Young People in Secure Settings- Feedback

1. Young People in Secure Settings- Feedback Dr Inyang Takon Consultant Paediatrician QEII Hospital, Welwyn Garden City, Herts. www.georgestillforum.co.uk

2. Background • Over 2200 young people held in secure setting in the UK at any time • Young people have significantly greater unmet , physical, mental and emotional health needs Moving services at a national level

3. Evidence of unmet needs • High level of substance abuse- 83% regular smokers, >60% drank alcohol daily or weekly, 66% reported binge drinking once a week, >80% had used illegal drug once a month. • 10% of males and 5% of females diagnosed with ADHD whilst in secure settings • High prevalence of conduct disorders, anxiety and depression, self harm, psychosis

4. Evidence of unmet needs • Unmet physical health concerns- longstanding musculoskeletal, dental , skin complaints, respiratory illnesses • Ryan M and Tunnard J. Healthy Children, Safer Communities programme, 2012

5. The Project • Led by RCPCH, GSF involved in care planning expert group. • Focus group sessions with young people 12-17 from across UK and across various secure settings • Secure children’s home • Secure training centres • Young offender’s institution

6. The Project • Joint working with RCPCH, RCCGP • Royal College of Nursing • Royal College of Psychiatrists • Faculty of Forensic and Legal Medicine • Faculty of Public Health

7. View’s of young people • Lack of information about available healthcare. • Concerns about confidentiality • Problems with management of medication.

8. Entry and Assessment • Young people want information about health • Identification of key health concerns on entry into secure setting • Information sharing and coordination of care between agencies. • Clear pathway for managing referrals when health need is indicated • YP receives full assessment including mental health assessment ( within 3 days)

9. Entry and Assessment • Annual health reviews • Mental health review within 3 months • Neurodisability assessment should include assessment for ADHD, ASD, LD • Check for features of self harm

10. Care Planning • YP want to be involved in planning their care • Lead healthcare professional • Healthcare plan developed along with young person

11. Universal Health Services • YP should know how to access health services whilst in secure setting • Access to 24 hour emergency medical and dental services • Comprehensive health promotion strategy in place

12. Physical Health Care and Intervention • Access to evidence based physical intervention • Access to advice on sexual health

13. Mental Health and Neurodisabilities • Comprehensive mental health and neurodisability strategy • Timely access to CAMHS and Psychological input • Lead mental healthcare professional • Pharmacological treatment delivered according to guidelines.

14. Substance Misuse Care and Interventions • YP should have access to substance abuse strategies. • Named lead nurse for substance misuse oversees treatment

15. Transfer and Continuity of Care • Continuity of care should be maintained when YP moves to another service • Health care records-should be sent to the GP and manager in new secure setting

16. Healthcare environment and facilities • Healthcare should be delivered in safe and fit for purpose places • Privacy and confidentiality of young person should be maintained

17. Planning and Monitoring • Service Planning/Commissioning of services for YP in secure setting. • Staffing levels

18. Multiagency working • YP is informed about how their information is being shared • Written safeguarding policy

19. Staffing and Training • Healthcare practitioners should access training in safeguarding policies, self harm and child and adolescent development .