Trajectories in to the criminal justice system for young people with complex needs: Experiences in early life and out of home care Presenter : Leanne Dowse Research Team: Eileen Baldry, Leanne Dowse, Jung-Sook Lee, Terry Cumming, Iva Strnadová, Han Xu, Julian Trofimovs Association of Child Welfare Agencies Conference 2014, SMC, Sydney, 18-20 August
Trajectories in to the criminal justice system for y oung people with complex needs: Experiences in early life and out of home c are. Presenter : Leanne Dowse Research Team: Eileen Baldry , Leanne Dowse, Jung- Sook Lee, Terry Cumming, Iva Strnadová , Han Xu , Julian Trofimovs. - PowerPoint PPT Presentation
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Trajectories in to the criminal justice system for young people with complex needs: Experiences in early life and out of home care
Presenter : Leanne Dowse
Research Team: Eileen Baldry, Leanne Dowse, Jung-Sook Lee, Terry Cumming, Iva Strnadová, Han Xu, Julian Trofimovs
Association of Child Welfare Agencies Conference 2014, SMC, Sydney, 18-20 August
Presentation Outline
• Context of the problem
• Background to the MHDCD in the CJS project
• Selected key findings: pathways & case studies
• Discussion/Conclusions: understanding and addressing complex needs in people with disabilities in the CJS
Context of the problem
• Concern with the social exclusion and criminalisation of a group of young people with disabilities.
• As young people (and later as adults) this group figure significantly in policing, justice and prisons, both as victims and offenders.
• Needs are complex, trajectory into the CJS begins early in life. • Responsive welfare provision and early intervention can be effective in
addressing social exclusion and reducing vulnerability for young people at risk of entering the criminal justice system.
• BUT specific experience for young people who have complex needs and are at risk of CJS involvement is poorly understood
• In Australia and comparable jurisdictions current systemic and welfare responses appear to have only limited impact on preventing early contact from escalating into a cycle of incarceration and re-incarceration.
• Need for multi-systemic pathway understanding & advocacy
People with Mental Health Disorders and Cognitive Disability (MHDCD) in the Criminal Justice System study• ARC Linkage Project 2007-2010 UNSW
• CIs: Eileen Baldry, Leanne Dowse, Ian Webster• PIs: Tony Butler, Simon Eyland, Jim Simpson• Partner Organisations: Corrective Services NSW, Justice Health, NSW
Police, Housing NSW, NSW Council for Intellectual Disability, Juvenile Justice NSW
• ARC Linkage Project 2011-2014 Indigenous Australians with mental health disorders and cognitive disability in the CJS• CIs: Eileen Baldry, Leanne Dowse, Julian Trollor, Patrick Dodson• Partner Organisations: Justice Health, Legal Aid, NSW Housing, ADHC
• Range of other ‘nested’ studies eg. Lifecourse costing; Use of S32; Acquired Brain Injury; Youny People with Disability in the CJS; Victimisation experiences
Study approachMethod: Innovative data linkage and merging• Cohort: 2001 Inmate Health Survey & CSNSW Statewide Disability
Service database – purposive sample not representative• Data on each individual drawn from:
• The Centre for Health Research in CJS Health NSW• NSW Department of Corrective Services – adult custody• BOCSAR – reoffending database - courts• NSW Police – events, charges and custody• Juvenile Justice – clients and custody• Housing NSW – application and tenancy• ADHC – disability service• Legal Aid NSW – advice, application• NSW Health (mortality, pharmacotheraphy, hospital admissions)• Community Services – out of home care
SQL server, relational dataset
CohortID
2,731
DCS
Police
Court
Housing
Justice Health
Child Service
s
Health
Disability
Legal Aid
Juvenile Justice
MHDCD Study Cohort by Diagnoses
BID_MH_AOD
ID_MH_AOD
BID_AOD BID_MH ID_AOD ID_MH MH_AOD AOD BID ID MH No MHDCD
Full Cohort N=2,731 Intellectual Disability (IQ <70) N=680 Borderline Intellectual Disability (IQ 70-80) N=783 Mental health disorder N=1642 Substance abuse disorder N= 1985 No diagnosis N= 174 Acquired brain injury identified for 19% N=511 Women = 11% Indigenous Australians = 25% ~40% had been Juvenile Justice clients 69% of the cohort have complex/multiple diagnoses (groups
not mutually exclusive)
Mental Health & Cognitive Impairment in JJ
• Juvenile detainees: 87% at least 1 psychological disorder.
