are where we are with this young person, 274 00:29:17,370 --> 00:29:21,120 that there were signs as well early on about the distress that this young person 275 00:29:21,120 --> 00:29:26,100 was feeling before they ever got to the point of actually taking their own lives. 276 00:29:26,430 --> 00:29:30,030 And that those all those opportunities were missed along the way. 277 00:29:30,750 --> 00:29:34,110 And that this isn't just about criminal justice. 278 00:29:34,200 --> 00:29:40,830 Youth justice system. This is actually about all parts of government working across and working better. 279 00:29:41,070 --> 00:29:45,120 And of course, that is the most difficult thing you can possibly ask for. 280 00:29:45,960 --> 00:29:53,970 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. 281 00:29:54,300 --> 00:30:00,480 When you talking about government departments, it's like becomes this enormous inertia that's within the system. 282 00:30:01,020 --> 00:30:04,610 But actually, he's right. It is about education. 283 00:30:04,620 --> 00:30:08,580 It is about social care. It is about community service. 284 00:30:08,650 --> 00:30:14,130 It is about mental health services and CAMHS. But it is also about the criminal justice system. 285 00:30:15,000 --> 00:30:18,060 And finally, we are talking about young people. 286 00:30:18,660 --> 00:30:29,220 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. 287 00:30:29,310 --> 00:30:35,730 One of the things he raised was just removing a young person from home and taking them 288 00:30:35,730 --> 00:30:41,549 away from all of their local community and contacts is drastic for a young person, 289 00:30:41,550 --> 00:30:46,350 has all sorts of impacts upon their own emotional wellbeing and mental health, 290 00:30:46,680 --> 00:30:50,760 which doesn't get recognised and that will have an impact on their behaviour. 291 00:30:51,480 --> 00:30:56,580 It will have an impact, a longer term impact on on their wellbeing and on their mental health. 292 00:30:56,910 --> 00:31:01,050 We need to understand that this actually has a neurological impact. 293 00:31:01,290 --> 00:31:04,350 It isn't just a bit sad at the minute. 294 00:31:04,710 --> 00:31:09,750 This has a much longer term and deeper impact on but on a developing person. 295 00:31:11,970 --> 00:31:17,400 So Young Minds was approached by the Barrow Cadbury Trust, 296 00:31:17,820 --> 00:31:25,410 who support transition to adulthood around offending in that particular age between 18 and 24. 297 00:31:25,800 --> 00:31:32,280 That's the and that's what they're interested in because this is a period where young people are particularly vulnerable 298 00:31:32,550 --> 00:31:39,360 and where most of all systems completely collapse because you're moving from children's services to adult services, 299 00:31:39,720 --> 00:31:44,130 whether that is in education, whether that's in from cans to arms. 300 00:31:44,380 --> 00:31:52,410 We've seen the justice system with that social care and looked after children get, you know, shifted around. 301 00:31:52,410 --> 00:31:59,450 Things have slightly changed from that. And what is it that's actually happening? 302 00:31:59,450 --> 00:32:04,709 Is that transition they're interested in but around mental health? And so we carried out a piece of research. 303 00:32:04,710 --> 00:32:08,610 Absolutely. Focusing on relationships and work. 304 00:32:08,610 --> 00:32:12,800 What actually is the detail of what's going on rather than numbers? 305 00:32:12,810 --> 00:32:17,370 It was what is it systematically that's happening to young people that we can learn from? 306 00:32:19,150 --> 00:32:22,330 There are really five critical issues that came out of that. 307 00:32:23,350 --> 00:32:29,020 One was around the need for consistency of relationships for young people about building trust and empathy. 308 00:32:29,290 --> 00:32:31,329 I know this seems really obvious, you know, 309 00:32:31,330 --> 00:32:37,870 and I sometimes I sort of pinch myself because a lot of things seem to be really quite obvious and quite common sense. 310 00:32:38,170 --> 00:32:48,069 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, 311 00:32:48,070 --> 00:32:54,940 you know, old in the tooth now been working with young offenders or young people at risk of offending for a long time. 312 00:32:55,720 --> 00:33:04,930 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 313 00:33:04,930 --> 00:33:13,540 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. 314 00:33:14,140 --> 00:33:25,390 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. 315 00:33:26,140 --> 00:33:29,470 The organ, like the organisation reorganises their structure. 