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Better human and health rights needed for vulnerable children

Custody inevitable for those failed by society, warns BMA

Jo Carlowe

Tuesday, 04 November 2014

Society’s failure to protect our most vulnerable children makes it inevitable that some will end up in custody.

This is the message from the British Medical Association in its report published today: Young Lives Behind Bars: The health and human rights of children and young people detained in the criminal justice system.”

The report highlights that while the origins of offending behaviour are complex, many of the children and young people in detention represent a failure by the individuals and agencies whose job it is to care for them and support them.

‘Young Lives Behind Bars’ finds that children and young people who enter the criminal justice system present with multiple and complex health and social needs prior to entering detention. Key figures include the fact that 40% of young people had been homeless in the six months before entering custody, 24% of boys and 49% of girls aged between 15-18 have been in care, 60% of children in custody have ‘significant’ speech, language and learning difficulties, more than a third were diagnosed with a mental health disorder. Of 300 in custody and on remand, 12% had lost a parent or sibling. 

The report identifies the following recommendations and issues for doctors, commissioners and policy-makers:

  • Early screening and identification of risk factors such as mental health problems – including post-natal depression – and substance abuse amongst parents and carers, and referral to appropriate services and support.
  • The need to address, as a priority, practices in the secure estate - including the use of restraint, force and segregation - which are detrimental to health and wellbeing.
  • Due to the prevalence of mental illness in the young offender population, and the high rates of suicide and self-harm, the development of high quality mental health services should be a key priority for those responsible for commissioning healthcare in the youth secure estate.
  • Concern over the low age of criminal responsibility currently in place in the UK and, ultimately, concern over the suitability of imprisonment in dealing with youth offending.
  • A call for an end to the practice of holding children and young people aged 17 and under overnight in police cells.
  • The need for an in-depth review by the government of the youth secure estate, with a view to exploring more welfare-based alternatives to custodial detention. 

Dr John Chisholm, Chair of the BMA’s Medical Ethics Committee, said: “Every child deserves the help and support necessary to preserve their physical, psychological, and emotional health and wellbeing. But for the thousands of children and young people in the UK who come into contact with the criminal justice system each year, this is not always the reality. 

“Many of these young people come from chaotic home lives, often characterised by violence, abuse or neglect, and are not thriving socially, emotionally or physically. Long before they reach detention they are among the most vulnerable individuals in our society and have been continually let down by the individuals and agencies whose job it is to care for them and support them.  

“Despite their high level of need, inadequacies in the systems that these children pass through sadly mean that they often fall between the cracks, and time spent in custody becomes an almost inevitable consequence.

“Going into detention can be an overwhelming experience that exacerbates existing mental health problems and anxieties: When children are placed at long distances from their families, friends and careers, in institutions that are unfamiliar and intimidating, it is easy to see how the problems that may have led the child to offend can be intensified.

“These children must not be let down any more. We must ensure that problems in children and young people are identified as soon as possible, and that they receive the necessary ongoing support and help they need in order to minimise and mitigate the underlying social causes of offending.”

In 2012/13 the average population in England and Wales of young people in custody (under 18s) was 1,544. In the twelve months to March 2013, 2,780 young people were placed in custody.

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