Finding out more about children in England detained in the secure estate
At any given time, there are well over a thousand children in England detained in secure care under the Children’s Act, the Mental Health Act or in the youth justice system. These are some of the most vulnerable young people in the country. Around a third of them are being detained for their own welfare or safety. They are children who have reached a desperate moment in their lives, a point of last resort, where the state has to intervene to keep them or others safe from harm.
All too often, we know little about their experiences. By definition, they are locked away for weeks, months and even years, almost invisible from society.
Occasionally though, what is happening behind those locked doors becomes public. Last summer, the heart-breaking case of ‘Child X’ made national news. Child X was in youth custody for a criminal offence. On her release, for her own safety, she required constant observation. Yet the mental health system was unable to provide her with the secure place she needed, with NHS England telling the court one might not be available for several months. The then President of the Family Division, Sir James Munby, castigated NHS England for a ‘disgraceful and utterly shaming lack of proper provision’ for Child X and others like her.
At the Office of the Children’s Commissioner, we know ourselves the strain the children’s secure mental health care system is unde from calls we have received to our ‘Help at Hand’ helpline. Amongst many calls we received last year, was one from a professional on behalf of a young person who was suffering a very severe mental health crisis but had been left for hours waiting in an ambulance outside A&E. This child needed to be sectioned for their own protection, but there was nowhere immediately for them to go and, after having been refused a bed for several weeks, they then spent several days in A&E. It was another illustration that there are gaps in the system.
It is very welcome then that NHS England has published three reports today that look across the entire secure estate including children sectioned under the Mental Health Act in low-secure, medium-secure, high dependency and psychiatric units. The experiences of these few hundred children are often particularly difficult to measure.
The research was commissioned by NHS England to provide more evidence about the present and future care needs of children in secure settings and should be a signpost for improving the secure estate system. They are a useful look at the size and makeup of the estate and the pathways into it for the children who are detained there.
First hand experiences of professionals and of the parents of children held in the secure estate are included and there is a sense from the comments made by some parents that this is a system that too often acts as little more than a ‘holding pen’, and that there is a lack of focus on positive future outcomes. It is noticeable as well that almost a half of young people in the secure estate have already had a previous secure placement and that two thirds have previously been placed away from home in a secure or non-secure setting.
It also appears that once a young person has been picked up by one part of the system (mental health, welfare or youth justice), they remain within that system. This is worrying because the part of the system which a child first has contact with often appears random. As one parent puts it:
“It seems fairly arbitrary if they end up in a secure children’s home or hospital or youth offending institute. In some secure children’s homes, the children seem to have incredibly significant mental health problems, but they aren’t in hospitals.”
In other words, it appears that some children are being detained in the wrong type of provision, and then staying there – despite it not meeting their needs.
Nobody will be surprised to learn either that many children in the secure estate suffer from mental health problems. The survey reveals 57% of young people in secure settings have at least one mental health or neurodevelopmental need or diagnosis. It begs the question as to how many of these children could have been kept out of youth custody if proper mental health care had been provided earlier in their lives.
I am particularly interested in the sections looking at those children in mental health secure accommodation because of the difficulties my office has had finding up-to-date and accurate data. For example, our own research – looking at data which NHS England itself recognises is incomplete, poorly reported by mental health units and inadequately collated – points towards there being significant numbers of children referred under the Mental Health Act to a low or medium-secure unit who are not then admitted. I want to find out more about who these children are, and why they are being refused admission. We are awaiting better data from the NHS to do so.
Today’s NHS reports provide an important insight into a secure estate that detains hundreds of children, for a variety of reasons. However, already much of the information in them is out of date. It is vital that NHS England collects much more real time data to improve transparency, so that we can shine a light on the experiences of these children and push for a system that gives them all the support, care and treatment they need to build better adult lives.