• JJNSW most recent health survey:– ID (20%) Aboriginal young people IQ below 70,
7% ID non-Aboriginal young people (both sig above the norm).
– 1/3rd (32%) borderline ID (IQ 70 to 79), with Aboriginal 39% vs non Aboriginal 26% (again sig above norm)
(Indig et al 2010 Young People in Custody Health Survey)
Defining complex needs• Associated with vulnerability and social marginalisation. • Multiple interlocking experiences and factors that span health and
social issues (Rankin & Regan 2004).• Includes: (a) mental health disorder;
(b) cognitive disability including intellectual and developmental disability and acquired brain injury; (c) physical disability; (d) behavioural difficulties; (e) precarious housing;(f) social isolation; (g) family dysfunction; (h) problematic drug and/or alcohol use (i) risk of harm in early life (k) early educational disengagement (Archer, 2009; AIHW, 2012; Baldry, Dowse, & Clarence, 2012; Carney, 2006; Draine & Salzer, 2002; Hamilton, 2010; Keene, 2001 MacDonald, 2012).
Key selected findings: the experience of young people with mental health and
cognitive disability in the CJS
Education
Those with complex support needs and cognitive disability had significantly lower educational attainment
BID_M
H_AOD
ID_M
H_AOD
BID_A
OD
BID_M
H
ID_A
OD
ID_M
H
MH_AOD
AODBID ID MH ND
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
College certificate/Diploma Completed Sec School Degree/tertiary qualification
HSC/VCE/Leaving Certificate Left school with no qualification Missing
Never Attended School Primary school only School certificate
Technical or Trade qualification
School Expulsion: MHDCD cohort compared with Inmate Health Survey Sample
Higher proportion of those in the MHDCD cohort both males (44%v 39%) and females (35%v29%) had ever been expelled from school. Much larger % reported being suspended.
men women men womenTotal sample Cohort sample
0
10
20
30
40
50
60
70
80
90
100
Ever been expelled from a school
NoYes
%
Experiences in education• Diagnosed groups in the MHDCD cohort have even lower levels
of education than general prisoner population. • Those with some form of Cognitive Disability have the worst
levels of education.• Complex groups: over 80% have no formal qualification with
majority leaving school without completing Yr10• Comparison between MHDCD cohort and non-MHDCD prisoner
(HIS) cohort shows that those in the MHDCD cohort had higher proportions • leaving school without a qualification• being expelled and suspended from school• attending special school (12% V 8%)
Out Of Home Care: MHDCD cohort by diagnostic category
AOD BID BID_AOD BID_MH BID_MH_AOD
ID ID_AOD ID_MH ID_MH_AOD
MH MH_AOD ND
Total 27 11 35 9 71 7 28 19 72 3 37 3
5
15
25
35
45
55
65
75
Family Context • 23% of the MHDCD cohort had been in OOHC compared with
19% non-MHDCD cohort• Of those who had been in OOHC 60% have complex diagnoses,
with 80% of this group having a cognitive impairment.• No difference in raised by family between ages 0-10 but from
11-16 significant difference where MHDCD group (45%) more likely to move into OOHC than non-MHDCD (40%).
• Intergenerational disadvantage greater for MHDCD cohort• Larger proportion of MHDCD cohort (18%) having a parent who
had been incarcerated compared to non-MHDCD cohort (12%)• Higher proportion of MHDCD cohort (11%) having a parent who
had also been in OOHC compared with non-MHDCD cohort (9%).
