Preventing Crime and Promoting Rights for Indigenous Young People with Cognitive Disabilities and Mental Health Issues Part 1
 Preventing Crime and Promoting Rights for Indigenous Young People with Cognitive Disabilities and Mental Health Issues
Preventing Crime and Promoting Rights for Indigenous Young People with Cognitive Disabilities and Mental Health Issues
Part 1
Why do we need this research? Arguing for
          protection, prevention and knowledge for Indigenous young people with cognitive
          disabilities and mental health issues
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a) Introduction
This report provides an investigation of early intervention and
          diversionary practices aimed at preventing offending behaviour in Indigenous
          young people with a cognitive
          disability[1] and/ or a mental health
          problem. It builds on our previous report, Indigenous young people with
            cognitive disabilities and the Australian juvenile justice
            system.[2] Specifically, it
          examines what is available for these young people, identifies systemic service
          delivery gaps and points to promising interventions that have the capacity to
          prevent offending behaviour. 
I decided to prepare this report as there is a lack of literature, evidence
          and interventions for this group of young people. Sadly, what commonly comes to
          light are stories of young people with cognitive disabilities or mental health
          issues falling through the cracks of community social services and ending up in
          custody. Once in custody, young people with a disability are more vulnerable
          than other detainees. They can face additional difficulties in adapting to a
          custodial environment that is rarely able to meet their needs and they face
          ridicule and adverse attention by other detainees who do not understand their
          medical predicament.
A publicly known, real life example, where all of these things have gone
          wrong is the case of Corey Brough. Corey Brough is an Indigenous young man with
          a mild intellectual disability, troubled background, limited communication
          skills and diagnosis of Attention Deficit Disorder. When he was only 16 years of
          age he was placed in solitary confinement in an adult prison. He was held in
          solitary confinement for 25 days, stripped of all clothing, belongings and
          bedding and administered antipsychotic drugs without a proper medical
          assessment. 
Corey Brough made a complaint about his treatment under the International
          Covenant on Civil and Political Rights that went to the United Nations Human
          Rights Committee. The United Nations Human Rights Committee found the NSW
          Government contravened Corey Brough’s right to be treated with respect for
          his dignity and did not have due regard for his vulnerability as a person with a
          disability and his Indigenous status in light of the Royal Commission into
          Aboriginal Deaths in Custody.[3]
Corey Brough’s story may have gone all the way to the United Nations,
          but there are elements of his story that are repeated day in and day out in the
          juvenile justice system. The scenario is all too familiar. An Indigenous young
          person with either a cognitive disability or mental health problem slips through
          all the nets of early detection and assessment. They struggle at school and act
          up in class. Their presentation is simply attributed to bad behaviour. Rather
          than address the cause of the problem, the education system deals with the young
          person through punishment and exclusion. Not surprisingly, the young person
          drifts out of education and into poor peer relationships, boredom and offending
          behaviour. From there they are fast tracked into the juvenile justice system
          because they most likely lack the skills and support to succeed in early
          intervention or diversionary measures. This trajectory is set against a backdrop
          of marginalised families and communities, social and economic disadvantage, poor
          access to services, the transgenerational effects of the Stolen Generations,
          racism and high levels of trauma, grief and loss.
The scenario above paints a picture of systemic failure. However, this report
          will set out to analyse various points of critical intervention and propose an
          alternative framework based on effective and holistic intervention. At every
          juncture where a young person can potentially slip through the cracks, there is
          equally a challenge to develop an alternative, culturally and developmentally
          appropriate intervention that can prevent offending behaviour. 
Contents of the Report
Part 2- What do we know about Indigenous young people with cognitive
          disabilities and/ or mental health issues? provides a literature review
          which considers Australian and international research on the problems facing
          Indigenous young people with cognitive disabilities or mental health issues, as
          well as different intervention models. 
Part 3- Stories from the Field is based on our consultations with
          community members and experts in the field. In some cases, these sorts of
          positive interventions are already occurring. A selection of case studies
          showing promising practice is also included in this section. 
Part 4- Conclusion and Recommendations draws together best practice
          principles based on the consultations, case studies and literature. It also
          provides targeted recommendations. 
