June 19, 2009 The physical and mental health needs of juvenile offenders should be treated as a priority if offenders held in detention have any real hope of rehabilitation, according to new research from the University of Adelaide, Australia.
Adelaide researchers have conducted a comprehensive review of previous studies into the health of young offenders undertaken in the USA, UK, Europe and Australia since 1997.
The results of the review have been published in this month's Australian Journal of Primary Health.
"Health - both mental and physical health - is an issue that has a serious impact on young offenders," says lead study author Dr Anne Wilson, Senior Lecturer in the Discipline of Nursing.
"The health of young offenders is commonly poorer in comparison with the general youth population. Previous studies document the growing concern for the health of young offenders, including their risk-related behaviors, mental health, social and family problems, and other physical health deficits.
"The underlying problems affecting these young offenders need to be addressed as a priority if they are to be successfully rehabilitated and reintegrated into the community," she says.
The review, co-authored by PhD student Phillip Tully in the School of Psychology, found:
- mental health, grief or trauma are among the most common issues impacting on young offenders - and this is consistent among both male and female offenders;
- youth who are detained in secure care show significantly higher rates of mental health issues than young offenders who are not detained;
- young offenders in secure care generally have a poor level of physical health because of issues such as:
- frequent substance abuse;
- head injury;
- exposure to direct trauma injuries or exposure to violence (eg, stab wounds, gunshot wounds);
- hepatitis C infection and liver disease; and
- exposure to sexually transmissible diseases.
- young offenders have a higher death rate in comparison with similar aged non-offenders, with as many as 70% of deaths attributable to drugs and suicide;
- for young female offenders, high-risk sexual behavior leads to higher rates of pregnancy, with estimates of up to 9% of detained youth being pregnant - and many of these young women give birth while in custody;
- bodyweight and eating disorders are also problem issues among young female offenders.
The review identifies various factors for successful mental health and trauma care, including: improving existing mental health services; identifying mental health problems with a high-quality screening process; ongoing support within and outside of secure care; improving the availability of services; and linking offenders directly to primary health or mental health services on release.
Dr Wilson says improving young offenders' access to health care could go some way to addressing their poor physical health status.
"However, additional social factors, such as education, peer support and family support, are likely to determine whether young offenders access the services they need," she says.
"There is little doubt that those released from secure care face immense challenges to maintaining their health and well-being.
"Many young offenders live in social conditions that are not conducive to achieving a healthy state. They are commonly exposed to poverty, social disadvantage, abuse and family dysfunction, and these factors may promote high-risk behaviors such as substance abuse, coping problems, truancy and low educational attainment.
"These social, familial, personal and peer-group factors can lead to repeat offender behavior and to a generational cycle of health problems. This is most clearly seen in neighborhoods where drugs are readily available to young people, where they are exposed to adult substance abuse, live in single-parent households, have caregivers with low levels of education, and receive government aid."
Dr Wilson says effective planning is needed to address ongoing health issues experienced by young offenders when they are released from detention.
"Young offenders have diverse and complex needs. By utilizing a comprehensive screening measure, individual plans can be formulated upon the offender's admission to secure care, with a view to looking ahead to their eventual discharge and their return to society."
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