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, JungSook 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 reincarceration.
• 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
http://www.mhdcd.unsw.edu.au/
Study approach
Method: 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
DCS
Juvenile
Justice
Police
Court
Legal Aid
Cohort
ID
2,731
Health
Child
Services
Housing
Disability
Justice
Health
MHDCD Study Cohort by Diagnoses
700
600
500
400
300
200
100
0
Total
BID_MH_A ID_MH_AO
BID_AOD
OD
D
351
308
214
BID_MH
ID_AOD
ID_MH
MH_AOD
AOD
BID
ID
MH
No MHDCD
Diagnosis
121
163
105
612
337
97
104
145
174
Diagnostic profile of the MHDCD Cohort











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
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
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
School Expulsion: MHDCD cohort compared
with Inmate Health Survey Sample
Higher proportion of
Ever been expelled from a
school
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.
100
90
80
70
%
60
50
No
Yes
40
30
20
10
0
men
women
Total sample
men
women
Cohort sample
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
80
70
60
50
40
30
20
10
0
Total
AOD
BID
BID_AOD
BID_MH
BID_MH_A
OD
ID
ID_AOD
ID_MH
ID_MH_AO
D
MH
MH_AOD
ND
27
11
35
9
71
7
28
19
72
3
37
3
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
6
2500
5
2000
4
2
Avg Placements
3
Avg Days
1500
1000
500
1
0
BID_AO
BID_MH
BID_MH
D
_AOD
AOD
BID
Average distinct placements
3.31
2.64
2.47
3.67
Average Days in Placement
1317
806
680
1186
MH
3.35
4.73
5.67
2.66
1.67
831
1233
468
1241
2124
ID_AOD
ID_MH
3.52
2.14
2.52
970
701
666
MH_AO
D
0
ID_MH_
AOD
ID
ND
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.
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
No OOHC
OOHC
DJJ Client
688
247
Not DJJ Client
1721
75
OOHC and JJ involvement - frequency
Higher frequency of
DJJ custody
episodes for those in
the MHDCD cohort
who have been in
OOHC.
10
9
8
7
6
5
4
3
2
1
0
Total
No OOHC
OOHC
4.40
9.14
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
10
9
8
7
6
5
4
3
2
1
0
No OOHC
OOHC
Avg DJJ Custody Eps
3.91
7.20
Avg DCS Custody Eps
7.20
9.28
OOHC and Indigenous Australians
100%
Higher proportion of
Indigenous
Australians in the
MHDCD cohort have
been in OOHC as
compared with nonIndigenous.
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Indigenous
Non-Indigenous
No OOHC
537
OOHC
139
1821
178
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).
100
90
80
70
60
50
40
30
20
10
0
Total
No OOHC
49.07
OOHC
89.46
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).
8
7
6
5
4
3
2
1
0
Total
No OOHC
OOHC
6.77
7.44
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
http://www.mhdcd.unsw.edu.au/sites/www.mhdcd.unsw.edu.au/files/u18/Lifecourse-InstitutionalCosts-of-Homelessness-final-report.pdf
Eddie
Police
DoCS
DCS
DJJ
Housing
Health
Courts
Legal Aid
PHDAS
Centrelink
Justice Health
ADHC
Total
Total Cost
$ 251,657
$ 134,496
$ 232,519
$ 684,200
$
$ 243,148
$ 59,216
$
5,198
$ 23,796
$ 129,819
$
70,102
$ 110,911
$ 1,945,066
Disability Service
•
800
Of those diagnosed ID only 23%
were Ageing Disability and
Home Care (ADHC) clients
700
600
•
•
•
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
500
400
Total
300
200
100
•
79% of ADHC clients imprisoned
prior to becoming a client. ie.
were diagnosed and referred for
the first time whilst in prison.
0
ADHC
BID
ID
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
100
90
80
5
70
60
4
50
3
40
30
2
20
1
10
ND
PD/AOD
MH
BID
ID
BID_AOD
ID_AOD
MH_AOD
MH_BID
0
MH_ID
0
Rate Police Contacts
6
Avg Police Contacts
People with Complex
Cognitive Disability had
significantly more
police contacts over
their lives, starting
young, and significantly
higher rates of police
contacts per year
7
First police contact & JJ
18
16
16
14
14
12
12
10
10
8
8
6
6
4
4
2
2
Police Contacts Before First DJJ Custody
18
Age
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.
0
MH_ID MH_BIDMH_AODID_AODBID_AOD
Avg Age First Police Contact
Police Contacts Pre First DJJ Custody
ID
BID
MH
PD/AOD
No DiagnosisTotal
Avg Age First DJJ Custody
30
0
Age at first record in DJJ involvements
Many in this
MHDCD subgroup
have lowest
minimum age
possible for DJJ
detention (10) and
informal contacts
below the legal
threshold for formal
charging
30
25
20
15
10
5
0
First
First
First
Class
Asse
Alerts
ificati
ss
on
Minimum Age 11
9
16
Maximum Age 19
19
21
Mean of Age 15.67 15.18 17.43
First
First
First
First
Com
First First
First
First
Custo
Speci
YJCC
munit
DJJ Notes
YJC
YLSI
dy
alist
on
y
10
10
8
12
11
11
8
12
21
19
21
25
19
18
18
19
15.27 15.37 14.95 16.52 15.98 15.56 13.83 16.14
JJ Custodial episodes & LOS
CD complex
significantly more JJ
custodial episodes
than MH & no
diagnosis \. All groups
significantly shorter av
days than no diagnosis
groups (largely
remand)
32
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)
33
Pathways: iterative, looping, cycling, compounding
Poverty/disadvantage
Courts
Prison
Housing/homelessness
Post-release
Poor School Education
Police
Breaching
Mental Health
Legal Aid
Reincarceration
Lack Disability services
34
New Conceptualisation of Disability in CJS
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.
References
Archer, 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_co
gnitive_disability_in_criminal_justice_system.pdf
References
Carney, 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 Dowse
Chair in Intellectual Disability and Behaviour Support
School of Social Sciences
UNSW Australia
L.Dowse@unsw.edu.au
MHDCD Project website UNSW
http://www.mhdcd.unsw.edu.au/