Prisons: Young People — House of Lords, 2015-10-29
Topic: Health
Keith Bradley (Labour, Centre-left): My Lords, at the start I declare my health and related interests—in particular, that I am a trustee of the Prison Reform Trust and the Centre for Mental Health I add my congratulations to my noble friend Lord Harris on securing this very important debate about his fine report on 18 to 24 year-olds who have died in tragic circumstances in prison. I commend his crucial recommendations, which must, I believe, be implemented In this short debate, I shall, not surprisingly, concentrate on the development of liaison and diversion services related to the recommendations of my own report—I am grateful for the kind words of the noble Lord, Lord Carlile, about that—and other reports that are complementary to it. I believe that my recommendations dovetail very clearly with the findings of my noble friend Lord Harris. Taken together, they can make a real contribution to tackling this appalling situation Crucially, as noble Lords have already stated, the need for early identification and assessment of mental health, learning disabilities and difficulties, and other complex needs, and where appropriate to divert those people out of or away from the criminal justice system, is absolutely essential. They need to be passported at that point to appropriate specialist services, whether that be in-patient services or community-based services The report of my noble friend Lord Harris looks specifically at 18 to 24 year-olds. But we must ask ourselves what could be done earlier with children to undertake crucial identification and assessment before they find themselves in the criminal justice system, or at least hitting against it. An example of this is what we do in our schools. I am not suggesting that everyone who works in a school should be a specialist in mental health problems or learning disabilities. However, what basic awareness training could be implemented for our teachers, canteen staff and caretakers so that they are aware of the issues that they see in children and can help to passport them quickly into other appropriate services? We should not have to wait—if I can caricature it as such—for a child to go from the front of the class to the back of the class, out of the classroom, out of the school, into the park and into trouble. Why can we not identify that problem earlier in the system so that they perhaps do not end up in the youth justice system As the noble Lord, Lord Carlile, rightly pointed out, excellent work has been undertaken by the Youth Justice Board and the youth justice services to reduce the number of children in custody. Even so, look at some basic facts from the youth justice system: young people with a mental health condition are three times more likely to be in the youth justice system; they are six times more likely than other young people to have a diagnosable conduct disorder; they are more likely to have a moderate learning disability; and they are more likely to have a speech and communication need or traumatic brain injury. Data from the previous youth point of arrest screening indicate that children on a current care order were significantly overrepresented in the youth justice system As we have a national rollout of liaison and diversion services, we have to look at the essential specific needs of children and young adults in that programme. It is clear that the success of such schemes is highly dependent on the existence of effective diversionary infrastructure of services. Although the extra investment over the next five years in children and adolescent mental health services is welcome, there is still a huge shortfall of services across the country, whether that be in-patient beds or services in the community. There is a shortage of therapy programmes and timely referral to them, and there is poor provision for learning disability and speech and language services across the country. With limited resources, thresholds for access to such services are raised and, therefore, become a barrier to effective diversion and liaison schemes As we heard from noble Lords, such schemes must take into account maturity. When children move from children’s services to adult services, the age barrier can be a real deterrent to effective continuity of care. The Centre for Mental Health set up the Bradley Commission and we looked at the issue of maturity. Our first recommendation was that: "National government should foster a whole systems approach to ensure all young people aged 15-24 years who require specialist intervention should experience continuity of care" I would be grateful if the Minister could comment on such a proposal The rollout of the liaison diversion service is interlinked with other important initiatives about assessment and identification—for example, street triage and the consequent reduction in the use of police cells for children. It is welcome that the Government intend to ban the use of these cells by July of next year, but we need further investment in places of safety away from the criminal justice system to ensure that people in mental health or other crises have the appropriate environment in which an assessment can be carried out effectively The key issue around liaison diversion is that it should start at the earliest opportunity—often when young people come into contact with the criminal justice system at the police station. The information that is gathered about their complex needs must then be shared along the criminal justice pathway from the police station to the court and to prison, if that is the appropriate next step, or, more effectively, into the community. There has to be continuity of care. If they end up in the prison system, they can link very effectively to the new officer that is recommended in the report by the noble Lord, Lord Harris. That information must be shared in the system and dealt with in the system. Services must then be in the system so that when the individual comes back into the community they have the effective services that they need for effective rehabilitation to ensure that they do not reoffend. To achieve all this, we need to build up those services, not just for people who find themselves in the criminal justice system, but for the community in general. We need better mental health services, better alcohol treatment services and better drug treatment services because offenders are only a subset of the community while they have offended. They need to return to the community and still need those effective services. Some 53% of rollout of the liaison diversion services has been achieved so far. I believe that 100% rollout can be achieved by 2017-18 with the Government’s commitment to that investment through the comprehensive spending review.