Evidence Centre seminar: February 2020

A health case study - video transcript

Speakers: 

Rosie Deutschle
Bridget Browne
Abigail Marwick

Rosie Deutschle: My name is Rosie Deutschle. I manage the Analytics and Insights Team within the Evidence Centre here at Oranga Tamariki. I've been involved with the Children’s Wellbeing Model right from its inception and all the way through its development, so that's what I'm here to talk to you about today.

The main part of our presentation is really about the Health Case Study that we've done, but this work was done within the Children’s Wellbeing Model, so we thought it was important to first give you a bit of an overview of the model and a bit of background as to what it is, what it's all about.

So before we get started, just another quick piece of housekeeping. This is the Stats NZ Disclaimer, which some of you may recognise. Essentially, all it's saying is that we haven't used any individualised data, and the findings that you'll see here today are not official statistics.

So the Children’s Wellbeing Model – what is it? There are four key elements to the model that I wanted to talk through. The first is that the Children’s Wellbeing Model looks at all children in New Zealand. So as a tool it has been designed to help aid the way that we think about and support all children, and the insights we can gather around the children's population as a whole.

Secondly, the model focuses on wellbeing. So this is not a surprise. It's called the Children’s Wellbeing Model. But I did just want to emphasise that briefly. The work that we do at Oranga Tamariki every single day is about children. So it's really important to us that we have got a model that reflects that and is child-centred.

Thirdly, the model recognises that wellbeing is complex. So it incorporates a lot of cross-sector data. We can't understand wellbeing just with our own data. So through the model we're able to draw a lot of data together into one place.

And lastly, the model when we built it, we wanted something that allows us to understand current state wellbeing, but also something that allows us to look at long term outcomes as well. So the model allows us to look at the present, but also the future.

So how does the model work? There are three main parts to the model. The first is the conceptual understanding of wellbeing, and this is really the theoretical backbone to how we use wellbeing and you might recognise six outcomes here on this slide. These are from the Child and Youth Wellbeing Strategy. So the strategy sets out six high level and interrelated wellbeing outcomes, and it also reflects what children and young people have said are important to them.

For the first outcome that we've got is that children and young people are loved, safe and nurtured. Then we've got children and young people have what they need; that they are happy and healthy; they are learning and developing; they are accepted, respected and connected; and, that they are involved and empowered in their own lives.

So there's a lot more thought below these outcomes and a lot more information. So if you are interested in finding out more all this information is available on the Child and Youth Wellbeing Strategy website if you did want to know more.

The second part to the model is how we measure current state wellbeing. So in order to do this, we've built our model within the Stats NZ Integrated Data Infrastructure most commonly known as the IDI. So for those of you who haven't heard of the IDI before, essentially it's a large resource database. It holds microdata about people and about households, and it's mostly about life events, and it brings together data from a number of different sources. So it's linked together, or it's integrated to form the IDI. And what's really important to note with the IDI is that all the data in there is anonymous - so we can't identify anybody in the IDI.

So we've used the IDI to measure wellbeing, and this is based on what we can currently see in there, so our Children’s Wellbeing Model is on a continuous journey of improvement, so it's going to continue to change and improve and develop over time as more information is added to the IDI and new information is added to the IDI as well. So that's really, really exciting.

At the moment we can measure the first four outcomes. We have done a bit of work on the fifth and sixth outcome, but as you can imagine, they are a lot more difficult and complex to measure. So work is still underway in that space.

Sitting underneath each of the wellbeing outcomes, we have a whole bunch of different indicators which allow us to measure the outcomes. Importantly, these are all proxies. So in the absence of direct measures, we've looked at what's in there that acts as the most valid proxy for what we do want to be measuring. And this is all multi-agency information. So we've got information in there from MSD, we've got information from the Ministry of Education, the Ministry of Health, Corrections, Police, of course, Oranga Tamariki and a whole bunch of other sources as well. So it's really taking a broad view.

Yeah, so to sum up that part, essentially we're looking at service usage and other indicators of need and of wellbeing to give us an understanding of what children look like in the context of them, their families and their communities, and in order to do that we also draw on information not only on the children themselves, but also on siblings and on parents too.

To provide you a couple of more specific examples -- I'm not going to go through all of the outcomes -- but as an example, children and young people have what they need, we can look at information such as benefit receipt, parental income and social housing. For children and young people that are happy and healthy, we can look at things such as hospitalizations, immunizations, mental health treatment and a whole bunch more as well, but those are the sorts of things that we have available to us.

