Racial-Ethnic and Gender Inequities in School SEND and Youth Justice Responses to Children and Young People's Mental Health: Population-based Cohort Study using Linked Administrative Data in England

Background: Mental health difficulties increase risk of justice system contacts, and justice involvement increases risk of and exacerbates existing mental health difficulties. However, discrimination influences both whether children's needs are supported and the likelihood of justice system contacts. Examining patterning in Special Educational Needs and Disability (SEND) provision for Social, Emotional and Mental Health (SEMH) needs and youth justice contacts may identify escalation pathways and opportunities for equitable support. Methods: In partnership with young people and community stakeholders, we analysed population-level linked school and police administrative data for 3.7m children (born 1997-2003) who attended state schools in England. We examined rates, timing and risk ratios for the sequencing of SEND-for-SEMH and youth justice contacts. Results: Children ever recorded with SEND-for-SEMH had markedly elevated rates of youth justice contact, and vice versa. First justice contacts clustered between ages 14-16, though Black Caribbean, Mixed White-Black Caribbean, Romani, and Irish Traveller boys experienced steeper increases from age 12. Most racially and ethnically minoritised boys, alongside Romani and Irish Traveller girls, were significantly more likely than White British boys to have youth justice contacts before/without SEND-for-SEMH. Following SEND-for-SEMH, racially and ethnically minoritised boys and Irish Traveller girls were at greater risk of contacts. Conclusions: Findings reveal intersectional discrimination in criminalisation of children and shed light on the complex bi-directional relationship between identified mental health need and youth justice contacts. A healing-centred, public health, multi-agency approach is urgently required to break the vicious cycle between unmet mental health need and youth justice system contacts.