Dr P J Kennedy BSc(Hons), MSc, D.Clin.Psych, C. Psychol, CSci, AFBPsS

1. Dr P J Kennedy BSc(Hons), MSc, D.Clin.Psych, C. Psychol, CSci, AFBPsS Consultant in Clinical & Forensic Psychology Northern Forensic Mental Health Service for Young People Tel: 00 44 (0)191 2232226 Fax: 00 44 (0)191 2232228 jack.kennedy@ntw.nhs.uk PJK/AFN/03.10.08

2. The Future of Adolescent Sex Offender Services in Forensic CAMHS The Consistent and Effective Management of ASO’s in and Returning to our Communities PJK/AFN/03.10.08

3. A Few Political Issues!!! • Every Child Matters • Children Bill • Safeguarding Children • Youth Matters • NSF • Foundation Trusts • Children's Trusts • Youth Offending Teams • Local Policy • Youth Justice Crime Action Plan 2008 • Post event enquiries / reviews Thrust - Inclusivity, Integrated multi agency / partnership commissioning and services, sharing resources, information sharing, access to services, governance issues, promoting resilience and reducing risk Problem – Notwithstanding good will and intention sometimes these can confuse, be a stressor, bureaucratic blanket, barriers to change to service / agency priorities – humans are protective of their organisational identities ‘require tolerance and navigation’ – organisations slow to change These children are our future – we need efficient, integrated and autonomous thinking policy makers that can ‘do’ and capacity to implement the ‘do’ PJK/AFN/03.10.08

4. The following tables indicate the total recorded number, and rate per 100,000 population for the three categories of violent crime, as according to the England and Wales' definition.Ref: http://www.justice.govt.nz/pubs/reports/2002/intl-comparisons-crime/section-7.html PJK/AFN/03.10.08

5. Recordable Levels (not conviction data) of Sexual Offences in England & Wales (Home Office) Official Statistics • In 1997, the recorded level of sexual offences in England and Wales was 33,200 • 6400 individuals were subsequently cautioned or found guilty of sexual offences: approximately 23% (c.1500) were between 10 and 21 years of age. • Young people accounted for 47% of all cautions and 13.5 % of all findings of guilt from the court • CYP responsible for 1/3rd all sex offences against children (some est. higher) • Year end March 2000, the recorded level of sexual offences in England and Wales was 37, 792 • Up to March 2007, the recorded level of sexual offences in England and Wales was 57,542 • WHY> - New Sex Offence legislation / offence classifications; willingness to report, better detection, improved recording procedures, better responses etc PJK/AFN/03.10.08

6. Who are we talking about? • Those convicted and serving community sentences • Those returning to the community from custody / secure environs • Those admitting offence • Those denying offence • Non criminalised cases PJK/AFN/03.10.08

7. Why is it important? • To promote public safety. • Society needs to hold individuals responsible for their offending. • To present these adolescents with an opportunity to receive specialist interventions / support to promote their mental health / emotional resilience and reduce risk (adaptive functioning into adulthood) • It follows then Intervention serves both the needs of the adolescent and community and reinforces the goals of public safety and accountability – • To this end all convicted ASO’s living in the community should be engaged in SO specific treatments to include aftercare from custody, educational and vocational guidance as required and anything else critical to their overall rehab. PJK/AFN/03.10.08

8. The ASO Population – a heterogeneous group • Individual variation in nature and severity (risk) of sexual behaviour, disorders, disturbance etc. • Exist within a variety of systems: peers, school, work, culture, familial influences. • At various stages developmentally e.g.chronologically, physically, emotionally, sexually, cognitively, socially. • Often low frequency behaviours. • Diagnosis of mental health difficulties often less clear. • Deviant arousal less common, fewer paraphilias. • Less evidence of compulsivity cycles or chronic relapsing patterns. • Motivationally different, fewer predatory patterns, more opportunistic. • Very different from adult population and present windows of opportunity for change. The individual and developmental differences then merit the availability of a continuum of intervention protocols (F-CAMHS) and series of graded sanctions (Court, custody, community etc) dependent upon differential assessed risk / need. PJK/AFN/03.10.08

9. Developmentally Sensitive SO Specific Interventions • Collaborative / motivational not adversarial relationship • Enhancing self esteem • Improving mood / coping skills • Relationship skills – intimacy, attachment, loneliness, jealousy etc • Understanding of the problem, origin, maintenance etc • Healthy sexual functioning • Relapse prevention / self control techniques • Facilitation of pro social values and competencies • Enhancement of empathy for victim • Pro social future planning PJK/AFN/03.10.08

10. Role of Forensic CAMHS • To improve mental health and emotional well being of the population • Promote access to service (specifically CYP with a Learning Disability) • Responsive and needs led assessment and intervention protocols • Early intervention – sharing / disseminating specialist knowledge and working across multi agencies / NHS tiers – access to targeted services faster, early identification and continuity of care • Flexibility in referral criteria – rigidity not the future! • Transitions / pathways from custody / secure environs • Supporting families • Specific offence reduction interventions • Promote resilience / reduce risk • Guiding care co-ordination and case / risk management – Any convicted sex offender referred to YOT F CAMHS liaison with appraisal of service need – not unusual to get a referral 3 weeks to the end of an order • Provision of evidence / best practice based criminogenic interventions • To be pivotal in the care planning / aware of CYP from locality detained and to be involved if possible in the custodial care planning and certainly discharge planning and community transition. PJK/AFN/03.10.08

11. Commissioning and service provision challenges • Agencies to be amenable to working together / across organisational boundaries – think shared aim not service privilege • Look towards co-ordinated regional SO service provision • Hybrid organisations – shared monies / value for money • Committed, knowledgeable, skilled and stable workforce retention • To ensure as far as possible a seamless and comprehensive service provision to this population • Inclusive services - marginalised groups or CYP with LD • To promote early intervention protocols • Specialist service commissioners to include forensic population in the forefront of its thinking • The development of integrated F-CAMHS across CYP domains (social services, health, youth justice, custody, education – integrated care pathways etc) • The development and use of robust service outcome measures and promotion of user involvement • Co-ordinating CYP services in planning strategy going forward • Reduction of stigma • To be client driven, effective and evidence / practice based PJK/AFN/03.10.08

12. Acknowledgments • Liam Marshall – Rockwood Psychological Services, Canada. • John Hunter – Department of Health Evaluation Services, University of Virginia, Virginia Department of Juvenile Justice. PJK/AFN/03.10.08

13. PJK/AFN/03.10.08

14. Principles Governing Intervention • Appropriate to level of considered risk – differential allocation of resources to low, medium & high risk • Needs led – Targeting established criminogenic need • Responsive to the needs of the individual – learning style, ability, culture, mood, attitude etc PJK/AFN/03.10.08

15. Transitions from Custody / Secure • Not everyone detained has access to SO specific interventions (availability; length of sentence etc) - Containment is often the only function served • F- CAMHS should be featuring as part of a young persons discharge evaluation / youth justice relapse plan. PJK/AFN/03.10.08