So, this is a visual demonstration of what the wellbeing of children and young people in New Zealand looks like. So it pulls together all zero to 16 year olds in New Zealand, and so that's roughly just over a million children and young people.

And so using the model, what we can do is we can begin to segment what different levels of wellbeing look like. So, if I come down to the very right hand side of the arch, we've got children who, through the data that we can see, it looks like they've got very poor wellbeing. So these are the children who at the very high end of need. That's roughly 10,000 children.

If we bring it all the way back to the big blue section, those all the children who, again, from what we can see -- because there are limitations -- it looks like they're doing well. That's 570,000 children and young people. And then we've got a bit of a spectrum in between.

The other interesting way to look at this is if we look at everything that's not in the blue, those are all the children and young people who look like in some shape or form, small or large, they could be doing better.

So, that's just under half of the population of children in New Zealand. That's really significant. That's why we come to work every day and that's essentially what it's all about, what we want to improve. 
Very lastly from me, so I mentioned there are three main parts to the model. The first is a conceptual understanding of wellbeing. The second was how we think about and measure current state wellbeing and the third is around those longer term outcomes. So I'm not going to go into any detail around that, but you will see that play out a bit in the work that we've done with the health information. 
So, I will pass you over to Bridget now to begin talking about that.

Bridget Browne: Thanks, Rosie. Kia ora. That's exactly the extra thing to say about the IDI. So, Rosie mentioned its integrated nature, but another very important feature is that it is longitudinal in nature. So we have a lot of information gathered over quite a long period of time, which means we're able to look at a life course. We're actually able to follow people's life courses for, actually there's decades of data in some cases available to us. That was really the key to help us with developing this health case study, which is a key component of the children's model.

So, what we were trying to do in this particular component was try and understand the share of some of the key chronic diseases that we see in adult life that could be attributed to poor childhood experiences. Just to add to our understanding of the interconnected nature of some of those life course outcomes and understand the impact of childhood experiences on future health outcomes. Part of that was in terms of thinking about some of the bounds we might have on the gains possible in the health domain from successful interventions in childhood wellbeing.

So, we did this work in conjunction with the Ministry of Health and a number of experts from the ministry and broader health sector using, in addition to the IDI, a lot of input from the New Zealand Health Survey and the New Zealand Burden of Disease study.

So, we took a four step approach to determine the expected lifetime impact of childhood experiences on health once children reach age 25. So I'll explain the phases because they don't quite go in the chronological order you might expect. So on the advice of the health experts, the first step was to determine the major adolescent risk factors that are associated with high morbidity and high cost adult health conditions and in that sense, the adolescent period was -- there's ages 18 to 25 and the sort of key conditions that we were looking at were things like long term mental health support needs, the impact of substance abuse, alcohol and other drugs and smoking, and the impact of obesity on future health costs such as diabetes.

There are actually six conditions in all the other three conditions around recurrent infections, accidental injuries and sexual and reproductive health, we did look at those but they contributed a substantially smaller proportion of the overall lifetime cost and burden.

So, having looked at the risk factors or the presence of those conditions or the precursors to those conditions in ages 18 to 25, we then went backwards in time to look at the childhood experiences of New Zealanders, to look at the association between the risk of developing those conditions in the adolescent period across a very wide number of factors, so starting from the demographic so gender, ethnicity, socioeconomic factors, but also specific factors related to care and protection experience, exposure to family violence and the like.

And so in that sense, there is some resemblance to studies that have been done internationally around adverse childhood experiences. This is not a reproduction of an Adverse Childhood Experiences study in full, but certainly the findings were analogous to what you would see in those in those studies.

So, we looked at the association between those childhood experiences and the adolescent risk factors. And then we took a step forward and looked forward into what was the expected lifetime burden associated with those conditions or the risk of those conditions in adolescence. And we did that in two ways.

One, we looked at the future disease burden using DALYs -- Disability Adjusted Life Years -- so, we looked at the DALYs associated over the life course around mental health, obesity and substance abuse as well as the others. And for that, that principle source for that was the Burden of Disease study and effectively it was an attribution of what we understand around the estimation of DALYs to the components that could be attributed to early life.

And separately from that, we also looked at how we could attribute the costs associated with treating those conditions and that was very much directly from the Ministry of Health's Health Tracker information. So the actual dollars spent by the health system, and what was particularly interesting about that is those two strands were done separately, but actually produced very similar results.

