ABSTRACT
This chapter outlines the placement options for extremely difficult and disturbed young people in the United Kingdom. On whatever dimension considered, the outcomes for very difficult young people appear to reflect the time, sophistication and effort taken by the institution selected to intervene. So, on the simple measure of conviction within two years of departure, for example, outcomes are best from the specialist centres, next best from the medium intensive local authority settings, and worst from prison custody. These findings hold true even when young people’s background characteristics, career route and protective factors are taken into account. It has been seen that there is no certainty of ‘cure’ in the treatment offered in sophisticated settings. Nevertheless, those that remain outside generally fare worse. In the United Kingdom there are not sufficient specialist beds to take all of those most difficult adolescents.
