2. Objectives of the session
To give an overview of the services provided for girls
and women currently in the criminal justice system
To give some examples of the extreme consequences
of not providing intervention at an early stage
To give an overview of the factors associated with
girls and women in the criminal justice system
To introduce the Primrose Service based at HMP YOI
Low Newton part of the personality disorder initiative
To spark discussion around what more can be done
3. YOT TO HIGH SECURE
FORENSIC FACILITY
An overview of the girls and women in the criminal
justice system and what is currently provided
5. Youth Offender Team
Young Offender Institutions
Secure Children's Homes
Adolescent Psychiatric
Facilities
Forensic And Community
Treatment Services
[FACTS]
6. Factors Contributing to Criminality
Substance Misuse
Self Injury
Neurological Deficits (IQ, Literacy and Numeracy)
Diagnosable Mental Health Disorder
Bereavement and Loss
Victim of Crime
PTSD
LD
Peer and Family Relationships
Long Standing Physical Complaint
Homelessness or Experience of Being in Care
7. Factors Contributing to Criminality
Substance Misuse
Self Injury
Neurological Deficits (IQ, Literacy and Numeracy)
Diagnosable Mental Health Disorder
Bereavement and Loss
Victim of Crime
PTSD
LD
Peer and Family Relationships
Long Standing Physical Complaint
Homelessness or Experience of Being in Care
9. Difficulties with Secure Environments
“Although some units accepted young women
with these emerging difficulties, others felt less
able to support them particularly if they already
had one or two other young women on the unit
with similar presentations. Some interviewees felt
that many young women slipped between the
cracks of services failing to access the support
they needed at an early enough stage”
» Centre for Mental Health, 2010
10. Real Life Case
Victoria Agoglia
She ran away 21 times in two
months from her care home in
Rochdale.
She was raped and was
known by her carers to be
used for sex by older men in
exchange for cash, alcohol
and hard drugs.
She died of a drug overdose
11. Is the CJS Gender Sensitive?
Interventions and Treatments are more often than not
developed with men in mind for men as there are
much higher numbers of men in the CJS.
Corston Report highlighted the gender inequality in
the prison service.
Specialist services for girls and women are relatively
non-existent in both the community and secure
establishments.
12. Interventions
Skills which will increase their ability to function
effectively in the community (i.e. useful)
Offence Focussed
Trauma Focussed
Counselling
Skills Based
Emotion Regulation
Socialisation
15. Miss A
Defence counsel Iain Ross said Bishop had "spiralled
out of control" around the age of 16 after her parents
broke up and her mother began a relationship with a
man who was abusive and addicted to heroin
Defence counsel Paul Hester said on the night of the
offence, Hadfield had left her own birthday celebration
because of an argument involving her partner. "She
went in, in that emotional state, having had drink and
things got out of hand," he said.
17. Miss B
A psychiatric report carried out after the discovery of
the document said there was nothing to suggest she
was capable of such violence.
"The psychiatric report did not predict any likely
occurrence of this," said a spokesman for Barnet
Youth Offending Team.
"Once her supervision was completed, there was no
mechanism for stopping her re-offending."
Henry Blaxland QC, defending, said: "The court has
before it somebody who is, on the face of it,
emotionally damaged.
19. The Primrose Service
Prison PD Pathway
Opened its doors on 1st
September 2006
12 beds on F wing, HMP YOI Low Newton
For women who have a current offence against the
person, including arson and sexual offences.
Assessed as presenting as high risk of reoffending
Likely to have a severe form of personality disorder
A clinically justifiable link between the above
20. Why did Primrose come about?
A gender specific strategy was needed to focus on
women who present a high or very high risk of serious
harm to others.
Almost all offending behaviour programmes for violent
and sexual offending are delivered for men.
The prevalence of PD in women in prison is about 60-
70%
To increase the workforce knowledge and ability to
cope with such a challenging group of women.
In 2002 117 young women and 2490 young men under 18 in prison.
In 2012
77% of proven offences were committed by young people were aged over 15+ (105,730)
23% of proven offences committed by young people aged 10-14 years. (31,605)
The proportion of proven offences committed by females was 18 per cent in 2011/12; this proportion has fluctuated between 16 and 22 per cent for the last decade.
