The CHAT is a semistructured assessment of health needs, delivered by a nurse during the first 10 days of admission. 21 The CHAT was introduced into the CYPSE in 2013 and is completed within all CYPSE sites in England, UK. One way was to recommend the use of the Comprehensive Health Assessment Tool (CHAT).
The publication of the Healthcare Standards for Children and Young People in Secure Settings 20 attempted to provide a more standardised approach to the assessment and care provided within the CYPSE. 4–13 The social and economic burden of untreated ADHD on society is significant. ADHD is associated with a range of poor outcomes, including a greater risk of developing other mental and physical health needs, educational and occupational problems and offending. 3 Additionally, many young people have comorbid mental health needs contributing to complexity in the assessment process. 1 2 However, a report raised significant concerns about undetected neurodisability, including ADHD within the CYPSE, due to a lack of appropriate screening and assessment processes and training of staff. The prevalence rate of attention deficit hyperactivity disorder (ADHD) in the CYPSE is approximately 30%–40%, which is significantly greater than the rate of 5%, seen in the general population.
The majority of young people are placed within the YOIs and there are four establishments in England accepting 15–17 years old. The CYPSE includes: Secure Children’s Homes, Secure Training Centres and Young Offenders Institutions (YOIs). In England, children and young people aged 10–17 years old remanded or sentenced into custody are placed in a variety of different secure establishments, known collectively as the Children and Young People Secure Estate (CYPSE).
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