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Child detention — BMA advises doctors on how to stop it

Doctors have a vital role to play in preventing vulnerable children and young people ending up in detention, the BMA has declared.

BarsIn a report published today the BMA sets out how doctors can recognise risk factors for future offending and seize the opportunity to intervene.

Young Lives Behind Bars: The Health and Human Rights of Children and Young People Detained in the Criminal Justice System warns that society too often fails to protect its most vulnerable young members, making time in custody inevitable.

BMA medical ethics committee chair John Chisholm (pictured below) said long before children and young people reached detention they had been continually let down by the individuals and agencies whose job it was to care for and support them.

He said: ‘Going into detention can be an overwhelming experience that exacerbates existing mental health problems and anxieties …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.’


Saving young lives

The report makes 17 recommendations for doctors working in the community and in secure institutions. It also provides advice for commissioners and policymakers.

John ChisholmDoctors in the community should:

  • Recognise and act upon risk factors: children and young people who enter the criminal justice system are an extremely disadvantaged group who present with multiple and complex health and social needs
  • Identify risk factors such as mental health problems and substance abuse among parents and carers
  • Have access to appropriate training and support to ensure they are confident in treating children and young people.

Doctors working with children and young people in secure settings should:

  • Ensure their patients have the same rights around dignity, privacy, confidentiality and consent as patients in the community
  • Make it clear they are independent from prison officers and should not carry out custodial officer tasks or be directly involved in disciplinary proceedings. Doctors are in prison to act in a clinical and welfare capacity and acting outside this role can erode trust and damage the doctor-patient relationship
  • Ensure a summary record of a young person’s health, including recommendations for future treatment is sent to the young person’s GP, so that interventions that have yielded positive results in custody are not lost.

In 2012/13 the average population of under-18s in custody in England and Wales was 1,544. Many came from chaotic backgrounds and were often victims of violence, abuse or neglect.

 Find out more about the BMA's work on children in custody

 Read Young Lives Behind Bars

 What needs to be done to tackle the healthcare needs of children in custody? Join the conversation in BMA Communities

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