Dr Leanne Dowse, Senior Lecturer in Social Research and Policy, School of Social Sciences, The University of New South Wales - Young People with Complex Needs and the Criminal Justice

Young people with complex needs in the criminal jus6ce system

Presenter : Leanne Dowse

Research Team: Eileen Baldry, Leanne Dowse, Jung-‐Sook Lee, Julian Trofimovs, Terry Cumming, Iva Strnadová, Melissa Clarence, Han Xu

5th Annual National Juvenile Justice Summit, Rydges Melbourne, 25-26 March 2014

Presenta6on Outline

• Context of the problem

• Defining complex needs

• Background to the MHDCD in the CJS project

• Selected key findings • Early lives of people with complex needs in the CJS • Juvenile JusJce involvement for people with complex needs in the CJS

• Discussion/Conclusions: understanding and addressing complex needs in young people in the CJS


Context of the problem • Concern with the social exclusion and criminalisaJon of a group of young people with disabiliJes.

• As young people (and later as adults) this group figure significantly in policing, jusJce and prisons, both as vicJms and offenders.

• Needs are complex. • Trajectory into the CJS begins early in life. • Responsive welfare provision and early intervenJon can be effecJve in addressing social exclusion and reducing vulnerability for young people at risk of entering the criminal jusJce 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 jurisdicJons current systemic and welfare responses appear to have only limited impact on prevenJng early contact from escalaJng into a cycle of incarceraJon and re-‐incarceraJon.

• Need for mulJ-‐systemic pathway understanding and advocacy


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 (l) contact with the criminal justice system (Archer, 2009; AIHW, 2012; Baldry, Dowse, & Clarence, 2012; Carney, 2006; Draine & Salzer, 2002; Hamilton, 2010; Keene, 2001 MacDonald, 2012).

People with Mental Health Disorders and Cogni6ve Disability (MHDCD) in the Criminal Jus6ce System study

• ARC Linkage Project 2007-‐2010 UNSW • CIs: Eileen Baldry, Leanne Dowse, Ian Webster

• PIs: Tony Butler, Simon Eyland, Jim Simpson • Partner OrganisaJons: CorrecJve Services NSW, JusJce Health, NSW

Police, Housing NSW, NSW Council for Intellectual Disability, Juvenile JusJce NSW

• ARC Linkage Project 2011-‐2014 Indigenous Australians with mental health disorders and cogni4ve disability in the CJS

• Nested studies uJlising the MHDCD dataset • Young People with Complex needs in the CJS 2013, Cis: Leanne Dowse,

Jung-‐Sook Lee, Terry Cumming, Iva Strnadová, Cumming, RA: Julian Trofimovs (UNSW Faculty of Arts and Social Sciences Research Grant)

http://www.mhdcd.unsw.edu.au/


The UNSW MHDCD Study approach Method: Innova6ve data linkage and merging • Cohort: 2001 Inmate Health Survey & CSNSW Statewide Disability

Service database – purposive sample not representaJve • Data on each individual drawn from:

• The Centre for Health Research in CJS Health NSW (+data from 2009 survey)

• NSW Department of CorrecJve Services – adult custody • BOCSAR – reoffending database -‐ courts • NSW Police – events, charges and custody • Juvenile JusJce – clients and custody • Housing NSW – applicaJon and tenancy • ADHC – disability service • Legal Aid NSW – advice, applicaJon • NSW Health (mortality, pharmacotheraphy, hospital admissions) • Community Services – out of home care


SQL server, relational dataset

Cohort ID

2,731

DCS

Police

Court

Housing

Justice Health

Child Services

Health

Disability

Legal Aid

Juvenile Justice


Descrip6on of the MHDCD Cohort ! Full Cohort N=2,731

! Those with IQ less than 70 N=680 ! Those with IQ 70-‐80 N=783 ! Those with diagnosed Mental health disorder N=965

! Those with No diagnosis N=339 ! Those with Substance abuse disorder = 1276 ! Women = 11%

! Indigenous Australians = 25% ! ~40% had been Juvenile JusJce clients


MHDCD Study Cohort

• ~ ½ the cohort complex diagnoses (groups not mutually exclusive). Eg MH_ID group may also have substance abuse disorder.

• ~ 2/3 of those with cogniJve disability have complex needs.


