We spoke to Leo*, a young adult and research assistant who has an ABI, about his experiences of the criminal justice system and how practitioners can adapt their approach to better meet the needs of young adults who have a brain injury.

Leo has a diffuse axonal injury, which is a form of traumatic brain injury. ABI doesn’t always present with obvious indicators, leading to it being sometimes called a ‘hidden disability’. But it can cause significant challenges for young adults in contact with the criminal justice system.

“I had a motorbike accident where my head stopped, but my brain carried on going and shook itself inside my head. I spent two months in a coma. I spent eight months in hospital where I had to learn to walk, talk, eat, drink, and do everything again.

“It affects my speech very minimally but more so when I’m tired. It affects my balance, memory, complex planning, judgement. I have issues with filtering inappropriate comments. When I’m fatigued or when I’m tired from sleep deprivation, they’re all enhanced.

“When I’m very tired, I start speaking slow like I’m drunk. People look at me and, if I don’t know them, they’re like, ‘Have you had a drink?’ I’m like, ‘No, I’ve got a brain injury.’”

When Leo first encountered the criminal justice system in March 2020, he presented the officer with his Headway Brain Injury Identity Card. This identification card is designed to help police officers and staff more easily identify individuals with a brain injury and ensure that they receive an appropriate response and support.

“I pulled my card out. It says if you ever have something to do with the police, call this number. They asked me if I needed food or drink, and they came and checked on me.

There was a delay in interviewing Leo because the police had difficulty securing an Appropriate Adult to accompany him in the interview suite. Leo feels that his interactions with the police were encouraging overall. All the officers he encountered made adjustments to accommodate his needs. However, he recognises that not every young adult will have had an official diagnosis and therefore may not receive the support that the Headway card facilitated.

“People who don’t have that card might not get the right support and adaptations.”

Leo didn’t have any specific challenges navigating courts and sentencing, but his experiences with the probation service demonstrate how much work needs to be done to raise awareness of ABI and its impact on behaviour and cognitive function.

His first probation officer did not have a comprehensive understanding of ABI or how it affected Leo’s ability to easily attend in-person appointments – resulting in two missed sessions early on.

“One of my impairments is complex planning, so travelling on my own somewhere I’ve never been before can be really difficult. When I finally got to meet her, I said that I was so sorry about not being able to come to the past few times. I told her I’ve got a disability, and I know I look well, but this is how it affects me in my day-to-day life. My probation officer said she deemed the absence acceptable due to my disability.”

While it was positive that Leo’s disability was recognised and future appointments were carried out by telephone, he believes that there was a lack of curiosity around his disability and how it fully affected him.

“Without a shadow of a doubt, there’s a level of ignorance to it, a not wanting to understand, and on another level a sense of ‘I’m not sure if I fully believe you’, which was disappointing.”

Around this time, Leo needed an emergency operation. As a result, he was unable to attend a third appointment. Despite offering evidence to his probation officer, his third absence was deemed unacceptable, and he was recalled to court.

“I was found not guilty of the breach. But it was hard to understand how certain missed appointments can be deemed acceptable due to my disability but not at another point because I was having emergency surgery?”

A new probation officer was assigned Leo’s case. Leo attended his first meeting with his father in attendance as his Appropriate Adult.

“We were in the waiting room and the lady came to the top of the stairs. She didn’t even come down the stairs to greet us. She just shouted down and walked off into another room and we followed. She was very standoffish from the get-go.”

Leo started to explain his story to his new probation officer when his father interjected to offer some relevant information.

“He said,’ Hi, I’m Leo’s father and I’m here as his Appropriate Adult.’ Then she stopped him. She said, ‘Sorry, who are you? Why are you here?’ My dad explained, ‘My son has a brain injury, and I’m here as his legal and appropriate adult.’

“She was very antagonistic and said to my dad that you can’t do this, and you can’t be in here. My dad repeated that he needed to be there because I had a disability, and he was my advocate.

“The appointment was scary. It shook us how appallingly unprofessional it was.”

Aside from the probation officer’s shocking lack of professionalism, Leo felt that his disability and the support he required was being questioned by someone who had no knowledge of his case or his ABI.

“I told her that I sometimes struggle to find the words to express what I want to say. She said, ‘Really? I’m talking to you, and you seem like you can express yourself completely fine by yourself.’ It felt like she thought I was lying.

“We complained and ended up getting a formal apology from the CEO of the probation service and the probation officer concerned.”

Thankfully, Leo’s third probation officer was a much more supportive professional who took the time to get to know him and his situation. It was also his first experience of a probation officer who was invested in properly understanding his disability and how it affected him.

Leo believes that all probation officers should be mindful of how they interact with young adults with an ABI and take a more thoughtful and appropriate approach.

“Based on my experience, they need a little bit more empathy and understanding. It’s not empathy over what I’ve done wrong, but empathy and kindness in the situation and how my disability might prevent me from effectively engaging in my rehabilitation, which is the reason I am there.”

Leo has recently been working with the United Kingdom Acquired Brain Injury Forum (UKABIF) on a research project into the prevalence of ABI among young adults in the criminal justice system. He’s also helped to create a flyer to help young adults recognise whether they have an undiagnosed ABI and how to access support.

“I really cared about what was in the flyer, and I was really excited about all the people, like me, that it could help. At the same time, I feel it is also very important that the probation service and other professionals in the criminal justice system see it too. I mean the probation service, by golly, they need to see it. They need to get this information. They need to understand it.”

Moving forward, Leo wants to continue to use his lived experience to ensure that all young adults with an ABI receive the right support at the right time.

“Since my ABI, I have become a father to the most beautiful child, and I’ve got myself back on my feet. Looking ahead, I hope that the work that I am doing with UKABIF on projects like this can continue to help other ABI survivors in the criminal justice system to get their lives back on track.”

*Leo is a pseudonym used to protect the young adult’s identity

Better outcomes for children and young people with an Acquired Brain Injury (ABI)

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We spoke to Stan Gilmour, National Risk Technology Lead in Policing, Strategic Consultant, and Professor of Practice, about how early intervention could prevent children and young people with an Acquired Brain Injury (ABI) from coming into contact with the criminal justice system.

T2A has had a longstanding interest in Stan’s research into ABI, which can impact the process of becoming a fully mature adult¹. That’s why it’s crucial to raise awareness of how it presents and impacts people’s behaviours.