So, that's very positive because it suggests that by improving outcomes, reducing the burden of disease, there will also be treatment savings in the system. Of course, the challenge is what those interventions should be and how much they might cost, which this study doesn't look into, but at least it points the way to areas to focus on.

So, the first component of the results was the prevalence of those adolescent risk factors. As we mentioned, the childhood factors broadly group themselves into socioeconomic factors and interactions with Care and Protection, police, family violence and the like, and we'll come back to those in more detail, but when we looked across the adolescent risk factors, the prevalence of having, or the chance of having, one of those conditions is really pretty significant across the population as a whole.

So, we're really talking about the whole population here. So, basically how you can read this is about a quarter of people by the age of 25 will have experienced some fairly significant mental health issues as we can see them through use of system supports.

So, whether it's mental health prescriptions or services, community services or hospital services, and the same goes approximately for both sort of nutrition-related obesity issues and for tobacco. Tobacco's about 16 per cent and alcohol and other drug issues were about 7 per cent, making up that 22. So, the other thing that you'll notice, obviously, is that the sum of those numbers adds up to more than 100 per cent, and this is because some people actually suffer from multiple conditions. Some people will have both issues with -- in fact, co-morbidity is pretty common with both substance abuse and mental health, for example.

So, one of the key findings that actually hadn't been established in New Zealand before was that only a third of the population reaches age 25 without any of these conditions. So this is a really substantial population health issue, which is I think, well understood in the sector. What we were then looking for in terms of going back in time was to see the extent to which we can discern differences in childhood experiences where there might be children who have a higher risk of developing these conditions or alternatively a lower risk of developing these conditions, and we did see some fairly substantial differentiation.

And so we're going to put the results in two in two different ways. We're going to express it as a bit of an individual case study, an example, a bit of a illustrative example, and then I'll come back and speak to the whole of population burden in terms of cost and DALYs.

So, to speak to the individual example and some of those relativities, I'll hand over to Abi and I'll be back with you in a moment.

Abigail Marwick: Thanks, Bridget. So just looking at it firstly from -- what it might look like from an individual's perspective. If we think about the rainbow that Rosie showed a little bit earlier, there's clearly a subset of the population that experience -- show signs of some areas of lower wellbeing.

So, in this example, we've looked at the most acute end of that spectrum where we've got, in this example, a subset of teenagers who experience low socioeconomic circumstances, extended low household income for most of their childhood, multiple hospitalizations, contact with the Care and Protection System and overall, there are several areas where it looks like things aren't going quite so well.

And so when you look back at the IDI longitudinal data and then also for the obesity factors, we looked at the health survey, there's an association between the accumulation of those factors and some of those development, some of those adolescent conditions that they develop later in life. So compared to other teenagers, we estimated that there is actually a disparity in the -- an increase in the likelihood that they will develop these factors later in their adolescence.

And so, for example, we estimated two and a half times more likely to have that contact with mental health services by the time they hit 25, three times more likely to smoke, seven times more likely to have substance usage treatment needs, two and a half times more likely to have indicators of recurrent infections and two times more likely to have nutrition and obesity related issues.

And so all of that combines into a significantly higher risk that they are going to go on and experience actually poorer health over the duration of their adult lives. So, I'm going to skip briefly to the next slide. This is just another way of showing it, but basically the whole population there is a, you know, a sort of general population prevalence of mental health treatment later in life. Smoking, obesity, and that's what you see at the right hand of the graph.

But for children who experience multiple areas of lower wellbeing, the likelihood that they will develop those conditions is a lot higher and so that's why as you go sort of more towards the left, the percentages increase and the disparity is greatest for substance usage treatment, but it's there across all of the conditions.

And so for the for the child population with at least one of the adolescent risk factors, we estimated an average nine disability adjusted life years lost that can be attributed to those adolescent risk factors. That's nine years of a healthy life lost.

And then the excess cost per child, we estimate at about $143,000. But for kids who at the very lowest end of the wellbeing spectrum, we would expect that to be substantially more. So that's really putting the case that some of these factors that develop over childhood and adolescence have impact over the whole of life, and it's quite substantial.

So, handing it over to Bridget again.

Bridget Browne: So, then taking that up to the population level and looking at how we bring all of that together, what we did was effectively look at those childhood factors and the extent to which they differentiated the development of the adolescent risk factors with the big three being those related to mental health, substance use and obesity and nutrition.

