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Royal Commission into Victoria’s Mental Health System

Case study:

Custodial Forensic Youth Mental Health Service

The Custodial Forensic Youth Mental Health Service is a specialist mental health service located in both Parkville and Malmsbury Youth Justice Centres. It provides clinical mental health services for children and young people on remand or sentenced in the centres. It began in February 2019.

The service is operated by Royal Melbourne Hospital (Orygen Youth Health) and works closely with Correct Care Australasia, which provides the primary health service to the children and young people in detention. It is funded through the Department of Health, which manages the program in consultation with Justice Health.

Ms Emma Burke, a clinical psychologist at Royal Melbourne Hospital, said the service was designed to provide tertiary mental health care through a multidisciplinary team made up of medical staff, including a neuro‑psychologist, psychiatric registrar and consultant psychiatrist, as well as other allied health clinicians (including psychiatric nurses, social workers, occupational therapists and psychologists).

Prior to this service, young people in custody were provided with a mental health service that was primarily focused on a psychiatric response. The Custodial Forensic Youth Mental Health Service is an attempt to start to make specialist mental health services that young people require in custody more equitable to what young people receive from a community youth mental health service.

Ms Burke said the service provides assessment, case management and therapeutic work, as well as discharge planning at both detention centres. Young people in custody present with a range of complex mental health illnesses, as well as conditions that are difficult to diagnose.

We often see young people in custody through this service who you wouldn’t typically see get into a tertiary mental health service. This is particularly the case in the under 15 cohort who may present with a lot of things going wrong but nothing that you can easily diagnose, but they clearly need specialist input.

Ms Burke said young people can be discharged to other tertiary specialist mental health services, or services such as headspace or to GPs, but it is catchment‑based, which can limit the type of care they receive and whether Orygen can provide continuity of care into the community.

If the young people are in Orygen’s catchment area, then we will refer them to other community teams. That’s where we actually find that this works, when we can all liaise together. For example, when someone in the court role can communicate that someone is coming into custody, or when the custodial team can let the justice mental health workers know when someone is being discharged we can work together to provide care.

Source: RCVMHS, Interview with Ms Emma Burke, November 2020.