Adolescent Forensic Psychiatry SIG Annual Conference 2023 Resources Page

Welcome to the Adolescent Forensic SIG Annual Conference 2023

Conference programme

Adolescent Forensic Psychiatry SIG Conference 2023
1st December 2023
Welcome by Richard Church, Chair AFPSIG

Hello everyone and thank you for joining us – whether you’re watching live today, 1st December 2023, or later, on demand. My name is Richard Church and as interim Chair of the Adolescent Forensic Psychiatry Special Interest Group at the Royal College of Psychiatrists it gives me great pleasure to welcome all of you to our Annual Conference for 2023.

Before we start hearing from our speakers today on the subject of medico-legal work, I wanted to tell you a bit about child and adolescent forensic psychiatry, and the youth justice context we work in.
Many of you will know that our Special Interest Group – the SIG - has been going for over 20 years and has been something of a home and a meeting point for our subspecialty which so many of us have benefitted from, whether as trainees or as more experienced clinicians.
As of September 2023 the Adolescent Forensic Psychiatry SIG had a total of 3678 members – a huge number, which demonstrates the level of interest in this most rewarding and challenging of subspecialties, that lies at a particular intersection of both child and adolescent psychiatry, and forensic psychiatry, whilst being quite different from either.
And I would suggest that whatever level you're at, the very nature of child and adolescent forensic psychiatry means that you’ll always be learning throughout your professional career. As many of you will know, one of the features of working with young people is that we are exposed to the latest interests, social trends, language and other aspects of the rapidly evolving ecosystem and subcultures that children inhabit.

Of course it can be challenging. Working with children in conflict with the law brings us straight into the middle of a complex multiagency landscape with families, social care, education, health, youth justice, police, courts of law, housing and secure settings – where we are called to consider the health and safety of children, as well as the safety of other children and the public.

And as doctors, and other professionals, working in this field, we have a privileged opportunity – in routine clinical and in medico-legal work – an opportunity to intervene, to educate others of all disciplines and agencies, to shape policy and law, to bring about the best possible outcome in difficult circumstances, to protect and safeguard others, and to advocate for the rights of children.

And internationally, we know there is a long way to go in achieving child-friendly youth justice – and maybe we should be interested in this.

At the most extreme end of punitive approaches for children in conflict with the law, I wanted to highlight that capital punishment - the death penalty - for young offenders is still carried out in some parts of the world. If this is shocking, it should be. It may be particularly shocking for some to learn that the death penalty for young offenders only stopped in the United States in 2005, following Roper v Simmons, the landmark ruling in the Supreme Court. Amnesty International takes a keen interest in this subject, and there’s a great deal of material about this on their website.

The comparatively small numbers involved shouldn't make this issue any less concerning.

Closer to home, we in England and Wales have been criticised for our low minimum age of criminal responsibility of 10 years of age, which is starkly out of keeping with our European neighbours.

Every January, the Youth Justice Board for England and Wales publishes youth justice statistics, which are a very detailed and accessible, and presents trends over the last 10 or 20 years.

Let me show you a few areas that caught my attention from the latest set of figures. I mentioned that 10 was the minimum age of criminal responsibility – here you can see that the numbers of 10 year old convicted and sentenced have reduced considerably over the last 10 years, and may be low, but are not trivial.

Next - the total population of children in the secure estate - YOI, STC and SCH - has decreased to under 500. I remember how momentous it was when the population dropped below 1000. This may be something to celebrate, but there may be implications for management of higher risk young people in the community, and perhaps greater challenges in looking after that smaller number in secure setting.
As you can see, the reduction has been primarily in the YOI estate.
Knife crime remains high, despite the dip that was observed due to covid.

The figures around self injury in detained young people certainly paint a compelling picture of marked emotional difficulties and self harm in girls in secure settings, who no doubt require a particular approach to care.
Interestingly, the analysis of ethnicity of young people cautioned or convicted has shown a reversal of a longstanding trend of a year on year increasing proportion of black children. For the first time, the proportion of black children has reduced, and the proportion of white children has increased. Just a 1% change, but something to watch nonetheless, and of course we should not forget that black children remain grossly overrepresented, when compared to the general population.
Reoffending remains stubbornly high – over 60% for those sentenced to custody.
The latest figures for Secure Children’s Homes, the more supportive or nurturing places in the secure estate (apart from secure health care) indicate only 60% occupancy, and a falling proportion of children placed by the youth justice system -  previously about 50/50 youth justice and welfare (s25 Secure Accommodation Order).
Then in February 2024 we look forward to the opening of our first Secure School in England, Oasis Restore, which has caused a great deal of interest.