At a population level, we were able to estimate specifically the DALYs lost and the excess cost associated with those conditions. So, in the Burden of Disease study, for example, overall, the system estimates there are a million years of healthy life being lost across the population. The majority of those are actually lost in adult life, some 900,000. Of those, 53 per cent are actually attributable to those major chronic disease conditions and we estimated -- and this was very much, as we say, a case study, so it was a first approximation -- we estimated 40 per cent of those could be attributed to experiences arising prior to age 25.

So, there's a really, you know, again, as Abi said, a strong case to say that a lot of this needs to be addressed earlier in the life course and there will be major benefits from doing so.

So overall, for the population as a whole, there were 370,000 DALYs lost that could be attributable to experiences before age 25, and that represents $5.6 billion of the approximately $15 billion spent annually on health in New Zealand, so a very significant proportion, which I think hopefully points towards a lot of expenses obviously incurred at that very acute end at the end of life, that's clearly a major component of health system costs, but those chronic disease costs that last over many, many years are becoming a greater share of our health systems cost and this points to being able to work in those early years in public health responses to reduce that burden. This is just another representation of that impact.

So, that's all that we were going to cover today. So, I think we are ready for the next presentation.

End of transcript.

Insights into the youth justice system - video transcript

Speakers: 

Dr Duncan McCann
Sarah Richardson

Duncan McCann: Tēnā kotou katoa. Thank you for the introduction, Steve. As you've mentioned, I'm Duncan McCann and today with my colleague, Sarah Richardson, we will be talking to you about Insights into the Youth Justice System. Now, we both work in the Analysts Insights Team as part of the Evidence Centre on a number of -- on doing research and analysis into a number of activities around Oranga Tamariki interventions. In particular, we also work with youth justice. Now, when we work in this space, there tend to be a fairly common set of questions that crop up from time to time.

So, what we want to do today is talk you through a couple of those questions using data that's basically publicly available or can be easily requested from organizations just as an answer to those common questions.

Now, to start off, I just want to give you guys a bit of a brief overview of what the sort of Oranga Tamariki processes are in terms of a Care and Protection sense and also a youth justice sense. Some of you in this room will know a bit about Care and Protection, some will know about youth justice and some of you will know a bit about both.

But just so we're on the same page, I'm just gonna go over sort of the brief sort of outline of these. And now these are just a very generic outline, in actuality the system is very complicated and there are a lot of different pathways that you can take. So, Oranga Tamariki as an organisation is -- one of the main things we do is look out for the Care and Protection concerns of New Zealand's children. Now, essentially, how that works is we, as an organisation, receive a report of concern about a Care and Protection risk for a young person. This can come from the public or the police or health or education, a number of different sources. A social worker assesses the report of concern and if it's deemed there isn't an actual risk involved here, then the process, it ends there, or it may be referred to a partner agency.

However, if there does seem to be a Care and Protection risk, it proceeds to the next stage which is an assessment and investigation. So, at this stage a social worker is meeting with the child, the family, meeting with relevant people in the community, performing a safety and risk assessment of the situation, and if there isn't a Care and Protection concern at this stage then the process can end here or can be referred to a partner agency, depending on what the assessment shows.

However, if it is deemed that there is harm to -- there has been harm to the child or there is a risk of their safety and well-being, then it can proceed what is -- pass what is known as the statutory threshold, and that is a statutory intervention by Oranga Tamariki.

So, the first stage of the sort of statutory invention is a Family Group Conference. So essentially a Family Group Conference is a meeting that Oranga Tamariki puts together with the child, the family, the extended family whānau and relevant people in the community such as like the schools or doctors involved, sometimes the police, depending on the nature of the concern, and they try to come up with a plan to resolve that Care and Protection concern and sort of resolve it, if at all possible, so that the child's safety and wellbeing is maintained and addressed.

If this is successful and the plan carries out, then the process sort of ends at that point and we monitor the plans as well as part of this.

However, in the most serious cases where there is still a serious concern to the safety of that child, then a child may be taken into the care of Oranga Tamariki. Now, essentially what being in care means is Oranga Tamariki has custody of that child and they are placed in a Care and Protection placement. The placement can be with a family whānau caregiver; it can be with a non-kin caregiver or sometimes it's actually with the family that they're with originally. But Oranga Tamariki maintains custody and monitors the situation. So that's a very, very brief nutshell of the Care and Protection system. In reality, very complicated and a lot more to it.