OOHC placements and average days in placement across diagnostic categories
AOD BID BID_AOD
BID_MH
BID_MH_AO
D
ID ID_AOD
ID_MH ID_MH_AOD
MH MH_AOD
ND AOD BID BID_AOD
BID_MH
BID_MH_AO
D
ID ID_AOD
ID_MH ID_MH_AOD
MH MH_AOD
ND
Average distinct placements
3.3076923076923
1
2.6363636363636
4
2.46875
3.6666666666666
7
3.515625
2.1428571428571
4
2.5185185185185
2
3.3529411764705
9
4.7323943661971
8
5.6666666666666
7
2.6562499999999
9
1.6666666666666
7
Average Days in Placement
1317.2756410256
4
806.38111888111
7
679.58333333333
4
1185.5934343434
3
970.41604662698
4
700.78571428571
4
666.05114638447
7
830.69607843137
3
1232.5439749608
8
468.22222222222
2
1241.0648674242
4
2124.2222222222
2
1
2
3
4
5
6
250
750
1250
1750
2250A
vg P
lacem
ents
Avg D
ays
OOHC and JJ involvement - proportion
Higher proportion of those in the MHDCD cohort who have been in OOHC have been in custody as a Juvenile.
No OOHC OOHC
Not DJJ Client 1721 75
DJJ Client 688 247
5%
15%
25%
35%
45%
55%
65%
75%
85%
95%
OOHC and JJ involvement - frequency
Higher frequency of DJJ custody episodes for those in the MHDCD cohort who have been in OOHC.
No OOHC OOHC
Total 4.39619047619047 9.14018691588785
1
2
3
4
5
6
7
8
9
10
OOHC and Gender
Females in the MHDCD cohort who have been in OOHC are more likely than males to have been in JJ custody and in adult custody
No OOHC OOHC
Avg DJJ Custody Eps
3.90697674418605 7.2
Avg DCS Cus-tody Eps
7.20370370370371 9.27906976744186
1
2
3
4
5
6
7
8
9
10
OOHC and Indigenous Australians
Higher proportion of Indigenous Australians in the MHDCD cohort have been in OOHC as compared with non-Indigenous.
No OOHC OOHC
Non-Indigenous 1821 178
Indigenous 537 139
5%
15%
25%
35%
45%
55%
65%
75%
85%
95%
OOHC and Police Contact
Higher average number of Police contacts for those in the MHDCD cohort who have been in OOHC (90 contacts) than for those with no OOHC history (48 contacts). No OOHC OOHC
Total 49.0709838107098 89.4596273291926
5
15
25
35
45
55
65
75
85
95
OOHC and Adult Custody
Higher average number of episodes of adult custody for those in the MHDCD cohort who have been in OOHC (7.5 episodes) than for those with no OOHC history (6.7 episodes).
No OOHC OOHC
Total 6.77210460772105 7.43788819875776
1
2
3
4
5
6
7
8
Impact of out of home care
Those in the MHDCD cohort who had been in OHC had:• 84% of the OOHC group have complex needs• 90% of this group has cognitive impairment• Younger age at first police contact • Twice as many police contacts over their lives• Twice as many custodial episodes over their lives• Three times as likely to have been incarcerated as a
juvenile• Aboriginal Australians more likely to have been in OOHC
Eddie• Indigenous man now in his late 30s.• Diagnosed with ID, Borderline Personality Disorder and AOD• Poly drug use from age 6 including alcohol, cannabis, prescription drugs,
amphetamines, heroin, methadone and buprenorphine. • Victim of violence and abuse from a young age.• He was first placed in OOHC at age 9 for 2 weeks, and over the following 6
years was placed in 9 different foster homes lasting between 5 days to 2 weeks.
• First police contact at age 11 and first custodial episode at age 13. • Constantly suspended and expelled from schools and from age 13 does not
attend any school and was known to distribute drugs when at school.• From age 14, moves between foster care, a youth refuge and his aunt’s house.
All placements break down due to his aggressive behaviour and his assaults on others. He tells police that he is “having problems coping with life generally, and that he is not able to get on with anyone and everyone is against him”.
• Much of his contact with police is related to his drug use and break and enter and robbery offences, often violent.
• As a young person regularly imprisoned for breaching bail conditions which state that he can only go out accompanied by a responsible adult.