Cogni6ve Disability in the MHDCD cohort

• ID = >70IQ

• BID = <70-‐ >80 IQ • ABI = persons with brain injury that significantly

affects their cogniJve and social capabiliJes

! 1464 people in the cohort had an idenJfied cogniJve disability

! Approx 2/3rd in the CD group experience addiJonal compounding / complex needs including mental health disorder or drug and alcohol use disorder.


Aboriginal persons in the MHDCD cohort

• 86% Indigenous cohort is male, 14% female.

• 91% Indigenous cohort idenJfied with MHDCD; most complex needs; eg of those with MHD 77% have AOD with 36% also CD.

• significantly higher number and rate of convic6ons than non Indigenous persons


Key selected findings: the experience of young people with complex needs in the

CJS


3 inquiries used to describe YPCN in the CJS 1. General descrip4on of those in the MHDCD cohort (n=2731) and

case studies drawn out.

2. Comparison of prisoners with complex needs and prisoners without complex needs -‐ individual, educaJonal, and family background of those in the MHDCD cohort who took part in NSW Inmate Health Survey (n=493) and those without MHDCD who also took part in the IHS (n=419).

3. Comparison of those with complex needs in contact with the JJ (n=914 718 had been in JJ custody; 196 JJ clients only ) and those who had not had contact with the Juvenile Jus4ce System (n= 1,643) using MHDCD dataset.


School education

Those with complex needs and cognitive disability had significantly lower education attainment


School Expulsion: MHDCD cohort compared with Inmate Health Survey Sample

Higher proportion of those in the MHDCD cohort both males (41%v 33%) and females (35%v29%) had ever been expelled from school. Much larger % reported being suspended.

0

10

20

30

40

50

60

70

80

90

100

men women men women

Total sample Cohort sample %

Ever been expelled from a school

No

Yes


Experiences in educa6on -‐ summary • Diagnosed groups in the MHDCD cohort have even lower levels

of educaJon than general prisoner populaJon. • Those with some form of CogniJve Disability have the worst

levels of educaJon. • Complex groups: over 80% have no formal qualificaJon with

majority leaving school without compleJng Yr10 • Comparison between MHDCD cohort and non-‐MHDCD prisoner

(HIS) cohort shows that those in the MHDCD cohort had higher proporJons • leaving school without a qualificaJon • being expelled and suspended from school • arending special school (12% V 8%)


Family Context • 23% of the MHDCD cohort had been in OHC compared with 19%

non-‐MHDCD cohort

• Of those in the MHDCD cohort who had been in OHC 60% have complex diagnoses, with 80% of this group having a cogniJve 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 OHC than non-‐MHDCD (40%).

• IntergeneraJonal disadvantage greater for MHDCD cohort • Larger proporJon of MHDCD cohort (18%) having a parent who

had been incarcerated compared to non-‐MHDCD cohort (12%)

• Higher proporJon of MHDCD cohort (11%) having a parent who had also been in OHC compared with non-‐MHDCD cohort (9%).


Experience of Out Of Home Care: MHDCD cohort compared with Inmate Health Survey Sample

Women in the MHDCD cohort have a much higher incidence of having experienced OOHC than those in the total IHS sample

0

10

20

30

40

50

60

70

80

90

100

men women men women

Total sample Cohort sample

%

Ever been OOHC

No

Yes


Out of Home Care case example: Eddie

Eddie has an ID, Borderline Personality Disorder and an AOD history from age 6. He was first placed in OHC at age 9 for 2 weeks, and over the following 6 years was placed in 9 different foster homes which oten only lasted between 5 days to 2 weeks. Eddie had first police contact at age 11 and his first custodial episode at age 13. He was regularly imprisoned for breaching bail condiJons which stated that he could only go out accompanied by a responsible adult.


Impact of out of home care

Those in the MHDCD cohort who had been in OHC had:

• Younger age at first police contact • Twice as many police contacts over their lives • Twice as many custodial episodes over their lives • Three Jmes as likely to have been incarcerated as a juvenile


Average Age First Police contact, convic6on & custody

CD complex – significantly lower av. age 1st contact with police. High victimisation

Those who were JJ clients sig. lower av. age of police contact for CD complex (12-13)


Early Police contact case example: MaUhew

Matthew is diagnosed with a BID and MH disorder. His first police contact was at age 7, and he had contact with the police on 20 occasions by the age of 10. By the age of 18 he had 349 police contacts for escalating crimes.


