Round Table on Mental Health And Youth Justice Renewal 31 January 2000 Summary of discussion

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Introduction

The Youth Justice Renewal Initiative stresses the importance of developing partnerships to deal effectively with offending youth and youth at-risk in their communities. The Round Table on Mental Health, held January 31, 2000, was the fifth in a series of round table discussions being held over the course of the fall 1999 and winter 2000. The aim of the round tables is to provide a forum for experts in the fields of education, social services, arts and recreation, child advocacy and mental health, to explore their role in preventing youth crime, dealing with youth who have committed offences and facilitating the reintegration and rehabilitation of young offenders.

Note: The following summary reflects the views expressed by participants at the Round Table, and will be considered by the Department of Justice in the implementation of the Youth Justice Renewal Initiative.

Were present at the discussion: See attached list

1. The Role of Mental Health Professionals in Crime Prevention

The major role of mental health professionals is to support other professionals in dealing with children in difficulty, whether in school, in recreational, arts or athletics programs, in day-care or in various types of treatment centres. They can help with the proper and effective treatment for many conduct disorders that are not well understood by parents, day-care workers, educators or other types of youth workers. The consultative role of the mental health professional is often more effective than direct intervention because in training and supporting those who care for, and work with children and youth in difficulty, they also help the child or youth.

A second important role for mental health care professionals is helping parents, teachers or childcare workers with the detection of behaviours that could be symptomatic of conduct disorders or mental health concerns in young children. To that end, mental health professionals can help parents and educators evaluate children who show early signs of behavioural or motor skills problems. It is important for children to receive helping interventions early, when they are young. The earlier the diagnosis, the better the chances of successful treatment.

A third role for mental health professionals is to help reclaim kids who have had bad experiences; it takes longer, requires a greater investment of professional time one on one, and is therefore more expensive. Mental health professionals can also help kids with their transition to the community when they are coming out of custody early. Their help will increase the chances of a successful reintegration.

Mental health gives us a context in which to act. Children do not exist outside the context of family / school / community, and, too often, there are no services for them unless they are in a crisis. Kids who are in the care of the state have even greater needs. We can't forget them because essentially the state is their parent, and their family. But there are two problems :

1. For many jurisdictions, the lack of resources is a problem. We espouse prevention and early intervention, but the money is not there. There is a need for more prevention and treatment resources. Self-help family resource centres provide some hope for the improvement of child-rearing practices for example, but there still needs to be more money put into providing those resources. Although provinces express concern over juvenile crime rates, many of them move in ways that increase the numbers of kids who will become young offenders by cutting resources of all kinds, either for prevention, detection or treatment.
   
    
2. Continuity of care for young people, particularly with child welfare, is a huge problem. When children keep getting shifted from one agency to another as they age, the prevention of anti-social behaviours is increasingly difficult. For those who offend early, the shifting of care agencies and caregivers seems to slow the process of getting behaviour back in control. Sometimes, physical containment is required to ensure that the child receives proper care. Treatment centres can be useful in those cases, providing some stability and proper mental care services.

As far as treatment is concerned, a lot of wonderful ideas require stretching one's thinking outside the box. There was a project, for example, where young offenders were given the responsibility of training some dog "offenders", thus matching up child welfare and animal welfare. In another project, a peer-support kind of relationship was established between families made vulnerable by poverty, single parenting or whatever, that had been paired with other families with more or less the same variables and situation, but working well. These projects produced very interesting results in terms of life skills and connection with community.

Unfortunately, risk-taking has almost disappeared among professionals. People want programs to work 100% of the time, want to work in a way that is safe, where they will not be criticized. In rehabilitation, you have to be creative. Responding to the individual young person's needs and interests is important because kids are different. Childcare workers are also different, with different talents and abilities. It can never be just one way if you want to respect people's differences and complexities.

In addition, it's hard to think outside the box when there are no resources, or when you have to worry about the competition for dollars, or evaluations that limit who can get help. Sometimes funding patterns are a definite disincentive to crossing over mandate lines to help out, and as funding and resources decrease, everyone sticks even more closely to their own mandate and there is less collaboration. Also, the trend towards privatization of services is perceived as a threat to people's jobs, as much as a threat to fragile, budding partnerships that are still in the process of building. We need more open conversations to deal with those perceptions.

