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May 18 33 tweets 15 min read
I'm catching up on some of the recorded sessions & will start a thread on the 'Impact of the UN Committee’s statement in 2019 in relation to the minimum age of criminal responsibility', one of #RANZCP2022's recorded sessions, presented by Invited speaker Dr Enys Delmage
Dr Delmage is a consultant in adolescent forensic psychiatry and has worked in an adolescent forensic inpatient unit in Porirua, New Zealand, since November 2017. He has an interest in the law as it relates to children.ranzcp2022.com.au/dr-enys-delmage #RANZCP2022
Minimum age of criminal responsibility is defined as the age below which is deemed incapable of having committed a criminal offence. Below this age, children are 'doli incapax' - incapable of knowing that what they were doing was wrong- Dr Delmage #RANZCP2022
In Australia, NZ and most of UK, the minimum age of criminal response is set at 10 years old. In Scotland, the minimum age has recently been changed to 12 years. Above the minimum age, a child can be charged, brought before court and incarcerated - Dr Delmage #RANZCP2022
Quotes by Franz Kafka, talking about his experience in prison, are below - Dr Delmage #RANZCP2022
Why should psychiatrists care? Developmental neuroscience has increased over past 30-40 years - we have great insights into how the brain function - Dr Delmage #RANZCP2022
Psychiatrists have a public health and education role; a duty to respond to consultations on the topic; and we have a role in courts (both civil and criminal)- Dr Delmage #RANZCP2022
We also have a role in protecting children, and witnessing children in very poor conditions is very dispiriting - Dr Delmage #RANZCP2022
How does criminal law manage children differently from civil? From the age of 10, you can commit an offence & be prosecuted, but (referring the UK) you can't buy a hamster until you are 16, nor be a trapeze artist until 12. More examples on the slide - Dr Delmage #RANZCP2022
The phrase "cunning" in a 10-year old didn't make an awful lot of sense to him, Dr Delmage says, it implies a level of executive functioning from frontal lobe that didn't sit very well. #RANZCP2022
Significant degree of variation in minimum age across the world, even in countries next to each other. There is a "colonial effect" though, Dr Delmage says #RANZCP2022
'Doli incapax' = "incapable of evil" or incapable of forming the intent to commit a crime. Rebuttable presumption - above the minimum age vs conclusive presumption - below the minimum age - Dr Delmage #RANZCP2022
To be 'doli incapax', the child must know that the act or omission was seriously wrong (but the notion is not really well tested) - Dr Delmage #RANZCP2022
'Doli incapax' has been described as early as 886AD - the first written description was in 1619 - Dr Delmage #RANZCP2022
Is there a better way to describe developmental immaturity? - "yes, and that's developmental immaturity" - Dr Delmage #RANZCP2022
Also important to be mindful of age of majority which is the age at which children can be managed in the justice system as adults - most countries are 18, but some such as India are younger - Dr Delmage #RANZCP2022
'Doli incapax' no longer in England, Wales and Northern Ireland, as of 1998. In the UK, between the age of minimum age and age of majority, children are usually trialed in youth courts - Dr Delmage #RANZCP2022
Minimum age rules for NZ, Aust and USA.
Aust and NZ have 'doli incapax' protections for 10-14 year olds. North Carolina state in US sets record for minimum age of 6 years old (!!!) - Dr Delmage #RANZCP2022
Further strangeness, Delmage says - 66 out of 220 countries still have 'doli incapax'; 10 countries have different MACR for boys vs girls (and "shocker, boys get a lighter ride than girls do", Delmage says) #RANZCP2022
13 countries have no minimum age of criminal responsibility (France as an example, relies heavily on secure education institutions); Gaza has multiple established legal processes running parallel. 5 countries don't have a position yet to be established - Dr Delmage #RANZCP2022
The beauty of recorded sessions...I am back after a short break to pick up the thread (hopefully!) on the presentation about the minimum age of incarceration rates - Dr Delmage #RANZCP2022
Relevant instruments exist that can guide human rights with respect to incarceration of children - Dr Delmage #RANZCP2022
General Comment No. 24 (2019), on the slide, replaced a General Comment Number 10 (2007) - Dr Delmage #RANZCP2022
Objectives of the change were to divert children away from court, have child's best interest at consideration, empower children & allow children to grow in non-averse conditions- Dr Delmage #RANZCP2022
A diversionary method in NZ is Family Group Conference which can deal with all offending aside from murder/manslaughter, they are chaired by a youth justice coordinator & sets goals for the young person as part of an FGC plan- Dr Delmage #RANZCP2022
Implications of the Comment= most of topics are fairly uncontroversial and most countries should be following this already (although many aren't), arguments for and against raising. UN have clearly outlined that upper age should be no lower than 18 - Dr Delmage #RANZCP2022
Children under MACR - differs significantly around the world, some models include re-education programs, welfare approaches feature most widely internationally - Dr Delmage #RANZCP2022
How do we analyse the cost of various different approaches? Not surprisingly, nobody has done that, calculation of direct and indirect costs vs direct and indirect benefits is very challenging - Dr Delmage #RANZCP2022
Delmage says, "I have had a go" analysing economic cost/benefit. Life time costs of low minimum age of criminal are significantly high. - Dr Delmage #RANZCP2022
Direct & indirect costs of having high MACR 👇- Dr Delmage #RANZCP2022
Some similarities Delmage has seen in recent youth inpatients. Some #SDOH, no mention of colonisation cc @MelissaSweetDr @MegBastard @Change_Record #RANZCP2022
How do we want children to see themselves? the impacts of labelling (ie "youth offenders") plays a significant role on their identity - Dr Delmage #RANZCP2022
In Australia, Queensland are considering raising the age, ACT are raising their age to 14 in 2022. At a Commonwealth level - it has been discussed but decision postponed until 2022 (so sometime soon??? #AusVotesHealth2022) - Dr Delmage #RANZCP2022

