Bringing ‘care’ back into locked residential institutions: What can we learn from adolescents' experiences of secure care?

In Canada and elsewhere, efforts have been made to regulate the use of secure care on welfare grounds. Yet, studies raise questions about its usefulness as a psychosocial intervention since it appears to be mostly experienced as a punishment. The main objective of the current study was therefore to explore adolescents' experiences of secure care. We conducted qualitative interviews with 25 adolescents aged 14 to 17 years old while they were placed in secure care units in the province of Quebec, Canada. Uncertainty regarding how to exit secure care was the most important theme that emerged. Participants did not always understand the words used by practitioners to frame their expectations. Adolescents were also uncertain about how to prove they no longer presented a risk to others or themselves while being in locked settings. This uncertainty generated a lot of anger and distress. To get some control back, adolescents chose to just comply and pretend to agree with practitioners. The present paper questions the utility and even legitimacy of secure care as it is currently used. However, we argue that if an ethic of care predominated our conceptualisation of secure care, rather than an ethic of justice, adolescents could feel both secure and cared for. Key Practitioner Messages Adolescents do not perceive they are being cared for while in secure care, so they only wish to get out as soon as possible; The fact that adolescents do not understand the objectives they must attain and how they can reach these goals in locked settings causes anxiety and distress; Adolescents only focus on how they can convince practitioners that they ‘deserve’ to get out and not on why they were placed in secure care.