The Youth Justice System is an entirely different kettle of fish. What Oranga Tamariki is also partly responsible for is the offending of young people in New Zealand. Now, this can cover 10 to 17 year olds but really the bulk of it is actually 14 to 17 year olds. And we don't do this in isolation. Oranga Tamariki only deals with generally the most sort of serious levels of offending of young people. We work in tandem with the police, which do a lot of work around lower levels of offending and also with the Youth Courts who held a lot of power in terms of what goes on with offending -- in response to offending behaviour.

But generally what happens is for the front end, the police are the frontline, they're the on the ground boots that are dealing with offences of young people in alleged offending. Now they actually have a number of options available to them with how to respond to offending at this point. And I'm not going to go into too much detail right now because I talk about this a little bit later in the presentation, so I'll leave a little bit of mystique around this point for now.

But essentially what happens is a lot of low level offending is dealt with at the police end through a number of options. Depending if an offence is quite serious or there is a lot of serious repeat offending for a young person, the police can refer to Oranga Tamariki for what is known as an Intention to Charge Family Group Conference. Now what an Intention to Charge Family Group Conference is, is basically what it says on the tin. Essentially, charges are intended to be laid against the young person in court unless Oranga Tamariki and the police work together to formulate a plan to address the offending behaviour.

Family Group Conference at this end is very similar to Care and Protection - involves the child, their family, relevant members of the community, the police, but most importantly, we try to involve the victim, if at all possible at this stage because the entire point of this Family Group Conference is around restorative justice. It's trying to have the young person take accountability for their action and make amends or reparation for whatever offence they have happened to have committed. And sometimes it helps assess the needs of the child and get them the relevant services that they may need -- sorry, young person, definitely.

So, and if the plan is successful and agreed by all parties, then essentially that is carried out and monitored and the process sort of ends there. However, if the alleged offence is even more serious or the young person is more of a repeat offender, the police can refer directly to the Youth Court system and also, depending on how the plan goes, the intention FGC stage, it can also escalate to court at that stage if it's agreed that court is the appropriate process to go through.

So essentially, what happens when a young person goes to Youth Court for an offence they will have the charges laid against them and they'll have their first hearing. What the court will almost always do is order a court ordered Family Group Conference. Very similar to the other Family Group Conference, again, involves the victim and relevant parties and it is an attempt to deal with that offending and come up with a plan to take accountability and make amends and reparation for that offence.

If an appropriate plan is put together and all parties agree and the court agrees as well, then it may end at that point once the plan is carried out and further monitored.

Now, what can also happen when a young person comes before court, before the first hearing is they can also be remanded by the court. Now, essentially what being remanded means is the court orders that Oranga Tamariki has custody of that young person for youth justice reasons. Now, this could be because perhaps they're a flight risk, perhaps they're considered a danger to others in the community, perhaps they there aren't suitable options available for them to be safely bailed back to their community.

So essentially, what custody in this instance means that Oranga Tamariki has custody of the individual and they're placed in a youth justice facility. Now, this can be a group community remand home, it could be a youth justice residence. This period of custody can be relatively short, it can be only a small period of time as part of their court case or could be the whole period of time of their court case, it really varies and depends on a number of factors. Either way, if you are remanded, you still get your court ordered Family Group Conference because it is still attempting to come up with a plan to address that offending.

Now, as part of that Family Group Conference plan, it can actually recommend certain charges may be laid -- certain outcomes may be laid against the person in relation to their charges, or the court may consider the aspects of the plan and deem that other charges may be necessary over what is recommended.

So the types of orders that Oranga Tamariki will be involved with that come out of this, that a young person is charged with it at the end of their case are things like support programs, so for drugs -- alcohol and other drugs, a type of mentoring or behavioural therapies, things like that, they can also be supervision orders and these are things like supervision and supervision with activity and these are essentially things like probation and community work, if you want to consider those in regard, sort of like administered by Oranga Tamariki, and the most serious one you can get is Supervision with Residence.

Now, Supervision with Residence is an order imposed by the court essentially that the young person has to serve a period of time in a youth justice residence as a consequence of the offence that they have committed. These tend to be about three to six months and they're only really for the most serious types of offences that you actually receive Supervision with Residence order, but you are given into the custody of OT as we are holding you in a youth justice facility.

So the bulk of what Oranga Tamariki does is the organising of these Family Group Conferences, the administering of the plans and the monitoring of them. And the other bulk is also the custody of individuals who either been remanded into our custody or have been sentenced to a Supervision with Residence Order along with some of the other programs and supervision as well.