• Regular self-harm and suicide attempts from a young age and history of overdose.
• As an adult regularly scheduled under the MHA and hospitalized for suicide and self-harm.
• Multiple custody episode for theft and when not in custody often noted by police as NFPA.
Eddie: Estimated lifecourse institutional costs
Baldry, E., Dowse, L., McCausland, R. & Clarence, M. (2012) Lifecourse institutional costs of homelessness for vulnerable groups. Report for the National Homelessness Research Agenda 2009-2013
• Of those diagnosed ID only 23% were Ageing Disability and Home Care (ADHC) clients
• Of the BID group 4% were ADHC clients
• Very low rate (15%) of CD in cohort with ADHC services
• Only 10/709 JJ CD group ADHC clients
• 79% of ADHC clients imprisoned prior to becoming a client. ie. were diagnosed and referred for the first time whilst in prison.
ADHC BID ID0
100
200
300
400
500
600
700
800
Total
Housing Assistance
Significant numbers of the complex groups experienced homelessness and unstable housing as young people
Significant numbers had parent(s) in public housing
Significant numbers accommodated in refuges and other crisis accommodation as young people.
28
Police Contacts
MH
_ID
MH
_BID
MH
_AO
D
ID_A
OD
BID
_AO
D ID
BID MH
PD
/AO
D
ND
0
10
20
30
40
50
60
70
80
90
100
0
1
2
3
4
5
6
7
Avg
Po
lice
Co
nta
cts
Ra
te P
oli
ce
Co
nta
cts
People with Complex Cognitive Disability had significantly more police contacts over their lives, starting young, and significantly higher rates of police contacts per year
First police contact & JJ
30
MH_ID MH_BID
MH_AOD
ID_AOD
BID_AOD
ID BID MH PD/AOD
No Diag-nosis
Total0
2
4
6
8
10
12
14
16
18
0
2
4
6
8
10
12
14
16
18
Avg Age First Police Contact Avg Age First DJJ CustodyPolice Contacts Pre First DJJ Custody
Age
Police C
onta
cts
Befo
re F
irst
DJJ
Custo
dy
Av. age first Police & JJ contact & number police contacts prior to custody:All CD significantly higher police contacts before JJ client& were younger at first police contact and younger at first custody than no diagnosis group.
Age at first record in DJJ involvements
First
Alerts
First
As-sess
First
Classi-fi-
cation
First
Community
First
Custody
First
DJJ
First
Notes
First
Specialist
First
YJC
First
YJCCon
First
YLSI
First
Alerts
First
As-sess
First
Classi-fi-
cation
First
Community
First
Custody
First
DJJ
First
Notes
First
Specialist
First
YJC
First
YJCCon
First
YLSI
Minimum Age
11 9 16 10 10 8 12 11 11 8 12
Maximum Age
19 19 21 21 19 21 25 19 18 18 19
Mean of Age
15.6666666666667
15.1814814814815
17.4285714285714
15.2683896620278
15.3712121212121
14.9546142208775
16.5189873417722
15.9823008849558
15.5633802816901
13.8349514563107
16.1447368421052
2.57.5
12.517.522.527.5Many in this
MHDCD subgroup have lowest minimum age possible for DJJ detention (10) and informal contacts below the legal threshold for formal charging
JJ Custodial episodes & LOS
32
CD complex significantly more JJ custodial episodes than MH & no diagnosis \. All groups significantly shorter av days than no diagnosis groups (largely remand)
Offences
Average National Offence Index rating for all offences was in lowest (least serious) 10%
Most common: road traffic & theft (50% of all convictions), justice, public order & acts intended to cause injury (~ 10% each)
• Highly disadvantaged places early in life & funneled into a liminal marginalised community/criminal justice space (Baldry 2013)
• Not falling through the cracks, rather, as young people on the conveyor belt / given a ticket on the CJS train. Systematic and patterned (Baldry 2013).
• The lack of appropriate support and services and the use of control agencies for persons experiencing multiple disadvantages together with mental and/ or cognitive disability, compounds these life issues creating complex needs (Baldry & Dowse 2012).