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More from @CroakeyNews

May 18
I'm going to join the session about codes of ethics in psychiatry. Three presentations by Paul Appelbaum, a "godsend" for psychiatry with an international perspective, Izaak Lim & @sidney_bloch #RANZCP2022

Follow @coopesdetat for tweets on 'psychosis and schizophrenia'
Prof Paul Appelbaum is, among other things, a Professor of Psychiatry @ColumbiaPsych, joining us live from New York- @appelbap #RANZCP2022
History of the World Psychiatric Association's involvement with history - @appelbap #RANZCP2022
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May 17
Starting a new thread for the next keynote by
Assoc Prof Loyola McLean, talking about 'changing bodymind: on attachment, trauma and regulation' #RANZCP2022
sydney.edu.au/medicine-healt…
How do we bring two or more very different points of view together, how do we bring the past and present together? How do we move forward as individuals, as dyads, as a college? - A/Prof McLean #RANZCP2022
To First Nation's people around the world, how do we move forward, how do we open up a future? - A/Prof McLean #RANZCP2022
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May 17
First keynote is by Prof Belinda Lennox @BLennox4, from University of Oxford, speaking about 'autoimmune psychosis-current state of play' #RANZCP2022
Schizophrenia/psychosis is a brain disorder, with neurological as well as psychiatric symptoms. The question being discussed is what evidence is there that some psychosis is autoimmune - @BLennox4 #RANZCP2022
Have diagnostic criteria and therapies - but not as much as known about the cause of psychosis - @BLennox4 #RANZCP2022
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May 17
Beautiful views in Sydney for the third day of #RANZCP2022! The third day sessions will start soon.
Below is a thread of 5 key takeaways from sessions I saw on Day Two, a day which focused on priority populations and the impacts of climate change.
1/ Important to embed cultural safety into mental health service provision that is based on authentic co-design, allowing culturally appropriate and flexible methods of sharing knowledge - Dr Kashyap #RANZCP2022
2/ Healthcare workers, including psychiatry clinicians, need to be open, honest and acknowledge own vulnerabilities - A/Prof Coleman #RANZCP2022
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May 17
While @coopesdetat is following Tim Flannery's keynote, I am going to jump in and catch up on the Indigenous mental health session from yesterday -@AlisonSBarrett. #RANZCP2022
Session chair, Dr Emma Adams, provides a heartwarming acknowledgement of country and lovely introduction to the presenters - Prof Helen Milroy, A/Prof Mathew Coleman, Dr Shraddha Kashyap & Dr Jemma Collova #RANZCP2022
Broad overview of Transforming Indigenous Mental Health & Wellbeing Project, aiming to improve Aboriginal & Torres Strait Islander mental health through Aboriginal leadership and authentic partnerships. #RANZCP2022
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May 17
Fabulous thread 👇by @coopesdetat following today's Presidential symposium on #COVID19 #RANZCP2022...
I'll be wrapping the session on PTSD and military and veteran's mental health in the following tweets. #RANZCP2022
First presentation in this session is by Andrew Khoo from Toowong Private Hospital - 'navigating the assimilation of evidence-based PTSD recommendations into the private practice management of real patients' #RANZCP2022
Read 19 tweets

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