So, now that we understand a little bit about Oranga Tamariki processes, and I understand it was quite a bit, let's move onto some of the questions we commonly get asked in this space, and one of those questions is, "Do care-experienced young people move into the Youth Justice System?" Now, when people talk about care experience, they're talking about those who have been in care in the custody of Oranga Tamariki for a Care and Protection reason.

So what we're going to look at is we're going to actually look at what does the overlap look like for young people who have been placed in a Care and Protection placement versus the overlap with those who have been placed into the custody of OT for a youth justice reason, either on remand or Supervision with Residence. So for this, we looked at some operational internal data for Oranga Tamariki and we looked at all 18 year olds at a point in time. So, they've aged out of the system, they've had all their time as a young person to interact with Oranga Tamariki and they're not going to interact with us any more beyond this point for any of these particular reasons.

So, all 18 year olds at a point in time. And what we see is we have about 1,600 eighteen year olds who had a Care and Protection placement at some point in their lives in the past. So the question is, how many of these 1,600 actually also had a youth justice placement, or in remand with Supervision with Residence? And the answer is actually very few of them. Only 11 per cent of those who had a Care and Protection placement also had a youth justice placement at some point in their lives.

Or if you consider this from the Care and Protection viewpoint, 89 per cent of these 18 year olds who had Care and Protection placements ever, ever touch the Youth Justice System in terms of being placed in OT's custody for youth justice reasons, which is really the vast majority of them. It's a bit of a different picture if you look at from the youth justice lens. Of those with youth justice placements, 45 per cent of them had a Care and Protection placement at some point in their lives.

Now, I'm going to go on it a little bit detail about this overlap in a moment but first, I want to take another view of what the care experience overlap might look like.

Beforehand, I talked about statutory involvement. I talked about if you've got a Family Group Conference for a Care and Protection reason or you were in care for a Care and Protection reason. So that represents quite a lot, quite a heavy involvement with Care and Protection. And I want to look at all those with FGCs and all those in care and I want to look at what was their overlap in youth justice terms, in terms of, were they in a placement for remand or Supervision with Residence, or did they receive a Family Group Conference for youth justice reasons? That intention of charge and court-ordered once because those are directly representative of a serious level of offending.

So, what we see is, again, we take all 18 year olds that had all this time to interact with the system and we see we've got about 2,600 eighteen year olds had either a Family Group Conference or a Care and Protection placement at some point in their lives. And what does the overlap lap look like in terms of Youth Justice Family Group Conferences and Youth Justice placements? It's a bit larger for this overlap. You're looking at about 18 per cent of those who had Care and Protection also had a YJ statutory involvement. But, again, if you look at that from the Care and Protection perspective, that means 82 per cent of young people who had involvement with Care and Protection at some point in their lives never even touched the sort of OT formal justice system at all, 82 per cent of them, four out of five. So it's really quite a vast majority.

From the youth justice perspective, we again see that there is a relatively large overlap. You're looking at 39 per cent of those who had YJ FGCs or were in our custody had also had a Care and Protection FGC or had been in care as well. Now, this is not really entirely surprising when you consider the fact that a lot of the drivers of offending, things like poorer socioeconomic factors, criminal sort of backgrounds in the environment surrounding them, substance use issues, trauma that they've suffered that leads to particular kinds of offending behaviour, a lot of these things are sort of relatively common in the Care and Protection population as well. A lot of the Care and Protection population has these types of factors.

But just because you have these types of factors that require a Care and Protection response to help alleviate these concerns in your life does not mean that you then go on to be an offender, because as we've seen here, over 80 per cent of those who've been involved in Care and Protection never even touch the formal justice system whatsoever.

So, given that, the next question I want to sort of go over that we get asked quite a bit is are re-offending rates actually worse for young people compared with adults? Now, this is a bit of a complicated question, because the fact is that the Youth Justice System and the adult system, they're fundamentally different in the way that they treat offences. They're very different, and you can't really make accurate comparisons between reoffending rates between them and the specifics show and illustrate that, I want to show you guys a breakdown of what police proceedings look like for a given year in both the adult system and the youth system.

So, essentially this is saying for people who've been apprehended, people who've been caught with an offence, how did the police initially proceed against them, what did they choose to respond in regard to that offence? So, we're going to compare the adult system and the youth system.