The exact number of young adults in the justice system who have an ABI is unknown, but studies suggest that 49-72% of young people in custody have an ABI. Hence we can assume there’s a comparable percentage within the 18- to 25-year-old group.

ABI and criminal justice system

Stan Gilmour has recently started coordinating a project titled “Lost in Translation, Found in Data: Decoding the Neurobiological Undercurrents of Youth Criminalisation” that explores how children and young people with an ABI encounter the criminal justice system. The project is also investigating different approaches to neurodisability worldwide and how those approaches might inform practice here in the UK.

Awareness of ABI among criminal justice agencies has been patchy, but the minimal data available reveals that children and young people with an ABI are being let down by multiple agencies.

“The data tells us that there’s a vicious cycle between adverse childhood experiences, criminal justice contact and brain injury that is largely unaccommodated within statutory systems – not just criminal justice but within social support, healthcare and other wider systems that have prevention as part of their remit.”

An ABI can lead to behaviours that may increase the likelihood of becoming involved in the criminal justice system. Stan explains in more detail:

“Impulsivity and risk-taking behaviours can lead to criminal justice involvement, both of which are key features of ABI.

“When you ask what makes people behave in such a severely non-typical way, one answer is they’re criminals and the other answer is that a condition or disability – such as ABI – is affecting their behaviour.”

Early identification

Stan believes that children and young people with an ABI need to be identified as early as possible to prevent future involvement with the justice system. Ideally, this would take place during early years education, but the likelihood of an assessment at this time is heavily influenced by socio-economic factors.

“You go to school, and if your parents have the resources to make sure you’re identified as having additional needs, then you go on a special educational needs (SEN) programme. If you’re not identified, and that’s much more common in lower-income families, then you go on a behavioural and school mental health (SMH) programme. So lower-income kids are defined as badly behaved, while affluent kids are recognised to have SEN.

“If you have a behavioural diagnosis, you’re badly behaved, you’re a bad kid, and that label can stick with you. This can happen to the extent that your behaviour becomes anti-social and eventually becomes criminal. Therefore, your journey into criminalisation can start at a very early age.”

“With this behaviour comes a good deal of exclusion. Recent research shows that children with brain injuries who are excluded from school are criminalised earlier, and their offending behaviour will be more likely to persist into adulthood. This is one of many examples of how early intervention can deliver better outcomes and save money in the long term.”²

A whole system approach

Stan is a firm advocate of a whole system approach where data is routinely shared between all agencies that are involved in the care of children and young people, including local authorities, healthcare providers, social services, and education.

“We want to identify ways in which the data can be collected more routinely and made available for research and prevention in ways that are more repeatable.

“This would allow a whole system approach to prevention so that interventions can be put in place to stop people from falling out of education. If you’re excluded from school, then often by default you’re forced into inclusion in other organisations, some of them criminal, who may exploit your vulnerability.”

Stan believes that no one agency has the resources to tackle this issue, so data sharing needs to be improved to make early identification possible.

“When we speak to teachers about this, unless they have a personal interest, it’s often the first time they’ve heard about ABI. So how do we ensure teacher training programmes raise awareness of ABI indicators among teachers? And then how do you identify on a local level where teachers can go for support when they recognise those indicators in their pupils?”

“We don’t want teachers to be endlessly searching for that support, so it has to be available locally to meet the need. Of course, capacity building will be required to join those things up, raise awareness, and make it easy to contact providers.”

Effective use of data

Previously, Stan had looked into the feasibility of a digital register that could facilitate better data sharing – ensuring that children and young people receive effective, joined up support.

“I was working on this service directory approach where needs could be entered into a system and support identified locally. These systems exist, but the ones we were developing could also link into the history of the individual and their family to offer suggestions.

“That could be something like, ‘Maybe you should think about this intervention because this is going on in the background and you’ve just not joined the dots.’ It makes it easier to leverage data to prompt people to think wider than just behavioural issues and sanctions, and into needs-based support.

“It is a multi-stakeholder approach. It is a multi-agency approach. There’s no one organisation that has the knowledge or the capacity to deal with these issues on their own.”

According to Stan this approach would require a cultural shift within statutory services, many of which default to working in silos.

“Often you see those organisations working together, but apart, if you will. They’ll come to the table once a month, and they’ll discuss what they’ve been doing since the last meeting. But what they aren’t doing is working together. You wouldn’t necessarily need a meeting if they were working in effective partnerships because they would all be communicating with each other daily. I think the endeavour really is to get more collaborative and work together at the same table.”

Preventing harm before it occurs

The prevalence of ABI among the population is again significantly affected by socioeconomic factors.

“When you’re under the age of five, you’re five times more likely to pick up a brain injury if you’re in the five per cent of the population on the lowest income.”³

Without effective cross-agency relationships, children and young people at risk of brain injury may be identified far too late.

“Generally speaking, you only get to know that they’re at risk of harm when they’ve already been harmed. Is it good enough that your attention is drawn to a child once they’ve been severely assaulted or abused? That’s too late.

“There’s nothing to stop organisations from proactively sharing data to identify risk, other than their own ambition and courage. The Information Commissioner’s Office is very clear that we ought to be sharing information more widely to identify risk before harm occurs.”

To deliver the best outcomes for children and young people with an ABI, we need to know how many people have this disability. This will lead to a better understanding of the role ABI plays in health, wellbeing, and the development of maturity, which in the long run will encourage systems to adapt.

“When we have the data and the greater awareness amongst professionals about how ABI presents, we can start to change systems. That’s when we start to move away from behaviour policies at schools towards inclusion policies that accommodate everyone’s needs. That’s the end goal.”

Neurodiversity, neurodisability and the needs of young adults

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1. Williams, W.H. (2012) Repairing Shattered Lives: Brain injury and its implications for criminal justice, London, Transition to Adulthood Alliance. ↩︎
2. Kent H., Kirby A., Hogarth L., Leckie G., Cornish R. & Williams H., School to prison pipelines: Associations between school exclusion, neurodisability and age of first conviction in male prisoners, Forensic Science International: Mind and Law (2023) ↩︎
3. Yates, P. J., Williams, W. H., Harris, A., Round, A. & Jenkins, R. An epidemiological study of head injuries in a UK population attending an emergency department. J. Neurol. Neurosurg. Psychiatry 77, 699 (2006) ↩︎

The 2021 Criminal Justice Joint Inspectorate report ‘Neurodiversity in the Criminal Justice System’ highlighted that the prevalence of neurodiversity is much higher than has previously been reported. Encountering the criminal justice system is incredibly stressful and worrying, especially for young adults who require additional support. That’s why we recently spoke to Professor Huw Williams and PhD Researcher Hope Kent from The University of Exeter about their work in this area and how the current system can be improved.

