Highlighting the impact of childhood trauma in secure care

The level of exposure to Adverse Childhood Experiences (ACEs) amongst children in Scotland’s secure care centres “is both broad and substantial”, a study by the Children and Young People’s Centre for Justice (CYCJ) has found.

‘ACES, Places and Status: Results of the 2018 Scottish Secure Care Census’ also reported that gender is a key factor, with girls in secure care seeming to experience a greater number of ACEs. Average rates of exposure to ACEs amongst girls was 5.96, compared to 3.77 amongst boys.

The study aimed to highlight the prevalence and impact of ACEs across Scotland’s five secure care centres, whilst aiming to address a lack of research in this area.

Findings also demonstrate the substantial levels of poverty and deprivation experienced by children in secure care, with a statistically significant relationship reported. Scotland’s Children and Young Person’s Commissioner has repeatedly described poverty as the biggest human rights issue facing children. As Scotland strives towards UNCRC incorporation and becoming a rights-respecting nation, the report recommends an approach of binding poverty to the cause of children’s rights that is “both principled and paramount”.

Recommendations made in the report could offer support to secure centres in developing services to respond to ACEs, whilst stressing the need to support families, communities and services in order to prevent them in the first place.

This study reiterates the recommendations of Scotland’s Independent Care Review, which called for therapeutic services within secure care, provision of care that reflects the needs of these children, and an increase in community alternatives.

Fiona Duncan, Chair of the Independent Care Review, said:

“This report on secure care has come at a time when Scotland is beginning a dedicated process of transforming its system of care. As stated in The Promise, Scotland must radically reform the provision and use of secure care.

“A secure care placement must always uphold the totality of children and young people’s rights and ensure relationships are always respected, upheld and prioritised. Making this the minimum standard within every setting will go some way to improving experiences and outcomes. However, it is also necessary to ensure secure care placements must only be used as a last resort and only when it is in the best interests of the child. Acting in the best interest of the child means properly listening to children and their families about their experiences and needs.

“Children’s experiences and the impact these have had must be taken into account in each and every decision that is made about what happens in their lives. CYCJ’s report acknowledges the role that accommodation within secure care plays in supporting children who face, take or make a high risk of harm.

“Use of this study and others like it alongside the voices and stories of children and their families will provide a better foundation on which to support practitioners and policy makers to better understand the lives of the children in question. This way of working must track through to Scotland’s national monitoring frameworks to ensure that it prioritises what matters to children and their families and reflects their experiences. The Promise is clear the data that is collected to monitor progress and outcomes must be capable of measuring the experiences and outcomes that children and their families say matters to them.

“All evidence used to inform day to day decisions and policy making must routinely include the voices of children and their families for the goal of improving individual and collective experiences and outcomes to be realised.”

Beth-Anne Logan, Chair of the STARR group of people with experience of secure care said:

“This report not only highlights the multiple adversities faced by children who are placed in secure care but lays down a call to action that we can and must do more for our country’s most vulnerable children. This includes ensuring the secure environment is a safe haven for these young people, where they are nurtured and supported to heal from previous trauma.

“It also needs our communities to be better educated to understand what secure care is and how they can play their part in helping reduce the stigma these children so often face. STARR will continue to advise, inform, challenge and support change across the sector.

“STARR will also continue to be a critical friend to our secure establishments, ensuring the voices of those with lived experience of secure care are listened to, heard and acted upon.

“This report also highlights the need for innovation of service design and delivery ensuring that the service meets the child’s needs, not the child meeting the service’s needs. This could be in the form of excellent, high calibre and safe community alternatives as we know restricting a child’s liberty must be a last resort.”

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood. The long-term relationship between ACEs, health-harming behaviours, poor health outcomes and, ultimately, early mortality was first documented in a study by Dr Vincent Felitti in 1998. This found that the greater number of ACEs an individual encounters prior to their 18th birthday, the greater the likelihood is of them subsequently experiencing poor outcomes (although such an outcome is far from guaranteed). A total of ten ACEs types have been identified.

Secure care is one of the most restrictive forms of care in Scotland. Although only a minority of children are currently in secure care (an average of 81 during 2017-18), young and vulnerable lives are significantly affected by being placed within a locked setting where liberty is deprived and freedoms heavily restricted. However, the current pool of research that links secure care and ACEs in the UK is small.

Using a census, the study collected data about each young person resident within the secure care estate on one particular day in 2018. Completed by staff who knew the child well, the census consisted of questions relating to the lives of children in their care, drawing on existing information held by the unit and charting a variety of demographics.

The study found that not only are levels of ACEs exposure high, but a large number of the children had encountered each of the ten ACEs. These may well contribute to their vulnerable state.

This work could potentially add weight to calls for gender specific responses within the secure care environment, with findings indicating a greater prevalence of ACEs amongst girls in secure care. A small number of young people identified as transgender.

Report author Ross Gibson said:

“Since the first study of ACEs was published in 1998, significant attention has been given to the study of ACEs, with a focus on the ten issues that are now widely recognised across the world as the traditional ACEs. These are prevalent across the youth justice population.

“Our aim was to fill this gap by examining both the profile of those within the niche, institutional setting of secure care, as well as illustrating the prevalence of ACEs amongst this population. In contrast to similar studies, we have taken a national approach, adopting the use of a census in all five of Scotland’s secure care settings.

“At a fundamental level everyone has the right to a childhood free from ACEs. We hope that these findings provide some suggestions as to what areas secure care placements may wish to focus their attention on in order to promote secondary prevention of adverse outcomes, whilst acknowledging that ACEs themselves may not be directly responsible for the circumstances that precipitated admission into that setting.

“More broadly, these findings are of relevance to policy makers and practitioners involved in the provision of care to children who pose or encounter a high risk of harm. By understanding the lives of children more fully, Scotland can take steps to make this the best country to grow up in and achieve its ambition of becoming a rights-respecting nation.”

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Children's and Young People's Centre for Justice
University of Strathclyde
Lord Hope Building, Level 6
141 St. James Road Glasgow G4 0LT

(0141) 444 8622


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