Young people with complex needs and JJ

Current situaJon in NSW • Psychological disorder: 87% of Juvenile detainees idenJfied

to have at least 1 psychological disorder

• Intellectual Disability: 14% of juvenile detainees idenJfied as having ID (sig above the populaJon norm of 2%), with 7% of non-‐Aboriginal young people and 20% Aboriginal young people found to have IQ below 70.

• Borderline Intellectual Disability: 1/3rd (32%) of juvenile detainees found to have BID, with 26% of non Aboriginal young people and 39% of Aboriginal found to have IQ between 70 -‐79) (again sig above populaJon norm of 7%).

(Indig et al 2010 Young People in Custody Health Survey)


Comparing people with complex needs in the MHDCD cohort with JJ and no JJ history

For those with JJ history there is a significantly higher proporJon of : • Males -‐ 91% of those with JJ history v 86% of those no JJ history

• Aboriginal persons -‐ 35% of those with JJ history v 21% of those no JJ history

• A history of OHC -‐ 27% of those with JJ history v 4.5% of those no JJ history

• MulJple diagnoses ie complex needs -‐ 81% of those with JJ history v 69% of those no JJ history

• CogniJve disability -‐ ID or BID -‐ 66% of those with JJ history v 52% of those no JJ history

• Alcohol and other drug use disorders – 83% of those with JJ history v 74% of those no JJ history

• The only tested variable on which no significant difference was found between the two groups was the presence of Mental Health Disorder.


Contact with Juvenile Jus6ce

Sig. higher rate of being a JJ client for cogniJve complex groups -‐ between 40% to 60%;

But ~ 20% for those with no diagnosis or MH only


Age and paUern of contact for MHDCD cohort with JJ and no JJ history

• Individuals with JJ contact had (as expected) earlier contact with all aspects of the criminal jusJce system. • The average age for first contact with JJ was 15 years • Contact with police occurred significantly earlier for those with JJ history (av age 13.1yrs) as compared with those with no JJ history (av age 18.5 yrs)

• Age at first adult custody episode was significantly lower for those with JJ history (av. Age 19.2 yrs) as compared with those with no JJ history (av age 27.2 yrs)


First police contact and JJ

0

2

4

6

8

10

12

14

16

18

0

2

4

6

8

10

12

14

16

18

MH_ID MH_BID MH_AOD ID_AOD BID_AOD ID BID MH PD/AOD No Diagnosis Total

Polic

e C

onta

cts

Bef

ore

Firs

t DJJ

Cus

tody

Age

Avg Age First Police Contact Avg Age First DJJ Custody Police Contacts Pre First DJJ Custody

Av. age first Police & JJ contact & number police contacts prior to custody: All CD significantly higher police contacts before becoming a JJ client & were younger at first police contact and younger at first custody than no diagnosis group.


JJ Custodial episodes & Length Of Stay

CD complex significantly more JJ custodial episodes than MH & no diagnosis.

All groups significantly shorter av. days than no diagnosis groups (largely remand)


Age at first record in DJJ involvements

First Alerts

First Asse

ss

First Classificati

on

First Communit

y

First Custo

dy

First DJJ

First Notes

First Specialist

First YJC

First YJCC

on

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 15.67 15.18 17.43 15.27 15.37 14.95 16.52 15.98 15.56 13.83 16.14

0

5

10

15

20

25

30 Many in this MHDCD subgroup have lowest minimum age possible for DJJ detention (10) and informal contacts below the legal threshold for formal charging


New Conceptualisa6on of Disability in CJS

• Highly disadvantaged places early in life & funneled into a liminal marginalised community/criminal jus6ce space (Baldry 2013)

• Not falling through the cracks, rather, as young people on the conveyor belt / given a Jcket on the CJS train. SystemaJc and parerned (Baldry 2013).

• The lack of appropriate support and services and the use of control agencies for persons experiencing mulJple disadvantages together with mental and/ or cogniJve disability, compounds these life issues crea6ng complex needs (Baldry & Dowse 2012).


Understanding complex needs for young people in contact with the CJS • Complex set of vulnerabiliJes across individual, social and

insJtuJonal domains, work together to bring some young people with complex needs into contact with the CJS.