Assessments in police custody

Young adults can present with various needs, including acquired brain injury (ABI), neurodiversity, ADHD, autism, as well as language and communication issues. Huw recognises that this can be daunting for professionals.

“How do we bring in a system for people to better recognise the signs and signals of neurodisability? We don’t want frontline staff to be overwhelmed by the complexity of the information but to be better equipped in the interaction with the person and think about how to support them because they’re vulnerable.”

32% of under 18s interviewed in the secure estate have a learning disability¹ (compared to about 4% of the general population). Unfortunately, similar data related to young adults aged 18 to 25 is not documented. However, we can safely assume that a significant number of young adults are coming into custody with additional needs.

That makes the screening process crucial. If young adults are properly assessed at this first point of contact with the justice system, their charges can be mitigated, and they can be diverted into local support systems. Particularly for those aged 18-25, proper screening could be the difference between being supported by an Appropriate Adult in police custody or not.

“We have supported various projects to help police to screen for brain trauma. Hope and I did some work with Devon and Cornwall Police, specifically with their Pathfinder diversion program. The team fed back that they saw the need to pick up on mild brain injury more effectively so that staff could be more mindful of how it affects people and make appropriate adjustments – which could be simple, like issuing regular reminders for appointments.”

As police forces operate independently, it’s challenging for best practice approaches, like this project in Devon and Cornwall, to be shared widely. Instead, there are often pockets of good practice.

Risk versus vulnerability

Earlier this year, Hope was working on a research project exploring the impact of the PACE safeguards on the detention and questioning of children in custody². She requested custody record data from the 43 territorial police forces in England and Wales. One of the factors examined in the project was the quality of information police forces were recording about the vulnerability of children appearing in custody.

She explains: “We heard back from 12 forces who could provide us with electronic datasets – eight of which were of high enough quality to include in our analysis. The vulnerability flags that police forces use varied hugely across the 12 forces and were generally collected under the heading of ‘person warning flags’. The number of electronically recorded ‘person warning flags’ ranged from 3 in some forces, to 12 in others. They also ranged significantly – including ‘Mental Health’, ‘Mental Disorder’, ‘Suicidal’, ‘Escaper’, ‘Drugs’, ‘Contagious’, amongst others.

“Flags for things that might make a child or young person particularly vulnerable in police custody, such as a mental health condition, are collected along the same lines as flags for their management in custody, such as ‘escaper’.”

“It’s clear that the vulnerability flags are not fit for purpose, and the consistent electronic recording of more detailed information would enable proper enforcement of safeguards for children and young people who need them.”

A unified approach to screening

The picture that starts to emerge is one where people’s vulnerability is viewed through a lens of risk, rather than a supportive lens that seeks to identify appropriate support or interventions. Hope believes that a more joined-up approach will help improve the situation.

“In South Wales, there are people working in police custody who understand this problem and have put screening in place, but there needs to be top-down management of what the forces are expected to collect.

“The quality of the data that police forces can easily access electronically was poor. The police forces don’t have to electronically report this data back to the home office and, without this requirement to report on people’s vulnerability, it’s incredibly hard to understand what’s going on ‘on the ground’ in custody suites.

“Asking for quality, routine data collection would make sure police forces ask questions about vulnerability in a much more consistent way.”

Effective identification of brain injury and neurodiversity

Huw Williams and Hope Kent are currently working on a research project with Thames Valley Police force. Huw and Hope were tasked with reviewing how neurodevelopmental issues and trauma may increase a young adult’s likelihood of coming into contact with the criminal justice system.

The aim is to be able to effectively identify experiences in someone’s background that may be indicative of a brain injury, and to help the police to divert people into appropriate rehabilitation services.

“We’re working with Thames Valley to work out what’s appropriate to screen for too because there’s lots of issues when children are involved as the courts can use information gained during the screening process against young women,” Hope explains.

“Police sometimes aren’t the best agency to have very sensitive information about people, but they’re often the ‘first responders’ in situations like domestic violence. So, we have to ask, what actually should go on record, what should be screened for, what the police should know about to support that person, and whether a functional assessment of what that person might be struggling with is better than having a brain injury on record?”

Functional assessments versus diagnostic assessments

Hope has also worked with Professor Amanda Kirby who created the Do-IT Profiler screening tool – a holistic assessment that considers an individual’s whole experience.

“Amanda was getting frustrated with diverse needs like autism and ADHD not being picked up and assessed properly. Do-IT Profiler operates in schools, universities, workplaces, but also in the prison system.

“They’ve worked collaboratively with prisons to design assessments that give staff the information they need to be able to support someone in education and also in their reintegration into the community.

“Do-IT is designed to be very holistic – they conduct whole person assessments. They collect somebody’s education history. Were they ever in care? Who did they live with before they came to prison? Are they struggling with homelessness, substance use, medical problems? Have they ever been diagnosed with the neurodisability?”

This innovative tool also incorporates a variety of functional assessments to better understand what support a young adult might require.

“The tools include both self-reporting and cognitive assessments – to help prison officers understand whether an individual has the skills they need to be able to go to probation appointments, for example. Do we know if they can read a bus timetable? It then produces a report for the prison that says this person might struggle with their memory, for example, and here are some simple techniques you could use to help them.”

What’s unique about this tool is the focus on function over diagnosis. This means prison staff don’t have to be experts in multiple conditions to understand what support a young adult might need.

International approaches to young adults and neurodiversity

Huw has also been looking at how criminal justice systems in other countries are supporting young neurodiverse adults.

“There are some really nice examples in the US of having social workers involved in policing, so instead of going down the arrest route, you’d be going down the support route. In New Zealand, there’s been shifts in the system so that, up to the age of 25, you are much more likely to be assessed for a neurodisability to see what support you need. So instead of going into the prison system, you’re given a community order.

