Mental health and therapeutic support recommendations

The Review made 83 recommendations. These were sorted into work programs for implementation.

Our objectives

To provide young people in detention with mental health and therapeutic services that support:

  • safety
  • wellbeing
  • rehabilitation.

The way forward

To achieve this we will:

  • strengthen and expand our health and therapeutic services
  • build staff capacity to identify and respond to emotional/psychological harm and mental health issues
  • communicate better with families about their child’s suicide risk, and emotional/psychological harm
  • establish governance arrangements to collaborate and coordinate health and therapeutic services at the local level.

Recommendations

Recommendation 21 (status: closed)

The Review recommends that consultation with external stakeholders should be undertaken in the development of programs for young people with disabilities and/or learning difficulties. (9.R5)

Our youth detention centre behaviour support teams:

  • have completed formal training to identify and diagnose FASD, with Dr Doug Shelton and Susan Astley
  • now include speech and language pathologists who:
    • undertake a range of assessments
    • help develop intervention plans for young people
    • deliver tailored individual and group programs to young people.

We developed a youth detention speech and language practice framework. A range of external experts and organisations helped us to do this. This included:

  • Professor Pamela Snow (LaTrobe University)
  • Mary Woodward (Speech Pathology Australia).

We also established an Aboriginal and Torres Strait Islander working group. The working group support speech and language practice and make sure that:

  • it is culturally appropriate
  • staff understand the differences between Australian Aboriginal English and standard Australian English.

Youth Justice will continue to:

  • embed speech and language practices
  • upskill staff in how to best communicate with young people.

We have started to adapt the Changing habits and reaching targets program to the needs of young people with a disability or learning difficulty.

Youth Justice trialled the Emotional regulation and impulse control program. Deakin University completed a trial evaluation report. We are now considering options for implementation.

Recommendation 44 (status: complete)

The Review recommends that there should be commonality between the definition of harm under the Child Protection Act 1999 and the Youth Justice Act 1992 and it should include an unacceptable risk of harm. (15.R1)

We amended the relevant policy to ensure commonality with the Child Protection Act 1999.

We improved our harm identification processes to support the changes. This includes a new harm assessment report that is completed by therapeutic staff in our client services teams.

The addition of child safety officers at each youth detention centre also supports these processes.

Recommendation 45 (status: closed)

The Review recommends that there should be specialised, ongoing training to youth detention staff to assist them in identifying signs of emotional and psychological harm of a young person, as well as how institutionalised practices can cause or trigger significant harm to a young person.

The training should be provided by representatives from the Mental Health, Alcohol, Tobacco, and Other Drugs Services (MHATODS). (It is understood there is currently no ongoing training on this issue). (15.R2)

We are committed to ensuring that youth detention staff are able to identify and report suspected harm to young people in detention. We recognise that the factors and issues that contribute to emotional and psychological harm are wide-ranging and may be related to:

  • a single traumatic event
  • chronic trauma
  • intergenerational trauma
  • a series of traumatic events.

As noted in recommendation 44, we have improved processes to identify and report harm.

Relevant policies and procedures have been updated. As part of our ongoing partnership with Queensland Health, training will continue to be developed and delivered in line with best practice and emerging issues.

Youth Justice adopted a trauma informed practice approach as the underlying philosophy for youth detention services.

Recommendation 46 (status: closed)

The Review recommends that harm reporting obligations should be subject to annual refresher training for all youth detention centre staff. (15.R3)

See recommendations 44 and 45. We also provide comprehensive training to youth detention staff, including annual suicide and self-harm prevention training.

Recommendation 47 (status: closed)

The Review recommends that all records of SR1 in ICMS should provide detailed information of the specific management of suicide risk and behaviour, detailing specific pro-active interventions, as a means of ensuring transparency and accountability between relevant government departments. (15.R4)

Our detention and community-based caseworkers regularly share detailed information. We include child safety caseworkers if it’s relevant. This is supported by a child safety officer being added to each youth detention centre.

Queensland Health staff work with Youth Justice staff inside the centre. Together they ensure young people can access mental health services, and that these continue when they leave the centre.

Amendments to the Youth Justice Act 1992 established an information sharing framework to provide a coordinated response to the needs of young people in the youth justice system.

We updated our partnership agreements to clarify referral, assessment and treatment pathways for young people who experience significant mental health issues.