Respect is important in dealing with anyone, but with youth in particular. Some professionals who are supposed to be helping youth are in fact judging the kids and their families. Some of the most vulnerable young people are somehow made to feel "guilty" for their own situation. In the mental health system, as in any other profession, you have different professionals each with their own strengths and weaknesses. Some professionals lack respect for youth. Sometimes instead of doing an assessment, the professional is trying to provoke the youth. Then it becomes so easy to confirm behavioural problems and criminal attitudes. The justice system professionals have to be aware of this.

Respect is also very important because there is a stigma attached to someone who is mentally ill, especially in school, but the stigma really covers all aspects of the child's life. There should be a lot more education in the schools about mental health to make it easier for those who need mental health care and find coping difficult enough already.

Some hospitals hire professionals for the simple reason that they are young and inexperienced, and therefore cost less in terms of salaries. When a young person of 17 or 18 has serious difficulties and is being treated by someone who is 19 or 20, that young person may be treated with less understanding just because of the person's age and inexperience. When the treatment focuses on: "This is your disease, this is what's wrong with you." instead of dealing with the whole situation and the whole person, that approach can be very harmful, very damaging to the character of the young person.

The whole area of professional development and in-service training needs to be reviewed. In some faculties of helping professions, the teaching curriculum doesn't provide a broad enough knowledge to be effective in the community. The preparation of child care workers, educational psychologists, and other mental health professionals leaves a lot to be desired because many teachers don't stay current; they isolate themselves in esoteric, individual programs. Their teaching becomes less and less relevant to the needs of professionals who are going to be working in communities and youth facilities. We need to look at standards of practice and at professional preparation to make sure that schools and universities that prepare students for the helping professions have to be more strongly aligned with communities. More research dollars should be made available to support the communities and the teacher training.

We are beginning to know a lot about Fetal Alcohol Syndrome (FAS) as it was identified as a disease in 1973, but not much is being done about it in terms of funding and research. The difficulties associated with FAS children and youth can be varied: trouble with the law, early school dropouts, difficulties with drugs and criminality, etc. With early diagnosis however, secondary behavioural disorders can be addressed. We are beginning to understand the organic brain differences that were often not readily identified because they are so similar to several other mental health problems. Education and support and healing are crucial when a diagnosis of FAS has been made, both for the child and the family. There are still outstanding issues related to FAS that need to be discussed. For instance:

• When children are ordered for assessment by the courts, FAS is not a category that can be used as a diagnosis. Why not?
• Suicide is still a big issue in aboriginal communities. They haven't looked at the FAS link to a person who is unable to cope. Why not? Many FAS people feel that nothing ever turns out right for them.

Education and prevention and awareness of FAS are all really important at the grassroots level even more so than at the clinical level.

Looking at the 5% of kids who are at the deep end, the aggressive, violent kids, we find that 77% of them have repeated failures with residential placements, and some of them have been moved between 15 and 37 times in foster homes. The higher the number of moves, the higher the assault rates, the greater the violence. If we look at the funding available for troubled children and youth, provincial governments seem addicted to wanting money to flow in different directions. There are small pots of money in separate places for designated problems, and kids that move across designations have trouble getting funded help in one place. When kids start to settle in a placement, after a while they go through an attachment crisis, start to act up and people immediately want to move the kid. It makes no sense. Frequent placements don't address the issues, and isolated, disjointed pots of funding dollars don't help as much as integrated funding would.

Aboriginal communities have a different subset of concerns in terms of mental health. The negative view of mental health makes it very difficult to ever make it a priority. We need to develop a definition of mental health that people can accept, and that can make it possible for communities to develop strategies aimed at better mental health. Aboriginal children often don't do well in the school system because of behavioural or social problems. While schools receive special funding for Aboriginal youth, not much seems to be done about the difficulties they are having in school. Many of the high school graduates seem to be functionally illiterate, making it unclear whether the graduation certificate is an authentic proof of competence or a social pass. This is unfair to the kids and unfair to the community.

