let s better use the brains when administering the juvenile criminal law

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1 let s better use the brains when administering the juvenile criminal law theo doreleijers prof. of child & adolescent psychiatry vu university medical center amsterdam prof. of forensic psychiatry law school leiden university

2 juvenile crime & juvenile criminal law development of the brain & of disruptive behavioral disorders a more rational criminal law discussion: what about spain?

3 what s the problem - in the netherlands juvenile crime is decreasing.. - recidivism remains high, even after justice interventions - as a result half of: of the youth prison capacity has been closed over last year!! 1200 employees have been fired - inefficient justice procedures: too much capacity to non-serious cases - too few effective ambulatory interventions too far away from the family - unhealthy environments in juvenile institutions and lack of aftercare ofwel: - wat te verbeteren in preventieve en curatieve zin? - jeugdstrafrecht effectiever en efficiënter maken - maar hoe??

4 what s the problem - in the netherlands juvenile crime is decreasing, but... - recidivism remains high, even after justice interventions - as a result of: ofwel: - inefficient justice procedures: too much capacity to non-serious cases the right winged political parties want more - too few effective ambulatory interventions too far away from the family - unhealthy environments in juvenile institutions and lack of aftercare punishment ~ revenge!! - wat te verbeteren in preventieve en curatieve zin? - jeugdstrafrecht effectiever en efficiënter maken - maar hoe??

5 what s the problem - in the netherlands juvenile crime is decreasing, but... - recidivism remains high, even after justice interventions - as a result of: - inefficient justice procedures: too much capacity to non-serious cases - too few effective ambulatory interventions too far away from the family - unhealthy environments in juvenile institutions and lack of aftercare ofwel: - wat te verbeteren in preventieve en curatieve zin? - jeugdstrafrecht effectiever en efficiënter maken - maar hoe??

6 what s the problem? - in the netherlands juvenile crime is decreasing, but... - recidivism remains high, even after justice interventions - as a result of: thus: - inefficient justice procedures: too much capacity to non-serious cases - too few effective ambulatory interventions - unhealthy environments in juvenile institutions and lack of aftercare - there is a lot to improve at the level of prevention and at the level of cure - make administration of juvenile criminal law more effective and efficient - how to perform this? (and how to convince policymakers and politicians?)

7 vision of the adolescent psychiatrist: - too little investment in prevention programs - primary, secondary, tertiary prevention - onderliggende stoornissen worden onvoldoende opgemerkt - te weinig diagnostiek en van onvoldoende kwaliteit >> - better food during pregnancy - >> strafrechtelijke - better food after interventie birth te weinig op individu gericht - interventies - professional te weinig assistance of young evidence based, staf te weinig opgeleid mothers without partners - te ver van huis, from ethnic te weinig minority betrokkenheid groups ouders - story telling to young kids - onderbroken schoolcarriere >> minder arbeidsmarktkansen - etc. - onvoldoende nazorg

8 vision of the adolescent psychiatrist: - too little investment in prevention programs - primary, secondary, tertiary prevention - onderliggende stoornissen worden onvoldoende opgemerkt - te weinig diagnostiek en van onvoldoende kwaliteit >> - >> strafrechtelijke - reading interventie programs te weinig op individu gericht - social skills training - interventies te weinig evidence based, staf te weinig opgeleid - programs to help parents to - te ver van huis, te bring weinig up their betrokkenheid children ouders - onderbroken schoolcarriere - assessment >> of minder disorders arbeidsmarktkansen (ASD) - treatment of disorders (ADHD) - onvoldoende nazorg

9 vision of the adolescent psychiatrist: - too little investment in prevention programs - primary, secondary, tertiary prevention - onderliggende stoornissen worden onvoldoende opgemerkt - te weinig diagnostiek en van - onvoldoende family therapies kwaliteit (MST, >> FFT) - forensic day treatment - >> strafrechtelijke interventie - te drugs weinig use op programs individu gericht - interventies te weinig evidence - continuation based, staf of te school weinig opgeleid - antidiscrimination programs - te ver van huis, te weinig betrokkenheid ouders - etc. - onderbroken schoolcarriere >> minder arbeidsmarktkansen - onvoldoende nazorg

