Psych · Forensic psychiatry — young offenders
Young offenders
Also known as Youth justice mental health · Juvenile offenders · Justice-involved youth · Youth detention psychiatry · Adolescent forensic psychiatry · CAMHS forensic liaison · Young people who offend · Juvenile detention mental health
Exam-exhaustive fellowship reference on young offenders and youth justice mental health — detention prevalence, Moffitt developmental pathways, trauma and neurodevelopmental comorbidity, SAVRY-informed assessment, suicide/self-harm, diversion, MST/FFT/TFCO principles, multi-agency care, and transition risk. FRANZCP-primary, globally tagged.
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Target exams
Red flags
- First nights in youth detention with active suicidal ideation, prior near-lethal self-harm, or acute intoxication-withdrawal — escalate observation and urgent clinical review immediately
- Emerging psychosis, severe mood disturbance, or organic red flags mislabelled as pure 'behaviour' or conduct disorder
- Isolation or prolonged segregation used as the primary response to distress, self-harm, or aggression — least-restrictive care and clinical review, not containment alone
- Missed ADHD, intellectual disability, autism, or trauma under an antisocial label — incomplete formulation drives failed interventions
- Child protection, exploitation, or trafficking indicators not escalated while focusing only on the index offence
- Age-18 transfer or community re-entry without throughcare plan — continuity break is a high-risk window
Meet the patient
A 15-year-old boy is received into youth detention on a Friday night. He smells of cannabis, his pupils are glassy, and there are fresh superficial lacerations on his left forearm. The referral form says "conduct disorder, rule in or out." His school record — not yet in the file — notes ADHD, a reading age two years behind, and exclusion since year 8. His mother is not answering the phone.[2][16]
The examiner's question is not "what is the label?" It is the developmental one: "What do you do in the first hour, and what framework do you use to think about this young person over the next six months?" Everything below is the answer.[7][16]
References16ShowHide
- [1]Fazel S, Doll H, Långström N Mental disorders among adolescents in juvenile detention and correctional facilities: a systematic review and metaregression analysis of 25 surveys J Am Acad Child Adolesc Psychiatry, 2008.PMID 18664994
- [2]Beaudry G, Yu R, Långström N, Fazel S An Updated Systematic Review and Meta-regression Analysis: Mental Disorders Among Adolescents in Juvenile Detention and Correctional Facilities J Am Acad Child Adolesc Psychiatry, 2021.PMID 32035113
- [3]Teplin LA, Abram KM, McClelland GM, et al. Psychiatric disorders in youth in juvenile detention Arch Gen Psychiatry, 2002.PMID 12470130
- [4]Abram KM, Teplin LA, McClelland GM, Dulcan MK Comorbid psychiatric disorders in youth in juvenile detention Arch Gen Psychiatry, 2003.PMID 14609885
- [5]Abram KM, Teplin LA, Charles DR, et al. Posttraumatic stress disorder and trauma in youth in juvenile detention Arch Gen Psychiatry, 2004.PMID 15066899
- [6]Teplin LA, Potthoff LM, Aaby DA, et al. Prevalence, Comorbidity, and Continuity of Psychiatric Disorders in a 15-Year Longitudinal Study of Youths Involved in the Juvenile Justice System JAMA Pediatr, 2021.PMID 33818599
- [7]Moffitt TE Adolescence-limited and life-course-persistent antisocial behavior: a developmental taxonomy Psychol Rev, 1993.PMID 8255953
- [8]Moffitt TE, Caspi A, Harrington H, Milne BJ Males on the life-course-persistent and adolescence-limited antisocial pathways: follow-up at age 26 years Dev Psychopathol, 2002.PMID 11893092
- [9]Colins O, Vermeiren R, Vreugdenhil C, et al. Psychiatric disorders in detained male adolescents: a systematic literature review Can J Psychiatry, 2010.PMID 20416149
- [10]Curtis NM, Ronan KR, Borduin CM Multisystemic treatment: a meta-analysis of outcome studies J Fam Psychol, 2004.PMID 15382965
- [11]Henggeler SW, Schaeffer CM Multisystemic Therapy: Clinical Overview, Outcomes, and Implementation Research Fam Process, 2016.PMID 27370172
- [12]Littell JH, Pigott TD, Nilsen KH, et al. Functional Family Therapy for families of youth (age 11-18) with behaviour problems: A systematic review and meta-analysis Campbell Syst Rev, 2023.PMID 37475879
- [13]Olsson TM, Långström N, Skoog T, et al. Systematic review and meta-analysis of noninstitutional psychosocial interventions to prevent juvenile criminal recidivism J Consult Clin Psychol, 2021.PMID 34264699
- [14]Lodewijks HP, Doreleijers TA, de Ruiter C, Borum R Predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) during residential treatment Int J Law Psychiatry, 2008.PMID 18508122
- [15]Dalsgaard S, Mortensen PB, Frydenberg M, Thomsen PH Long-term criminal outcome of children with attention deficit hyperactivity disorder Crim Behav Ment Health, 2013.PMID 23576439
- [16]Underwood LA, Washington A Mental Illness and Juvenile Offenders Int J Environ Res Public Health, 2016.PMID 26901213