Who are the ARTS team?

The service aims are to:

• Assess and treat the mental health needs of young people in the criminal justice system (CJS) and those whose offending behaviour could lead them into the criminal justice system.
• Work with young people involved in the CJS or Children’s Social Care (Lewisham) showing signs of sexually inappropriate behaviour.
• Ensure through integrated working that all YOS interventions are trauma informed.

Children and adolescents display a range of different sexualised behaviours. However harmful sexual behaviour (HSB) is developmentally inappropriate sexual behaviour displayed by young adults and adolescents, which may be violent and abusive (Hackett, 2014). To help professionals working with young people to distinguish between developmentally typical sexual behaviours from sexual behaviours that are problematic, and how to respond, the Hackett’s Model of HSB is a helpful tool to use (shown below)

Here is a video by NSPCC learning on why HSB’s a safeguarding concern and child protection concern: https://www.youtube.com/watch?v=hnLQFUi6uWk

Many young people referred into mental health services for HSB have experienced abuse, trauma (Hackett et al., 2013), and have several other psychosocial complex needs. Young people who display HSB may also develop further behavioural problems, for instance, poor self-regulation/coping skills, post- traumatic stress disorder (PTSD), depression, anxiety disorders, poor attachments and self-esteem, deficits in social skills, and have poorly defined personal boundaries sometimes on the background of neurodevelopmental difficulties (Hollis, 2017; Rich, 2011). Given the complexity of these cases a thinking space should be provided to consider risk factors in order to appropriately target the intervention and prevent future occurrences.

Further to this, the NICE guidelines explicitly state as part of their recommendations that “children’s social care services should identify services employing staff with the skills to undertake a specialist assessment of risk for children and young people displaying HSB” this includes child health services such as CAMHS.

The forum aims to:

• Have multi-agency representation when considering harmful sexual behaviour (HSB) cases.
• Act as a steering group.
• Act as the referral route for Lewisham CAMHS Forensic Team.
• Act as a source of knowledge, expertise and support for the practitioner presenting the case at the forum.

**For any HSB behaviours that fall within the inappropriate category on the Hackett’s model, practitioners and clinicians should seek a referral with the Safer London Team**

In the borough of Lewisham, multi-agencies aim to work together to provide a specialist service to children and young people who have engaged in harmful sexual behaviour (HSB). This includes harm to other children, young people, and themselves.

**Please note this consultation space will not be attempting to formulate the HSB behaviour but provide a reflective space to all presenting practitioners, and give consideration to the safety planning and risk management **

The consultation panel consists of multi-agency practitioners who are knowledgeable in the subject matter and may also be trained in the specialist AIM3 model.

The AIM (Assessment Intervention Moving on) project developed an assessment framework model in Manchester in 2000. The Framework was revised into AIM3 in 2007 and again in 2012, based on further research and evidence of young people aged 12-18 years. It is not an actuarial risk assessment tool, but an assessment framework designed to assist practitioners in the task of assessing HSB within the context of multiple domains of a young person’s life and identify the needs it is meeting. AIM3 has identified five domains: sexual behaviour, non-sexual behaviour developmental, environmental/family, and self-regulation.

AIM3 intends to be dynamic and responsive to developmental, systemic, and behavioural change.

More information about the assessment framework can be found here: https://aimproject.org.uk

Arts Team

Lewisham Youth Justice Service

Lewisham Children Social care

South East London Integrated Care System (SEL ICS), Lewisham

Primary Education

MET Police: Child Abuse Investigative Team (CAIT)

The panel will meet every last Friday of the month at minimum (subject to change as the forum develops and service demands change).

Referrals will be considered from targeted and specialist agencies that are concerned about a young people who meets the criteria below.

Inclusion criteria for referrals concerning young people:

• Who have engaged in HSB resulting in significant harm to another child or young person.
• Are assessed as being likely to engage in HSB that would result in significant harm to themselves or others.
• All children under the age of 18 years for assessment and/or interventions.
• Panel may provide discretionary consultation for younger children.

Exclusion criteria for referrals concerning young people:

• Young people over the age of 18 years.
• No mention of HSB as the primary source of concerning behaviour.
• The HSB incident or the case has not been raised with Lewisham Children’s social care services.
• If the case is Child Sexual Exploitation in nature.
• Who are the victims of HSB?

Referrals will be:

• Submitted to the Chair via secure email by the beginning of the 3rd week of the month.
• Lead practitioners to provide a succinct written summary of the case and current safety plan for the young person and family.
• The ARTs team will have sole discretion over whether a referral is accepted or not into the forum. Where a referral is not accepted, the ARTs team will provide explanation as to why it is not accepted and signpost to other relevant services.
• In CAMHS cases, it will be expected that the referring practitioner will act as care co-ordinator for the case and team acting to support their work, with a more specialised assessment of risk and intervention
• Cases that are accepted for an AIM3 assessment, lead practitioners are expected to send the ARTs team appropriate assessment reports.
• AIM3 assessment will be carried out by two practitioners, which may be decided in the forum or between the ARTs team and other relevant agencies.

HSB Forum Consultation Request Form

All presentations to the panel will be made by the lead practitioner. If the lead practitioner is unable to attend, their manager is expected to present the case on their behalf. To allow for an in-depth discussion each case will be allocated 60 minutes (subject to change as the forum develops). Once introductions have been completed, practitioners will have 10 to 15 minutes to present the case to the forum (i.e., what they would like to achieve from this consultation space, a brief overview of the presenting problem, family dynamics, what agencies are involved, and what the current safety plan is). The panel members will be invited to ask any clarifying questions, share reflections, identify any gaps in the case that need further consideration or what relevant information should be collated, and suggest possible interventions.

The ARTs team aim to audit the forum by keeping a log of cases discussed and collecting qualitative feedback from all lead practitioners who have presented at the forum via a Google feedback form.

Regular feedback will also be sought from the panel members to help improve the service design and delivery. The panel is dedicated to collecting and acting on feedback to ensure that the panel is a useful space to think about HSB cases with external partners and agencies.

For all referrals, inquiries or further information please email: artsteam@slam.nhs.uk

NSPCC

The Lucy Faithfull Foundation

Barnardo’s

The Marie Collins Foundation

Safe4me