The purpose of this paper is to outline the challenges to achieving positive outcomes for young people within the secure estate in England, and introduces a psychologically informed framework, SECURE STAIRS (SS), aimed at improving outcomes.,The paper argues that there is a need for a fundamental shift in the way care and intervention for young people within the secure estate is delivered. It gives an overview of current challenges and needs and summarises the theoretical concepts and evidence base which can guide practice and form the foundations of the SS framework.,The framework recommends that intervention shift from focussing primarily on individual assessment and treatment to a greater emphasis on supporting the work of the wider system of care. Recommendations include promoting trauma-informed care, a focus on the system dynamics within institutions and how these impact on the care young people receive, and on the collaborative development with residential staff and young people of formulation-led care plans that include a focus on issues of sustainability after leaving the secure estate.,These include the establishment of discrete residential groupings with truly integrated and trauma-informed work across residential, mental health, education and criminal justice agencies. This involves addressing governance issues around shared record keeping, and challenges to sustainability and the accompanying need for local implementation plans for each establishment alongside central support at a strategic level.,This paper describes a new and innovative way of working within secure settings to ensure children and young people’s needs are better met.

中文翻译：

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重新考虑在儿童和年轻人的安全场所中的精神卫生服务：综合护理框架（安全楼梯）

本文的目的是概述在英格兰安全庄园内为年轻人取得积极成果所面临的挑战，并介绍一种旨在改善结果的心理知情框架SECURE STAIRS（SS）。需要从根本上改变在安全场所内对年轻人的照料和干预方式。它概述了当前的挑战和需求，并总结了可以指导实践并构成SS框架基础的理论概念和证据基础。该框架建议干预措施应从主要侧重于个人评估和治疗转向更加侧重于支持更广泛的护理系统的工作。建议包括促进创伤知情护理，重点关注机构内部的系统动态以及这些动态如何影响年轻人获得的护理，以及与居民员工和年轻人合作​​制定配方主导的护理计划，其中包括关注离开安全资产后的可持续性问题。这些措施包括建立离散的居民团体，并在住所，心理健康，教育和刑事司法机构之间进行真正的综合和具有创伤信息的工作。这涉及解决共享记录保存方面的治理问题，可持续性挑战以及随之而来的对每个机构的地方实施计划的需求以及战略层面的中央支持。本文描述了一种在安全环境中确保儿童安全的新的创新方式。更好地满足了年轻人的需求。