316 00:33:29,950 --> 00:33:33,940 It changes for that young person who's had chaos. 317 00:33:34,270 --> 00:33:41,680 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? 318 00:33:41,710 --> 00:33:46,910 Why would I? Why would I trust you? And unless you have that trusting relationship, actually, you know what? 319 00:33:46,930 --> 00:33:50,680 Nothing's going to happen. So how do we get over that one? 320 00:33:50,680 --> 00:33:57,770 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. 321 00:33:57,820 --> 00:34:00,490 That is the core for anything else to happen. 322 00:34:00,850 --> 00:34:06,580 So that's number one, greater knowledge and skills through identification and awareness of mental health issues, 323 00:34:06,600 --> 00:34:11,590 as I just talked about, the lack of coordination, the collaboration between services. 324 00:34:12,460 --> 00:34:16,540 So not only is it about changing in terms of developing trust, 325 00:34:16,870 --> 00:34:26,800 but across the piece you have a young person who goes to their GP having come out of of custody. 326 00:34:27,430 --> 00:34:31,389 They have a mental health problem because you're under that psychiatrist. 327 00:34:31,390 --> 00:34:35,980 I can't do anything. I'll put you on the list. So they go away. 328 00:34:35,980 --> 00:34:39,430 They wait, wait, wait, wait. 329 00:34:40,480 --> 00:34:43,540 And then they they might have a support worker. 330 00:34:44,230 --> 00:34:50,260 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. 331 00:34:50,260 --> 00:34:58,030 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, 332 00:34:58,030 --> 00:35:04,150 not talking to each other, bits of information held by different people in different places. 333 00:35:05,260 --> 00:35:11,950 What came through really strongly in this research was that the only people who actually sat with them and kind of went 334 00:35:11,950 --> 00:35:20,290 with them and advocated on their behalf was in the voluntary sector because they felt they had that was their job. 335 00:35:20,680 --> 00:35:26,920 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. 336 00:35:27,580 --> 00:35:31,809 Are statutory services overwhelmed as they all tend to go? 337 00:35:31,810 --> 00:35:40,420 No, this is my job and that's not my job that I'm here and information sharing, but confidentiality issues. 338 00:35:40,420 --> 00:35:44,440 I can't I can't tell you that the young people were going, I don't care. 339 00:35:44,650 --> 00:35:48,940 You know, tell them I'm telling my story again and again and again. 340 00:35:49,210 --> 00:35:52,570 Why can't we just don't call these professionals, just talk to each other and just tell them. 341 00:35:53,080 --> 00:35:56,680 And I don't know the impact of these drugs a lot on me. 342 00:35:57,010 --> 00:36:01,930 They're not telling me, you know, how often or what what I might have to manage alongside it. 343 00:36:02,800 --> 00:36:07,240 One young person who ended up overdosing because they weren't they weren't kind 344 00:36:07,240 --> 00:36:11,440 of engaged with what the that how they should be taking these this medication. 345 00:36:11,620 --> 00:36:18,700 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, 346 00:36:18,880 --> 00:36:24,190 self-medicating with drugs and alcohol as a way of just coping and feeling a bit better 347 00:36:24,460 --> 00:36:28,240 because they were scared about how they how they're about their own mental state. 348 00:36:29,470 --> 00:36:32,710 So we actually make things worse all the time so easily. 349 00:36:32,950 --> 00:36:36,189 And so it comes down to this who holds the ring? 350 00:36:36,190 --> 00:36:43,270 It's never very clear who it is who actually should be saying, okay, you're mine, right? 351 00:36:43,390 --> 00:36:46,570 You do that, you do that and you do that. Have you done that? 352 00:36:46,570 --> 00:36:48,879 Have you done that? Nobody does that. 353 00:36:48,880 --> 00:36:58,630 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, 354 00:36:58,960 --> 00:37:03,850 not just to see them once every three months and just check that they're taking 355 00:37:03,850 --> 00:37:08,829 the medication to actually ensure that the different elements are being chased up, 356 00:37:08,830 --> 00:37:16,180 all happening. And you know how good we are about not not following up one things again, everyone's busy. 357 00:37:16,660 --> 00:37:19,969 So what's happening around that? That policy management. Who is it? 358 00:37:19,970 --> 00:37:26,180 Who who should be doing that? And the other bit was just about access to accurate information for everyone. 