Young offenders — structured clinical viva

Epidemiology anchors. Cite Fazel 2008 and Beaudry 2021: detained adolescents show very high CD and SUD, with elevated ADHD, depression, and related morbidity; psychosis elevated vs community but not modal. Teplin/Abram establish multi-disorder burden and comorbidity as the rule; trauma/PTSD is substantial.^[1][2][3][9]

Developmental pathways. Moffitt LCP vs AL: early onset and neurodevelopmental/adversity load versus peer-contextual adolescent onset with greater desistance potential. Follow-up supports differentiation — formulate probabilistically, not fatalistically. Do not diagnose ASPD under 18.^[4][5]

Assessment. Multi-source (youth, caregiver, school, youth justice, health). Risk triad: suicide/self-harm, violence, vulnerability/exploitation. SAVRY SPJ domains plus protective factors — structure judgment, not crystal-ball scores. Fitness/capacity in youth uses developmental maturity principles; statutes are local.^[8]

Suicide/self-harm systems. Reception and early custody are high-risk windows. Observation ladder, means restriction, treat drivers, never isolation-as-care. Self-harm is clinical, not pure discipline.^[2]

Interventions. Least-restrictive diversion; multi-agency plans; MST and FFT as named multi-system/family models with outcome literature; TFCO-type foster care concepts for high-need community alternatives. Treat ADHD, depression, PTSD, SUD, psychosis on their merits with youth monitoring — do not medicate “offending.”^[6][7]

Special populations. Girls (trauma/self-harm), Indigenous youth (cultural safety, structural over-representation), ID/ASD, LGBTQ+ placement safety.^[3][9]

Throughcare. Release and age-18 transfer are continuity risk peaks; 15-year data show psychiatric continuity after justice involvement — plan long-horizon care.^[10]