Appendix 1 provides a list of consultations.
Appendix 2 collates the data and responses on Indigenous young people
          with cognitive disabilities/ mental health problems provided by relevant
          government agencies.
Appendix 3 provides a list of government respondents.
b) Methodology
There is little research about Indigenous young people with cognitive
          disabilities and/ or mental health issues and there is next to nothing about how we practically keep this group of young people out of the juvenile
          justice system. For these reasons, this is an exploratory, qualitative research
          project built on close review of the literature, consideration of existing
          service provision and targeted case studies and consultations.
Information from government departments
To map service provision to this group, a letter was sent to state juvenile
          justice, health, education, disability services and crime prevention departments
          as it was considered that these agencies would most likely have direct service
          provision involvement in early intervention and diversionary programs for this
          client group. Information was requested about:
- data that the department/ agency may collect on the numbers of Indigenous
 young people who have been assessed as having a cognitive disability and/ or
 mental health issues;
- a break down of this data by age, sex and location;
- any information of relevant early intervention or diversionary programs that
 they run for the target group of young people; and
- any other research or stakeholder who is working in the field.
 
A summary of the responses, found in Appendix 2, provides a
          snapshot of reported services available to Indigenous young people with
          cognitive disabilities (to a lesser degree mental health issues) at various
          points when they are either considered ‘at risk’ or actually
          involved in the juvenile justice system. 
Consultations and case studies
There is a divide between the government policy, programs and the real world
          where these young people live. For this reason, we have consulted with a
          selected group of service providers and experts to get ‘on the
          ground’ expertise. A list of consultations is provided in Appendix
            1. 
These stakeholders are at strategically placed at points of intervention or
          responsible for promising practices with Indigenous young people. This is by no
          means a comprehensive consultation but even this small sample highlights some of
          the common factors and approaches relevant to Indigenous young people with these
          issues.
The consultations map some of the common pathways of these young people into
          crime, as well as the junctures or interventions along the way that have the
          potential to divert them from offending behaviour and the juvenile justice
          system. 
Each of the case studies represent a promising practice which has the
          potential to develop healthy, pro social alternatives to offending for
          Indigenous young people with cognitive disabilities and/ or mental health
          issues. Selection of case studies was based on the information provided by
          government departments and suggestions from stakeholders.
c) Definitional Issues
Concepts around disability and mental illness can be confused and contested.
          The following definitions are used in this report and discussed in terms of
          their relevance to Indigenous communities.
Cognitive Disability
          The category of cognitive disabilities
          includes a range of disorders relating to mental processes of knowing, including
          awareness, attention, memory, perception, reasoning and judgement. Cognitive
          disabilities include intellectual disabilities, learning difficulties, acquired
          brain injury, foetal alcohol syndrome, dementia, neurological disorders and
          autism spectrum disorders. 
People with intellectual disabilities and some people with cognitive
          disabilities experience:
Significantly lower than average intellectual ability and deficits in social
and adaptive functioning, that is, limitations in such areas as communication,
social, daily living or movement
skills.[4]
There was a conscious decision to use a broad definition of cognitive
          disability to capture the range of different conditions which may affect
          Indigenous young people. In particular, there is a growing awareness in
          Australia about prevalence of Foetal Alcohol Syndrome in Indigenous communities.
          Similarly, acquired brain injury, particularly from substance use (especially
          petrol sniffing) may also have links to offending behaviour. 
Mental Illness
          We found that a lot of the Indigenous young people
          in the juvenile justice system were suffering from mental health problems.
          Although cognitive disabilities and mental illness can be very different, in
          terms of early intervention and diversion from the juvenile justice system, the
          impact of interventions is similar. For this reason, we have decided to expand
          our research parameters to look at both of these conditions.
Cognitive disabilities and mental illness are two separate conditions.
          However, in the first phase of this research we found that there is a connection
          between the two. Some young people have a cognitive disability as well as a
          mental health condition (which may or may not be associated with substance use)
          that can make their lives and the interventions they require, more complex.
