Better health services needed to break cycle of juvenile offending

A report has found 34% of young people serving a community-based order and 66% in custody have a substance abuse problem. Image from shutterstock.com

Improving health services in the juvenile justice system and the community could reduce the risk of youth offenders repeating anti-social behaviours, an Australian study has found.

Published in the Journal of Adolescent Health, the research found many offenders came from profoundly disadvantaged backgrounds with family histories of incarceration, mental illness and substance abuse.

Researchers from Murdoch Children’s Research Institute and the University of Melbourne surveyed more than 500 young people aged between 13 to 21 who were in custody or serving a community-based order from 2001 to 2003.

The findings revealed 34% of young people serving a community-based order and 66% in custody had a substance abuse problem, mostly cannabis. Depression and self-harm were common in both groups.

The majority of offenders reported having sex before they were 15 years of age, some having had more than five different sexual partners in the past six months.

Lead researcher Associate Professor Stuart Kinner said that despite familial influences, improving health services for young offenders would help their future outcomes.

“The links between substance use, poorly managed mental illness and offending are well documented. Addressing the complex health needs of these young people therefore has the potential to not only improve their future, but also reduce the risk of re-offending – it’s potentially a win-win situation,” he said.

Australian adult prisons have recently introduced health-monitoring programs to meet the health needs of the prisoner population. A similar system should be adopted to help improve the behaviours of juvenile offenders, the researchers said.

The report found that while the level of overall health was poorer in young people in custody, the number of people serving community-based orders across the country was significantly higher.

A/Prof Kinner said it was important to focus on improving the health of juvenile offenders in the community as they had less access to the same low-threshold health services usually available to detainees.

“It’s one thing to achieve improvement in health for young people while they are in custody, but it’s another thing to maintain those improvements when they return to their communities.

"We need to be providing mental health services at a level proportional to need and we need to provide substance related services in proportion to need,” he said.

A/Prof Kinner said improving the health of young people in youth detention had multiple benefits including improved public safety, potentially reduced transmission of infectious diseases related to drug injection and avoided future costs in terms of health care and criminal justice proceedings for those who experience poor outcomes.

“It’s also a whole lot easier and more effective to address the health needs of young people and maintain those improvements when they return to the community than to pick up the pieces after everything falls apart,” he said.

Monash University’s Associate Professor of Psychology Pamela Snow said early intervention programs in schools such as CASEA, which aims to reduce the incidence of poor conduct by children, needed to be strengthened.

“Better identification and early supports need to be put in place and sustained over many years if [youth offence rates] are to be altered. It is much harder to turn around the ‘baked on’ problems of a 16 year old than it is to change the trajectory of a six year old,” she said.

Professor of Paediatrics and Child Health at the University of Sydney Elizabeth Elliott said a high proportion of youths with in-utero alcohol exposure conditions such as fetal alcohol spectrum disorder (FASD) come into contact with the justice system.

Young people affected by FASD have problems with cognition, hyperactivity, impulse control and general behaviour, Prof Elliott said, and there was a growing concern about their treatment by the judicial system.

“These children need to be properly assessed for cognitive impairment or functional problems that make them unable to understand the differences between right and wrong and the consequences of their actions,” she said.

Prof Elliott said these youth would be better dealt with by the health system.