10 vision of the adolescent psychiatrist: - too little investment in prevention - primary, secondary, tertiary prevention - underlying disorders are not identified sufficiently - te weinig diagnostiek en van onvoldoende kwaliteit >> - >> strafrechtelijke how interventie do disorders te weinig develop op in individu kids? gericht - interventies te >> weinig development evidence based, of disruptive staf te disorder weinig opgeleid - te ver van huis, te weinig betrokkenheid ouders - onderbroken schoolcarriere >> minder arbeidsmarktkansen - onvoldoende nazorg

11 development disruptive disorders: from gene to schoolkid gedragsgestoord schoolkind: agress, jengelen, ongehoorz. moeder: stelt geen eisen overresponsief emot. moeilijke p/kleuter: lage frustr. tolerantie, overactief moeder: overstimulatie kan cues niet lezen geboorte complicaties zwangsch: intox / stress prikkelbare baby: huilen, kan zz niet troosten genetics

12 gene/environment interaction decreased autonomic nervous system in combination with neglect leads to more aggressive behavior at 10 yrs Raine, Mednick, Brennan en Venables ea (1994, 1996, 1997) combinatie van passieve variant van het MoA-gen en kindermishandeling leidt tot meer gewelddadigheid Caspi A, McClay J, Moffitt TE, et al. (2002) Science 297 (8): samenhang verwaarlozing, reparatief gedrag moederdier en (ir)reversibel agressief gedrag M Schmidt, MS Oitzl, S Levine, ER de Kloet (2002) Dev. Brain Research 139, 39-49

13 cortisol (nmol/l) cortisol (nmol/l) CHILD & ADOLESCENT PSYCHIATRY VUmc Amsterdam FORENSIC PSYCHIATRY Law School Leiden lower neuro-endocrinological reaction to stress (cortisol level) in juvenile delinquents with disruptive behavioral disorders compared to the ones without (popma 2006) >> fearless + kick seeking >> not sensible for punishment NC (n = 32) DP- (n = 61) DP+ (n = 20) 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 time 4 3,5 3 2,5 2 1,5 1 0,5 prepare speaking time NC (n = 30) DP- (n = 45) DP+ (n = 21)

14 gene / environment interaction decreased autonomic nervous system in combination with neglect leads to more aggressive behavior at 10 yrs Raine, Mednick, Brennan en Venables ea (1994, 1996, 1997) combination of passive form of the MoA-gen and child abuse leads to more violence in later life Caspi A, McClay J, Moffitt TE, et al. (2002) Science 297 (8): samenhang verwaarlozing, reparatief gedrag moederdier en (ir)reversibel agressief gedrag M Schmidt, MS Oitzl, S Levine, ER de Kloet (2002) Dev. Brain Research 139, 39-49

15 gene / environment interaction decreased autonomic nervous system in combination with neglect leads to more aggressive behavior at 10 yrs Raine, Mednick, Brennan en Venables ea (1994, 1996, 1997) combination of passive form of the MoA-gen and child abuse leads to more violence in later life Caspi A, McClay J, Moffitt TE, et al. (2002) Science 297 (8): samenhang verwaarlozing, reparatief gedrag moederdier en (ir)reversibel agressief gedrag M Schmidt, MS Oitzl, S Levine, ER de Kloet (2002) Dev. Brain Research 139, 39-49

16 Composite index of antisocial behavior (z-scores) CHILD & ADOLESCENT PSYCHIATRY VUmc Amsterdam FORENSIC PSYCHIATRY Law School Leiden 1,25 1 0,75 0,5 0,25 0-0,25-0,5 Low MAOA activity, n = 163 High MAOA activity, n active = 279 MAO passive MAO none probable severe Childhood maltreatment Caspi A et al. : Role of genotype in the cycle of violence in maltreated children. Science. 2002;297:

17 development disruptive disorders: from gene to schoolkid gedragsgestoord schoolkind: agress, jengelen, ongehoorz. moeder: stelt geen eisen overresponsief emot. moeilijke p/kleuter: lage frustr. tolerantie, overactief moeder: overstimulatie kan cues niet lezen geboorte complicaties pregnancy: intox / stress prikkelbare baby: huilen, kan zz niet troosten genetics

18 somatic toxic influences in early pregnancy >> later harm to psychic functionning, i.e. antisocial behavior - chemicals - hormones: DES, oestrogens, corticosteroids - neurotransmitters - other pharmacons: amfetamines, barbiturates, diazepam, oxytocine - nicotin, alcohol, opiates, marihuana, coke swaab et al. 2001