• Many risk factors are known and idenJfiable from a young age • Pathways into the CJS for these young people with complex needs are

mulJ-‐factorial and mulJ-‐stage (Baldry 2013). • Difficult for currently disconnected service systems to idenJfy and

address. • Failure to address contributory condiJons oten precipitate further

involvement in the criminal jusJce system • Poor coordinaJon across areas of criminal jusJce, welfare and human

services and educaJon, appears to result in responsibility for management oten falling to the criminal jusJce system (Baldry & Dowse, 2013).


Addressing complex needs for young people in contact with the CJS • Comprehensive response means addressing models and pracJces in

individual and family support, service system cohesion, and overarching policy direcJon.

• Premised on support not criminalisaJon.

• Responses specifically recognise and address complex needs as pervasive and interlocking rather than simply co-‐occurring, and therefore cannot to be addressed in isolaJon from each other.

• Service providers face a challenge in recognising the presence of complex needs in their young clients and ensuring assessment and early intervenJon.

• Policy makers to enact strategies that enable shared recogniJon and understanding of the nature of complex needs in young people, including common criteria and language.

• Specific cross-‐porvolio integraJon promoJng collaboraJve and coordinated service response across educaJon, child protecJon, disability and criminal jusJce system agencies.

References Archer, W. D. (2009). IntroducJon: Challenging the school to prison pipeline. New York Law

School Law Review, 54, 875-‐908. Australian InsJtute of Health and Welfare (AIHW). (2012). Children and young people at risk

of social exclusion: Links between homelessness, child protec4on and juvenile jus4ce. 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 educaJon. Paper presented to Forum on intellectual disability, mental health and school educa4on. UNSW May 31.

Baldry, E. & Dowse, L. (2012) Pathways into and avenues out of criminal jus4ce for young people with cogni4ve and mental disabili4es. UNSW, Public Lecture. December 6th.

Baldry, E. & Dowse, L. (2013) Compounding mental and cogniJve disability and disadvantage: police as care managers in Duncan Chappell (ed) Policing and the Mentally Ill: Interna4onal Perspec4ves. Boca Raton: CRC Press, Taylor and Francis Group.

Baldry, E., Dowse, L., & Clarence, M. (2012). People with intellectual and other cogniJve disability in the criminal jusJce system: Report for NSW Family and Community Services Ageing, Disability and Home Carehrp://www.adhc.nsw.gov.au/__data/assets/file/0003/264054/Intellectual_and_cogniJve_disability_in_criminal_jusJce_system.pdf

References Carney, T. (2006) Complex Needs at the Boundaries of Mental Health, JusJce and

Welfare: Gatekeeping Issues in Managing Chronic Alcoholism Treatment? Current Issues in Criminal Jus4ce 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 JusJce System Current Issues in Criminal Jus4ce 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. & Whiron, G. (2009) NSW Young People in Custody Health Survey: Full Report. JusJce Health.

Keene, J. (2001) Clients with Complex Needs: Interprofessional Prac4ce. Oxford: Blackwell

MacDonald, (2012). Macdonald, S. J. (2012). "Journey's end": StaJsJcal pathways into offending for adults with specific learning difficulJes. Journal of Learning Disabili4es and Offending Behaviour, 3, 85-‐97.

Rankin, J & Regan, S (2004), Mee4ng Complex Needs: The Future of Social Care, The InsJtute for Public Policy Research

Relevant forthcoming publica6ons and contacts Dowse, L., Cumming, T. M., Strnadová, I., Lee, J-‐S., and Trofimovs, J. (forthcoming

2014) Young People with Complex Needs in the Criminal JusJce System. Research and Prac4ce in Intellectual and Developmental Disabili4es.

Lee, J-‐S., Dowse, L, and Trofimovs, J. (under review) Understanding the Early Experiences of People with Complex Needs in the Criminal JusJce System.

Cumming, T. M., Strnadová, I., and Dowse, L. (under review) At-‐risk youth in Australian schools and promising models of intervenJon.

Contact:

Associate Professor Leanne Dowse

Chair in Intellectual Disability and Behaviour Support

School of Social Sciences

UNSW Australia

[email protected]

MHDCD Project website UNSW: hrp://www.mhdcd.unsw.edu.au/