“60 or 70% of police work is supporting people who are vulnerable, but this is the wrong place for people to end up. A shift in what policing does is really important, a move towards a trauma-informed supportive stance.

“But you need a system in place for that to happen, and for the police to have confidence in this approach, and local stakeholders and crime commissioners to have a stake in that and see the purpose in that.”

Bringing all the partners to the table

It’s clear that a joined-up approach – involving local health and social care partners – is needed across the criminal justice system to ensure that young neurodiverse adults are properly assessed, given appropriate support, and diverted away from crime.

“We need better systems with all the stakeholders engaged and sharing information. Rather than escalate things down the criminal justice route, you can have a more supportive response.

“What we’re calling for would be adoption of a youth justice system, in the sense that you know the young person who’s in the system is the product of what’s happened to them in early life – including adverse childhood experiences – and the responses from education, health, and social care systems. The point of the justice system should be to alert us to what support they need. But the current system doesn’t do that.”

“There’s a level of ignorance, a not wanting to understand” – Raising Awareness of Acquired Brain Injury (ABI)

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1. http://psychology.exeter.ac.uk/documents/Nobody_made_the_connection_Neurodevelopment%20Report_OCC_October2012.pdf ↩︎
2. https://www.nuffieldfoundation.org/wp-content/uploads/2021/07/Kemp-Examining-the-impact-of-PACE-on-the-detention-and-questioning-of-child-suspects.pdf ↩︎

Gemma Buckland, Policy and Public Affairs consultant for T2A, is the lead author of UKABIF’s latest report, Time for Change – Acquired brain injury and young adults involved in the criminal justice system. This new publication focuses on how young adults with an Acquired Brain Injury (ABI) are identified and assessed in the criminal justice system and the level of support they receive. Here she shares some key findings from the research project.

The impact of an ABI can vary hugely from person to person. Some may experience short-term effects, while others must manage the impact long term. It can present with relatively mild symptoms or as a profound disability, highlighting just how diverse and complex this condition can be.

In general, ABI leads to functional difficulties across cognition, memory, social communication, and self-regulation of emotions and behaviours. The impact varies according to the site and nature of the injury which can result in fatigue, increased irritability, frustration, agitation, stress and anxiety. Completing a series of tasks or remembering appointments and instructions may be challenging too. Unfortunately, as there may be no visible or obvious presentation of the condition, ABI’s behavioural effects can often be misinterpreted by professionals.

All these symptoms can pose significant challenges for young adults as they navigate the criminal justice system: What if your defense lawyer explains the court process using words you are unfamiliar with? What if your key worker doesn’t understand why you get angry and upset so easily? What if your probation officer doesn’t recognise why you have difficulty remembering your appointments or following what they are saying?

That’s why early identification and assessment is vital.

What led to the Time for Change report?

The United Kingdom Acquired Brain Injury Forum (UKABIF) is a membership charity that aims to promote better understanding of all aspects of ABI.

The UKABIF 2018 Time for Change report set out the “sequential intercept model”, a framework for where appropriate interventions could be made at different stages of the criminal justice system that could improve outcomes for individuals with an ABI. Its latest report aimed to dive deeper into this topic and look at the specific experiences of young adults. We chose this age group due to the potential for an ABI to delay the development of maturity and hence make it that much harder to shift towards a pro-social identity.

The prevalence of ABI in young adults aged 18-25 is not fully understood but is estimated to affect between half and three quarters of young people in custody¹. However, the prevalence of ABI in data collected by Liaison and Diversion schemes is much lower. It was key for UKABIF to understand the reasons behind this discrepancy in the data, and what the consequences might be for young adults with an ABI.

Freedom of Information request to Police Forces

The police are often a young adult’s first point of contact with the criminal justice system, underscoring their crucial role in ABI identification and signposting for assessment.

To get a clearer picture of how the police respond to ABI, UKABIF sent out requests under the Freedom of Information Act 2000 to all police forces in England and Wales in January 2022. Its questions focused on practices and procedures regarding young adults with ABI in their custody suites.

Ten of the 44 forces didn’t have any screening or training in place, and most areas had not yet developed appropriate assessment processes, adjustments and referral pathways. Only one police force had data on prevalence of ABI and this was not broken down by age.

These findings suggest that many young adults with an ABI are not being identified by the police in custody suites. That means they may not be receiving appropriate interventions in the police station or in court that fully consider the effects of their ABI. This results in missed opportunities to enable young adults with an ABI to participate fully in justice processes, for example, by ensuring that they have access to appropriate adults who can support and advocate for them.

Neurodiversity Vs ABI

In recent years, awareness and understanding of neurodiversity amongst people in the criminal justice system has significantly increased – both at a government level and on the frontline. The 2021 Criminal Justice Joint Inspectorate Report ‘Neurodiversity in the Criminal Justice System’ was a landmark publication that played a key role in highlighting the importance of specialist screening, assessment and support for all neurodiverse needs.

Unfortunately, progress has been relatively slow when it comes to looking at ABI. Professionals are typically much more familiar with other forms of neurodiversity such as autism and ADHD.

That’s one of the reasons UKABIF created resources for young adults affected by ABI, so they feel empowered to navigate the criminal justice system and get the support they need.

Police forces rarely have specific assessments for ABI, and risk assessments commonly refer to a head injury as a physical injury. This could cause misconceptions on the part of officers about how an acquired brain injury might present in police custody. Furthermore, training for the police that raises awareness of neurodiversity may not cover ABI.

ABI is also one of a complex set of priorities for Liaison and Diversion services. ABI is unlikely to be identified by these services unless they use a specialist screening tool, like the Brain Injury Screening Index (BISI) developed by Brainkind or Do It Profiler. Knowledge of such tools heavily relies on staff champions sharing the information amongst their teams. But screening does not constitute a whole system approach that delivers for every young adult with an ABI.

UKABIF believe that funded community pathways, which make clear the responsibilities of all the different agencies which should support the young adult, including justice, health and social care, could be a viable, long-term solution.

Best practice

To understand what these pathways could look like, UKABIF turned its attention to areas pioneering innovative approaches.

