Mental health needs and services for severely troubled and troubling youngpeople including young offenders in an NHS Region

Penal, social services, special education and health agencies in one Nation al Health Service Region were screened for severely troubled and troublesom e young people in need of mental health services. One hundred and sixteen d etailed assessments were undertaken on young people: 57 in "penal" and 59 i n "welfare" establishments. Little difference was found between those in th ese two types of setting except that the "penal group" were much more likel y to have high levels of violent behaviour and to have had more changes of placement. The needs for mental health care greatly outstripped supply. As part of this overall neglect, 11 of 15 young people with serious mental ill nesses and all 13 who had suffered sexual abuse in the sample were not rece iving appropriate treatment. A tentative estimate of the size of the proble m in the region yielded a rate of around 11.4 per million with very severe disorder but this is probably an under estimate. The effectiveness of treat ment for the problems of these young people is discussed and a possible str ucture for a service is explored. (C) 2000 The Association for Professional s in Services for Adolescents.