Speech and Language Therapy: Criminal Justice System

Private Members' Business – in the Northern Ireland Assembly at 12:30 pm on 20 February 2024.

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Photo of Doug Beattie Doug Beattie UUP 12:30, 20 February 2024

I beg to move

That this Assembly recognises how speech, language and communication difficulties can be a contributory factor in offending and reoffending within our criminal justice system; applauds the work of speech and language therapists, while recognising the concerns of the Royal College of Speech and Language Therapists in respect of the impact communication difficulties can have on mental health; and calls on the Minister of Justice, in consultation with other Ministers, to examine how speech and language therapists can work with the Youth Justice Agency, and all our prison estate, to support the communication needs of prisoners and to develop training for prison officers to allow them to identify and support prisoners with communication difficulties.

Photo of John Blair John Blair Alliance

The Business Committee has agreed to allow up to one hour and 30 minutes for this debate. The proposer of the motion will have 10 minutes to propose and 10 minutes to make a winding-up speech. All other contributors will have five minutes.

Photo of Doug Beattie Doug Beattie UUP

In opening this debate on speech and language therapy in the criminal justice system, I need to acknowledge two things. First, I thank the Justice Minister for coming along to respond to the debate. I wish her well in her role. I do not envy her, but she will certainly have my support. Secondly, I want to be absolutely clear that this is not an issue solely for the Justice Department. In fact, it covers so many different Departments. It is a Health issue, because it is the Health Department that provides the speech and language therapists to give the outcomes that we require. It is also an Education issue, because if we do not find the trouble early on with our children, that stores up troubles for later on. It is an issue for Economy, because, in our education system, we do not have enough undergraduate places for speech and language training. Of course, it is an issue for Finance, because if we do not get the finance, we do not have the resource and cannot provide the outcomes that we need. I hope that, in the debate, other Members will outline some of those points, because it is important to realise that the issue does not sit only on the shoulders of the Justice Minister. I am talking about the criminal justice system and the youth justice system, and that is where the focus is. However, there is so much to it.

Communication skills are a central plank of social inclusion for a number of reasons. The first is expression. Expressions are used to make ourselves understood. You all know what it is like and the frustration that you feel if you cannot make yourself understood. Next is comprehension, which is our ability to understand what is being said to us. If we do not understand what is being said to us, it can lead to poor outcomes. The next reason is social communication, which is how to speak to different people in the right way at the right time. I think that we all take that a little bit for granted, but we should not.

Developmental language disorder (DLD) is a lifelong condition that is characterised by significant and persistent impairment in understanding the use of language. That goes back to the point that I am making. When we talk about developmental language disorder, we are talking about something that appears at a very early age in our youth. It is not something that just happens when young people get into the criminal justice system. It happens beforehand, when they are at school. That just expands the point so that people understand.

A study on the youth justice system found that, of 145 young offenders, three in five had DLD. In 2023, a screening of a sample population of Hydebank Wood Secure College found that 75% of those assessed had underlying speech, language and communication difficulties. The South Eastern Health and Social Care Trust conducted that screening, which very much outlines the problem that we face in the youth justice system. It means that many of those young people simply do not understand the terms of their sentence or what is required of them in court orders or under licence. We have young people ending up in the youth justice system finding themselves at its disposal but not understanding it, and because they do not understand it, they end up reoffending. Some 62% of people with DLD reoffended, and 25% who did not have DLD reoffended, so there is a real difference there.

The Royal College of Speech and Language Therapists asked for a three-pronged approach. The first prong is to screen everyone entering the criminal justice system for speech and language difficulties. That is no easy task. It is a huge task, because we have a limited number of speech and language therapists. We have only 28 undergraduate places per year at Ulster University, and 10 of those are provided by the Irish Government, so we are likely to lose those people once they have qualified. That number comes from an application pool of 700. Therefore, there is a need to train people. We cannot do the screening unless we have the people. The screening could, and possibly should, act as a mitigating factor when judges review sentences. However, once an individual enters a prison estate or probation in a sentence-management plan, they should have a personal development record outlining the very issues that they face.

The second part of the approach is training. The judiciary needs to be trained to understand DLD and other speech and language issues. That could help them to understand the problem when youth offenders go in front of them. Prison officers must be trained from an early stage, as should probation officers, to understand the effects of speech and language difficulties.

Photo of Paula Bradshaw Paula Bradshaw Alliance

I thank the Member for giving way. With the new Encompass programme that is being rolled out in the trusts, it is hoped that, in future, other statutory bodies will have access to patient records. Does the Member agree with me that the sooner we have that joined-up approach across government, the better, so that, when people enter the judicial system, staff have access to medical records and those assessments are there for them?

