Meeting the health needs of young males in Kibble s Secure Care

1. Meeting the health needs of young males in Kibble�s Secure Care Denise Carroll

2. Admissions since opening June 2007 Overall admissions 92 65 young people in last year Average length of stay 106 days (1-364 days ) 35% discharged to Kibble�s main school 47% Discharged external

3. Reason for admission to secure care 12% place of safety warrant 3% unruly certificate 31% administration process 11% supervision requirements 25% remand convicted 5% remand charged 2% section 44 CPA 11% section 208 CPA

4. Services to meet their health needs GP Dental Sexual health Immunisations Chiropodist Audiometrician Optician CAMHs

5. Quality of life The WHO defines quality of life as people�s �perceptions of their positioning in life in the context of the culture and value system in which they live and in relation to their goals, expectations, standards and concerns� ( WHO QoL Group 1994).

6. Research within Kibble Differences across the sectors of care for looked after males (Day pupils, residential, intensive support, secure care and main stream schools). Quality of life (PedsQoL, PedsIC, SF 36) Anxiety (Multidimensional Anxiety Scale for Children) Depression (Birleston Depression Scale) Health assessments

7. Access to health services Health assessment within 72 hours 42% had diagnosed health conditions 20% asthma (1 young person had inhaler) Seen by GP within 7 days Registering with a GP when discharged from secure unit Emergency services RAH and NHS24

8. Vision and hearing checks Vision Now entitled to free eye test Within 48-72 hours 58% required vision checks Hearing Community audiometrician � within 1-3 weeks 12% (2 required hearing aids, 1 operation, 1 ears syringed, 1 referral to ENT)

9. Dental care NHS community dentist 95% of the young people required treatment 4 have required dentures for front teeth 1 all teeth removed 1 gingivitis requiring hospital treatment 4 required antibiotics for abscesses

10. Meeting health needs Immunisations 45% required immunisations Only arranged through school health Missed opportunity Healthy eating Weight increase on admission Exercise � linking with PE teacher

11. Sexual Health 60% took up offer of chlamydia screening 3 positive results No outreach/ domiciliary visits No access to male sexual health advisors

12. Lifestyle Smoking cessation 90% smokers None required NRT for more than a 4 days Prevention work against resuming smoking Binge drinking 57% problematic binge drinking Substance use 33% problematic drug use

13. Mental health Admission process risk screening Wellbeing screening within 24 hours Health assessment and risk screening 72 hours Assist trained staff CAMHs consultation

14. CAMHS 17% concerns regarding mental health 28% ADHD (co morbidity) 37% have history of self harm/suicidal ideation Case transfers Follow up of discharged cases Diagnosis

15. Developments in main school Health coordinators Ensuring appointment attendance Medication Health needs as part of Kibble Journey Working toward health promoting establishments

16. Conclusion It is going the extra mile Willingness of professional to work with the difficulties of the situations Benchmark good practice To have good practice statutory Contact details denise.carroll@kibble.org