Pathfinder, for example, is a deferred prosecution scheme used by Devon and Cornwall Police. All participants who take part in the scheme are screened for ABI. Young adults are assessed using Do-IT Profiler, an innovative tool that incorporates a variety of functional assessments to better understand what support a young adult might require. These assessments ensure that, if required, a young adult can have an Appropriate Adult present to support them during their interview.

In a separate study, the University of Exeter analysed the screening of all adults under the Pathfinder scheme. It found that 59.3% of those screened reported a lifetime traumatic brain injury (TBI). This confirms what UKABIF suspected about the prevalence of ABI in the justice system, and the high proportion of individuals who are not receiving appropriate support.

UKABIF also took into account the Collaborative approaches to preventing offending and re-offending by children (CAPRICORN) framework as a blueprint for how local agencies and organisations outside the justice system can prevent offending among young adults with an ABI.

The right support at the right time

By combining the learnings from CAPRICORN and Pathfinder with UKABIF’s “sequential intercept model”, UKABIF have been able to map out the opportunities for interventions and the partners involved at each stage.

For example, this could involve working with health and justice coordinators – a key link between the healthcare and justice systems – in probation settings to develop a strategic approach to working with young adults with ABIs. In prison settings, specialist training could be delivered to neurodiversity support managers, so they can effectively support young adults with an ABI while they are in custody and as they prepare for release.

Time for Change – Acquired brain injury and young adults involved in the criminal justice system

Read report

1. Page 20: https://barrowcadbury.org.uk/wp-content/uploads/2012/11/Repairing-Shattered-Lives_Report.pdf ↩︎

Increasingly, foundations are showing an interest in systems change work as a means of achieving greater impact when tackling intractable issues. In this new report ‘Funding for systems change: The story of Barrow Cadbury Trust’s Transition to Adulthood Campaign’, IVAR and Barrow Cadbury Trust explore the conditions needed for this model of working.

In this blog, Ben Cairns, Director at IVAR and Sara Llewellin, Chief Executive at Barrow Cadbury Trust, offer their reflections for others to sense check whether they have – or even want to develop – those conditions.

Ben

Increasingly, foundations are showing an interest in systems change work as a means of achieving greater impact when tackling intractable issues. From our point of view this is to be welcomed. In this report, IVAR and BCT have attempted to explore the conditions needed for this model of working. We offer this for others to sense check whether they have – or even want to develop – those conditions.

Telling the story of Transition to Adulthood (T2A) – Barrow Cadbury Trust’s collaborative criminal justice campaign making the case to policy makers, practitioners and sentencers for a distinct approach for young adults (18 to 25-year-olds) – presented an opportunity to press pause, and do a deep dive. It also felt like a good fit with our wider work on facilitating shifts towards more open and trusting grant-making.

As researchers, the story makes a compelling case for funders to be active in systems change. It might be different and difficult, but the gains can be profound and significant. But there is also much that may alarm those interested. The field expertise required to work in this way; the uncertainty and unpredictability around success; the open-ended nature of the commitment; the complexity of the collaboration – most or all of these are a far cry from traditional grant programmes. It reminds us that systems change isn’t for the faint-hearted, for people in a hurry, or for people who prefer order and certainty of outcome. It’s messy, it’s erratic, and you’re never really sure what’s just around the corner.

Our intention, though, is not just to deter or discourage. Trusts and foundations – with their wealth of assets and their independence – are uniquely placed to support systems change They have the money, the time, and the patience. They can afford to take risks, to shift power, to disrupt. To play a leading role, like Barrow Cadbury Trust, or to be a patient cheerleader. All of these choices – to do it well and thoroughly – are in their gift.

Sara

At Barrow Cadbury Trust we see ourselves as actors in civil society, not just supporters of it. We are rooted in the social justice values of Quakerism, although of all faiths and none. We work purposefully to tackle the root causes as well as manifestations of injustice, alongside coalitions and ecologies of others who share our desire for change.

However, working like this demands a number of conditions which are significantly different to those which many foundations can provide. By setting them out here we hope they will prove useful to others either considering or embarking on this kind of work for the first time. The most important of these is a long time horizon: real systemic or structural change takes many different hands working together over a long period.

Rest assured, we do not think that this is the ‘right’ or the ‘better’ way. It’s a way and it’s our way but there are many ways to assist changemakers and this is just one of them. What matters is that we each do deliberately and consistently what we can do best.

This is a repost of a joint blog co-hosted on the Barrow Cadbury Trust and IVAR websites.

T2A Chair Leroy Logan MBE reflects on the findings of the Alliance for Youth Justice’s (AYJ) briefing paper on the transition from the youth to adult justice system – focusing on the experiences of Black, Asian and Minority Ethnic young people.

A spotlight on racial disparities

As the briefing suggests, young people who turn 18 while in contact with the justice system face a steep cliff edge. Studies show that this age is a crucial turning point where many young people begin to desist from crime with the right support and interventions. But rather than take advantage of this capacity for change, statutory services fall away. For Black, Asian and Minority Ethnic young people, the transition to the adult justice system can be even more challenging.

This latest briefing from AYJ has cast a harsh spotlight on the failings of our justice system to address the racial disparities that have blighted many young people’s lives. From an early age, many Black, Asian and Minority Ethnic young people find themselves associated with criminal stereotypes. Labelling young people in this way is incredibly damaging, eroding self-belief and making it harder to move towards a pro-social identity.

Once Black, Asian and Minority Ethnic children enter the justice system, they are less likely to be diverted, more likely to receive harsher sentences, and more likely to be sent to custody, sentenced or on remand, compared to white children¹.

“Guilty before proven innocent… you kind of learn authority figures don’t actually care.”

Young Person

This can create a huge gulf in understanding and trust between Black, Asian and Minority Ethnic young adults and the professionals working in the system.

Sadly, these findings confirm what many of us working in the sector already expected. That’s why I welcome AYJ drilling down into the causes of this crisis, and what needs to change to deliver better outcomes.

Too often, we focus solely on what’s not working and forget that we must create a roadmap for the future we wish to see.

An overstretched and under resourced system

It’s clear that even with a diverse workforce, culturally competent training, and the best will in the world, the probation service is struggling to keep its head above water.

A professional quoted in the briefing had this to say:

“Record levels of staff sickness, extended sick leave, people fleeing the service in droves – that then exacerbates every other issue we have. We can’t be ambitious, we can’t be progressive, we can’t make many changes if you’re barely able to keep the regime running.”