359 00:37:26,720 --> 00:37:34,280 The young people didn't know what the system was or who they should be seeing, when they should be seeing them. 360 00:37:34,550 --> 00:37:37,730 Who they saw for what if they were on drugs? 361 00:37:37,730 --> 00:37:41,030 Whether what? What the impact of those drugs might be on them? 362 00:37:41,030 --> 00:37:45,290 What combination it might be. And also that the treatment, 363 00:37:45,290 --> 00:37:53,810 the mental health treatment tends to focus on medication and not on any other kind of either talking therapy or other kind of support. 364 00:37:54,200 --> 00:37:58,850 And again, with vulnerable young people, we also know that that isn't going to be enough. 365 00:37:58,880 --> 00:38:03,290 We need both elements. But they didn't know that either. 366 00:38:03,380 --> 00:38:11,990 So those are really critical issues. And it's about this is much more about the practical human delivery of service and 367 00:38:11,990 --> 00:38:16,760 the human relationships rather than necessarily that which is about the systems too. 368 00:38:16,760 --> 00:38:18,950 But it's about how those systems work in practice. 369 00:38:20,790 --> 00:38:29,130 So the conclusions from that research was that this was trying to offer effective help can in fact exacerbate already problematic circumstances. 370 00:38:29,700 --> 00:38:36,540 Too often the result for young people is increased cynicism, further loss of self-esteem, motivation, confidence and basic skills. 371 00:38:37,350 --> 00:38:41,579 For the state. It can mean spiralling costs of welfare dependence, health problems, 372 00:38:41,580 --> 00:38:46,080 policing and custodial sentences, as well as the loss of an active working citizen. 373 00:38:47,100 --> 00:38:54,060 We were a bit fed up and we tend to the end of that research. So is it all bad? 374 00:38:54,240 --> 00:38:59,610 Is this is this the situation? It isn't. And you always have to be optimistic and hopeful. 375 00:39:00,150 --> 00:39:05,850 But what actually is happening so this always looks very complicated to start with, but it isn't. 376 00:39:05,850 --> 00:39:12,990 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. 377 00:39:13,350 --> 00:39:18,930 But why is it all so hard for young people in general accessing accessing CAMHS? 378 00:39:19,230 --> 00:39:22,320 But it's just made ten times harder for young offenders. 379 00:39:22,320 --> 00:39:31,260 So this is this is can and I would say comes from as it was maybe last September, things are beginning to shift. 380 00:39:31,800 --> 00:39:37,020 So we have universal services here, young people with mental health or emotional needs. 381 00:39:38,780 --> 00:39:42,740 What should happen is as mental health problems may, may emerge, 382 00:39:43,190 --> 00:39:50,299 that they're able to access universal services out of the community should they need something 383 00:39:50,300 --> 00:39:56,110 a bit a bit more structured that they're able to access what is known as Tier two services. 384 00:39:56,120 --> 00:40:03,230 So these are the when you haven't got militarily a diagnosable mental health disorder. 385 00:40:04,250 --> 00:40:09,860 Often these are all sorts of things like youth counselling. They might be all sorts of other things as well. 386 00:40:10,100 --> 00:40:17,030 There are things like, for instance, one might be anger management, it might be group work. 387 00:40:17,690 --> 00:40:21,980 They often called step up, step down services generally in the local community. 388 00:40:24,320 --> 00:40:28,790 What's happening? Actually, tier two services have been decimated. 389 00:40:28,940 --> 00:40:32,600 Local authority. These were said to be generally funded by local authorities. 390 00:40:32,960 --> 00:40:40,040 And with the local authority cuts from since 2010, they have practically disappeared. 391 00:40:41,000 --> 00:40:44,980 And so they young people wanting to access services are being rejected. 392 00:40:44,990 --> 00:40:48,110 So there isn't anything and they come back out into universal services. 393 00:40:49,460 --> 00:40:56,390 What should happen again is those young people who had access to this kind of thing of of get what they need. 394 00:40:56,600 --> 00:41:01,340 And often they're okay or they need further help. 395 00:41:01,730 --> 00:41:07,010 They have access to Specialist CAMHS, which is what we traditionally know is as CAMHS, 396 00:41:07,010 --> 00:41:17,600 which then tends to be much more pathway orientated there and is around more about diagnosed mental health problems. 397 00:41:18,440 --> 00:41:29,060 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. 398 00:41:29,390 --> 00:41:35,060 And then from that you come out of those services, you may then have set down services. 