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Responding to Violence, Suicide, Psychosis and Trauma

Physical restraint of volatile young offenders

Physical restraint of volatile young offenders is both controversial and risky. So why are ministers keen on rule changes that could see it used more widely?

Jon Scott, Wednesday November 28 2007, The Guardian



Watching CCTV footage during a visit to one of England’s four privately run secure training centres (STCs) for young offenders, I see a girl who, I am told, had grabbed the duty manager by the collar as he was sitting on her bed talking to her. A female officer, also in the room, raises the alarm. On the laptop screen, I see responding staff go into the girl’s room, then emerge a couple of minutes later with the girl, using what is known as Phase 3 restraint.


That’s when I recognise her: a quiet girl I had talked to earlier in my visit. Six staff are involved in restraining her: two on the legs, one on each arm, one with a hand under the back, and one holding the head. It’s not pretty.


Unsurprisingly, the Youth Justice Board (YJB) was nervous about my visit to the STC; a prerequisite for access was that I did not reveal which one. STCs have been stung by criticism after two youngsters in their care died within three months in 2004. Fifteen-year-old Gareth Myatt choked to death at Rainsbrook STC, near Rugby, while under restraint by staff, and 14-year-old Adam Rickwood hanged himself by his shoelaces hours after being restrained at Hassockfield STC, near Durham. Both cases attracted widespread press attention.


A damning investigation by Liberal Democrat peer Lord Carlile, on behalf of the Howard League for Penal Reform, into physical restraint, solitary confinement and forcible strip-searching, and a subsequent debate in the House of Lords, have helped keep up the pressure for an accurate picture of how such practices are carried out.


According to the Howard League, getting across the seriousness of issues around restraint, such as when it is used inappropriately and its long-term consequences, is an uphill struggle. “I think people don’t understand why this is such a big issue,” a spokesman says. “One of the things we are really concerned about when it comes to restraint in STCs is that these are troubled kids who have often experienced neglect and abuse – sexual or emotional – and they may provoke restraint to get attention.


“They are used to the language of abuse. One girl [told us] that, for her, it was a way of getting her anger out. It was a kind of catharsis. What often happens is restraint [reinforces] behaviour and they end up leaving the STC more resentful. It perpetuates the language of violence, which is all a lot of them know.”


In July, the government announced a review of restraint across all juvenile secure settings. Its two co-chairs, nominated last month, will examine the medical safety and “operational efficacy” of restraint techniques, and better ways to manage volatile children. The 2,574 recorded incidences of restraint of children in STCs between February 2006 and March 2007 (there are around 250 young people in STCs at any time) suggest there is plenty of scope.


When I meet the director of the STC, he explains that of the 58 children in his care, two-thirds are boys, most aged 14 to 16; the girls, on average, are slightly older. He is keen to establish that his staff-to-trainee ratio (trainee is the name given to young people in the youth justice system) is three times higher than in a young offender institution (YOI) – hence triple the cost per head – but lower than in a secure children’s home. Children sent to STCs tend to be more vulnerable, although their offences may still be serious, he says. At the time of the visit, his staff were caring for three murderers and a serious sex offender.


Justified scrutiny


During lunch, the director fields questions from boys crowding round the table, who address him by his first name as he vents frustration at what he terms “this myth” about STCs. “Obviously, the tragedies were horrendous,” he says, “and it’s right we are scrutinised. But we’ve had thousands of young people through the doors, from the tiny 13-year-old boy with ADHD [attention deficit hyperactivity disorder] who fights with absolutely everyone, to the 16-year-old girl who has been on the streets. Almost all come from chaotic backgrounds, many have not been to school for years, have suffered violent or sexual abuse, and arrive here with a chronic drug or alcohol habit. That’s why all our senior team here are qualified social workers.”


Much of the afternoon is spent in the STC’s healthcare facility talking to one of five full-time nurses, and in the substance-misuse department, where I learn that some recent arrivals had been downing a litre of vodka a day. It’s then on to education, where we drop in to a “beauty clinic”, then craft, design and technology, and a catering class. In an information and communication technology class, I notice a boy learning to use a spreadsheet. He tells me he’d been excluded from school in year 5 [aged 9-10] and that he had not been back since.


The buildings, none more than eight years old, are in good order, and the site – the size of a secondary school – is clean enough for my guide to be embarrassed about scuff marks made when pushing a trampoline into the sports hall. We also walk past two artificial football pitches, just relaid, on our way to the “Champions” unit, for boys whose good behaviour has earned them extra privileges. There, five adolescents are slouched on the sofa in front of a gigantic TV, half-shouting to each other over a blaring pop video.


A care officer asks the boys if I can see their rooms, then unlocks two. Larger than their YOI equivalents, the rooms are also more homely, helped by large, barless windows and rugs on the utilitarian, checked carpets. In common with a YOI, posters of women in bikinis and the odd photo plaster the walls.


As we walk to the adjoining unit, a tall boy is playfully slapping a much smaller lad on the head. “He started it,” shouts the tall one, pointing to another boy, who begins running around wielding a pool cue, half shrieking, half laughing. Two circuits later, plus many staff requests to “stop it!”, he is running at the tall boy, cue raised, when a care officer grabs the weapon, put her arm round the back of the small boy and ushers him towards a residential manager five yards away, who takes him by his forearm into another room.


The small number of boys on the unit meant it never felt unsafe, but the director says to me afterwards that the boy does actually hit people with cues, and he could have resisted the manager’s arm. “Even so, that ‘caring gesture’ – to use children’s homes terminology – is what we call a Phase 1. It counts as a restraint statistic and requires paperwork to be filled in.”


Back in his office, the director reminds me that physical control in care, known as PCC, is used only in STCs, and comprises three phases in all. The first two essentially mean taking a young person by the hand or arm, but the third is an escalated response, involving multiple staff. PCC is also meant to be “non-pain compliant”, meaning that pain should be inflicted only if the behaviour puts people in danger.


The director shows me the restraint statistics for last month. Out of a total of 57 incidents, 38 concern only three boys. “September was higher than normal, and it only takes a few characters to really escalate our figures,” he explains. Of those 57 restraints, 16 were Phase 1, and 12 were Phase 2. No child is restrained using Phase 3 during my day-long visit.


The director admits that he has concerns about the lack of consistency across secure juvenile facilities. And he does not object when I suggest that the six-month government review of restraint is long overdue. “The YJB have got to be brave about the restraint issue,” he says. “They’re looking for other people to make the decisions for them. For instance, we had to go and find our own de-escalation tool ourselves, and came up with therapeutic crisis intervention, which has halved our restraint figures since we introduced it 18 months ago. Normally, though, we don’t have time to be creative because we’re busy meeting targets.


Action plans


“We have two full-time YJB monitors on site who produce a monthly report, we’re due a two-and-a-half-day unannounced Ofsted inspection some time after Christmas, and then an announced five-day one in July,” says the director. “Sometimes, it seems all we do is implement action plans – so if we’re told to do things differently, we will.”


According to the Howard League, the YJB responded to recent criticism of deaths involving restraint by widening the conditions under which restraint can be used. This, they say, puts even greater responsibility on the forthcoming government review to identify improvements. Inquests had found that restraint was being used inappropriately to force young people to comply with orders from staff. “Rather than deal with this, the YJB changed the rules,” the Howard League spokesman says. “The original rules around restraint were very clear, but then the YJB added that it could also be used to maintain ‘good order and discipline’. The YJB argued that it clarified things, but what it actually means is more vagueness.”


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