19 psychic toxic influences in early pregnancy (experienced stress) >> later harm to psychic functions, i.e. antisocial behavior >>> mothers who experience a lot of stress during their (early) pregnancy bear a foetus which is characterized by more fysical movements, a higher hart rate variability, shorter episodes of sleep and more episodes of being awake >> they risk a child that will adapt less to the new environment, which will show more difficult behavior and which will have a retarded psychomotor development huizink e.a., 2001; robles de medina, 2004; van den berg e.a. 2005

20 development disruptive disorders: from gene to schoolkid gedragsgestoord schoolkind: agress, jengelen, ongehoorz. moeder: stelt geen eisen overresponsief emot. moeilijke p/kleuter: lage frustr. tolerantie, overactief moeder: overstimulatie kan cues niet lezen birth complications pregnancy: intox / stress irritable baby: cry, cannot console itself genetica

21 gene / environment interaction decreased autonomic nervous system in combination with neglect leads to more aggressive behavior at 10 yrs Raine, Mednick, Brennan en Venables ea (1994, 1996, 1997) combination of passive form of the MoA-gen and child abuse leads to more violence in later life Caspi A, McClay J, Moffitt TE, et al. (2002) Science 297 (8): relationship between neglect/reparative behavior of the mother rat and (ir)reversible aggressive behavior M Schmidt, MS Oitzl, S Levine, ER de Kloet (2002) Dev. Brain Research 139, 39-49

22 development disruptive disorders: from gene to schoolkid behaviorally disordered schoolkid: agressive, disobedient mother: not asking overresponsive emot. difficult toddler: low frustr. tolerance, overactive mother: overstimulation cannot read cues birth complications pregnancy: intox / stress irritable baby: cry, cannot console itself genetica

23 development of aggression (tremblay e.a.) level of aggression 5% % ++ 35% + 50% yrs age

24 vision of the adolescent psychiatrist: - too little investment in prevention - primary, secondary, tertiary prevention - underlying disorders are not identified sufficiently - te weinig diagnostiek en van onvoldoende kwaliteit >> - >> strafrechtelijke interventie te weinig op individu gericht - interventies te weinig evidence based, staf te weinig opgeleid - te ver van huis, te weinig betrokkenheid ouders - onderbroken schoolcarriere >> minder arbeidsmarktkansen - onvoldoende nazorg

25 prevalence psychiatric straf voor wie de wet overtreedt disorders (%) functie van straffen: leed toevoegen bij wijze van genoegdoening grenzen stellen: algemene en speciale preventie beveiliging maatschappij general population youth with police contacts adjudicated youth assessed youth convicted youth phases criminal law procedures

26 vision of the adolescent psychiatrist: - too little investment in prevention - primary, secondary, tertiary prevention - underlying disorders not identified sufficiently - too few diagnostic assessment s of too low quality >> >> penal interventions not directed at the individual - interventies te weinig evidence based, staf te weinig opgeleid - te ver van huis, te weinig betrokkenheid ouders - onderbroken schoolcarriere >> minder arbeidsmarktkansen - onvoldoende nazorg

27 vision of the adolescent psychiatrist: - er wordt veel te weinig in preventie geïnvesteerd - primair, secundair, tertiair - onderliggende stoornissen worden onvoldoende opgemerkt - te weinig diagnostiek en van onvoldoende kwaliteit >> - >> strafrechtelijke interventie te weinig op individu gericht - too few evidence based interventions, too few trained staff - te ver van huis, te weinig betrokkenheid ouders - onderbroken schoolcarriere >> minder arbeidsmarktkansen - onvoldoende nazorg

28 vision of the adolescent psychiatrist: - er wordt veel te weinig in preventie geïnvesteerd - primair, secundair, tertiair - onderliggende stoornissen worden onvoldoende opgemerkt - te weinig diagnostiek en van onvoldoende kwaliteit >> - >> strafrechtelijke interventie te weinig op individu gericht - too few evidence based interventions, too few trained staff if not treated behavioral disorders have a - te ver van huis, te weinig betrokkenheid ouders bad outcome in 80% of the cases: - onderbroken schoolcarriere >> minder arbeidsmarktkansen - onvoldoende nazorg antisocial personality disorders depression borderline personality disorder addiction

