Intersectional Inequalities in Mental Health Need and Youth Justice Contact among Pupils enrolled in Alternative Provision

Background. Unmet mental health and education needs increase the risk of youth justice contact. Understanding inequalities in alternative provision (AP) and how these relate to school recorded mental health needs or police criminalisation may identify opportunities to intervene. Methods. We analysed population-level linked school and police administrative data for 3.7m pupils (born 1997-2003) who attended state schools in England. We examined differences by racial-ethnic group and gender in rates and timing of AP enrolment and recording patterns of mental health-related provision and youth justice contacts among pupils with AP enrolment. Results. Our findings indicate heightened mental health need and vulnerability to criminalisation among pupils recorded with AP enrolment. Enrolment was highest among Irish Traveller and Romani pupils, followed by Black Caribbean and Mixed White-Black Caribbean pupils. Boys were enrolled more than girls, but some girls had higher rates than boys from other groups. Over 50% boys from Black Caribbean and Mixed White-Black Caribbean backgrounds with AP enrolment had a youth justice contact, the majority of whom had recorded mental health needs. Conclusion. Heightened need and intersectional inequalities among pupils enrolled in AP highlight the importance of a co-ordinated public health approach to understanding and responding to children's needs.