Young offenders' health critical to rehabilitation
New research at the University of Adelaide is helping to provide a clearer picture of the all-important health needs of young offenders.
"Health - both mental and physical health - is an issue that has a serious impact on young offenders," said Dr Anne Wilson, Senior Lecturer in the Discipline of Nursing and lead author of the study.
Dr Wilson and Phillip Tully, a PhD student in the School of Psychology, conducted a review of previous research into the health of young offenders undertaken in Australia, the US, the UK and Europe since 1997. Among the issues considered by the review were the health needs of young offenders, their utilisation of health services, and the kinds of programs and interventions that would assist them when discharged from secure care.
The results of the review have been published in the Australian Journal of Primary Health.
"The health of young offenders and detained adolescents is commonly poorer in comparison with the general youth population. Previous studies document the growing concern for health issues regarding young offenders, including their risk-related behaviours, mental health, social and family problems, and other physical health deﬁcits," Dr Wilson said.
Figures from the Australian Institute of Criminology show that the incarceration rates in juvenile correctional facilities have remained stable at 44 per 100,000 for males and five per 100,000 for females. "But 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 said.
The key issues for young offenders are mental, physical and social aspects of health.
"Mental health, grief or trauma are among the most common issues impacting on young offenders, with the high prevalence of mental health disorders consistent among both male and female juvenile offenders," Dr Wilson said.
"Youth who are detained in secure care show significantly higher rates of mental health issues than young offenders who are not detained."
The review identified 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.
"The poor level of physical health experienced by young offenders in secure care is largely unsurprising given adolescent offenders' more frequent substance abuse, head injury, exposure to direct trauma injuries or exposure to violence, hepatitis C infection and liver disease, and exposure to sexually transmissible diseases," Dr Wilson said.
"Young offenders also 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 behaviour leads to higher rates of pregnancy among youth, with estimates suggesting between 1% and 9% of detained youth are pregnant.
"The reality is that many of these young women give birth while in custody, which is of great concern to health professionals. Consequently, sexual health, obstetric and gynaecological care have been identified as essential health needs for female offenders. Bodyweight and eating disorders are also issues among young female offenders."
Dr Wilson said 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.
"There is little doubt that those released from secure care face immense challenges to maintaining their health and well-being," she said.
Dr Wilson said effective planning is needed to address ongoing health issues for young offenders.
"By utilising 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."
Story by David Ellis