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Detained children receiving ‘pitiful’ mental health support

A mentally-ill child detained at Adelaide’s youth detention centre was locked in a room for long periods of time and handcuffed when in common areas because staff didn’t know how to provide proper care, a damning report to parliament has revealed.

Nov 19, 2021, updated Nov 19, 2021
Kurlana Tapa youth detention centre at Cavan. Photo: Tony Lewis/InDaily

Kurlana Tapa youth detention centre at Cavan. Photo: Tony Lewis/InDaily

The young person’s circumstances have been described as “inadequate” and “pitiful” by the state’s Training Centre Visitor Penny Wright, who in a report to parliament wrote that she tried raising concerns about the “wretched” conditions with several government ministers but didn’t receive a satisfactory response.

The child, who is unidentified, was reportedly detained on remand at the Kurlana Tapa Youth Justice Centre (KTYJC) at Cavan north of Adelaide for over three months last financial year.

They are described as having “symptoms of significant mental illness” that placed them and others at “serious risk” while they were in detention.

Wright wrote that apart from several “brief” visits to the Women’s and Children’s Hospital, the child was required to spend long period of time locked in their room.

When they were not locked in their room, she wrote that they were sometimes handcuffed in common areas.

“They were effectively restricted from fresh air, stimulation, and social interaction with others because of the risks posed by their behaviour and the limitations of the KTYJC environment for managing a resident with such needs,” Wright wrote.

“Apart from a visiting psychiatric nurse from time to time, and occasional visits from a psychiatrist, there were no qualified mental health staff on site and, at times (after hours and on Sundays) no medical staff at all.”

Staff working at the detention centre reportedly responded to the child’s behaviours with “commendable compassion and care”, but Wright said they did not have medical or mental health qualifications.

“(They) were understandably troubled that they were required to manage the young person’s treatment and even administer psychotropic medication, on an ‘as needed’ basis, without medical supervision,” she wrote.

Wright told InDaily she was unable to provide additional information about the young person, including whether they were under the guardianship of the Child Protection Department.

Her report also raised concerns about another detained child who “experienced a mental health crisis” and who frequently attempted self-harm.

It is inevitable that this issue will occur again in the future

According to Wright, the child was required to wear prophylactic clothing, which she argued “seriously compromised the young person’s dignity”.

“Despite strong advocacy by the TCV (Training Centre Visitor), an alternative option, to protect their dignity, was not able to be found,” she wrote.

Young people in detention are more likely to develop mental health disorders than the general population, with many experiencing abuse, trauma or neglect during childhood.

More often than not their mental health disorders go undiagnosed.

Wright reported that over the last four years her office had observed several young people remanded at the youth detention centre who experienced “pronounced symptoms” of mental illness, particularly psychosis.

She wrote that she “advocated strongly” to the Health, Child Protection and Human Services Ministers arguing that the youth detention centre was “not capable of providing the support and effective treatment required for a child or young person with a significant mental illness”.

But she wrote that “at this stage, no alternative has been offered”.

“It is inevitable that this issue will occur again in the future,” she wrote.

“Just as with adults who are charged with offences that have likely or potentially arisen from a mental illness or mental impairment, they need treatment in a secure but therapeutic setting staffed by skilled and qualified mental health practitioners.”

Following questions from InDaily, Wright said concerns about mental health treatment at the youth detention centre had “existed for some years”, but recent cases “really brought them to a head”.

She said in response to her advocacy, the ministers “acknowledged the significant challenges faced by the young person and referred to the availability of services”.

But she said they did not address “the fundamental absence of a therapeutic environment or qualified staff for severely mentally ill young people charged with an offence, and the consequent adversity experienced by this young person every day”.

InDaily contacted Human Services Minister Michelle Lensink and Health Minister Stephen Wade for comment.

In response, a spokesperson from the Department of Human Services said the safety and wellbeing of young people at the Kurlana Tapa Youth Justice Centre was a priority and all responses considered clinical advice.

They said mental health services at the centre are provided by the Child and Adolescent Mental Health Service and that clinicians from that service provide advice on “Behaviour Support Plans and individual routine changes” for young people with mental health needs and those assessed as at-risk.

The spokesperson said after hours or on weekends the Women’s and Children’s Hospital has an on-call psychiatrist that staff at the centre can contact.

“Staff receive training in working with people with mental health issues and there are also staff trained in mental health first aid,” they said.

“The State Government is committed to improving youth justice services, including improving the provision of therapeutic services within a rehabilitative environment.

“Work underway includes the Enhanced Support Team pilot, to support children and young people with complex needs.”

The spokesperson added that the Government was in the process of a $18.7 million refurbishment of the centre and the new buildings would be designed to consider the needs of young people with complex needs, as well as the “physical and psychological influences of the environments”.

They said an agreed staff ratio ensured “sufficient and appropriate supervision while promoting close attention to individual needs”.

Last financial year 256 young South Australians were detained in youth detention – a decrease of 72 from the previous year.

The Department said over the last year, the average daily population at Kurlana Tapa Youth Justice Centre had reduced from 40 young people in 2018-19, to 35 young people in 2019-20.

“Data indicates it’s continuing to decline,” the spokesperson said.

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