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What you are saying about secure care

by PeakCare Queensland on 18th April 2013

Home -> Articles -> 2013 -> April -> What you are saying about secure care

Prompted by proposals for the introduction of a secure care option for young people having been brought to the attention of the Child Protection Commission of Inquiry, PeakCare recently released a discussion paper, Secure Care – Needed or Not?

Feedback that has been received to date indicates that widely divergent opinions are held about whether or not a secure care option should be established, and if it is, what it should look like.   Even amongst those who perceive that there is a role to be played by secure care, their support is highly qualified and there is strong acknowledgement of the concerns held by those who oppose its introduction.  In other words, whilst some have arrived at a different conclusion, most appear to share some commonly-held concerns.   Others have told us that, at this stage, they remain undecided.

Four key areas of concern that have been consistently raised with PeakCare are summarised below:

  1. A concern that secure care may potentially contravene key principles contained within international agreements

Some contend that secure care will contravene key principles contained within relevant United Nations Conventions and Rules, all of which are detailed in PeakCare’s discussion paper. 

An argument is made by some that there is sufficient provision established within the Youth Justice Act 1992 and Mental Health Act 2000 to have young people detained when necessary and it is difficult to envisage other circumstances under which they may need to be detained in secure care without significantly intruding upon their civil rights. 

Others who contend that there is a role to be played by secure care acknowledge that it must only be used as a measure of last resort when it is in a young person’s best interests and argue that safeguards can be put in place to ensure that adherence to this principle is strictly maintained. 

There is considerable disagreement however about the maximum length of time that a young person should be able to be contained within secure care and ‘who’ the appropriate decision-maker and reviewing body should be in ensuring that young people are not detained unlawfully or arbitrarily.

  1. A concern about the therapeutic value and effectiveness of secure care

All feedback received by PeakCare to date notes that secure care must not be used for ‘punitive’ purposes.  Those who argue that there is a place for secure care state that it must be used for therapeutic purposes only.  A concern commonly expressed is that secure care must not simply serve as a time-limited hiatus in containing and curtailing the behaviours of some young people with no or inadequate less intrusive service responses available to build on any benefits which may have been gained from their stay in secure care.

Some query whether any therapeutic value can be effectively gained from programs that are coercively imposed upon young people with it being unlikely that they would view secure care as anything other than a form of ‘youth detention’.  In the event that secure ‘containment’ is regarded as necessary due to a young person being at imminent risk of significant self-harm or injury, it is argued by some that this would more appropriately fall under the ambit of a mental health response in accordance with provisions of the Mental Health Act 2000.

Others argue that secure care should incorporate a mental health response, but the environment in which this occurs should differ significantly from a secure mental health facility or hospital ward.

  1. A concern that some groups of young people will be become disproportionately represented amongst those admitted into secure care

A concern is expressed that some groups of young people will be detained inappropriately and become disproportionately represented amongst those admitted into secure care.  This includes, in particular, Aboriginal and Torres Strait Islander young people, those with disabilities and girls.

Amongst those holding an opinion that secure care should exist as an option, there is nevertheless a concern that the ‘integrity’ of its purpose may become compromised by inappropriate referrals of young people outside of the targeted group due to shortages of placement options. 

  1. A concern that secure care represents a poor investment and a reactive response

Some argue that the financial resources which would need to be expended on meeting both the establishment and ongoing costs of secure care would be better invested in alternative service responses.  This includes earlier intervention services including, in particular, adequate child and youth mental health services, which may reduce the demand for secure care.

Others contend that, despite the considerable cost that would be incurred in providing secure care, this represent a necessary investment that may assist in reducing the likelihood of some young people’s involvement with other tertiary systems in the future including the mental health, youth justice and adult criminal justice systems.

PeakCare’s Suggestions about moving forward

Taking into account the feedback that has been received to our discussion paper, PeakCare is keen to ensure that:

·      if secure care is introduced that the best possible model is developed that properly targets its services to young people who are genuinely in need of a response of this nature and intensity and that no alternative responses exist or should be developed which may more effectively address their needs, and

·      if secure care is not introduced (or until its introduction), that other new or improved models of service are developed that are better able to address the needs of those young people for whom an inadequate response is currently being provided which, it may be assumed, has contributed to calls for a secure care option.

PeakCare is of the view that there are high stakes involved in reaching a determination about the introduction of a secure care option and at this stage, more information is needed to ensure that the right decisions are made.  The risk is one of leaping to a solution before the problem is properly defined.  With this in mind, PeakCare has suggested to the Honourable Tracy Davis, Minister for Communities, Child Safety and Disability Services that a task force be commissioned to undertake a study of the demand for secure care in Queensland and based on their analysis of the nature and extent of this demand, produce recommendations about the most suitable model and/ or other service models that might provide an alternative response or ‘sit alongside’ secure care.  Advice about PeakCare’s suggested task force was also conveyed to the Child Protection Commission of Inquiry.

Underpinning our suggestion to Minister Davis about the commissioning of a task force are PeakCare’s concerns that:

·           secure care, if introduced, does not simply serve as a time-limited hiatus in containing and curtailing the behaviours of some young people

·           the ‘wholesale’ adoption of another state’s model does not occur without a critical analysis having been undertaken of the ways in which elements of the models used in other jurisdictions may or may not cater for Queensland requirements

·           if secure care is introduced, clarity is achieved in respect of its purpose and aims, the characteristics and needs of the young people for whom the service would be targeted, its ‘fit’ within the service system and relationship with other service responses (such as child mental health services and therapeutic residential care), its governance and administrative arrangements, service quality and monitoring systems, and safeguards in relation to maintaining the integrity of its purpose and service design, and

·           if secure care is introduced, it does not inadvertently detract or remove pressure from other services in  improving their effectiveness in providing earlier intervention and/ or an alternative response that prevent the need for costly and intrusive admissions (or re-admissions) into secure care.

Minister Davis was very appreciative of the concerns held by both those who are opposed to the introduction of secure care and those who are of the opinion that It is has a role to play.  Commendably, she stated that “open minds” were needed to think through all of the relevant issues.

PeakCare continues to have an interest in what you have to say about the matters raised in our discussion paper as well as the suggestion we have made about the formation of a task force.   You may email your responses to the discussion paper or suggested task force to lwegener@peakcare.org.au or add a comment to this post and generate more discussion.

 

Lindsay Wegener

Executive Director, PeakCare Queensland