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What needs to be done to tackle the healthcare needs of children and young people in custody?

A new report published by the BMA, “Young Lives Behind Bars: The health and human rights of children and young people detained in the criminal justice system”, presents an overview of the complex reasons why children and young people offend, their multiple needs and the challenges they present. It aims to help practitioners and policy makers to reflect on their work with young people in trouble. Its recommendations include:

  • 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 have a critical role in addressing factors linked to child wellbeing. 
  • 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. 

Tell us what you think of these recommendations and what you think needs to be done to tackle the healthcare needs of children and young people detained by the criminal justice system.


3 replies

  • A very comprehensive and thought-provoking report . I did not see any reference to the monitoring of YOI's generally and Heath Care in particular. Each establishment has a mandatory Independent Monitoring Board whose remit is to ensure, amongst other tasks,  the decent care of the inmates and make necessary recommendations for change. I suspect some Boards have medically qualified members ( like myself) who operate not as doctors but individuals whose specialist knowledge can be useful. It would appear IMB's need to raise their profile.

  • In reply to John Leslie Hardman:

    As an IMB member in a prison with Young Offenders I would endorse Dr Hardman's views. Something which I have recently discovered is the absence of any specific training for doctors who work in prisons-Nottingham GP department used to run a diploma course but this ceased some years ago.Perhaps the BMA might look into this ?

  • In reply to John Leslie Hardman:

    I was concerned to see Baroness Butler-Sloss's resignation. She advocated 'listening to the children'. My recall of lawyers and child care cases in the past is that the former didn't really want to know, and the defending counsel would make light of the child's case. The child often found the whole business intimidating. I feel that the Baroness' family connections were just an excuse to get rid of someone who was asking the right, very awkward questions, and promoting the right, difficult road ahead.  I also think that another lawyer, here an ex-lady mayoress, was perhaps an unfortunate choice. Where to from here? I have not caught up with developments.

    However, over 20 years ago I was asked if my dept (Watching brief in Nuclear Medicine, but mainly Radiotherapy & Oncology) could help in the case of a possibly battered 18-month-old name James. I recall that a bone scan, provided the child could be kept still, might help tho' ordinary x-ray pictures were the first radiological port of call.

    It was then felt by the other party that, with a bone scan, I might find things that were not there. In retrospect I suppose I was expected to say 'no' rather than offer a solution. Importantly, could one of today's Consultant Radiologists give the up-to-date view on bone scans in battered babies, as I retired 20 years ago.

    As regards prison doctors the advice in yesteryear was that such people needed psychiatric training as a third of inmates had frank mental problems...in the event, many were retired psychiatrists which seemed a good choice.