Doing Better with “Bad Kids”: Explaining the Policy-Research Gap with Conduct Disorder in Canada

Conduct disorder (severe and persistent antisocial behaviour in children and youth) is an important community mental health problem in Canada and has been the focus of considerable recent public policy debate. Good research evidence is available on effective (and ineffective) interventions for conduct disorder. Paradoxically, however, relatively little of the research evidence is incorporated into policy decision-making. There is a policy-research gap. An example (Hamilton, Ontario) is used to illustrate this gap. The gap is then explained using a framework for health policy analysis that incorporates values, institutional structures, and information. Values and institutional structures greatly outweigh research evidence in influencing current Canadian policy-making for the problem of conduct disorder. Possibilities for improving the situation are suggested. The youth who sprang his girlfriend from Arrell Youth (secure custody) Centre has a record many career criminals would envy. Unfortunately for society, he just turned 15 and has discovered an interest in illegal handguns. “This is a one-kid crime wave,” said a Hamilton-Wentworth police officer who spoke on condition of anonymity. “He's not like other child criminals—not even close. He's a bad kid.” That kid is in police custody today (Herron, 1995).

Ces dernières années, il y a eu des débats publics importants au sujet du désordre de conduite (comportement antisocial sévère et persistant chez les enfants et les adolescents et adolescentes), un problème de santé mentale communautaire de taille au Canada. La recherche démontre clairement quelles interventions sont efficaces pour traiter le désordre de conduite, et quelles interventions ne le sont pas. Cependant, relativement peu de cette recherche est incorporée au processus décisionnel. Il y a un écart entre la politique et la recherche. Une étude de cas est employée pour illustrer cet écart. On explique alors l'écart en utilisant un cadre pour l'analyse de politique de santé qui incorpore les valeurs, les structures institutionnelles et l'information. Les valeurs et les structures institutionnelles semblent avoir beaucoup plus d'influence que la recherche sur le processus décisionnel en ce qui concerne le problème du désordre de conduite. On trace les grandes lignes des suggestions pour améliorer la situation.