1. Ulf Engqvist PhD, Senior Lecturer Mid Sweden University, Dept. of Social Work Östersund ulf.engqvist@miun.se

2. A FOLLOW UP STUDY OF FORMER CAP-PATIENTS A project that lasted 12 years conducted in Jämtland county, Sweden A longitudinal study descriptive in nature where 1,400 Child and Adolescent Psychiatry (CAP) patients were followed for 12 to 33 years PUPILS AT A SPECIAL APPROVED HOME (REFORM SCHOOL) A project that lasted two years conducted in in the midst of Sweden 82 pupils were investigated at admission according to an extended, refined routine including somatic, psychiatric, psychological, educational and social assessment

3. Convicted of offences 530 (37,9%) Convicted of offences 530 (37,9%) Schizophrenia and / or affective psychoses 62 (4,4%) Schizophrenia and / or affective psychoses 62 (4,4%) Mortality and suicide 38 (2,7%) (19 suicides) Mortality and suicide 38 (2,7%) (19 suicides) 1,400 former CAP-patients followed up for 12-33 years General (adult) psychiatric care: 531 (37,9%)

4. 82 pupils at the special reform school Routine physical health assessment Adolescent Drug Abuse Diagnosis (ADAD) and Alcohol Use Disorders Identification Test (AUDIT) Wechsler Intelligence Scale for Children (WISC-III) and Raven's Progressive Matrices Teacher assessment of knowledge in Swedish, English and Mathematics and standardized reading tests Psychiatric interview (DICA -R-A ) based on DSM The Gordon Diagnostic System (Record Form Model III) Conners-Wells’ Adolescent Self-Report Scales (CASS-S) Family situation: 80% had parents who were divorced 83% came from families with low socioeconomic status A quarter stated that there was criminality in the family One third stated that there was abuse among family members Family situation: 80% had parents who were divorced 83% came from families with low socioeconomic status A quarter stated that there was criminality in the family One third stated that there was abuse among family members

5. Risk factors for conviction of offences, former CAP-patients Independent variableNp-valueOdds Ratio Sex (male)1400≤ 0.0011.8<2.1<2.4 Split family1379≤ 0.0011.4<1.6<1.8 Problems at school1170≤ 0.0011.5<1.8<2.0 Reason for admission to the CAP unit Behavioural disorder1389≤ 0.0012.7<3.5<4.5 Relationship problems13890.0061.1<1.5<1.9 Convicted of offences 530 (37,9%) Convicted of offences 530 (37,9%) Every second male (55 %) and every fifth female (22% ) former CAP-patient were convicted of offenses

6. There were more male than female (p ≤ 0.001) More had inpatient care at CAP (p ≤ 0.001) More had behavioural disorder or mental retardation and developmental problems as reason for admittance to CAP (p ≤ 0.001) More died a premature death (p ≤ 0.001) and More had General (adult) psychiatric care (≤ 0.01)

7. PROBLEMS AT SCHOOL Three quarters was judged to be low achievers in school 93% were observed for truancy Nearly half (40%) had problems with learning and 46% had reading and writing difficulties On average they performed almost three grade levels below the grade they belonged CRIMINALITY Any form of crime was listed for 81%. 77% of the boys and 61% of the girls were registered for some form of crime:  Crime directed against persons, such as assault, robbery, or both, 53%.  Crime directed against objects, such as shoplifting, theft, vandalism, driving without a license was listed for 73%  Crimes against both persons and objects were noted for 45%

8. From the two studies referred it can be stated that relationship problems, problems at school, behaviour problems as well as problems at school, must be paid attention to and that all authorities working with children, adolescents and their families and network must work focused and together around these problems to prevent criminality.

9. ulf.engqvist@miun.se http://diss.kib.ki.se/2009/978-91-7409-519-7