Photo of Doug Beattie Doug Beattie UUP

That is a really good point. It is about that joined-up approach that I am making the point. As I said at the start and will continue to say, this is not just for Justice; it is far wider than Justice. You are right, and thank you for the intervention.

The speech and language difficulties can create challenging behaviour. There may be disruptive, violent or aggressive behaviour; self-harm; poor mental health; segregation; and the increased use of physical restraint and intervention. We need to train to prevent that.

Support is the third element of the three-pronged approach. Direct speech and language therapy and intervention should be provided for those in the criminal justice system, particularly the youth justice system. That is provided by the Department of Health, but there must be a structured intervention combined with the screening and training functions. It is about providing support to transform.

The advantages of having speech and language therapists in the justice system are extremely clear. Speech and language therapists have an increased knowledge and understanding of the barriers to engagement and can help with communication, which helps staff. Speech and language therapists help those with needs to better understand what is happening to them. People fall into the criminal justice system. They may find themselves at someone's disposal and simply not understand it. It is important that we work with them so that they understand what is happening to them.

The other clear advantage is for society. Speech and language therapist interventions can reduce offending by enabling individuals in the criminal justice system to access a wide range of rehabilitation programmes, which empowers change. It is about empowering the young people who find themselves at the wrong end of the law.

I will revert back to the very start. I have repeated time and again, as others have and will, that this is not just for the Justice Department; it really starts from the bottom up.

Photo of Sinéad McLaughlin Sinéad McLaughlin Social Democratic and Labour Party

I thank the Member for giving way. Does the Member agree that early intervention is critical to outcomes later in life, including predictions about interaction with the justice system? That is particularly important for people with speech and language communication needs. It is another reason why we need to invest in our early years education and childcare.

Photo of Doug Beattie Doug Beattie UUP

Absolutely. Your point is about prevention. It is always better to prevent than to deal with the aftermath. I am 100% with you on that.

As I come to the end of outlining the motion, I will say that being proactive is important. It is important that Departments share and pool budgets to get the outcome that we want. We can literally save people and money if we act early, before people end up in the criminal justice system. Once people are in the criminal justice system, it is incredibly important that we take action to stop them reoffending so that we can get them out the other end.

Speech and language therapists do not get the credit that they deserve. They are not spoken about as often as they should be. The resources are not there for them to provide the outcomes that we want them to. I hope that, today, we can change that, and that other Departments can look to see what they can do, in a joined-up manner, to move this forward and support our Justice Minister in respect of the youth justice system and criminal justice system. At the end of the day, society will gain if that happens.

Photo of Ciara Ferguson Ciara Ferguson Sinn Féin

I support the motion and thank the Members for bringing it forward.

First, as others have mentioned, this is an opportunity to commend the work of our Royal College of Speech and Language Therapists. We have over 700 committed professionals who work in the field in the North, and they do the vital work of supporting our most vulnerable children, young people and adults who have speech and language communication delays and difficulties.

Sinn Féin recognises and very much values the important role that speech and language therapists play not only in our justice system but in our schools, our local communities and our health service. I have been fortunate enough to work closely, particularly in the communities, with our speech and language therapists to support the early years through our Sure Start programmes that provide language-rich environments to support our young people in the development of their communication skills.

Speech and language obviously underpins everything that we all do. Just imagine your life if you struggled to express your needs to others, to express your likes and dislikes, to interact with others, to build relationships, to learn in school and to understand and control your emotions and feelings. Unfortunately, for so many, that is still the case today. We are aware that speech, language and communication needs are often hidden difficulties. Instead of communication difficulties being identified and supported, the person may be seen as someone who struggles to learn, needs to improve their behaviour or is just difficult, does not like socialising and is withdrawn. People with speech, language and communication needs can be misinterpreted, misdiagnosed and missed altogether in our neighbourhoods and communities.

The Department of Health workforce review 2019-2029 reiterated that:

"unsupported, speech, language and communication needs (SLCN) can have long-term implications for educational attainment, employment, social inclusion ... mental health and involvement with the justice system."

In the justice service, we have continuous research that shows a prevalence of up to 60% of young offenders who have low language skills at a poor or very poor level. A lot more needs to be done. Too many of our people with communication needs are being overlooked. A National Institute of Health and Care Research report in February 2021 found that young offenders with undiagnosed language problems are twice as likely to reoffend within a year.

There are huge gaps, but there is also some great work being done by the Royal College of Speech and Language Therapists — for example, The Box, which is a free e-learning package designed to support people working in the justice system, such as the offenders team, the Probation Board, prison staff, the police and other professionals in our court system such as judges, barristers and solicitors. I welcomed the appointment by the Minister of a speech and language therapist in the Prison Service in 2018, but it is not enough.