White ethnic committed 80% of proven crimes by young people in 2011/12.
The number of proven offences by young people has fallen 47 per cent between 2001/02 and 2011/12.
Distribution of secure environments for women- sparse. 14 Womens prisons
Wheatley et al (2004) conducted a study examining the characteristics of 80 adolescents referred for secure in-patient care. They note that the young people requiring such care present most commonly with psychotic, personality or post traumatic stress disorders. In addition, of the young people assessed for admission, 90% presented with a risk of aggression, 60% presented a suicide risk, 50% had been charged with one or more offence and 30% had at least one conviction. Most of these young people had historically been detained under the Children and Young People’s Act (1969), or the Mental Health Act (1983). Many young people in secure health care are seen as requiring detention and treatment in a secure environment due to the risk they pose to themselves. There are a wide range of psychiatric diagnoses, but co-morbidity (the existence of more than one diagnosis or difficulty) is common. A significant proportion of young people as young as 16 in the prison system present with mental health problems that go largely undiagnosed and untreated.
Nichol et al (2000) looked at one Strategic Health Authority (SHA) and found that 75% of young people living in all its residential facilities (penal, social services, special education and health agencies) had significant mental health needs, including some serious conditions like psychosis or suicidal ideation. They concluded that “the study revealed a picture that puts the many recent concerns about the risks and needs of looked after young people in a wider context. Huge needs were found in all the areas examined: in basic social adjustment, where the study revealed huge deficits on family adjustment and support, in mental health, where a high proportion of the young people had multiple emotional and behavioural problems, and in education, the majority of young people were severely behind in basic school subjects and had spent many years out of school. The picture of criminality in this study group was that overall, those in penal settings and in non-penal settings showed a comparable level of recidivism, but the rate of violence in the prison group was much higher. To a large extent, the needs of these young people were not being met”.
Background Research has revealed high levels of mental health needs in young offenders but many studies have been small, focusing on specific populations.
Aims To evaluate the mental health and psychosocial needs of a nationally representative sample of juvenile offenders in England and Wales, including female offenders and those from Black and minority ethnic groups.
Method A cross-sectional survey of 301 young offenders, 151 in custody and 150 in the community, was conducted in six geographically representative areas across England and Wales. Each young person was interviewed to obtain demographic information, mental health and social needs, and psychometric data.
Mental health needs of young offenders in custody and in the community 2003 BJ Psychiatry
Results Young offenders were found to have high levels of needs in a number of different areas including mental health (31%), education/work (36%) and social relationships (48%). Young offenders in the community had significantly more needs than those in secure care and needs were often unmet. One in five young offenders was also identified as having a learning disability (IQ<70).
Conclusions Needs for young offenders were high but often unmet. This emphasises the importance of structured needs assessment within custody and community settings in conjunction with a care programme approach that improves continuity of care.
Sheffield Forensic CAMHS are unique in that they are situated within the YOT and receive 60% of refferals from the YOT.
Withecombe (2008) also explores clinical diagnoses of psychopathy, sexual offending, and substance misuse, but acknowledges that “in practice it is common for young people presenting to adolescent forensic services to be adversely affected by multiple contributory factors [including] trauma and abuse, aggression, substance misuse, poor empathy and socialisation, mental illness, learning and neurological problems, inattention and impulsivity, antisocial, delinquent and conduct disordered behaviour”.
Harrington and Bailey (2006) state that “Asset was found to underestimate the rates of mental health problems. Of the 600 forms evaluated, only 15% of young offenders were identified with mental health problems. This is much lower than the 31% of young people identified in (their) national study”.
High rates of women in prison who state they have mental health difficulties prior to entering prison.
McKeown Female DV Perp and Victim
Relational Theory
Because of these factors girls and women throughout all levels of the CJS are known to a lot of staff as ‘difficult’ and due to this there are less staff willing to take time to understand the isues which a girl or women may be presenting with or just be banded with the term attention seeker or time waster.