Recommendation 48 (status: closed)

The Review recommends that the SR1 in ICMS should be relayed to CHQ Statewide MHS to ensure that appropriately skilled mental health practitioners are aware of the incident and risk alert and can assist where appropriate. (15.R5)

Queensland Health provides essential care and support for young people in detention with suspected mental health issues via on-site services. Their multi-disciplinary teams include:

  • psychologists
  • speech pathologists
  • occupational therapists
  • social workers
  • Indigenous health workers
  • psychiatrists.

We have updated our partnership agreements with Queensland Health to clarify referral, assessment and treatment pathways for young people. Legislation has been changed to establish an information sharing framework that provides a coordinated response to the needs of young people.

Youth detention and health care staff also have after-hours access to psychiatrists to help with urgent and significant mental health issues.

Recommendation 49 (status: complete)

The Review recommends that Queensland Health staff responsible for conducting mental health assessments on young people in response to a serious suicide attempt should be trained (if not qualified) in mental health assessment specific to young people (particularly those with complex needs). (15.R6)

See recommendation 48 for details on Queensland Health’s onsite mental health teams. The mental health teams ensure young people get appropriate and high quality mental health services.

The mental health teams give advice and support to each centre’s behaviour support team, for young people assessed as high risk of suicide or self-harm.

Staff also have after-hours access to psychiatrists to help with any mental health emergencies.

Primary health care staff who work in a youth detention centre do not conduct mental health assessments. This is outside their scope of practice.

Recommendation 50 (status: complete)

The Review recommends that parents and guardians should be advised of all significant incidents occurring in the centre for which children may have suffered harm as defined in the Youth Justice Act 1992, section 268 as soon as there is a recognition that harm has been suffered. (15.R7)

Parents/guardians are to be notified if their child may have been harmed while at a youth detention centre, under existing policies. We have amended procedures and created factsheets to improve these processes. These documents also clarify timeframes and thresholds for contact with families.

Recommendation 76 (status: complete)

The Review recommends that further investigation should be undertaken as to the concerning allegation of the misuse of Individual THHS-12’s electronic signature and accuracy of meeting minutes. (19.R1)

Youth Justice does not have electronic signatures. Our information system (DCOIS) provides notifications to staff members to alert them to items for their information or action. We reviewed the relevant records to see where we can improve clarity.

Recommendation 80 (status: closed)

The Review recommends that youth detention centre employees should receive more training in identification, treatment and management of young people with mental health issues. (19.R5)

We are working with Queensland Health and the Queensland Centre for Mental Health Learning to deliver specialised mental health training and therapeutic upskilling for youth detention centre staff. Training is focussed on the identification, treatment and management of young people with mental health issues.

Some Youth Justice staff have attended specialist Indigenous psychological services training delivered by Adjunct Professor Tracy Westerman. This training gives staff the most up-to-date Aboriginal mental health and suicide prevention information in Australia.

Our on-centre behaviour support teams also support and build the capacity of operational staff to better manage young people with mental health issues. Staff work together to develop practical and effective plans that best meet the needs of individual young people.

See response to recommendation 45.

Recommendation 81 (status: complete)

The Review recommends that Youth Justice policies and risk assessment tools should:

  • distinguish between suicide risk and self-harm risk
  • reflect the research undertaken by Youth Justice that physical restraints escalate self-harming behaviour. (19.R6)

We have amended relevant policies to differentiate between suicide risk and self-harm risk. We continue to update our risk assessment tools. This work will reflect contemporary research about the impact of physical restraints on young people at risk of suicide or self-harm.

These changes are supported by:

  • strong local partnerships with onsite mental health services
  • ongoing consultation with Queensland Health about best practice for managing young people at heightened risk of self-harm.

Recommendation 82 (status: closed)

The Review recommends that consideration should be given to creating a 0.5 FTE consultant psychiatrist and a 1.0 FTE psychiatry registrar to be based at each youth detention centre. (19.R7)

Onsite mental health services provide essential care and supports for young people in detention who present with suspected mental health issues. The teams are multi-disciplinary (see recommendation 48).

After-hours access to psychiatrists is also available to help with urgent and significant mental health incidents.

Queensland Health has increased the psychiatric support available to youth detention centres, in response to this recommendation.

Recommendation 83 (status: closed)

The Review recommends that a consultant psychiatrist should be available on call after hours and on weekends. (19.R8)

See recommendation 82.