There are many admirable professionals working in the system who want to do better for young adults, but they don’t have the time, resources, or support to implement creative approaches.

Without sufficient investment, the system can barely meet young adults’ basic needs – let alone support them to take steps towards a more positive future.

Collaboration with the VCSE sector

In this depressing climate, the work of voluntary and community organisations has become even more vital.

Specialist Black and Ethnic Minority-led organisations have an intimate understanding of the communities Black, Asian and Minority Ethnic young people come from and how their experiences inform their behaviour and identity. As the research highlights, these grassroots organisations are well placed to provide nuanced support that recognises these young people’s overlapping needs – support that statutory services would struggle to provide.

These organisations are also more likely to have lived experience embedded in their staff and support services, meaning they can provide peer mentoring and positive role models – both of which are essential components in facilitating the shift towards a pro-social identity.

Ring-fenced funding to commission specialist organisations

I believe that we could take this further by developing a model where specialist Black and Minority-Ethnic led grassroots organisations are commissioned to operate services in their communities. Funding would be ring fenced for these local organisations who have the expertise to deliver the best outcomes.

This model could be supported by local roundtables where information and knowledge are shared regularly so that young adults can access support from multiple agencies. Meeting in this way will also help criminal justice agencies better understand how these organisations are well placed to support young adults. Having buy in from all partners will be vital to the success of this model.

The Newham Transition to Adulthood Hub is a great example of how this approach can work in practice. They have a wide variety of services in one space, so staff can consult each other on individual cases and referrals to different services are much easier and more efficient. Regular spotlight sessions are held where different teams share their expertise and explain how their services can benefit young adults.

Grassroots organisations excluded from funding opportunities

Unfortunately, the AYJ’s report found that organisations with strong community links and knowledge are effectively excluded from funding opportunities. They lack the resources to compete with larger organisations who can meet the excessive commissioning processes and compliance requirements demanded by the Ministry of Justice and HMPPS.

However, many of these larger organisations lack the knowledge and cultural competence to successfully deliver these services. Shockingly, they often subcontract their services at a lower rate to the very grassroots organisations that have been denied a place at the table.

It is crucial that the Ministry of Justice and HMPPS immediately reform VCS funding allocation so that specialist Black and Minority-Ethnic led grassroots organisations can build the capacity of their services – ensuring every young person receives age-appropriate, trauma-informed, culturally competent services that reflect their entire lived experience.

Bridging gaps and changing tracks

Alliance for Youth Justice briefing on supporting racially minoritised young people transitioning from the youth to adult justice system.

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1. xxvii Microsoft Word – BAME research report_final_v4.docx (publishing.service.gov.uk); Centre for Justice Innovation (2021) Equal diversion? Racial disproportionality in youth diversion; JUSTICE (2021) Tackling Racial Injustice – Children and the Youth Justice System ↩︎

We spoke to Stephanie Curtis, HMPPS Custody Improvement lead, about her master’s research project titled Growing up in custody: the importance of supportive relationships for adolescent men serving long-term sentences.

Steph recently completed a master’s degree in Applied Criminology, Penology and Management at Cambridge University in partnership with HMPPS. She has worked in the youth estate for many years, and a lot of her work focused on the transition period when young people move from the youth to the adult estate.

“It was always an interest of mine. In my first role, I got two phone calls about children in one day. One guy was 16 and he got a life sentence with a 25-year-old tariff. I just thought, ‘God, how will he cope with that? What must he be feeling?’

“I got a call about a girl later in the day who also received a long sentence. She was only 13 or 14. I remember thinking to myself that all those teenage experiences you go through, learning things from peers and family, they’re not going to get any of that.”

These experiences prompted Steph to undertake a research project into the experiences of young men who have long-term and life sentences. Her specific focus was on the importance of supportive relationships, and the key role they play in helping young men remain resilient and positive in custody.

“I interviewed 10 men, aged between 26 and 37, who had all served one continuous period of custody since the age of 18. The shortest was 12 years long, and the longest was 20 years plus.”

The interviews covered life skills, emotional and physical development, and identity.

“I knew how to cook before, but I believe I am better in prison. So when I first had access to onions and oil and cooking facilities, as you know in prison before you get to a spur, and in certain jails you have to cook in a kettle, as mad as that sounds you know the flat bit at the bottom you put oil, garlic and peppers, make sure its finely cut, turn it on, you might have to hold it on, and fry it up and add seasoning. (Ali, interviewee)

Nearly all the young men were passionate about exercise, which played a key role in cementing friendships with their peers.

“Most of the men I spoke to discussed weight training. There is quite a lot of research that looks at when you physically train with a friend, that the camaraderie you build is really strong. You get improved self-confidence and there’s a mutual dopamine hit that you get together and a sense of achievement.”

Stephanie was keen to investigate how a prolonged period of custody had affected these young men’s sense of agency. She found that there was quite a divergence in the interview group in their levels of independence and self-efficacy.

“I asked all the participants: ‘What was the biggest decision you’ve had to make in your life?’

“Some said, ‘I don’t get to make any decisions, I’m told what to do.’ But others had a real sense of agency and purposefully took courses, so they have a better chance of getting a job when they get out.

“The young men ranged from the fiercely independent, who often didn’t have family connections, to those with turbulent childhoods, who had often come to depend or rely on the rules. Some of the men interviewed struggled to deal with life in open conditions.”

“I first went to the TC when I was 21, but I didn’t, basically I just fucked about there so I left. I struggled, I tried to do it here twice, I came back, and I stayed out of trouble.” (David, interviewee)

All the participants were asked about their experience of the transition from the youth to the adult estate. Interestingly, most remarked that this hadn’t been a particularly formative or challenging event.

“When I pressed on the transition issue, the men reflected on the fact that they had moved around a lot, so it hadn’t felt as significant. The one person who did move only a few times felt that he was well prepared for that transition.”

Despite the challenges of living in custody long term, most of the young men had developed significant emotional and life skills.

“In an icebreaker I asked each of the men to describe themselves in three words. These came up repeatedly: ‘loyal, caring, family man, humble’.”

Positive family relationships provided the most valuable practical and emotional support, so ensuring these support networks are maintained is crucial. Steph believes that technology could be more effectively utilised in the future to help young adults with long-term sentences stay connected to their families.

