Young offenders — detention reception and multi-system plan (MEQ)

(i) Reception priorities. Treat first-night remand as urgent clinical triage in a high-prevalence population. In the first hours: (1) medical stability and substance withdrawal/intoxication (cannabis; screen for other depressants/stimulants); (2) suicide/self-harm (current ideation, scars, first custody); (3) psychosis/severe mood screen; (4) medication continuity — confirm prior ADHD treatment and plan safe restart after multi-source review; (5) vulnerability (age, peer bullying, family context). Obtain collateral from mother, school, youth justice, and prior CAMHS. Do not invent local youth justice section numbers.[1][2][8]

(ii) Suicide/self-harm and violence risk. Full risk interview (ideation, intent, plan, means, protective factors), developmental MSE, and collaborative safety plan. Recommend enhanced/constant observation as indicated; ligature-aware placement; meaningful staff contact. Self-harm history is a clinical signal. For violence risk, use multi-source history and SAVRY-style SPJ domains (historical, social/contextual, individual/clinical, protective) — structured judgment, not false-precision scores. Dynamic factors tonight: peer context, untreated impulsivity, legal stress, substance crash.[6][8][1]

(iii) Formulation. Integrate importation (possible ADHD, emerging CD pattern, cannabis, family adversity, maternal depression, paternal imprisonment) with detention deprivation (first night, isolation threat, legal uncertainty). Apply Moffitt framing: early impulsivity/school failure hints at higher LCP risk load versus pure adolescence-limited peer assault — provisional, needing developmental history. Comorbidity is expected (ADHD, SUD, possible depression/trauma), not exotic.[4][2][3][7]

(iv) Isolation response and stepped care. Decline isolation as “treatment.” Prefer least-restrictive observation and healthcare placement with increased mental health input. Stepped plan: treat ADHD/mood/SUD drivers; multi-agency plan with family and youth justice; consider MST (or FFT/TFCO-type programmes when community-based) for multi-system antisocial drivers when fidelity-available; hospital transfer if risk exceeds detention capacity. Pharmacotherapy targets diagnosed disorders with monitoring — not sedation-for-offending.[5][8][7]

(v) Throughcare principles. Even if release is distant, document that transitions (court outcomes, release, later adult transfer) are risk peaks: scripts, appointments, school/vocational re-engagement, substance plan, crisis contacts, family support, and risk summary handover. Longitudinal data show psychiatric continuity after justice involvement — plan beyond tonight.[1][8]