Further, because of the cultural differences, the outcomes of mental health services are perceived differently. The trust in professionals can be absolute and people just take their word for everything without asking questions. If a medication is prescribed, no one will ask what the drug actually is and what it does, they just take it. Also, Aboriginal communities are not large, may not have the strong norms that characterize healthy families, and the Aboriginal populations were disrupted for decades by state and church. Outside professionals lack the real understanding of the history and situation that would help them succeed in building good healthy families.

Professionals are now attempting to treat Aboriginal people in a more culturally respectful and relevant way. Several incidents where Aboriginal youth were mistreated out of ignorance have emphasized the need for education about some of the traditional Aboriginal ways. There is a better way of dealing with problems than force or punishment, and healing can only occur in an atmosphere of respect and understanding.

2. Dealing with Offending Behaviour in the Community.

Participants noted that alternative measures were possible with the previous YOA, but that in many provinces they were never developed or acted upon. They wanted to know what the federal government was going to do this time around to encourage the provinces to develop and use alternative measures. In response, the federal representative indicated that the federal government has developed bridge funding - $125 million over the implementation phase - to help the provinces develop community-based alternative measures programs. Work is also being done on training the police and mobilizing them so that they understand what the range of their discretion is in terms of alternative measures, and are able to use that discretion. The RCMP have identified youth justice as one of their top four priorities for this year, and Justice is working with NAACJ to look more constructively at what might be done to encourage the use of alternative measures. Legislative incentives, funding, training and mobilization are key elements in trying to support the use of front end measures.

Participants also felt that the new Bill does not constitute a net improvement over the previous YOA in the area of restorative justice and alternative measures. They pointed out that youths already rarely receive custody for a first offence. Repeat offenders and those who breach conditions are only likely to receive custody the third time around, and judges, through the catch-all provision still retain a great deal of discretion. They suggested that the proposed wording of Section 38 be reviewed to make sure that it meets its intended objectives and that there be training for judges as well as police on prescribing and using alternative measures.

On the subject of family group conferencing, one participant remarked on the admirable skill of some of the police officers that have been trained in this. When people are well trained, mental health professionals don't have much to add in family group conferences. But, particularly when resources are short, there is a tendency to want to take the easy cases. Once a kid gets a diagnosis of conduct disorder, nobody wants to have anything to do with him in mental health, and sometimes in education. That acts as a prelude to getting him out of the school system. Rather than moving a kid from one system to another, the main challenge is to get the people with expertise from a different system to help meet his needs (e.g. educational professionals could obtain help from mental health professionals) unless there is a clear indication that the youth would do better in another system. Family group conferencing can be used both in child welfare situations and young offender situations. One of the key points is the role of the coordinator in supporting the process and making sure that everyone who is present at the conference has the support required. Also, if there is a need to follow-up afterwards, the coordinator is in place to see to it.

In the area of peer support, Newfoundland is presently working with a model that came out of CMHA and was established very successfully with adults. It provides skills to people via a "training the trainer" model, teaching people in communities fundamental listening, supportive, helping skills. It differs from peer counselling in that it is more about getting people to realize what's helpful and isn't. The program, introduced in communities where there are no professional services, has been so successful with adults that it is now being piloted with youth. For young people who are at-risk, dropping out of school and into alcohol and drug use, it's very interesting. The most dynamic thing about the program is that the emphasis is on people helping each other and on each individuals' strengths and knowledge. Peers know what feels helpful and what doesn't and can use this kind of knowledge to be supportive to others.

When we talk about peer-helping models, one problem is that there is a strong flow of conservatism about saving money in the system. Kids are free; they represent a cheap pool of labour. The fact is, unless the peers are very skilled, they might not be effective with kids with important disabilities. Peer models should be used selectively, not across the board and in all cases. Peer helpers need training, help, support and supervision because there might be liability issues as well. The presence of an adult mentor and an infrastructure that gives support to those kids who are doing the mentoring are essential. We need to provide the back up and the expertise. It's not a cheap alternative; but a way of tapping into the energy and trust and shared understanding that there is amongst peers, and making that a more accessible resource. It is not an issue of cost, but a tool that can be included among other things.

