Title: Recovery from COVID-19 within the Children and Young Peoples Secure Estate (CYPSE): A mixed-methods study of wellbeing
Funder: Department of Health and Social Care

Abstract: Background: Children entering prison have increasingly complex mental health needs and the rates of self-harm, violence, and the use of restrictive physical interventions (restraint) have increased recently. In response to COVID-19, the daily programmes within the Children and Young Peoples Secure Estate (CYPSE) have been severely restricted, with most children being locked in their rooms for prolonged periods, with no face-to-face visits with families, and limited access to education or interventions. Of concern is that when the roadmap for easing COVID-19 restrictions in prison was published, the CYPSE featured very little. The needs of children in CYPSE are different to those of adults in the prison estate, and therefore separate plans are required in recognition of their vulnerability and complex needs. We must capture what is happening, both positive and negative within the CYPSE to inform policy decisions on recovery, but also to mitigate longer-term impacts on children s wellbeing. Aims and Objectives: To understand the impact of COVID-19 on the wellbeing of children within the CYPSE to identify ways of enhancing the environment and informing policy for service provision. Objectives to: assess the impact of COVID-19 on rates of self-harm, violence, restrictive physical interventions and other restrictive practice e.g., use of single separation; look at the variance in response to COVID-19; understand the impact of COVID-19 on the wellbeing of children; establish casual pathways associated with positive and/or negative outcomes; co-produce with stakeholders key policy actions regarding recovery from COVID-19 and planning for further lockdowns due to major incident/pandemic. Methods: A mixed-methods project, over three phases. In phase one we will obtain centrally held anonymised, population-based data on the rates of self-harm, violence, and restrictive physical interventions, for all sites within the CYPSE. For a smaller number of sites, we will collect additional anonymised data to understand what might contribute to the high or low rates of self-harm, violence, and restrictive practice interventions. In phase two, we will conduct semi-structured interviews with children, family members and staff to understand their experiences and perception of the impact of COVID. In phase three, we will conduct a Qualitative Comparative Analysis using data from the previous phases to create a number of explanations for the our outcomes e.g., self-harm. These will be presented at a stakeholder event and a nominal groups approach used to develop a consensus to produce policy recommendations. Timelines for delivery: The project will run for 12 months, phase one between months 3-6, phase two between months 1-5 and phase three between months 9-11. We will produce bi-monthly updates for relevant policy stakeholders. Anticipated Impact and Dissemination: Key policy recommendations are likely to be identifying the contributing factors to variance in rates and identifying the additional impact of COVID-19 e.g., disproportionate effect on certain groups (BAME). Policy recommendations will also support the CYPSE s recovery from COVID-19 and help plan for future major incidents/pandemics. We will disseminate findings in open access peer-reviewed journals and our PPI groups will co-produce dissemination materials for children and the CYPSE.

Lay abstract: Background: Living with Coronavirus has been hard for everyone. Children in prison have faced a lot of limits on what they can do. They may have been locked in their bedrooms, not been able to see or talk to their families and not been able to go to school. Children in prison have lots of mental health problems, more than those in the community. They often hurt themselves, other children, or staff working in the prison. Coronavirus and how the prisons have had to deal with it, might have changed how often children hurt themselves or others. Aim: We would like to see what Coronavirus has done to how children in prison feel and how often they have hurt themselves or others. We want to do this to help make the prisons better and safer places for children. Design and methods: This project is split into three parts and they all link together. In part 1 we will get numbers that are already collected about how often young people hurt themselves and hurt others in the different prisons. We will look at these numbers before and during Coronavirus to see if there are changes. In part 2 we want to talk to staff who work at each prison to find out how the prison dealt with the virus and what changes they made to how the children were looked after. We want to do this to help see if any of the changes increased or decreased the harms in part 1. In part 2 we also want to talk to some children, their families, and staff in more detail about their experiences during Coronavirus. In part 3, we will put the information from part 1 and 2 together. We will then show this to children in prison, their families, staff who work in the prisons and the people in charge of the prisons to help us make a list of changes. These changes might be about making the prison safer, or a better place for children, or what the prisons might do differently during Coronavirus or if we have a new virus in the future. Patient and public involvement: Children at a prison called Wetherby have helped write this Plain English Summary. They have made us think about what questions we should ask. They will help us write information about the project, work with us to make the list of changes and with telling other people what we find. The children in Barton Moss, another prison, will help too. Dissemination: At the end we will share what we find with the help of the children and staff. This will be by writing reports and telling people at meetings.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;7.1 INDIVIDUAL CARE NEEDS
Health categories: MENTAL HEALTH