We spoke to Tracy Hammond​, Research and Innovation Director at KeyRing, and Paul*, who has a mild learning disability, about how we can divert neurodiverse young adults away from the criminal justice system.

Paul is 60 years old and resides in supported living accommodation. When he was a child, there were multiple opportunities to ensure he didn’t get involved in the criminal justice system. But these opportunities were not taken up, and he was let down repeatedly by a system that did not cater to his needs.

Paul explains: “My childhood wasn’t very good. I was taken into care at the age of two because I was being abused by my brother and his friend.

“I ended up going to a special school, but then I was being abused again. So, I was put into a care home. I was 12 when I did my first offence and I ended up going to another place, testing centre, then back into the court, then back into a children’s home.”

Paul attended a special educational needs school, so his learning disability was formally recognised. However, it’s painfully clear that he didn’t get the right support from statutory services and that his early years were fraught with unpredictability, abuse, trauma, and neglect.

Tracey adds: “Paul’s 60 now, and he’s been through the justice system for most of his life. But the opportunity was there when he received his diagnosis as a child to get him the right support.

“If that had happened, he wouldn’t have ended up trapped in the system.”

At 16, Paul was convicted of arson. He spent a year at HM Prison Risley before successfully appealing his case. It was a harrowing experience for Paul because no attention was given to his additional needs. He didn’t even understand at first that he had received a prison sentence.

Paul adds: “I’d never been in prison. I was put into this cell, and I didn’t know where we were. He [prison officer] took the clothes off me, and I got quite abusive to them because I had obviously been abused myself. I just sat there thinking am I allowed to go to sleep? I were terrified.”

“From there I was put onto the hospital wing. I thought we’re going to a hospital somewhere. Anyway, they took me onto this wing, and it was just convicted murders. If you got done for murder, you went to the hospital wing. I was just gone 16.”

“They did have a wing there for young people, but I think it was the nature of the sentence and they must have thought I was suicidal. I saw that’s why they put me in there. I were a mess.”

On leaving prison, he moved regularly between secure units before returning to an abusive home at the age of 19. For a while he had some social care support, but Paul found it challenging to live with his alcoholic father.

Paul ended up back in contact with the justice system and at 21 he received a probation order for burglary and theft. While still on probation, he was arrested for a burglary he still maintains he didn’t do. However, he was too afraid to disclose the real offenders, so he served two and a half years in prison and left just before his 25th birthday. He then had a string of convictions before committing a serious offence at age 26 which saw him sentenced to 12 years in a secure hospital.

Paul believes that neurodivergent young adults can be diverted from the justice system, if the appropriate support networks are in place.

“If I’d had the support, and if I’d had the right people looking after me, I wouldn’t have got convicted. I would have had someone to talk to, refer me for mental health support, and I wouldn’t have had to make such a drastic cry for help.”

Since Paul’s involvement in the justice system, there have been vast advances in our understanding of neurodiversity. Organisations like KeyRing and the National Autistic Society (NAS) have been building the evidence base in this field for many years, and the 2021 Criminal Justice Joint Inspectorate Report ‘Neurodiversity in the Criminal Justice System’ was a landmark publication.

Furthermore, both KeyRing and NAS have been funded by the Barrow Cadbury Trust to carry out research into the specific needs of neurodivergent young adults and how to effectively support them.

Despite this, Tracy sees many young neurodiverse adults ending up in the criminal justice system rather than being diverted into appropriate support networks.

“I started to think about what happened to Paul and asked myself if this could still happen today? I’m absolutely certain it could. I think children still do very poorly in care. The care system almost sets children up to go to prison.

“The other thing is that children who are neurodivergent often just can’t face school. School is set up for neurotypical people. It’s very busy. There’s everything from sensory overload to the social interaction all the time, and the need to perform in this environment is difficult for neurodiverse people.

“And of course, if they’re not going to school, you’ve then got two problems. One is that signs of abuse are not going to be picked up, and the other is the potential for young people to find their way into criminal activities – and this isn’t going to be picked up either. A particular worry is that they could be exploited and targeted for county lines drug supply rings.”

And when young neurodiverse people transition into the adult justice system, the few support structures they have – and desperately need – fall away. Tracy explains:

“Suddenly, they must take responsibility for things like making their own appointments. They’re becoming an adult, yes, but they are still the same person with potentially unrecognised neurodivergent conditions that make these things inherently difficult.

“If your additional needs affect your ability to remember appointments, for example, you’re now being punished for missing meetings rather than supported to turn up for things. That’s just plain unhelpful, and it creates the wrong kind of atmosphere to look at any other reasons behind offending behaviour.”

KeyRing believe that all statutory services working with neurodivergent young adults must consider their whole experience – and the consequences that might arise if appropriate support is not provided.

“It’s not enough to say yes, they can make a friend, therefore they don’t need support with social interaction. Can they form a friendship that is healthy and reciprocal rather than one which is manipulative and will lead them into trouble?

“I’ve worked with people who take one look at a police uniform, and you know, colloquially speaking, they kick off. They weren’t born with that extremity of reaction.

“In order to understand these behaviours and somebody’s entire range of needs, we need access to good diagnostic services.

“One of the things I have learnt talking to neurodivergent people is that, if they are able to see themselves in the diagnosis that they receive, they’re much more likely to be able to deal with the way their own brain works and to move on with their lives.”

*Paul is a pseudonym used to protect the individual’s identity

KeyRing – Fairer Justice For All

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Clare Hughes, Criminal Justice Coordinator at The National Autistic Society (NAS), believes the most pressing challenge neurodivergent young adults face today is accessing support from local health and social care services.

“Lots of young people are sitting on a waiting list for a diagnosis, or on a waiting list for Child and Adolescent Mental Health Services (CAMHS), or some sort of intervention. We’re leaving it longer and longer and longer before we’re able to respond.”

With their needs left unmet, neurodivergent young adults end up coming into contact with the criminal justice system – a system ill-equipped to provide the tailored support required.

“I’ve had lots of conversations with the police where they’re saying that they don’t have the training or the skills or the expertise to help these kids.

“That is a real worry because it’s not addressing the issue, which isn’t necessarily a criminal issue, but it will become one. That underlying issue is most often an unmet need, and we will never be able to address that through the criminal justice system. Nor should we.”