Prescribed treatment programs for young offenders are not always positive. Kids have to show up on time, be there and participate, no matter how they feel, how far they live, or how expensive the commute. Sometimes, they don't show up. In addition, some programs set very rigid schedules for young people, and some have difficulty adjusting to these prescribed schedules. As for the activities themselves, whose main thrust is to make it possible and positive for young people to reintegrate society, success varies. Kids in troubled states don't always appreciate doing cooking and grocery shopping when they are really upset and really angry. Too often, parents and professionals often don't accept the way a child or youth chooses to express himself and feel compelled to redraw or reframe the child's output to produce what is expected. There is a lack of understanding of where young people come from, and thus a need to teach people to accept and respect how young people and children are going to express themselves.

In Arts and Recreation Programs, it is sometimes possible to achieve things with a few kids on the verge of delinquency that could not be achieved in the office of a mental health professional. There is no doubting the therapeutic effect of good recreational programming. Recreation people can have a beneficial effect on these kids because there are no games of: "I am a young offender, a kid who screwed up." One of the big tragedies is that mental health people don't even think of what can be achieved through good recreational programming. To be effective, the activity must be inclusive and the head of the activity has to be flexible enough to meet the needs of the individual child so that the child will feel at home there. Mental health people could help those people in the recreation sector who are trying to get activities to be more inclusive, by helping them to develop techniques that might allow more kids to stick in rather than have a bad experience and drop out. That's where mental health professionals might play a minor part.

On the topic of continuity of care for children in difficulty, it was suggested that a child who is identified as potentially requiring professional services throughout his/her life be assigned to a team, rather than to a single child worker, to increase the chances of continuity of care. The team would consist of a small group of people, constant enough in the life of the young person that, hopefully, a two-way attachment might develop over time. The team would follow through with the child, individualize treatment, include teachers or others who might help, and make sure he/she gets what is needed when it is needed. Another major role of the people on the team is to be an advocate for, and mentor to, the young person. The WrapAround model in Ottawa-Carleton was cited as a good working model of that concept. The consultative team that is brought together builds a capacity for follow-up to take place within the family and within the community, ensuring continuity of care.

One of the issues is that even on teams, there isn't a specialist for every situation (an addictions expert, a personality expert, a neuro-psychology expert, etc.). That's part of the difficulty. One might say, "Let's get a team with all these different sub-specialities represented." Then the problem is that the people who look at this young person from many different perspectives come up with very different understandings of what's wrong with him, what is underlying the whole thing. When there are different competing perspectives, we need to use a conflict resolution process to get to what the child really needs.

When you are dealing with youth in difficulty, there is a certain complexity superimposed on other problems because of the levels of development of children and youth. Everything must follow and take a developmental perspective. A solution will be different if you are dealing with a 12-year-old or a 16 or 19-year-old. We tend to forget that a teenager likes to date and hang out with their friends, likes sports and music, needs to stay in school, and in treatment a lot of those pieces go missing. We define the problems in terms of what we offer and give narrow solutions, but we forget that this is a whole adolescent with all these other needs that go with it. We need to make sure that, from the provisions mental health services to how a judge disposes of a case, everything must reflect the developmental perspective.

Privacy is an important issue in the treatment of young people. There should be a few people who know they youth's problems because there should really be a base. But sometimes this base grows too large. It affects the youth as a person to have so many people know what's wrong with him. It's very intruding. The problem might stem from something outside the youth, his family environment for example, but the problem becomes personal, something that comes from inside. The issues have to be dealt with carefully and privately.

3. Working as Partners with the Youth Justice System and Helping the Rehabilitation and Reintegration of Young People in the Community.

When violent young offenders were queried on what they found most difficult about incarceration, they mentioned the following:

• A sense of disconnect from their family, community, culture and language, from everything that is normal for them.
• The limit of ½ an hour placed on visits with family when incarceration is for a year or more.
• The need for back up when you go into custody. Other violent youth protect youth so that you can survive within that system.With time and experience, you become back up for other people. The youth saw this as incredibly unhealthy. They also felt unable to separate from these "friends" after custody because they have become involved with gangs, or their back-ups were part of gangs, so that when they return to their communities, those ties are maintained.
• The lack of privacy, the fact that they can't swear, can't smoke, and many little things that take away the sense of person and flexibility.
• The sense of not being listened to in terms of their own rehabilitation, just being told what they need.