399 00:41:35,060 --> 00:41:39,290 You may come back out into into the community and not need further help. 400 00:41:40,160 --> 00:41:46,399 Should you need further help or should it be a much more serious mental health problem? 401 00:41:46,400 --> 00:41:51,380 Mental illness there is inpatient care, crisis care, urgent care teams. 402 00:41:51,980 --> 00:41:59,900 So either inpatient care in a clinic, hospital or urgent care teams, crisis teams locally in the community. 403 00:42:00,230 --> 00:42:09,320 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. 404 00:42:09,560 --> 00:42:15,230 Step up, sit down, services, what's happening? You are having access to this service. 405 00:42:15,230 --> 00:42:25,670 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 406 00:42:25,670 --> 00:42:32,810 list for tier three for specialist care has gone up and because of community services being decimated, 407 00:42:33,020 --> 00:42:39,260 the thresholds, the way that council has coped is by saying, okay, you actually have to be this will now roll. 408 00:42:39,320 --> 00:42:45,860 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, 409 00:42:45,860 --> 00:42:52,010 your BMI isn't low enough yet and, you know, so we can't offer you any help. 410 00:42:52,250 --> 00:42:57,740 And so we've got these very weird and disincentives for getting better. 411 00:42:58,310 --> 00:43:02,330 What we're creating are incentives. We're getting worse in need to get any help at all. 412 00:43:02,570 --> 00:43:09,770 And indeed that has been what has been happening. And and councils have been absolutely stressed, 413 00:43:09,770 --> 00:43:17,150 completely stressed because what they are then dealing with is much more complex cases, much greater need, 414 00:43:17,930 --> 00:43:25,459 and so are then also restricting the services even more so in this kind of spiral and the allowance 415 00:43:25,460 --> 00:43:31,940 element and like how these often young people aren't even getting 2 to 3 services back out again, 416 00:43:32,180 --> 00:43:36,319 getting ill and the first time they get care is going into inpatient care because 417 00:43:36,320 --> 00:43:42,740 they have become a crisis point and inpatient care has also been at crisis point. 418 00:43:43,310 --> 00:43:48,860 And you will have heard in the news all sorts of things around young people being sent all over the country. 419 00:43:49,100 --> 00:43:57,140 And we know and we know the impact that has about being cut off from your community and friendship networks and support networks. 420 00:43:58,870 --> 00:44:01,960 So it's a system under huge amounts of stress. 421 00:44:02,320 --> 00:44:07,900 So then when you have young people who are also going into custody, coming back out of custody. 422 00:44:08,050 --> 00:44:13,960 So how they are tracked and supported within the system is an impossibility. 423 00:44:14,770 --> 00:44:17,830 You have a system already under huge pressure. 424 00:44:18,070 --> 00:44:23,360 And when you have young people who aren't necessarily in your area. 425 00:44:23,380 --> 00:44:27,490 One of the other things is, well, who has responsibility? Who is it? 426 00:44:27,580 --> 00:44:32,200 Who should be making sure linking that young person back into the services locally? 427 00:44:32,570 --> 00:44:37,330 And do they then have to go to the GP to go through the whole system of referral all over again, 428 00:44:37,330 --> 00:44:45,160 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. 429 00:44:45,460 --> 00:44:53,740 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. 430 00:44:53,950 --> 00:44:58,120 And you're talking about a young person who's coming out of prison who's already very vulnerable. 431 00:44:58,360 --> 00:45:01,360 You're talking about a very serious situation that you're setting up. 432 00:45:02,850 --> 00:45:06,180 Was this is this really familiar to you? Is it? Yeah. 433 00:45:07,300 --> 00:45:13,800 So in last March after work by Norman LAMB, 434 00:45:14,280 --> 00:45:22,139 who was then K minister and set up the taskforce for John People's Mental Health and the report 435 00:45:22,140 --> 00:45:30,900 that came out of it was to remind which had 49 proposals and there was I co-chaired the work, 436 00:45:30,900 --> 00:45:38,220 the task group on vulnerable young people. And one of these groups, of course, is young offenders. 437 00:45:39,720 --> 00:45:46,170 One of the things that we had big debates in this task group about vulnerability, 438 00:45:46,770 --> 00:45:52,350 because everyone was chipping in that particular vulnerable group that they wanted to to fight for. 439 00:45:53,370 --> 00:45:55,290 And hang on a minute. 