Abstract
Background The system of secure care for young people in England and Wales comprises youth justice, welfare and mental health facilities. Empirical studies have failed to investigate the system as a whole. The National Adolescent Study in 2016 was the first to provide comprehensive system wide information. This paper, derived from that data set, addresses equity of service provision for young men and women in secure care who have mental health problems.MethodsThe detained census population of English young people was 1322 and detailed data were available on 93% of this population, including 983 young men and 290 young women. The descriptive census data were interrogated to identify associations between gender, other sociodemographic and clinical variables, using Chi-square and Fisher’s exact tests. To control for Type 1 errors, the False Discovery rate approach was used. SPSS (V25) was used for statistical analysis.Results Numerically more young men in secure care than young women in secure care warrant a psychiatric diagnosis but young women had a 9 fold increase in the odds of having a diagnosis compared with the young men. The pattern of mental health diagnoses differed significantly by gender as did the pattern of young men and women’s secure care placement. This different pattern of placement continued to differ by gender when the nature of the mental health diagnosis was taken into account.Conclusions No definitive explanation is evident for the significantly different, placement patterns of young men and young women with the same, mental health diagnoses but the anticipated consequences for some, young men and some young women are important. Proper explanation demands an examination of process variables out with the remit of this study. The lack of routine scrutiny and transparent processes across secure settings could be responsible for the development of these differential placement practices; these practices seem at odds with the duty placed on public services by the Equality Act.
Mental Health Diagnoses and Utilization of VA Non-Mental Health Medical Services Among Returning Iraq and Afghanistan Veterans