On the flip side, they wanted to see:

1. Education. – These youths wanted to stay in school (even while in custody) , not be kicked out for not attending, but have a more flexible system, cultural education, arts and crafts programming, and other types of programs.They realize it will take them longer to do their schooling but they need the flexibility.
   
2. Treatment in jail – Many of the youth aren't getting any treatment until the end of their sentence when they are in an addiction treatment centre. That's a waste of years. If they started treatment in the young offender system, by the time they get to the end of their sentence, they would have had time for a significant treatment.
3. Not just be returned to the community – They don't want reintegration into their community without support. The probation officer isn't someone consistent in their lives and offers no support. Families are often dysfunctional with major unresolved systemic issues that hinder rehabilitation.
   
4. More flexibility for the kids to stay on a voluntary basis, whatever way legally that can be done, so that they can get more intensive treatment and learn skills before they go back out on the street.
   
5. Follow-up. – An adjustment period with follow-up where they can come back to the residence for follow-up rather than being referred elsewhere to start a whole new relationship once again. They want to come in for a couple of hours a week to see someone they know and trust, and talk to them. Sometimes an adolescent will break the law again just so he can stay and finish treatment.

Conversely to all that, however, there are adolescents in young offender treatment centres who want to go to secure custody, because they just want to put in their time. They don't want to be in a treatment program where they are being pressured to change. They would just as soon put in the time and then be done with it. Nevertheless, participants were against imposing adult sentences unless absolutely necessary, in very rare cases. There was concern that with the new Bill, the 3-year placement could be shortened at the beginning if time spent waiting for sentence is counted, and again after 2/3 of the sentence when the automatic intensive supervision period is imposed. Some of the participants disagreed with the automatic nature of that 2/3, finding that with juveniles in treatment, the treatment program depends on the way they evolve.

Some young people receive adult sentences while being placed in juvenile facilities with the understanding that when they turn 18, they will be transferred to an adult facility. This is self-defeating. Most of those juveniles who receive adult sentences, or long specific sentences, are those who are very difficult to work with. Neither the youth nor the staff will invest the required efforts to really try to effect a rehabilitation when the only possible outcome is transfer to the penitentiary. These kids are described generally as needing help, but some of them need a lot of help, and require a lot of patience from the staff. Sometimes the educators or treatment team are discouraged, and in such cases, the temptation would be very strong to transfer the youth right away if he is to be transferred in a year or so anyway. This is a very difficult aspect of the law.

Some of the participants were also surprised at the many conditions that accompany the intensive supervision period. In their opinion, the proposed conditions were those more characteristic of surveillance, not of support. Also, they felt that the 2/3 automatic release followed by the supervision will take away the flexibility that is so necessary with treatment of uniquely different individuals. With the current YOA, the young person is released under supervision and begins working outside when he is deemed ready. If something seems to be wrong, residential staff can pull the youth back in for a couple of days, find out what's wrong, help him through it. Then, when he is ready, he can be sent back out. There is flexibility to react at the opportune time. With the new law, there are a lot of procedures around this kind of action. To bring a youth back in, you need the judge's permission. To send him out again, it has to be part of a plan. There is a feeling that the flexibility needed to work with kids is not there.

Other comments related to the new Bill were as follows:

1. The presumptive transfer at age 14 is going to make reintegration and continued involvement with the family more difficult since identifying information will be released. This is important because of the level of stigmatization to the youth, but especially the level of stigmatization to the family which is going to further strain the relationship between the family and the child.
2. There's an ethical question about treatment for kids who don't want treatment. There are kids for whom treatment as a condition (e.g. substance abuse) would be important, although it would also be important for the adolescent to buy-in as much as possible. There doesn't seem to be incentives built into the new Act that will make youth agree to involvement in a treatment that isn't a complete abrogation of their rights. Let them get into the treatment and see that it can be helpful and they can hopefully take advantage of it on a voluntary basis later on.
   
3. Inequity from province to province about the support provided to young offenders.
4. Finally, the new Bill seems far more adult-centred than the YOA, which tried to balance the protection of the community against the special needs of adolescents. There doesn't seem to be any attempt to achieve the same kind of balance in the new Act. The primary objective of this Act is clearly the protection of society. What is said afterwards about the special needs of youth is at a secondary level. That's one of the chief concerns with the new Act.