440 00:45:55,650 --> 00:46:01,890 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. 441 00:46:02,220 --> 00:46:10,920 What is it? Was the common denominator here. What's underneath that all of these young people had are experiencing that we could actually 442 00:46:10,920 --> 00:46:15,420 do something about because we can't do something about every every single particular group. 443 00:46:16,470 --> 00:46:23,220 And also, we are very good at splitting young people up into, you know, fragmenting them into different needs. 444 00:46:23,700 --> 00:46:31,799 And we're talking about a whole young person. What is it about their experiences of vulnerability that is impacting on their mental 445 00:46:31,800 --> 00:46:37,770 health that we can actually do something about and what we did come to agreement with? 446 00:46:38,010 --> 00:46:46,740 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. 447 00:46:46,770 --> 00:46:54,179 It could be a thing that happens bereavement is often kind of a of a key person 448 00:46:54,180 --> 00:47:00,000 can often be one of those things or it might be cumulative over a period of time, 449 00:47:00,270 --> 00:47:03,360 through an exposure, through childhood and adolescence. 450 00:47:04,760 --> 00:47:09,350 This is quite contentious, this idea. And some people really pooh poohed it. 451 00:47:09,650 --> 00:47:13,700 And we said we're not talking about trauma as in necessarily PTSD. 452 00:47:13,970 --> 00:47:19,910 We're talking about trauma is having an impact at absolute concrete impact on that person, 453 00:47:19,910 --> 00:47:29,060 that child's development and their neurological and emotional development, so much broader sense and terminology. 454 00:47:29,750 --> 00:47:36,560 The traumatic impact of violence, abuse loss is not always taken into account nor reflected in the case management or therapy. 455 00:47:37,280 --> 00:47:43,700 So as an example here is that serious behaviour issues being referred for anger management rather than therapy for trauma and loss. 456 00:47:44,390 --> 00:47:52,010 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, 457 00:47:52,010 --> 00:48:02,060 if you like, who they are, have one of the highest incidences of mental health problems, yet they don't get access to services. 458 00:48:02,300 --> 00:48:05,780 And it was like when we were going, Well, why is this? What's going on here? 459 00:48:07,160 --> 00:48:13,580 And where we got to is that what those young people are presenting to? 460 00:48:13,580 --> 00:48:20,750 CAMHS is not a classic mental health disorder, so they can't be put into a clear pathway for care. 461 00:48:21,530 --> 00:48:28,129 What they're coming is with a complexity of issues and come this is coming from their 462 00:48:28,130 --> 00:48:35,690 experiences and just through their experience of of family breakdown and loss can be enough. 463 00:48:36,200 --> 00:48:42,350 But because that isn't understood in that way, they are being looked at more through a more medical lens. 464 00:48:42,620 --> 00:48:46,340 Those that's being lost and they're being seen as only there's nothing we can do for you. 465 00:48:46,610 --> 00:48:55,900 But actually there's lots that could be done. It just needs a different type of questioning and finding out and discovery and because 466 00:48:55,930 --> 00:49:01,640 actually if we can get in there early before the mental health disorders do develop, 467 00:49:01,940 --> 00:49:10,070 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. 468 00:49:11,780 --> 00:49:17,360 So this, I think, is a really important part where where we're at in terms of cans. 469 00:49:17,990 --> 00:49:26,600 And what's interesting is that the Home Office in the their response to Harris and in response to future mines have 470 00:49:26,600 --> 00:49:33,860 also endorsed this and also endorsed the point about asking these questions again around gangs in particular. 471 00:49:35,420 --> 00:49:41,390 And the other part I think that we should want to really focus on is around sharing information, 472 00:49:41,660 --> 00:49:46,850 because this is so often such an enormous block in our in our care for young people, 473 00:49:46,850 --> 00:49:53,080 for everybody, but in particular around young people and mental health and the Caldicott Review. 474 00:49:53,210 --> 00:50:01,250 Number two has absolutely focussed on this and that we must review and change our paranoia around 475 00:50:01,250 --> 00:50:08,450 sharing information and in the medical profession and our whole approach to data protection, 476 00:50:08,780 --> 00:50:11,520 it can be, can be, can be different. 