So that’s a brief glimpse of the youth justice landscape, with implications for other services in the community and mental health settings.
And it’s in this context that you might be called upon to provide a medico-legal opinion, for any of a number of courts, tribunals and official bodies.
I hope you find today interesting, illuminating and that by the end of today you feel better prepared to undertake medico-legal work in whatever form that may take.

Dr Richard Church
 

Benjamin Aina - I have been practising as a barrister for over 35 years and as a KC for 14 years. I am based at Church Court Chambers in London and Exchange Chambers in Manchester/Liverpool. I have prosecuted and defended in over 70 murder cases; and prosecuted numerous serious sexual offences in the past 10 years. I have a particular interest in mental health in murder cases involving young and vulnerable persons; and I have been in a number of cases where I have called Forensic Psychiatrists both for the prosecution and defence.

Dr Sarah Argent is a Consultant Child and Adolescent Forensic Psychiatrist working in the all Wales Forensic Adolescent Consultation Service which is hosted by Cwm Taf Morgannwg University Health Board. Dr Argent also works as a Consultant Psychiatrist for 2 sessions a week in the Trauma Pathway in Aneurin Bevan University Health Board. Dr Argent was awarded a PhD from Cardiff University in 2023 and continues to hold an Honorary Research Fellow contract with the university. 

Dr Aileen Blower is Consultant Child & Adolescent Psychiatrist working in NHS Greater Glasgow & Clyde Forensic Child & Adolescent Mental Health Service. She is a Designated Medical Practitioner, CAMHS Psychiatry Adviser to Scottish Government and Medical Member of the Mental Health Tribunal for Scotland. Aileen is committed to reducing health inequalities through clinical practice and service development.

Dr Nick Hallett is a Consultant Forensic Psychiatrist and Training Programme Director at Essex Partnership University NHS Foundation Trust working on an inpatient medium-secure acute adult ward. He has published a number of articles on medicolegal issues and has provided expert psychiatric evidence in criminal cases on numerous occasions. He has a BSc in Bioethics from the University of Bristol and an LLM (dist) in Mental Health Law from the University of Northumbria. He teaches regularly on the Maudsley Training Programme in London. He is a co-author of the Royal College of Psychiatrists CR193 guidance 'Responsibilities of psychiatrists who provide expert evidence to courts and tribunals'.

Dr Peter Misch - After a varied medical career, I specialised in outpatient adolescent forensic psychiatry. I have now retired from the NHS and continue to provide medico-legal reports as an independent psychiatrist.

Dr Gabrielle Pendlebury is a Child and Adolescent Psychiatrist with a special interest in forensic adolescent psychiatry and neurodevelopment disorders.

Dr Mindy Reeves is currently working at the Gardener Unit in Manchester and with the Northwest FCAMHS team. She will continue to work with these services as a Consultant when she completes training in February 2024.

Alexa Rutten is a child and adolescent psychiatrist also working at the Catamaran since 2005. She is also a forensic psychiatrist for the Court. And she is involded in the proces of teaching of the psychiatrists at our institution. She is writing doctorat on autism and abusive sexual behavior.

Jim Shingler was a career Detective serving with the Metropolitan Police, Strathclyde Police South East Regional Crime Squad, National Crime Squad, Counter Terrorism Command and the London Regional Asset Recovery Team. Jim has been decorated for his Police /NCA service and also “ Highly Commended” at the Crown Court for : Detective Ability , Case Preparation & Fairness to the Defendant. Since 2016 Jim has been a Crime Adviser with the National Crime Agency providing advice on Major Crime Investigations and access to Forensic Experts listed on the NCA Expert Adviser Database for which he leads on recruitment of Expert Advisers.

Dr Ollie White has been a Consultant Child & Adolescent Forensic Psychiatrist since 2011, working across two Trusts in a Secure Forensic Adolescent Psychiatric Unit and in Community Forensic CAMHS. His clinical interests include psychosis, emerging personality disorder, offending behaviours, and safeguarding. Ollie has also held leadership positions within the Royal College of Psychiatrists, the Academy of Medical Royal Colleges, and NHS England. he has undertaken research in child maltreatment recurrence and adolescent forensic mental health. He has undertaken medico-legal work throughout his career, with a particular focus on criminal proceedings.

Dr Holly Wolton, is a newly appointed Consultant Psychiatrist for Thames Valley Community FCAMHS, after completing 5 years of Dual Forensic and CAMHS training at Oxford Health. After completing her Medical degree at University of Manchester she completed her Core Training in Psychiatry at North Central London deanery.
Dr Holly Wolton also works alongside Oxfordshire Children and Family services REOC (residential and edge of care) team, working with young people who are either in residential care or at risk of entering care and may have unmet mental health needs. 

Ingrid van den Bogerd is a clinical psychologist, since 2002 working in juvenile forensic psychiatry hospital with in and outpatients ( the Catamaran). she is member of the board of Efcap -Netherlands.


 

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