On the issue of meaningful consequences and rehabilitation, it was suggested that meaningful consequences should not be at the level of sentencing but at the level of the kind of information before the courts. It was further noted that ‘Rehabilitation' is the wrong word. Rehabilitating these adolescents would mean trying to restore skills that were lost. We are in fact trying to habilitate these kids, helping them learn skills they never acquired in the first place.

Another point has to do with the severely violent offenders. A lot more research has to be done in terms of classifying types of violence and coming up with specific interventions to target those different types of violence. What works reasonably well with one type of violence will be completely ineffective with another. That research is still relatively in its infancy, and once there is understanding of the processes involved, prediction will be aided considerably. Justice might want to look at that down the road since that's where better answers will be coming from, with clear applicability to the issues discussed in this session.

With respect to evaluation, it is important to look at the whole child's life, not just deficits, but strengths also. It would be useful if, while the young person is in care over a span of six months or more, there were a picture of the whole child in that process at any given time. You would be able to tell if the child is growing in life skills, awareness, anger management, functioning, friendships, as well as more psychometric areas. You might not see a dramatic change in the level of aggressiveness for example, but you might find that the kid is doing better at school or has changed in other areas. An evaluation that focuses only on one particular intervention, say violence, and measures only that as an indicator of treatment impact or failure might miss 99% of the things in that child's life that are showing positive measurement.

There is perhaps room in our system for a kind of a correctional foster care. This would be kids who come out of state custody and go and live with people who provide as close to one can get to a natural setting family. Kids tend to come out of care and go into the street or other settings, institutions, etc. But if there was a trained set of people who were doing a different kind of fostering and provide what looks like a more normal life, this would be effective for kids. There was a program in Oregon where they had trained foster families with tools for managing kids with real behaviour problems who were coming out of the corrections system and they were having tremendous success with it. One comment is that it was very resource-intensive, but seemed to be doing a good job, primarily with girls.

The diagnosis for FAS is way below what anybody could reasonably expect.It's grossly underdiagnosed. When you realize that 75% of violent young offenders in jail in B.C. have FAS or FAE, and 50% in Manitoba, there has to be concern about the treatment for young people with FAS. If children who are suffering from FAS were diagnosed correctly early on, different techniques could be put into play to help the FAS child. For example, structure is one of the things that helps people with FAS. While incarcerated, they do well because of the structure. Once they are outside of that, they fall apart. People that develop programs for incarcerated youth need to be educated about FAS so that they can make appropriate programs. The youth need to be pulled in to help develop these programs to find out what works for them. Then, when the FAS child goes back to his community, the after care plan should include some kind of education for the people looking after him (family, school, others) so that they understand that they should provide a structure because that will work.

4. Specific Responses to Assist Youth and Children with Conduct Problems, and Next Steps

Better and more wide-spread education about Fetal Alcohol Syndrome. Include lawyers, judges and police officers, all counsellors in youth facilities as well as parents or guardians, all those working directly with the youth, in custody or in the communities for after care so that there is understanding of the effects of the disability and support there for young people.

Education for the workers in the institutions so that they become more aware of mental health issues and the potential damage to the young people from provocative and disciplinary actions on people with mental health concerns.

A continuous mentorship process in co-operation with child welfare so that when there is a youth worker or mentor working with a young person, that mentorship could continue while the young person is in custody and even when he is released to the community.

The possibility of alternative facilities or specialized units within the centres for those individuals engaged in the intensive rehabilitative custody process.

The containment of individuals with severe conduct disorders isn't always available through the normal processes (hospitals and other kinds of adolescent treatment settings). The young offender centre becomes the common pathway, and the containment that's available there can be helpful even if it has a mental health bias. That goes against the idea of steering people away from centres, but in the absence of other resources, it's an important part.