477 00:50:11,540 --> 00:50:19,520 We all know that there is a paranoia around this rather than a healthy use of respecting people's confidentiality when, 478 00:50:19,760 --> 00:50:25,970 when wanted and when, when necessary, and that it is important to share information. 479 00:50:27,290 --> 00:50:34,370 Of course, respecting safeguards, of course respecting confidentiality appropriately, but doing that appropriately. 480 00:50:34,610 --> 00:50:44,360 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, 481 00:50:44,360 --> 00:50:50,900 all these aspects really, really build up to actually creating a worse situation and more offending. 482 00:50:52,370 --> 00:50:57,049 We've talked about some of these recommendations that I will take out to have time for discussion. 483 00:50:57,050 --> 00:51:05,300 So and this is what we came through, came out with in from our same old report around. 484 00:51:05,300 --> 00:51:09,890 That is some good policy. There's some good policy and good strategy that's been well implemented. 485 00:51:10,430 --> 00:51:17,059 Training we know about talked about there is something about the senior clinicians role where lots of people 486 00:51:17,060 --> 00:51:23,299 are very unconfident and we have got some really excellent clinicians and what can we not bridge this better? 487 00:51:23,300 --> 00:51:34,160 Can I not be providing advice and leadership around around care management and building confidence and skills within the more generic workforce? 488 00:51:35,210 --> 00:51:37,970 Can we not have somebody who actually does hold the ring, please? 489 00:51:38,480 --> 00:51:45,560 Can we not also make sure our commissioning works much better so that we are working across departments locally? 490 00:51:45,950 --> 00:51:49,910 And can we not do something about access to services and information? 491 00:51:50,180 --> 00:51:57,530 And we within talking about a single point of access, what's really exciting is that in future in mind. 492 00:51:59,110 --> 00:52:06,040 Of the recommendations going through. A lot of these actually have been picked up not because of us, but because everybody. 493 00:52:06,050 --> 00:52:12,250 It's common sense. And this is actually the fusion mine has a massive workforce, a task group. 494 00:52:12,580 --> 00:52:17,080 I think there was about 40 people in it. It wasn't it wasn't a no, a small select group. 495 00:52:17,980 --> 00:52:25,020 And there was real there was a real consensus about what we need to do, which is very exciting. 496 00:52:25,300 --> 00:52:28,870 And it's the first time I've experienced it in, in this field. 497 00:52:29,890 --> 00:52:33,850 And and there were some specific elements as well around young offenders. 498 00:52:33,850 --> 00:52:41,230 So the transition times was really recognised as being we have really got to do something about this integrated working 499 00:52:41,440 --> 00:52:49,440 with and about between mental health services and youth justice assessments really needs to tie up much more strongly. 500 00:52:50,080 --> 00:52:56,350 And I was talking to the magistrates last year and they were also saying what we do, 501 00:52:56,350 --> 00:53:00,220 we're having so many young people coming in with very clear mental health problems, 502 00:53:00,520 --> 00:53:05,649 but if we do a community order, then actually there aren't the services there to to deliver them. 503 00:53:05,650 --> 00:53:09,879 So then what happens actually may be going having some time in prison is will be a 504 00:53:09,880 --> 00:53:13,510 much safer option than just leaving them back out in the community with nothing. 505 00:53:13,990 --> 00:53:20,680 So that we've actually got to tie this up much better designated lead professional to act coordinate the care and 506 00:53:20,680 --> 00:53:26,770 inter-agency working around a young person in the youth justice system which could be the carrot that is now talked about. 507 00:53:26,980 --> 00:53:30,040 And these have all been supported in the government response. 508 00:53:30,730 --> 00:53:33,370 These these have all been supported, which is great. 509 00:53:33,790 --> 00:53:40,240 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 510 00:53:40,540 --> 00:53:48,790 as being an efficient way of of speeding up access and actually helping young people get the help they need much more quickly. 