Rethinking mental health provision in the secure estate for children and young people: a framework for integrated care (SECURE STAIRS)

Abstract

Purpose

The purpose of this paper is to outline the challenges to achieving positive outcomes for young people within the secure estate in England, and introduces a psychologically informed framework, SECURE STAIRS (SS), aimed at improving outcomes.

Design/methodology/approach

The paper argues that there is a need for a fundamental shift in the way care and intervention for young people within the secure estate is delivered. It gives an overview of current challenges and needs and summarises the theoretical concepts and evidence base which can guide practice and form the foundations of the SS framework.

Findings

The framework recommends that intervention shift from focussing primarily on individual assessment and treatment to a greater emphasis on supporting the work of the wider system of care. Recommendations include promoting trauma-informed care, a focus on the system dynamics within institutions and how these impact on the care young people receive, and on the collaborative development with residential staff and young people of formulation-led care plans that include a focus on issues of sustainability after leaving the secure estate.

Practical implications

These include the establishment of discrete residential groupings with truly integrated and trauma-informed work across residential, mental health, education and criminal justice agencies. This involves addressing governance issues around shared record keeping, and challenges to sustainability and the accompanying need for local implementation plans for each establishment alongside central support at a strategic level.

Originality/value

This paper describes a new and innovative way of working within secure settings to ensure children and young people’s needs are better met.

Citation

Taylor, J., Shostak, L., Rogers, A. and Mitchell, P. (2018), "Rethinking mental health provision in the secure estate for children and young people: a framework for integrated care (SECURE STAIRS)", Safer Communities, Vol. 17 No. 4, pp. 193-201. https://doi.org/10.1108/SC-07-2018-0019