The emphasis put on really helping the kids doesn't come out in the proposed new Act. The Bill leans toward the "tough" side, and leads people to believe that the adult system is better, that adult penalties are going to protect society better than rehabilitation does in the juvenile system. The principles do not mention protection of youth and protection of society on the same level. The way the principles are stated is a concern, as well as the publication of names, the imposition of adult sentences in juvenile facilities, and presumptive offences that will make it easier to give youth an adult sentence in the juvenile system. All those things set the tone of a Bill, which seems to be turning away from the habilitation and education process. This Bill makes it easier to use the adult system. In fact, not only should it not be easier to sentence young people to the adult system, it should be made more difficult. Only in very rare circumstances should a young person be sent to the adult system. The Act should reflect that.

Recognize that, in the context of rehabilitation and reintegration, kids need jobs, housing, support for addictions, skills to find and keep jobs. These things are perhaps the most important foundations to mental health. Yet, they are not firmly in place for young people. Those issues must be put on the table as part of the things we have to sort through.

There is a need for resources at all levels. An Act can talk all it wants about therapeutic remediation as part of a disposition. But if there aren't the resources in the community, young offenders will be the first to be denied service.

There are distinct barriers to consultation from one sector to another and for collaboration between one sector and another. One of the results of those barriers is the inability to make a long-term commitment to children, youth and families we know are in serious trouble.

The federal government should take real leadership in public education in two areas in particular:

1. Increasing poverty, cutting down on support services, and implementing zero tolerance policies in schools is actually moving to increase the number of youth that are going to be young offenders.
2. When a youth has offended for the first time, a choice must be made between moving to rehabilitate that youth or moving to punish him. And the harsher the punishment and the treatment of that youth, the more likely the recidivism.

Make mental health care consultation available to some of the mainstream services, such as education, child care and recreation so that they can help to keep some of the more difficult youth from being expelled from the various systems.

Mental health care professionals need to share their knowledge with the significant others in the lives of the young person who is in difficulty. Far too often family members and relatives are left out of case conferences when in fact they are expected to be resources to the people who are in difficulty. Greater attention must be paid to finding ways of acknowledging and affirming their importance. Sharing information with mental health professionals at the same level, so that there is reciprocity, will help mediated kinds of learning to take place.

There are now several new agencies dealing with family and children services that are controlled locally. Involve the major agencies in Canada that are really on the front line of some of the issues being discussed.

The wide discrepancy in how the various provinces have implemented the current YOA has not been positive. With the new YOA, there should be more common implementation across the country and that may call for some fairly prescriptive clauses in the Act or in the regulations.

Funding for follow-up services: that is probably the biggest weakness from a service-delivery point of view, and youth themselves want this. That is one of the key things that is consistently identified.

Some measures to make the young offender system less isolated, less fragmented from other parts of the system, such as using the beds where the youngsters best fit in as opposed to which bed has a dollar coming from the ministry of corrections or the social services ministry or the health ministry. In other words, the Act, or the regulations, must somehow prescribe more of that flexibility or allow it.

Bring the notion of accreditation for young offender services up to scratch. We wouldn't dream of going to a hospital, university, or a mental health service that isn't accredited. Accreditation for the young offender system services could ensure that kids who end up in that system could get services of the same standard that every other part of the population is entitled to.

Continuity of services is crucial, and there needs to be some publicly-funded, available kind of system, however it works. Make sure that services are not only co-ordinated but that there is good, ongoing assessment for kids so that we're not slotting them, but continually finding what's really appropriate for them.

When mental health is involved with young offenders, this must be done ethically and with respect for those young people's privacy. When too much of what is therapeutic is shared back with youth justice as part of risk assessment or sentencing, it can be damaging for the youth. What is therapeutic should be shared only amongst therapists.

Do not mandate, recommend or put in a legislation any service that does not exist. If you say that children need to receive follow-up services, preventative services, make sure those services exist. Judges are constantly sentencing children to mental help and anger management when these things are not available for children.

We need to show understanding and respect for the youth that are in the system and to be youth-centred and client-centred. We can't really understand the problems unless we respect those who are using the programs.

Use what works. Funds are being cut from programs that already work well. Reverse that trend. Keep the programs, and expand on them as necessary.

When youth come to the end of a carceral sentence, there must be an examination of the youth's family and community milieu. The offence may have been the result of physical abuse, sexual abuse, alcohol, physical or mental illnesses in the parents, and they should not be returned to an environment that will almost guarantee recidivism without conditions or support.