511 00:53:49,720 --> 00:53:57,820 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 512 00:53:57,820 --> 00:54:05,620 role of the senior clinician and how they can be somebody locally who others can turn to for some advice and help and like, 513 00:54:05,860 --> 00:54:09,490 should this person be referred to cans? What should we be doing here? 514 00:54:09,730 --> 00:54:15,400 That there is huge amounts of expertise sitting in some clinics which is not accessible to others, 515 00:54:15,670 --> 00:54:20,080 and we need to open that up and make it make make those people much more available. 516 00:54:20,380 --> 00:54:28,050 And there are good models of practice where this is happening. So it's not that it's impossible more accessible in engaging settings. 517 00:54:28,060 --> 00:54:34,180 Again from our work with failed and what we gain we know is that young people want to 518 00:54:34,180 --> 00:54:39,430 make it a bit intimidating and they find GP surgeries also can be quite intimidating. 519 00:54:39,760 --> 00:54:45,880 Let us put services where that, where that, where young people will go and also where they feel comfortable. 520 00:54:46,210 --> 00:54:51,520 And I think the Youth Information Advice Centres is a really good role model for these 521 00:54:52,180 --> 00:54:58,780 which are supported by youth access to the there are youth centres if you like, 522 00:54:58,780 --> 00:55:03,340 but that which provide housing support, benefits advice, employment advice, 523 00:55:03,610 --> 00:55:11,260 all sorts of things as well as often having a nurse on site, providing youth counsel, linking in to into cans. 524 00:55:11,560 --> 00:55:20,560 And these have been now supported much more through the local CCGs and that is really good news. 525 00:55:20,560 --> 00:55:24,940 And there again are some lots now or models across the country where they are 526 00:55:24,940 --> 00:55:29,770 developing and becoming much more closely tied into the local can service. 527 00:55:30,640 --> 00:55:35,830 And finally, about multidisciplinary multi-agency pathways, and this is the local transformation. 528 00:55:35,830 --> 00:55:38,170 This is embodied in the local transformation plans. 529 00:55:38,470 --> 00:55:45,100 So every local area must have their local plan about how they're going to address and meet the needs, 530 00:55:45,100 --> 00:55:47,140 the mental health needs of the local young people, 531 00:55:47,350 --> 00:55:55,840 and what the role is of schools, local authorities and youth justice as well as mental health services. 532 00:55:56,140 --> 00:56:03,850 So this and this is where the additional money. So the 1.25 billion that has been agreed and is starting to be spent, 533 00:56:04,120 --> 00:56:13,179 is it the local transformation plans is the passport and they also great news for the for us is that the local 534 00:56:13,180 --> 00:56:21,579 areas have to give a financial account of that funds back to NHS England each year so we can it's for us, 535 00:56:21,580 --> 00:56:28,479 it gives us an opportunity to monitor that this is actually being delivered because the trouble with that money is it kind of evaporates. 536 00:56:28,480 --> 00:56:36,100 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. 537 00:56:37,930 --> 00:56:41,860 So I've just talked about this other good. I wouldn't say that again. I've actually covered that one. 538 00:56:42,670 --> 00:56:50,440 And this one was about young people and about and the the example I gave around when a young 539 00:56:50,440 --> 00:56:56,169 people needing to have the consistency of contact and this is from a professional who said, 540 00:56:56,170 --> 00:57:00,110 you know, I remember more than one in personal. How long are you going to be here for? 541 00:57:00,680 --> 00:57:06,200 Young people do want to access support, but the trust is a massive, massive issue. 542 00:57:06,710 --> 00:57:13,220 And and if they open up and trust them when they get and they disappear, they become mistrusting and they don't. 543 00:57:13,220 --> 00:57:18,650 And they're not going to actually do any work. And for us as professionals, that's really quite difficult. 544 00:57:20,300 --> 00:57:26,510 So what we need to do is do things differently, re-orientate services and programmes, stop the problem. 545 00:57:26,510 --> 00:57:36,140 Developing early on is absolutely the key. Look at the individual in their context and look at the social and community factors. 546 00:57:36,860 --> 00:57:38,899 Tackle those other determinants. 547 00:57:38,900 --> 00:57:46,040 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? 548 00:57:46,040 --> 00:57:49,430 Not just is there a diagnosable mental health problem? 549 00:57:49,670 --> 00:57:53,600 And also, let's just keep being good about measuring out because let's look at the practice. 