Understanding complex support needs for young people with cognitive disability in contact with CJS • Complex set of vulnerabilities across individual, social and
institutional domains, work together to bring people with complex support needs into contact with the CJS.
• Many risk factors are known and identifiable from a young age • Pathways into the CJS for these young people with complex needs are
multi-factorial and multi-stage (Baldry 2013).• Difficult for currently disconnected service systems to identify and
address. • Failure to address contributory conditions often precipitate further
involvement in the criminal justice system • Poor coordination across areas of criminal justice, welfare and human
services and education, appears to result in responsibility for management often falling to the criminal justice system (Baldry & Dowse, 2013).
Addressing support needs for people with mental health and cognitive disability in contact with the CJS• Comprehensive response means addressing models and practices in
individual and family support, service system cohesion, and overarching policy direction.
• Premised on support not criminalisation. • Responses specifically recognise and address complex needs as pervasive
and interlocking rather than simply co-occurring, and therefore cannot to be addressed in isolation from each other.
• Service providers face a challenge in recognising the presence of complex support needs in their clients and ensuring assessment and early intervention.
• Policy makers to enact strategies that enable shared recognition and understanding of the nature of complex support needs, including common criteria and language.
• Specific cross-portfolio integration promoting collaborative and coordinated service response across education, child protection, disability and criminal justice system agencies.
ReferencesArcher, W. D. (2009). Introduction: Challenging the school to prison pipeline. New York Law
School Law Review, 54, 875-908.Australian Institute of Health and Welfare (AIHW). (2012). Children and young people at risk
of social exclusion: Links between homelessness, child protection and juvenile justice. Data linkage series no. 13. Cat. no. CSI 13. Canberra: AIHW
Baldry, E. (2013) Pathways from school to prison: Intellectual disability, mental health and school education. Paper presented to Forum on intellectual disability, mental health and school education. UNSW May 31.
Baldry, E. & Dowse, L. (2012) Pathways into and avenues out of criminal justice for young people with cognitive and mental disabilities. UNSW, Public Lecture. December 6th.
Baldry, E. & Dowse, L. (2013) Compounding mental and cognitive disability and disadvantage: police as care managers in Duncan Chappell (ed) Policing and the Mentally Ill: International Perspectives. Boca Raton: CRC Press, Taylor and Francis Group.
Baldry, E., Dowse, L., & Clarence, M. (2012). People with intellectual and other cognitive disability in the criminal justice system: Report for NSW Family and Community Services Ageing, Disability and Home Carehttp://www.adhc.nsw.gov.au/__data/assets/file/0003/264054/Intellectual_and_cognitive_disability_in_criminal_justice_system.pdf
ReferencesCarney, T. (2006) Complex Needs at the Boundaries of Mental Health, Justice and
Welfare: Gatekeeping Issues in Managing Chronic Alcoholism Treatment? Current Issues in Criminal Justice 17(3): 347-361.
Draine, J., Salzer, M. S., Culhane, D.P., and Hadley, T.R. (2002) Role of social disadvantage in crime, joblessness, and homelessness among persons with serious mental illness. Psychiatric Services 53(5): 565-573
Hamilton, M. (2010) People with Complex Needs and the Criminal Justice System Current Issues in Criminal Justice 22(2): 307-324
Indig, D., Vecchiato, C., Haysom, L., Beilby, R., Carter, J., Champion, U., Gaskin, C., Heller, E., Kumar, S., Mamone, N., Muir, P., Van Den Dolder, P. & Whitton, G. (2009) NSW Young People in Custody Health Survey: Full Report. Justice Health.
Keene, J. (2001) Clients with Complex Needs: Interprofessional Practice. Oxford: Blackwell
MacDonald, (2012). Macdonald, S. J. (2012). "Journey's end": Statistical pathways into offending for adults with specific learning difficulties. Journal of Learning Disabilities and Offending Behaviour, 3, 85-97.
Rankin, J & Regan, S (2004), Meeting Complex Needs: The Future of Social Care, The Institute for Public Policy Research
Contact
Associate Professor Leanne DowseChair in Intellectual Disability and Behaviour Support