So first, this is the adult systems. For 20 plus year olds, of all the police proceedings in a particular year, 23 per cent were given a warning or other some other type of police action. 77 per cent, the remaining amount of offences all went to the adult court system. So you see that over three quarters of offences in the adult system to proceed directly to the adult court. Now, the question is, what does this look like for the youth system? And it's actually quite a different picture. And this is where I'm going to go into a bit more detail about how the police deal with the front end of offending.

So, for quite low level offences, what you see is the police are giving former warnings and other types of action to about 17 per cent of the offences that are coming through to them in that year. 
For the next most serious types of offences, they encounter or people with sort of multiple offending behaviour, you see the next 45 per cent of offences go to what is called an alternative action. Now, alternative action is a police-led diversionary tactic, which is essentially them organising a plan trying to deter, try to bring accountability to the young person for the offence and making amends or reparation for what they have done.

So, as you can see, the police have already diverted over 60 per cent of the offences in the youth system to alternative types of actions and warnings.

For the next types of offences, the other offences leftover that are even more serious or for offenders who are even more -- have even more like offending history, the next 6 per cent get referred to Oranga Tamariki for an Intention to Charge FGC, where we try to come up with a plan to address that offending behaviour if at all possible.

And for the last 32 per cent of offences which are the most serious offences, and for young people who have the most offending history, that last 32 per cent goes to the Youth Court.

So, what you can see here is there's actually -- the youth system and the adult system are very different in how they treat offending. The youth system is entirely geared towards trying to divert away from formal court proceedings, if at all possible. In fact, this is a central part of the Oranga Tamariki Act, that if at all possible, if offending can be dealt with, without restrictive court proceedings, then it should be. And if that can be resolved, then that all well and good.
So, what this means is that the Youth Court is actually only reserved for the most serious types of offences and the most serious repeat offenders, whereas the adult court deals with almost all levels of offences, they get referred up to it. Now, you can see this in a little bit more detail when you actually consider the actual seriousness scores of the charges and cases that are brought into the various courts. 
In the adult court, it deals with 72,000 people, so already a very large amount of people in a particular year. And the average seriousness score of the cases seen at the District Court is 113. Now, for reference, a seriousness score of about 113 is equivalent to an offence of benefit fraud. You can see that the median seriousness score is 19, which is much, much lower. So, this is sort of indicating that there is a very large proportion of low level offences in the District Court.

So, what does it look like for the Youth Court picture? Well, the Youth Court deals with a much smaller cohort, only about 1,300 individuals, and the average seriousness score in their court is 474, which is four times greater than what you saw in the adult court. And for reference, the score of 474 is equivalent to an offence of arson. And you can also see that the median seriousness score, 243 - about 13 times greater than what you see in the adult court is much higher. So there is a much higher distribution of more serious end cases.

So, ultimately what it comes down to is comparison of re-offending between the adult system and the youth system is very complicated and you can't really do it effectively because the youth system is geared entirely towards diverting away from formal court proceedings if possible and the mix of cases that you see in the youth system are much more complex and serious than the mix of cases that come before the adult court. So, comparison of just straight up re-offending statistics can be relatively misleading.

And that is just me for now and I will pass it on to my colleague, Sarah Richardson, who's going to talk a little bit more about re-offending.

Sarah Richardson: Thanks, Duncan. So, one of the other questions we get asked quite often is, "Do a large portion of young people involved in youth justice go on to re-offend?" And if we look at the published Youth Justice Indicators, you can see that 45 per cent of 14 to 16 year olds with a proven court outcome receive another proven court outcome within 12 months. So quite high. There's been some research done within the Evidence Centre by by Phil Spiers into reoffending post high end Youth Court orders. So the high end Youth Court orders we're talking about here are supervision, supervision with activity and Supervision with Residence. And when I talk about re-offending for these, it's slightly different to this measure in that it's looking at a young person that received that order and then whether they were proceeded against by police in the following twelve months. Phil's research is published on the Evidence Centre website, so if you want to know more, I highly suggest you go and read that.

So for those that received supervision 81 per cent re-offended within twelve months. 82 per cent of Supervision with Activity, and for the most serious Youth Court order you can receive, 88 per cent of these young people re-offended within twelve months.

However, if you're looking at re-offending in this way, it's very binary, so you either re-offend or you don't re-offend. It doesn't tell us anything about the pattern of re-offending post these orders. And when you're dealing with young people at the sharp end of the system, it's highly unlikely and maybe a little bit unrealistic to expect them to stop offending immediately.