550 00:57:53,600 --> 00:57:58,280 What are the outcomes of this practice isn't working. If it's not working well, how do we change it? 551 00:57:58,340 --> 00:58:03,379 Let's do it better. And keeping it sanguine about early intervention, 552 00:58:03,380 --> 00:58:09,740 the trusted adults building resilience is think about all of those aspects about how this young person's going to cope in 553 00:58:09,740 --> 00:58:18,190 the in the in the future and increase the workforce depend and skills and there are some really good examples of practice. 554 00:58:18,190 --> 00:58:29,959 So Mac UK are you aware of Mac UK founded eight years ago of by a psychologist but that working with gangs 555 00:58:29,960 --> 00:58:36,770 on the streets going out great where young people are really interesting with a really exciting way about 556 00:58:36,770 --> 00:58:46,819 delivering services and and it's the and the staff you know working in in in risky ways well for the normal 557 00:58:46,820 --> 00:58:52,790 practice risky ways but actually been really successfully engaging with young people working in gangs. 558 00:58:52,790 --> 00:59:01,910 They focus on on gangs and young people on streets and beat the adolescent mental ization based in terms of treatment. 559 00:59:02,870 --> 00:59:04,159 I'm sorry, I have a real thing, 560 00:59:04,160 --> 00:59:11,270 but this is a fantastic program and it adolescent mental isolation based in terms of treatment was a young person going, 561 00:59:11,270 --> 00:59:15,319 I think when they're being told that's the kind of service they're getting and Anna from Frye's 562 00:59:15,320 --> 00:59:21,860 fantastic organisation and doing and this is a fantastic model but please can we just call these 563 00:59:21,860 --> 00:59:29,360 sensible things and I have it is my thing about the mystification that we are very keen on doing the 564 00:59:29,360 --> 00:59:34,340 I said this only is one of the examples of the youth information advice and counselling centres. 565 00:59:34,940 --> 00:59:40,120 Youth Access is the is the umbrella organisation due to the means and fantastic organisations. 566 00:59:40,580 --> 00:59:46,549 This the is one of them. GP's are now coming out and being allocated in co-located with those. 567 00:59:46,550 --> 00:59:52,879 It's, it's some really good stuff. And finally red threads that are King's youth violence projects and they are 568 00:59:52,880 --> 00:59:57,860 working in accident and emergency and so picking up when young because that's 569 00:59:57,860 --> 01:00:07,130 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. 570 01:00:07,790 --> 01:00:16,400 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. 571 01:00:16,610 --> 01:00:22,159 And what I'd like to focus on is the last point in this one we are picking up in the work from 572 01:00:22,160 --> 01:00:29,930 the Vulnerable Working Group and we're very interested around this trauma focussed care. 573 01:00:29,930 --> 01:00:33,680 We are being approached now suddenly everyone's interest in junior people's mental health, 574 01:00:33,680 --> 01:00:38,450 which is great, but it does mean that everyone's fighting from their particular corner. 575 01:00:38,780 --> 01:00:43,390 So here we go again, fragmenting young people and talking about, you know, 576 01:00:43,400 --> 01:00:49,520 looked after children, adopted children, young offenders, sexual abuse and poverty. 577 01:00:49,760 --> 01:00:52,870 And all of those things are right and important. We don't want it. 578 01:00:52,880 --> 01:00:59,120 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. 579 01:00:59,880 --> 01:01:12,440 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 580 01:01:12,440 --> 01:01:19,549 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, 581 01:01:19,550 --> 01:01:23,840 how do we bring these elements together and what it where are some good practices and 582 01:01:23,840 --> 01:01:28,490 what can we learn and what does this mean about doing it and actually on the ground? 583 01:01:29,120 --> 01:01:38,000 So we will be holding a bit of a launch of it and discussion in the spring, late spring with a summit in autumn. 584 01:01:38,770 --> 01:01:44,930 And it would be great if you were interested in that because again, unless we keep a focus on this, it will slip away. 585 01:01:45,140 --> 01:01:52,460 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. 586 01:01:52,670 --> 01:01:55,850 But we do need to we need to work holistically. 587 01:01:55,850 --> 01:01:59,860 We need to work together. We need to. Young people as whole people as well. 588 01:02:01,800 --> 01:02:05,090 We also run some training. If you if anybody's interested. 589 01:02:05,480 --> 01:02:08,810 And finally, this. That's that's us. Thank you all very much.