Children with mental health needs and low IQ caught up in the criminal justice system

A new report from Prison Reform Trust’s Care not Custody programme offers professionals practical advice on helping vulnerable young people in England and Wales.

“I took lots of medication, but it was just knocking me out,” says Adam, who at 17 years old is homeless and living in bed and breakfast accommodation. “I’d take it and like an hour later I’d be doing my work at school and I’d then fall asleep on my desk. They just gave me medication. They were supposed to check my blood levels every two or three weeks but they didn’t do that for two years.”

Adam has a diagnosis of autism spectrum disorder and needs emotional support due to significant emotional abuse during early childhood and bereavement, following the death of his mother. He has alcohol and drug misuse problems. “I’d like to get my own place," he says, "my own car, wife and children and a decent job...I could pick it [college] up again; my attendance was good but when I got homeless and have been moving about it stopped.”

Adam, now being supported by a youth offending team and the Child and Adolescent Mental Health Service, is one of the young people quoted in a Prison Reform Trust Briefing Paper, Turning young lives around: how health and justice services can respond to children with mental health problems and learning disabilities who offend. (PDF) 

Many children who offend have health, care and education needs which, if not met, can lead to a lifetime of ill health, unemployment and crime. High numbers of children who have mental health needs and learning disabilities are slipping through the net of care and support in the community and getting caught up in the criminal justice system. Contact with youth justice services can create opportunities to identify and meet children’s support needs. However, health, education and criminal justice services frequently do not work effectively together to ensure that these vulnerable children get the right support.

In total, around 85,000 children were supervised by Youth Offending Teams in England and Wales in 2010/11. All children who come into contact with youth justice services are vulnerable by virtue of their young age and developmental maturity. Many are doubly vulnerable, being disadvantaged socially, educationally, and also because they experience a range of impairments and emotional difficulties. Research shows that:

  • Around a quarter of children who offend have very low IQs of less than 70 (the general population average is 100);
  • 43 per cent of children on community orders have mental health and care needs, and the prevalence amongst children in custody is much higher;
  • 60 per cent of children who offend have communication difficulties and, of this group, around half have poor, or very poor, communication skills.
  • The Prison Reform Trust and YoungMinds briefing paper for frontline staff in the NHS and children's and youth justice services, Turning young lives around offers a blueprint for change and makes practical recommendations to improve the system of justice, care and support for vulnerable children who offend. 


Our paper highlights the importance of effective joint working between Health and Wellbeing Boards and youth justice services, in particular, to ensure that local strategies reflect the needs of children and young people who offend, especially those with mental health problems and learning disabilities. We outline a practical action agenda of positive steps local services can take to improve service delivery. For example, we encourage local organisations to work together to assess the health and wellbeing needs of children who offend and to use this data to help inform the planning of local services, through the new Health and Wellbeing Strategies. There is advice for youth offending teams and police and crime commissioners as well as those responsible for health and social care, clinical commissioning groups and local authorities.

Examples of good practice on integrating services are included. For example, in Nottinghamshire, a comprehensive assessment of health needs amongst young people who offend led to an Action Plan and Commissioning Plan to address areas of often unmet need. The needs of vulnerable children who offend have been prioritised by the county council, youth offending teams, and child and adolescent mental health services.

In Hampshire, a forensic psychiatric team works closely with the local criminal justice system, for example, providing input into pre-sentence reports where mental health may have been a salient factor. Due to close joint working the need to commission full medical reports is reduced, which cuts costs and delays.

The profile of children who offend has been well known and well understood for years. Children who offend become adults who offend, at great cost to the public purse, society, the individuals concerned and their families. It is a persistent and slow burning tragedy. The Prison Reform Trust and YoungMinds hope that this briefing paper will help speed the transformation that is so urgently needed in society’s handling of some of our most vulnerable children.


The Briefing Paper, Turning young lives around: how health and justice services can respond to children with mental health problems and learning disabilities who offend was jointly prepared by the Prison Reform Trust and YoungMinds, with support from the J Paul Getty Jnr Charitable Trust and the Diana, Princess of Wales Memorial Fund and is available in PDF here