As a previous Member mentioned — it is pertinent — we need to look for solutions. One key solution is that the speech and language therapy degree that is currently located in the Ulster University in Derry could be expanded. There is a shortage of therapists, and we should call on our Health Minister to work with the Executive to increase places at the Magee campus. As was mentioned, there are 28 commissioned undergraduate SLT places at the Ulster University, but there were over 700 applications in 2023-24. Obviously, there is a clear need, and a lot of young, educated people in the North are keen to invest in the service.

We need to explore alternative routes to pursue a career. Speech and language therapists and the Royal College of Speech and Language Therapists have recommended the exploration of an apprenticeship scheme to train additional SLTs. We all recognise that we must commit to work together to ensure that anyone with communication difficulties or a disability has a right to expect and receive specialist support in our criminal justice system and ensure, most of all, continuity of care.

We should ensure, particularly for young people and adults, screening of their speech, language and communication needs when they come into contact with the criminal justice system; it is imperative. It is also imperative that we provide support to train staff to recognise and support those —

Photo of John Blair John Blair Alliance 12:45, 20 February 2024

Will the Member conclude her remarks?

Photo of Ciara Ferguson Ciara Ferguson Sinn Féin

— with needs.

Finally, on tailored programmes and intervention, we need to ensure that our people can benefit from rehabilitation programmes.

Photo of Joanne Bunting Joanne Bunting DUP

This is a really interesting topic, and I am grateful to the Members for bringing it forward. At the outset, it may be helpful to contextualise: over 60% of people in prison have speech, language and communication needs, which is a higher figure than is found among the general population. Some of the issues experienced by individuals in the justice system include difficulty understanding spoken words and using language to communicate; difficulties remembering and recalling information accurately; difficulty understanding commonly used legal vocabulary, such as "liable", "remorse", "reparation", "threatening" or "victim"; difficulties in listening and understanding; difficulty with sequencing information to tell a story; difficulties using abstract language, such as metaphors; difficulties staying on topic; difficulties understanding non-verbal communication and relating to others in socially acceptable ways; and difficulty expressing feelings and emotions appropriately, for example, they may use aggressive behaviour instead of words to express themselves.

Many young people in justice settings who have speech and language communication needs (SLCNs) have grown up with multiple adverse childhood experiences, including deprivation and poverty, trauma, neglect and abuse. Many are care-experienced or looked-after children. Looked-after children have a much higher rate of involvement with the juvenile justice system than those in the general population.

Part of the issue is that the screening processes in prisons are still ineffective. There is no nationally used screening tool for communication needs. Prison staff receive limited training on those vulnerabilities, but we know that the failure to appropriately support people in prison can result in disruptive, aggressive or violent behaviour and increasing self-harm.

In the Budget debate yesterday, I mentioned prisoners having problems with addiction, anxiety, depression and their inability to control their emotions. That does not just go away. A prime example of what I describe can still arise on leaving prison. Until the point at which they are released, their life has been under the control and responsibility of others: then they leave. On exiting the gate, they may be sent to a hostel because they are homeless. That hostel can be far from home: I am talking about Belfast to Londonderry or Newry or vice versa. They may have no family support, but they are supposed to get there, while left to their own devices, via public transport, perhaps with a daily requirement for a prescription in Belfast. They make their way to the pharmacy, something goes awry, the miscommunication cycle starts, and boom: they are tired and alone; they have nothing and nobody; they are afraid, anxious and frustrated; and their temper is lost. They are back to square one, defeated. It can feel as though we are teeing them up to fail.

Photo of Joanne Bunting Joanne Bunting DUP

Yes, go ahead.

Photo of Justin McNulty Justin McNulty Social Democratic and Labour Party

The Member refers to the number of people who are involved with the justice system and in prison. The Member who spoke previously did so as well. To what extent do you feel that their frustration about their lack of support in navigating the uncertain territory that, they feel, they occupy as a consequence of their difficulties and challenges is a contributing factor to their involvement in the justice system?

Photo of John Blair John Blair Alliance

The Member has an extra minute.

Photo of Joanne Bunting Joanne Bunting DUP

Thanks, Mr Deputy Speaker. The Member is absolutely right. That is the point that I am trying to make and will go on to emphasise.

Interventions in justice settings, such as counselling or education programmes, are often verbal. Therefore, they disadvantage those with prior speech, language and communication needs. The knock-on effect is that those schemes are potentially less likely to contribute positively to reducing rates of reoffending if participants' difficulties and needs go undetected or are misinterpreted as general aggression. That is why a joined-up approach is needed, as the proposer mentioned. There is little point in prison staff being equipped to communicate effectively with prisoners with SLCNs when external providers who deliver rehabilitative or educational initiatives lack the knowledge on how to identify and address the needs of that cohort.

