Family and impulsivity

• Dr Cheung Wai-him, a psychiatrist, helps arrested youth referred by social workers.

• Drug abuse, shoplifting and sexual assault are some of their offences.zz

• He emphasizes the significant role of both nature and nurture in their development. • 精神科醫生張偉謙跟社工合作，為被捕 青年提供協助。 • 部分青年干犯與毒品、偷竊及性相關的 罪行。 • 他強調先天和後天因素對青年發展同樣 重要。

Trying to understand youth crime begins with understanding what causes it. The roots lie in the complex interaction of several factors, according to Dr Cheung who mentions personality traits, the home environment and vulnerable mental health status. “There are many factors that act together to predispose young people to commit crime. They include mental health issues, family background and school environment, as well as peer pressure, but none can be singled out as the root cause.”

While a combination of these underlying factors may help to explain why young people get into trouble with the law, a gender factor is also at play. There are many more male than female young offenders. “The reasons may be a function of the way in which girls and women tend to internalize negative emotions and develop anxiety and mood disorders. Males tend to externalize negative emotions and act out impulsively and aggressively,” Dr Cheung says.

Girls and women tend to internalize negative emotions and develop anxiety and mood disorders. Males tend to externalize negative emotions and act out impulsively and aggressively.

Nevertheless, both male and female youth can be impulsive enough to break the law. Understandably, they become very emotional after arrest and during all the legal proceedings that follow. Such vulnerable youth need sensitive treatment if they are to recover successfully. Dr Cheung describes a couple of typical cases he has seen that involve impulse control.

“First, I make a detailed assessment to see if there is a need for medical treatment. Depending on the diagnosis, sometimes we advocate psychotherapy.” Once his clients have become more emotionally stable, the key to rehabilitation is motivation and the empowerment and confidence to not revert to crime. In both of the cases he describes, families play a significant role. Indeed, some young people’s problems stem from family issues. If these can be discussed openly and all the family is committed to change, progress is easier to make.

“A 16-year-old boy with family issues was sent to me for treatment. He lived at home with his mother, a single parent. They often argued and he would storm out late at night after a fight with her and wander round the streets. He was found twice, in quick succession, molesting underage

It is important to recognize that mental health factors and family factors alone are inadequate in explaining why young people commit crimes.

girls. After arrest for indecent assault, he was referred to social workers and then came to me for assessment because of his volatility. I diagnosed ADHD and conduct disorder and started him on medication. His mood improved quickly and so did his relationship with his mother.”

But there is always a challenge involved with parents, Dr Cheung points out. “By the time there is trouble, parents will have come to their own conclusions about a kid’s behaviour so in the case of this boy, I needed to explain my diagnosis to the mother. She had labelled him as bad and lazy. In fact there is a strong genetic element in ADHD so if a parent recognizes this, it helps them understand.” When the boy appeared in court on the two charges, he was given a lenient sentence as a result of the intervention which convinced the court there was a reduced risk of him reoffending. The second case described by Dr Cheung involved a girl in her late teens who was a habitual shoplifter. Compulsive shoplifting can occur because of an acute sense of deprivation, whether or not money is scarce, and although stealing provided the girl with temporary relief, she had underlying problems of emotional and behavioural self-control. “Her life was difficult. She was left at home to look after her sick father while her mother went to work to support the family. When the police arrested her, she became so emotionally disturbed about the possibility of being sent to prison that she was referred to me for counselling. I helped her calm down throughout the legal process.” Her family were eventually encouraging and supportive too, benefitting from Dr Cheung’s counselling and a social worker’s supervision.

The young people he sees mostly have two factors in common, as in the cases described above. Those are mental health and family issues. “Most of the young people who come to see me have also shown willingness to change. Usually I have no problem in establishing a good relationship with them. However maintaining that is important and usually the family has a role to play. I try to involve family members at consultation sessions.”

While working with young offenders and observing the correlation between mental health status and family background, Dr Cheung focuses on the critical role of parents in child development. Nevertheless, he says, “It is important to recognize that mental health factors and family factors alone are inadequate in explaining why young people commit crimes.”

Dr Cheung Wai-him has worked for many years in cooperation with HKFYG. He has offered training workshops for social workers both at work and while studying at university. Formerly, he worked as a medical professional in the substance abuse section of the public health service.