title: Mental health provision for young offenders: service use and cost.
abstract: BACKGROUND
  The full costs of accommodating and supporting young people in the criminal justice system are unknown. There is also concern about the level of mental health needs among young offenders and the provision of appropriate mental health services.
  
  
  OBJECTIVE
  To estimate the full cost of supporting young people in the criminal justice system in England and Wales and to examine the relationship between needs, service use and cost.
  
  
  METHODS
  Cross-sectional survey of 301 young offenders, 151 in custody and 150 in the community, conducted in six geographically representative areas of England and Wales.
  
  
  RESULTS
  Mental health service use was low despite high levels of need, particularly in the community. Monthly costs were significantly higher among young people interviewed in secure facilities than in the community (pound 4645 v. pound 1863; P<0.001). Younger age and a depressed mood were associated with greater costs.
  
  
  CONCLUSIONS
  Young people in the criminal justice system are a significant financial burden not only on that system but also on social services, health and education. The relationship between cost and depressed mood indicates a role for mental health services in supporting young offenders, particularly those in the community.
authors.affiliation: Centre for the Economics of Mental Health, Box PO24, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. b.barrett@iop.kcl.ac.uk
authors.forename: Barbara
authors.initials: B
authors.lastname: Barrett
authors.forename: Sarah
authors.initials: S
authors.lastname: Byford
authors.forename: Prathiba
authors.initials: P
authors.lastname: Chitsabesan
authors.forename: Cassandra
authors.initials: C
authors.lastname: Kenning
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry / Q000191:economics / Q000458:organization & administration; D003415:Crime / Q000191:economics; D004739:England; D005260:Female; D005555:Forensic Psychiatry / Q000191:economics* / Q000458:organization & administration; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000628:therapy; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D014852:Wales