A highly specific group of aggressive and destructive children who are failed by child protective services should be placed in a secure facility for their own welfare, RANZCP has told the QLD Child Protection Commission of inquiry.
In a submission to the state inquiry, the Queensland branch of the Faculty of Child and Adolescent Psychiatry recommended the government consider a “secure children’s home” based on the current UK model for “high risk” children and adolescents who have “disengaged with placements and services”.
The government would need to introduce new legislation to establish such a facility, considering these young people do not meet the criteria for coercive treatment under the Mental Health Act, and with no significant criminal history, they can’t be incarcerated by youth detention services.
“These facilities must be secure”, the author of the submission Dr Michelle Fryer wrote, to ensure the welfare of this group, who – absconding from foster care or other services – experienced substance misuse, homelessness, antisocial or criminal behaviour and exploitation or assault (including sexual assault).
“There is no legislative framework at the moment to keep them in a safe environment,” Dr David Hartman, Clinical Director at Townsville Child and Youth Mental Health Service told Psychiatry Update.
UK legislation could provide a good model, he said, but secure placements would need to be a “last resort”.
Dr Hartman, who was involved in the wider group of QLD psychiatrists consulted for the submission, said children in secure care would ideally receive moment-to-moment therapeutic interactions, access to youth workers trained in mental health, as well as psychiatrists and specialist psychotherapists.
Responding to questions concerning whether past allegations of child abuse in QLD institutions would overshadow the recommendation, Dr Hartman said he recognised the political sensitivity surrounding the issue but “there are children currently in residential placements who are not being protected becasue we’ve gone too far the other way”.
“We’ve become too scared of taking responsibility for children’s safety by providing a secure environment, so we put them in residential placements where they have highly disturbed behaviour which cannot be controlled … including deliberate self harm, drug use, and I’m talking about young children”.
Extrapolating current UK placement numbers, Dr Hartman estimates roughly 20 children in Queensland would fall into this “highly specific group”, most with a history of significant trauma and abuse.
“There are young people who are desperately seeking out that kind of secure care … and many will offend deliberately to get into a detention centre because they know it’s a safe environment, they’ll be kept off the street, fed and receive education.
It’s a reverse incentive,” he said.
The submission stressed the criteria for a secure facility placement would be based on the “child’s risk and welfare, not their offending; and the aim is explicitly therapeutic”.
The inquiry is expected to release its recommendations April 2013.
Dr Hartman’s views are his own and not the views of QLD Health or Townsville Hospital and Health Service.
As first appeared in Psychiatry Update, 1 November 2012