29 vision of the adolescent psychiatrist: - er wordt veel te weinig in preventie geïnvesteerd - primair, secundair, tertiair - onderliggende stoornissen worden onvoldoende opgemerkt - te weinig diagnostiek en van onvoldoende kwaliteit >> - >> strafrechtelijke interventie te weinig op individu gericht - interventies te weinig evidence based, staf te weinig opgeleid - prisons too far away from home, too little commitment parents - disrupted school careers >> lower chances at the labor market - insufficient aftercare

30 vision of the adolescent sychiatrie: - er wordt veel te weinig in the preventie public prosecutor geïnvesteerd states about the - primair, secundair, tertiair juvenile penal system: - onderliggende stoornissen is important worden onvoldoende to find the truth opgemerkt in criminal - te weinig diagnostiek en cases van onvoldoende kwaliteit >> - >> strafrechtelijke interventie te weinig op individu gericht contrary to the youth care system we - interventies te weinig evidence reach denying based, and staf not te weinig willing opgeleid families - te ver van huis, te weinig betrokkenheid ouders is more directed to the victims and - onderbroken schoolcarriere sentiments >> minder society arbeidsmarktkansen - onvoldoende nazorg

31 vision of the adolescentpsychiatrie: - er wordt veel te weinig in preventie geïnvesteerd - primair, secundair, tertiair but the public prosecutor agrees that - onderliggende stoornissen worden onvoldoende opgemerkt - te weinig we diagnostiek should try en to van avoid onvoldoende criminalizing kwaliteit side effects >> when administring the juvenile criminal law (i.e. no registrations - >> strafrechtelijke for life) interventie te weinig op individu gericht - interventies te weinig evidence based, staf te weinig opgeleid non serious delinquent acts should not be adjudicated - te ver van huis, te weinig betrokkenheid ouders - onderbroken for prevention schoolcarriere reasons >> minder better arbeidsmarktkansen provisions to taken, in educational matters, especially for mentally disabled - onvoldoende youths nazorg

32 the adolescent psychiatrist adds: a childrens criminal law is not apt for kids under 15 yrs. - parents play an important role in their lives - they do not understand the essence of criminal law procedures - it is against the international convention of children s rights ten aanzien van het adolescentenstrafrecht:: - adolescente hersenen zijn pas rijp rond het 25e jaar - het relationele leven is adolescenterig tot 25 jaar - hun verdere sociale leven is adolescenterig tot 25 jaar - de maatschappij is daarop ingericht: scholing, huisvesting - alc/drugsgebruik èn criminaliteit wijzigen van karakter v.a.24

33 the adolescent psychiatrist adds: een kinderstrafrecht is niet geschikt voor kinderen tot 15 jr. - ouders spelen een te grote rol in hun leven - deze kinderen snappen essentie niet van het strafrecht/proces - druist in tegen afspraken IVRK concerning an adolescent criminal law: - adolescent brains are only get mature at the age of 25 - het relationele leven is adolescenterig tot 25 jaar - hun verdere sociale : scholing, huisvesting - v.a.24

34 the adolescent psychiatrist adds: fysical development (length, condition) goes on until 23 years een kinderstrafrecht is niet geschikt voor kinderen tot 15 jr. brains: - ouders spelen een te grote rol in hun leven grey matter decreases: pruning - deze kinderen snappen essentie niet van het strafrecht/proces white matter increases until 25 years - druist in tegen afspraken IVRK capacity to take risky decisions autonomically ten aanzien better view van on long het term adolescentenstrafrecht:: consequences more space for later ripening - adolescente hersenen zijn pas rijp rond het 25e jaar independent decisions, financ.independence, housing, lasting relationships - het relationele leven is adolescenterig tot 25 jaar adult - hun conscience, verdere sociale independant leven is adolescenterig from peers tot 25 jaar - societal alc/drugsgebruik context: education, èn criminaliteit living wijzigen conditions, van karakter insurances va24

35 what can/should we do? justice - invest in youth care instead of in justice - juvenile criminal law only in severe cases - children s magistrates to help kids - lock up the violent guys in a humanitarian way - light cases short detentions, close to their home youth care and psychiatry - treat disordered youths in forensic settings - administer evidence based treatment programs - commit parents, families, school, clubs, neighb. invest in scientific research

36 European let s better Association use the Forensic brains when Child and Adolescent administering Psychiatry, the juvenile Psychology criminal and law allied professions EFCAP Next congress: EFCAP Berlin 2012, March t.doreleijers@debascule.com