The National Autistic Society, and other voluntary sector organisations, recognise that the current situation will mean that many neurodivergent young adults are ending up in the system without an official diagnosis or a recognition of the additional support they require. That’s why working in partnership with HMPPS is vital, and the charity has been contracted to work with probation services in the North West, Yorkshire and Humber, and the South West.

“We provide training and facilitate reflective practice sessions so staff are able, as a group, to discuss the people they’ve worked with, what they’ve learned from those experiences, and things that they might be struggling with.”

The National Autistic Society also takes referrals and works directly with the probation officers and young adults. Working in this way helps cement the learnings from training into real-life practice.

“We are able to do direct pieces of work with the person on probation and the practitioner, which is really important because training only goes so far. That way, the practitioner gets an understanding of why we might go in with one idea and then totally switch it up and try something different to better suit that young adult’s needs.”

While Clare believes progress has been made in these areas, she is saddened that many neurodivergent young adults are coming through probation who simply shouldn’t be there in the first place.

“I’m finding this a really difficult process. Sometimes practitioners say to me, ‘I’ve got no idea how this person has ended up where they are. I can see that their needs are really significant, and I don’t think the criminal justice system is the right place for them.’”

Clare cites one particular case to illustrate how immensely challenging it can be for neurodivergent young adults to access support.

“James* is a young person who lived with his mum until he was about 19. His mum then said, ‘I just can’t do this anymore. I’m really struggling with his behaviour.’ She has done for a long time and hasn’t had any support from any services.”

James found school particularly challenging and, even though concerns were raised by staff about his behaviour, he didn’t receive an official diagnosis. Social care services assessed James as not requiring additional support, so he now lives on his own in a small flat.

“I wouldn’t even call it living. I would say he’s existing at the moment in a flat that is in a terrible state. Although he doesn’t live with his mum, she sees him every single day. He’s abusive to her as well and probation have said to her that they don’t think it’s wise for her to go to his flat.

“But James is her son at the end of the day, and he can’t look after himself. He can make toast and that is it, so she takes food for him each day. He can’t sort out his bills. He can’t manage day-to-day living. He lives in a room where the curtains are permanently drawn, and he just has a mattress on the floor.”

Even though James’s mental health is deteriorating, and he’s regularly self-harming, he still doesn’t meet the threshold for support.

“Mental health services have said he doesn’t meet the criteria. The worry that we’ve got is he’s on probation for another three months and he needs lots of support. He’s got two practitioners. He needs to be case managed by two people.”

Clare believes that James would meet the criteria for support from social services, but his anxiety can be triggered by face-to-face contact with new people, and social care services are unwilling to adapt their approach to meet his needs.

“He wants to have access to people socially, usually by phone, so he will ring people and he does want and need that. But he gets overwhelmed by face to face contact unless it’s somebody that he’s comfortable and familiar with, so fortunately he will let his two probation practitioners come to his home.”

James now requires such regular support that he calls his probation officers daily.

“They’ve managed it as best as they can, but this isn’t an appropriate way of dealing with this and what will happen when he’s no longer on probation?”

Clare believes that identifying neurodivergent young adults’ needs much earlier on will be key to diverting them from the justice system. This would require a multi-agency approach where different agencies, including partners from criminal justice, mental health, education and social care, come to the table to work together.

“It’s going to require people moving out of that mindset – that we’ve all been in for a long period of time – where we protect our own budget no matter what.

“The long-term gain would be that if we get in there early enough, we can reduce spending overall. For me, the argument that you need to be at crisis point before we do anything has never really made sense. To fix somebody at a point of crisis is always going to cost you more than it does when someone presents early on with more manageable needs that we can do something about.”

*James is a pseudonym used to protect the young adult’s identity

“My life could be so different”

Experiences of autistic young people in the youth justice system

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Dr Ailbhe O’Loughlin, Senior Lecturer at York Law School, University of York, discusses the experiences of neurodiverse children and young people in the criminal justice system and how they can be supported to transition to the adult estate.

The terms neurodiversity or neurodivergence are used within the criminal justice system to describe neurodevelopmental disorders. At least one in three people in the criminal justice system are neurodivergent compared to one in six people in the general population. Rates are particularly high amongst children and young people aged 19 or under in custody.

Around 12% of children and young people in custody have attention deficit disorder or attention deficit and hyperactivity disorder and 15% have an autistic spectrum condition. Rates of learning disability range between 23% and 32%, rates of dyslexia range between 43% and 57%, and rates of communication disorders range between 60% and 90%. According to the Youth Justice Board, 72% of sentenced children have mental health needs and 71% have speech, language or communication needs.

Neurodivergence does not necessarily mean that a person is more likely to offend. While people diagnosed with ADHD are more likely to have contact with police and are at an increased risk of conviction and imprisonment, a diagnosis alone is not a significant risk factor for offending. People with autism spectrum disorder offend as frequently, or less frequently, than people without the condition. While people diagnosed with a traumatic brain injury are 2.3 times more likely to commit a violent offence than people without a diagnosis, this risk is significantly lower than that associated with alcohol or drug abuse.

Neurodivergence is often under-recognised. Neurodivergent children and young people may be prone to make inappropriate confessions or guilty pleas if processes are not adequately explained to them or they are not given enough time to process information. Their communication style or demeanour may be misinterpreted or viewed negatively by others in court. Busy, noisy environments may lead to distress, and trigger behaviours that are dealt with through segregation or physical restraint.

The primary aims of sentencing for children and young people are to prevent offending and to have regard to their welfare. Neurodivergence can be a mitigating factor in sentencing but it depends on these factors being identified. While youth rehabilitation orders are an option at sentencing, treatment or education requirements rely upon the availability of support services. Moreover, children and young people are more likely to breach such orders if they are not supported to understand them or to adhere to their requirements.

While youth justice services are more aware of neurodivergence than adult services, information is not routinely sent across when young people are transferred to the adult prison estate. Inadequate screening in many adult prisons may result in young people falling through the cracks. Recommendations for addressing these problems include improving support for families, improving screening processes and staff training in the education and youth justice systems, and introducing a ‘child first’ or ‘whole child’ approach. However, those who are convicted of offences after they turn 18 will be sentenced as adults: an outcome that may become more likely due to significant delays in the court system.

Neurodiverse young adults falling through the net – “A drastic cry for help”

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