SPECIALIST treatment for one young sex abuser from Northern Ireland cost £1.5m, it can be revealed today.
The Detail has learned that the teenager – who had abused other children – was sent to a residential treatment centre in another part of the UK where he stayed for over three years. The help needed to reform his sexually abusive behaviour is not available in Northern Ireland.
A social worker and his mother were flown over to the centre from Northern Ireland once a month. The boy, who had not been convicted of any crime, returned home last year.
His local health trust paid for the treatment but this means it was ultimately the Department of Health which footed the bill.
Barnardo’s Northern Ireland confirmed that it is aware of the case but declined to give any further information.
This case is by no means unique. It is understood that millions of pounds are spent every year on similar treatment programmes for young people from here who are dislaying sexually harmful behaviour.
Sending a teenager away like this goes against the Children’s Order 2005 which says that a child should be placed no more than 70 miles from home.
Consultant forensic psychiatrist Dr Ian Bownes, who is an expert in the field, said that the treatment is expensive but worth it.
“The cost of the private treatment centres is usually money well spent, although they will also require an extensive follow-up programme when they come back,” he said.
A paper produced by the National Organisation for the Treatment of Abusers (NOTA) estimates that children and young people are responsible for about a third of all sexual abuse against children. This is likely to be an under estimate due to low rates of reporting and even lower prosecution rates.
Around half of all adult sex offenders commit their first offence as a juvenile.
Sexually harmful behaviour (SHB) by young people is defined as sexual activity with another person they have power over by virtue of age, gender, physical strength, intellect or emotional maturity. It can include contact – like touching – and non-contact behaviours, for example exhibitionism and voyeurism.
Young people who display SHB are likely to come from troubled backgrounds which could include being abused themselves or living in a sexualised environment. The younger the child, the more likely they are to have been abused or exposed to sexual activity.
Barnardo’s Young People’s Therapeutic Service provides specialist assessment and intervention to young people aged between 10 and 18 who live in two trust areas in Northern Ireland and display sexually harmful behaviour. The service, which has been running since 1997, treats up to 37 children and young people every year.
The other health trusts use other services for children displaying SHB.
A NOTA conference, organised in partnership with Barnardo’s, is taking place in May and aims to raise awareness of SHB and highlight the importance of addressing the gap in provision. It will be held at Queen’s University in Belfast.
Mary Ferris, Barnardo’s Children’s Services Manager (Young People’s Therapeutic Service), said that a number of young people the charity deals with who are displaying sexually harmful behaviour are considered to be very high risk and not appropriate for community based treatment.
“Typically these are the most serious offenders, and those with complex mental health and behavioural issues," she said.
“At present there is no forensic child and adolescent mental health service here so some of these young people will be sent to specialist treatment centres outside of Northern Ireland."
In the rest of the UK, there are six in-patient and four out-patient specialist forensic psychiatric services for young people, including one in Scotland, forming part of the NHS National Adolescent Forensic Service.
Mary argues that there is a need for a similar service here.
She said: “By establishing and developing such a service here, the needs of vulnerable young people under 18 who are in contact with the criminal justice system, the child protection system, looked after children and those whose mental health needs show high levels of complexity and severity and who present a serious risk of harm to themselves and others will be addressed.
“In the current financial climate, given the risk to the public and the financial and social costs of misplacing children and young people with complex needs and high risk, the question is more about the cost of not providing this service than the cost of providing it.”
Dr John Devaney, from the School of Sociology, Social Policy & Social Work at Queen’s University, said if young people who display sexually inappropriate behaviour are not worked with their behaviour becomes more entrenched and difficult to deal with later.
Dr Devaney, who is due to speak at the conference next month, told The Detail: “We are becoming more aware of the small number of young people who display behaviour that is sexually harmful to others.
“Typically such young people have experienced adversity in their own life, such as sexual abuse, exposure to domestic violence and parental substance misuse. As a consequence the boundaries between appropriate and inappropriate behaviour have become blurred.
“Research tells us that the earlier we recognise the risk that these young people present, and provide them with intensive and very structured therapeutic interventions, the greater the likelihood that they can be supported to desist from this behaviour.
“There are a small number of services in Northern Ireland able to work with these young people, and there is evidence that they are making an important difference.
“However the funding for these services is limited but we know that if young people who display sexually inappropriate behaviour are not worked with then their behaviour becomes more entrenched and much more difficult to deal with later."
The Detail posed a series of questions to the Department of Health – including how many children have been diagnosed as displaying SHB, whether they received the treatment they needed, how many have been sent for treatment outside of Northern Ireland and what the total cost for this has been in the last five years. We also asked for a comment on the £1.5m treatment costs for one child.
However, just a two sentence response was issued.
A department spokeswoman said: “The information requested is not routinely collected by the DHSSPSNI and it is our understanding that such children and young people would be provided services appropriate to their needs by the Trust upon completion of a UNOCiNI (Understanding the Needs of Children In Northern Ireland) child in need assessment. Services would therefore be generally provided from the HSC Trusts Children’s Services funding.”
However, The Detail has obtained a research report funded by the Department of Health and the Northern Ireland Office which did recently examine the issue in depth.
The study looked at the number of young people under the age of 18 in Northern Ireland referred over a one-year period to Social Services, the police and education sector for displaying sexually harmful behaviour.
A total of 163 cases were referred between April 2004 and March 2005. The vast majority were male – just 12 were female. The average age of the children was 14-years-old but almost a third were aged under 10.
Twenty percent had special educational needs, 15% had previously displayed sexual harmful behaviours and 20% had been victimised in some way themselves.
Of the cases, 115 included details on their victims. A total of 145 victims were identified with an average age of seven-years-old, 37% were friends and 21% were family members. The study states that “a significant proportion” of the victims were under 10-years-old.
There was evidence of criminal proceedings in just 23% of cases.
Around half of the behaviours identified were described as “sexually inappropriate” including inappropriate touching or kissing and indecent behaviour, 25% were indecent assault and the remainder were described as indecent exposure, rape, unlawful carnal knowledge, buggery, penetration and indecent images.
The report states that children and young people who sexually abuse others can use a variety of measures to overcome victim resistance. These include games, bribery, the use of authority by age, threats (including the use of a weapon) and physical force. Childminding situations can also provide opportunities for young people to access children as victims.