A mental illness is a condition that:
Severely impairs (temporarily or permanently) the mental functioning of the
person and is characterised by the presence of one or more of the following
symptoms: delusions, hallucinations, serious disorder of thought, a severe
disorder of mood, and sustained or repeated irrational
behaviour.[5]
Indigenous definition of health
          Our first report also noted that
          Western medical definitions don’t necessarily reflect an Indigenous view
          of health. The Indigenous view of health is ‘holistic, encompassing mental
          health and physical, cultural and spiritual
          ³ó±ð²¹±ô³Ù³ó’.[6]
Holistic health acknowledges the impact of colonisation on Indigenous
          health:
        
Any delineation of mental health problems and disorders must encompass
recognition of the historical and socio-political context of Aboriginal mental
health including the impact of colonisation; trauma; loss and grief; separation
of families and children; the taking away of land; and the loss of culture and
identity; plus the impact of social inequality, stigma, racism and ongoing
losses.[7]
This holistic view of health has contextualised the way we have approached
          the issues of cognitive disability/ mental health issues with Indigenous young
          people. 
Diversion
          This report adopts a broad definition of diversion that
          looks beyond ‘front end’ diversion. ‘Front end’
          diversion takes place through Police, court and alternative processes that aim
          to decrease the incidence of young people being formally charged with offences
          in the first place. 
We are also looking at the issue of diversion from custody. Firstly, because
          there seems to be some positive actions that can be taken once a young person
          has become involved with the juvenile justice system. For instance, this may be
          the first time a cognitive disability is actually assessed and there is an
          opportunity for assistance. 
Secondly, based on the youthful and rapidly expanding Indigenous population,
          over representation is projected to worsen in the
          future.[8] We have an obligation to
          look at all available diversionary options to try and avert this source of
          national shame and promote social justice for our communities and young people. 
Obviously, the earlier a diversionary option is applied the better, but we
          can’t give up on finding solutions for young people once they are formally
          involved in the juvenile justice system. We know the likely consequences of
          juvenile detention: graduation to the adult criminal justice system; poor life
          outcomes; and the intergenerational transmission of disadvantage. These are
          compelling reasons for continued commitment to diversion and rehabilitation
          options.
Endnotes
[1] In this report cognitive
          disability is commonly defined as any sort of cognitive disorder that impairs
          understanding and functioning. Cognitive disabilities include intellectual
          disabilities, learning difficulties, acquired brain injury, foetal alcohol
          syndrome, dementia, neurological disorders and autism spectrum disorders. A more
          comprehensive definition of cognitive disability can be found on page 9. 
          [2] Aboriginal and Torres Strait
          Islander Social Justice Commissioner, Indigenous Young People with Cognitive
            Disabilities and Australian Juvenile Justice Systems, Human Rights and Equal
          Opportunity Commission, Sydney,
          2005.
          [3] New South Wales Council
          of Social Services, Briefing Note: ºÚÁÏÇ鱨վ (Detention Centres) Amendment
            Bill 2006, May 2006, available at , accessed 18 March 2008.
            [4] NSW Law Reform Commission, People with Intellectual Disability and the
                Criminal Justice System: Courts and Sentencing Issues, 1994, Discussion
          Paper 35, p2.
          [5] Freeman,
          K.,‘Mental Health and the Criminal Justice System’, Crime and
            Justice Bulletin: Contemporary Issues in Crime and Justice, NSW Bureau of
          Crime Statistics and Research, No 38. October 1998,
          p2.
          [6] Swan, P and Raphael, B., Ways Forward- A National Consultancy Report on Aboriginal and Torres Strait
              Islander Mental Health, National Mental Health Strategy, AGPS, 1995,
          p13.
          [7] Swan, P and Raphael, B., Ways Forward- A National Consultancy Report on Aboriginal and Torres Strait
              Islander Mental Health, National Mental Health Strategy, AGPS, 1995,
          p2.
          [8] Victorian Department of
          Justice and Jones, R., Diversion: A model for reducing Indigenous criminal
            justice over- representation, Paper prepared for consideration at the Second
          National Indigenous Justice Forum November 2006,
          p3.