So, what I'm going to show you now is the results for the Supervision with Residence cohort and look at how the frequency and seriousness of their offending changed post serving that Supervision with Residence order.

So, this is the average number of offences committed by a young person who received a Supervision with Residence order and you can see in the two years prior to this Supervision with Residence order, their offending escalated. Then they would have gone to court, received that order and then spent three to six months in a youth justice residence and upon release, in the six to twelve months afterwards, the average number of offences they committed decreased. And if you're comparing the twelve months post the order or the 12 months pre the order, 69 per cent of these young people reduced the frequency of their offending. So that's a step in the right direction.

However, looking at the number of offences they committed doesn't tell us anything about the types of offences they committed and whether they're just still continuing with the same level of severity in them. So, we've also got a view of what the average total seriousness score was for these young people and a seriousness score is just a way of quantifying the relative seriousness of an offence based on sentences that have been imposed for that offence type.

So, you can see in the two years before the Supervision with Residence Order, the seriousness of their offending escalates, similar pattern to the frequency and in the twelve months post the Supervision with Residence Order it decreases again and comparing the twelve months post the order with the twelve months pre the order, 74% of these young people decrease the seriousness of offending.
So, although a high proportion of these young people are re-offending, they are decreasing the seriousness and frequency of their offending, possibly putting them on a path to assistance and sending them in the right direction.

Another question we get asked quite often is, "Has youth crime become more serious?" So, to answer this question, I'm just going to show you some data that shows the number 14 to 16 year olds proceeded against by police, and I'm going to show you this by the level of seriousness of their offending.

So, over the period 2010 to 2018, you can see that low level and low to medium proceedings decrease quite substantially. So, for each of these categories it's between two, 2,500 young people over that period and low-level offences are things like wilful trespass and theft under $500 for the low to medium.

Medium level proceedings also decrease, not quite to the same extent, and these are things like theft over $1,000.

Medium to high level offences followed a similar trajectory and there was around -- you can see 1,200 less young people in 2018 proceeded against compared with 2010 and these are offences like aggravated robbery -- sorry, burglary, strike that, it's not aggravated robbery, it's burglary. Very important distinction.

And for the really high level offences, and these are the ones that generally people would receive Supervision with Residence for, this has also decreased. So, from 2010 to 2018, you can see there's about 350 less 14 to 16 year olds proceeded against. And these are your really high level offences like aggravated robbery, sexual violation, grievous bodily harm.

So, you can see that the seriousness has decreased, the number of proceedings decreased across all levels of seriousness, however, what we're left with now is a different relative mix of seriousness of offending. So the higher level offences are now accounting for a much higher proportion than they did before and this can create the perception that youth crime has become more serious when we're actually dealing with smaller volumes across the board.

Often this decrease gets attributed to police behaviour, and you can see that police have done a really good job at decreasing those low and low to medium level offences and this is in part due to Policing Excellence being launched in 2009-2010, and Policing Excellence shifted the focus from being an offender and reactive-based to being more prevention, proactive and victim focused.

But there are other factors at play and there are likely actual reductions because police have more limited options in whether they proceed against someone that's committed a high level offence like a grievous bodily harm offence versus a trespassing offence. So it's likely actual reductions because we wouldn't have necessarily seen those reductions at the higher level ends offending.

Another reason why it's indicated that these are true reductions is that there are other countries in the world that have seen youth crime reducing as well. So, in Australia over the past seven year period, there's been a 25 per cent reduction in youth crime. England and Wales are seeing falling numbers of first time entrants into the system, in the United States, since the mid-1990s, they've had a 75 per cent decrease in youth arrests, and Canada's also seen a 48 per cent decrease in youth proceedings.

So that's me. I'm just going to give you a quick summary of what Duncan and I have talked to you about. So, we've tried to answer a few key questions that we get asked often. So we've told you that the vast majority of young people and children that are care experienced don't go on to touch the formal Youth Justice System. You can't really compare re-offending statistics between the adult system and the youth system because they operate very differently and have very different cohorts of people going through them. It's not realistic to expect a young person who is already engaged in serious offender behaviour to stop offending immediately. But Oranga Tamariki interventions do coincide with a reduction in the frequency and seriousness of their re-offending. Youth crime is reduced across all levels of seriousness. More so for low level offendings, leaving a higher level of seriousness in the mix, and youth crime has also decreased across other countries in the world, indicating that we've got a true reduction in youth crime.

So, that's me and Duncan.

End of transcript.