Forensic Mental Health Services Factsheet due for update October 2013. Helpful
Asset analysis indicates that young female offenders in England and Wales can be
placed into three overall groups, those who commit:
offences of theft and handling stolen goods
offences of violence
‘other’ offences.
The girls in each group present with a different range of needs and criminogenic
factors.
Comprehensive and standard assessment of need in young offenders in custody and in the community, in six different geographical areas in England and Wales. A total of 301 interviewed, 151 in secure facilities and 150 in the community.
A third had a mental health need. Almost 20% had problems with depression, 10% reported self harm and 5% psychotic symptoms.
(Depression and Anxiety). Psychosis 9% for female offenders. Atleast 95% had atleast one disorder and about 80% having more than one.
Anti-social PD 80% and Paranoid PD 25%
29% drug or alcohol abuse; in breakdown 60% used drugs and 25% drank heavily, 36% educational/ work needs. Almost half had significant needs relating to peer and family relationships.
One quarter had learning difficulties, a further third landed on the borderline IQ range (70-80). Lack of educational opportunities.
Young offenders in the community had significantly more needs than those in secure settings in terms of education and risky behaviour and social relationships.
Working with a very deprived population in terms of positive factors in their lives. Of which most of their needs are overlooked by interventions and environemnts used to help and support young girls.
Pathway of women in the CJS- When think about women more often than not they are diagnosed with a personality disorder.
Through discussion with staff at these units a general lack of appropriate provision for young women in general and especially those women with emerging borderline personality disorders.
Out of the roughly 60,000 young people in the care system, just 1,800 girls are in children’s homes.
Such a small number should be easy, you would think, to look after. But in the past five years, the homes have reported an astonishing 631 suspected cases of girls involved in prostitution while in their care — including 187 in the past ten months.
Some practitioners in community or custodial settings cited examples of young people who they had seen get ‘stuck’ in forensic medium secure mental health settings for many years. CASE STUDIES
There is so many examples of this within the female forensic population currently residing in secure psychiatric facilities throughout the country.
Prevention
Women only make up 5% of the adult prison population.
Days in which women and men shared secure forensic psychiatric wards are over however the treatments often continue to be underpinned by men and their specific criminogenic needs and factors.
Offences of violence by girls appear to have a common pattern – there is usually a relationship with the victim and it is most often perceived that the victim did something to ‘deserve’ the violence. These findings are congruent with other research (Batchelor, 2005; Pettersson, 2005; Ness, 2004; Phillips, 2003). In
addition, the recent use of alcohol is often linked to the offence/offending pattern.
A young female offender in England and Wales is most commonly White, most likely to receive their first Reprimand aged 13–15 years old and their first
conviction aged 15–16 years old. In general, convicted girls have no previous convictions, and show a range of risk factors. The offence most frequently committed by girls in England and Wales is theft or handling stolen goods, and this is congruent with the traditional pattern for female offenders.
However, the offence committed by most girls in the youth justice system in England and Wales is an offence of violence against the person; this appears to be a new pattern that should be monitored.
There does not appear to be a rise in the number of girls committing offences, but more girls are entering the youth justice system. Girls are also being convicted at a younger age. These findings are congruent with concerns elsewhere, for example, in the USA (Steffensmeier et al, 2005). This pattern should be monitored as most offences committed by girls continue to be low-level.
Most offending continues to be perpetrated by boys and interventions have been designed to meet their needs. The indications are that risk and protective factors are broadly similar for boys and girls, but that those for adult female offenders are different
There is still little evidence about ‘what works’ with girls in the youth justice system. Nonetheless, qualitative data indicates that girls and boys prefer
interventions which are stylistically different; girls prefer the building of one-to-one relationships and a female-only environment, whereas boys prefer more structure and rules. However, work directed at criminogenic needs appears to be of most value with both boys and girls, and this is congruent with research into effective interventions (Harper and Chitty, 2005).
If gender-mainstreaming is to be taken seriously then staff developing and delivering gender-specific programmes require considerably more support than they currently receive. Much good work goes unshared or is unsustainable because it is reliant on the goodwill and energy of staff who deliver it in addition to their other tasks. Sustainability is a key issue in work with girls and for gender-specific programmes.