Gaps in identifying SLCNs are also exacerbated when sufficient numbers of speech and language therapists are not being trained or in post, as others have mentioned. We have higher rates of SLT vacancies than Scotland and Wales. That limits what can be achieved in rolling out innovative multidisciplinary team-working in other aspects of the system where SLCNs could be addressed. The picture is not all one of gloom, however. Strides have already been made. Recent examples from Maghaberry prison have highlighted a good provision of speech and language therapy there.

A number of issues need concerted action. Training is only one part of the jigsaw. We need a sustained funding uplift for our prisons and the wider criminal justice system to ensure that sufficient numbers of trained allied health professionals are working alongside prison staff and to facilitate adequate and ongoing training for staff in justice settings.

[Interruption.]

Apologies. It is the new placement of the microphones.

It should also be noted that the strategic framework for youth justice for 2022-27 and the five-year action plan, led by the Department of Justice and the Youth Justice Agency, place little emphasis on SLCNs. There is perhaps a need for the Minister of Justice to revise those strategies and the operation of the regional care and justice campus to ensure that there is a focused strategy for breaking down communication and language barriers.

We support the motion and welcome the focus on breaking down barriers to better engagement between those with speech, language and communication needs in our prisons and youth justice populations and those who care for them in justice settings and the many rehabilitative, restorative and educational programmes in which they participate.

Photo of Stewart Dickson Stewart Dickson Alliance

When individuals, particularly young people, find themselves entangled in the criminal justice system, caught up in a cycle of offending and reoffending, it is driven by a broad spectrum of underlying issues, such as poverty, substance abuse, homelessness, mental health problems and communication problems. A lack of early opportunity from the start of life makes the factors that contribute to criminal behaviour both widespread and deeply ingrained. In addressing those issues, however, we should not overlook the critical aspect that often remains hidden or invisible: the additional needs associated with speech, language and communication challenges. That area is under-assessed and can easily go unnoticed until an individual comes up against the need to use a particular system.

As other Members have indicated, research has consistently shown the prevalence of those challenges in our judicial system, with over 60% of young offenders and 80% of adult inmates affected by speech, language and communication needs. That contrasts starkly with percentages in the general population, highlighting severe disparity and underscoring deeply rooted systemic failures. Let me be clear: people do not arrive in the criminal justice system and develop those issues. Once they are involved in the system, however, such issues can significantly hinder their rehabilitation, thereby fuelling a cycle of crime. That not only devastates the individual caught in that cycle but has far-reaching consequences for communities and society at large.

The Royal College of Speech and Language Therapists has emphasised the profound implications that communication difficulties can have on an individual's mental health. Without timely and effective intervention, the cycle only worsens, adversely influencing behaviour and drastically limiting the opportunities for positive engagement in society. That underscores the necessity for early intervention, outside and long before anyone interacts with the justice system, as part of a broader cross-departmental strategy that, undoubtedly, could mitigate offending and reoffending rates.

In Northern Ireland, under the leadership of my colleague the Justice Minister, Naomi Long, and in conjunction with the Department of Health, the integration of speech and language therapists into our justice system has already begun. Pivotal steps towards systemic improvement are being made. We are just at the beginning, however. The scope of the challenge demands not only continued but expanded efforts to ensure that all individuals in the justice system who struggle with communication receive the support that they need. Let us therefore be clear about who delivers that in the justice system: it is the Department of Health. It bears the statutory responsibility for the provision of speech and language therapy services and for prioritising and ensuring the allocation of adequate funding and resources. That is not merely an investment in the rehabilitation of individuals but an investment in the safety and well-being of our communities. By improving health outcomes and addressing the communication needs of those in contact with the justice system, we can significantly reduce reoffending rates and facilitate more successful reintegration into society.

Moreover, it is crucial to foster a collaborative approach that involves educators, health providers and justice system professionals in the identification and support of individuals with speech, language and communication challenges. We need to create a cohesive support network that can more effectively address the root causes of criminal behaviour and ensure that individuals receive the holistic care that they require.

I extend my appreciation to Members for their recognition of the critical role of speech and language therapists in our judicial system. The journey towards a more inclusive and effective approach to rehabilitation and reintegration is long and complex. However, by committing to address the communication needs of individuals in our justice system, we take a significant step forward. Let us continue to work together to enhance our justice system's responsiveness and to ensure that every individual has the opportunity for rehabilitation, recovery and a positive return to society. The focus of today's debate is on Justice, but, in truth, the focus of the debate should be on all Departments from the earliest days of life.

Photo of John Blair John Blair Alliance 1:00, 20 February 2024

Thank you, Members. The Business Committee has arranged to meet at 1.00 pm. I propose, therefore, by leave of the Assembly, to suspend the sitting until 2.00 pm. The debate will continue after Question Time and a question for urgent oral answer, when the next Member to speak will be Patsy McGlone.

The debate stood suspended. The sitting was suspended at 1.01 pm.

On resuming (Mr Speaker in the Chair) —