Offer a variety of treatment services to take into account the individual's needs. A young person must be involved in an activity of some sort to gain self-confidence, whether arts, recreation, athletic, or academic. It is important to help them go back to school; and if school in the traditional sense is not possible, the youth must be given the necessary preparation to access technical courses that will allow him to find and keep a job. Activity is important at every level, but the youth will do better if the activity is something he likes and that motivates him.

Youth must be involved in their own therapeutic planning, as well as the family and the professionals. They know the context of their life and living conditions better than any of us, and are able to say whether this is going to work for them. We need to treat youth with dignity and respect because disrespect just leads to lack of control on the part of the adults, hostility in the lives of youth, and increases chances of the offence reoccurring.

All organizations working with young people can help to reinforce the positive aspects of the work that Justice is doing by informing the public and keeping the dialogue open and accessible to everybody. There is a lot of fear around the Act, generated mostly through sensationalized media coverage. The general public doesn't have an opportunity to get the straight goods perhaps, but NGO's could help because they are not as threatening.

The new Bill is a proposal for legislation based on the protection of the public. In point of fact, if we focused on looking at the needs of the adolescent, we'd be, in the long run, doing a far better job of protecting the public than by reversing the order of priorities. The federal government should be putting a lot of effort in just simple public education.

There is no research base on the effectiveness of long-term residential care. People talk about long-term residential treatment not working, but there is no evidence. There are no studies because it's complicated and there are no funds at the provincial level for that kind of research. Around the world, there are several long-term studies, such as the one which has been going on in New Zealand for the past 25 years. We need more of that kind of long-term study.

Severely conduct-disordered kids are most often academically impaired, impulsive, unreflective and disorganized-attached adolescents. Professionals talk about the need for psychotherapy. Those adolescents aren't available for psychotherapy at this point in time. Research tells us we should be doing habilitation at this point in time, skill-based interventions. We need to look at the kinds of skills these kids should be developing. We need to provide stability in living circumstances, whatever kind of circumstance is available for that young person.

In the service delivery system, there is a need to create mechanisms to provide funding that is not tied so directly to the focused provincial process. There needs to be a different way of funding creative programs not necessarily currently accepted as credible or meant to fit the current popular agenda, particularly as it is presented in the press. If there are options available to find funding for services that are creative and unique, that would be one way that the federal government could impact the national agenda.

Invest in prevention. If you don't spend enough time intervening in young children's lives, if you put their problems off for too long, that's when they are going to run into conflict with the law; you're going to end up paying for it then. Take the time to prevent that from happening.

One very important aspect in dealing with people with mental health problems is individualization. Each person is so uniquely different. Everything that happens to someone from the very first day determines why they turn out the way they do. Categorizing somebody into a certain classification is not positive. Look to someone's individual needs instead of looking at the big problem, the one underlying problem they have because there is so much more that goes on with somebody who is young and having problems. Sometimes, it's really hard to be young.

Some of the knowledge bases we need to help young people in conflict with the law:

1. The community resource base , which is person-centred and really represents that continuum of support that all of us need when we have difficulty and certainly can be applied to young people with mental health difficulties and in trouble with the law.
2. The knowledge resource base, is useful in organizing the different perspectives needed to understand problems in general and mental health problems in particular. It includes clinical and medical expertise. All too often in the mental health system, we've regarded that as the most important kind of knowledge. However, we need to put it on a scale and balance it with sociological knowledge which tells us about all the social conditions (violence, poverty, etc.) which lead to mental health problems.
3. Experiential knowledge that we get that from families and individuals who tell us what it's actually like to be identified as a problem, and to have to deal with the consequences of that.
4. Traditional and customary knowledge , such as is found in native cultures. It also includes the myths and stereotypes that are found in any society which tend to perpetuate stigma and make coping with any perceived deviation from ‘the norm' much more difficult.

These four knowledge bases constitute a useful framework for public education, professional education and for continuing education. If we haven't included all these perspectives in problem solving, we may be missing something.

In the symposium coming up, allow an opportunity for youth to speak to the whole symposium, and for the whole symposium to ask questions and engage in discussion with the youth.

Report by Jeanne N. Ruest
February 13, 2000