Health determinants of adolescent criminalisation

Rates and causes of death after release from incarceration among 1 471 526 people in eight high-income and middle-income countries: an individual participant data meta-analysis

BACKGROUND

Formerly incarcerated people have exceptionally poor health profiles and are at increased risk of preventable mortality when compared with their general population peers. However, not enough is known about the epidemiology of mortality in this population-specifically the rates, causes, and timing of death in specific subgroups and regions-to inform the development of targeted, evidence-based responses. We aimed to document the incidence, timing, causes, and risk factors for mortality after release from incarceration.

METHODS

We analysed linked administrative data from the multi-national Mortality After Release from Incarceration Consortium (MARIC) study. We examined mortality outcomes for 1 471 526 people released from incarceration in eight countries (Australia, Brazil, Canada, New Zealand, Norway, Scotland, Sweden, and the USA) from 1980 to 2018, across 10 534 441 person-years of follow-up (range 0-24 years per person). We combined data from 18 cohort studies using two-step individual participant data meta-analyses to estimate pooled all-cause and cause-specific crude mortality rates (CMRs) per 100 000 person-years, for specific time periods (first, daily from days 1-14; second, weekly from weeks 3-12; third, weeks 13-52 combined; fourth, weeks 53 and over combined; and fifth, total follow-up) after release, overall and stratified by age, sex, and region.

FINDINGS

75 427 deaths were recorded. The all-cause CMR during the first week following release (1612 [95% CI 1048-2287]) was higher than during all other time periods (incidence rate ratio [IRR] compared with week 2: 1·5 [95% CI 1·2-1·8], I2=26·0%, weeks 3-4: 2·0 [1·5-2·6], I2=53·0%, and weeks 9-12: 2·2 [1·6-3·0], I2=70·5%). The highest cause-specific mortality rates during the first week were due to alcohol and other drug poisoning (CMR 657 [95% CI 332-1076]), suicide (135 [36-277]), and cardiovascular disease (71 [16-153]). We observed considerable variation in cause-specific CMRs over time since release and across regions. Pooled all-cause CMRs were similar between males (731 [95% CI 630-839]) and females (660 [560-767]) and were higher in older age groups.

INTERPRETATION

The markedly elevated rate of death in the first week post-release underscores an urgent need for investment in evidence-based, coordinated transitional healthcare, including treatment for mental illness and substance use disorders to prevent post-release deaths due to suicide and overdose. Temporal variations in rates and causes of death highlight the need for routine monitoring of post-release mortality.

FUNDING

Australia's National Health and Medical Research Council.

Interventions to Prevent and Respond to Violence Against Justice-Involved Young Women: A Scoping Review

Young women who have had contact with the criminal justice system (justice-involved young women) have an increased risk of being a victim of violence. However, no reviews have synthesized the evidence on interventions to prevent or respond to violence against justice-involved young women. We conducted a scoping review to identify interventions designed to prevent or respond to violence against justice-involved young women. We searched Medline, Criminal Justice Abstracts, Web of Science, and Google Scholar for peer-reviewed and gray literature published in English from January 1, 2000 until March 23, 2021. Consistent with the public health approach to violence, we included primary, secondary, and tertiary interventions. Excluding duplicates, our search returned 5,603 records, 14 of which met our inclusion criteria. We narratively synthesized the included studies, all of which were conducted in the United States. Most included studies examined a tertiary intervention (n = 10), and few examined a primary (n = 2) or secondary (n = 2) intervention. Across the Joanna Briggs Institute Critical Appraisal Tools, the percentage of items met ranged from 0% to 78%. There was some limited evidence that tertiary interventions that included cognitive behavioral therapy reduced the mental health impacts of violence victimization among justice-involved young women. There was little evidence on primary and secondary interventions. Effective and evidence-based interventions to prevent violence victimization and revictimization against justice-involved young women remains a critical gap in knowledge.

Review of the India Adolescent Health Strategy in the context of disease burden among adolescents

Background

A nuanced understanding of the health needs of adolescents in the context of the India Adolescent Health Strategy (IAHS) is needed to inform policy interventions for improving the health and well-being of adolescents in India.

Methods

Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, we identified the top ten causes of years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) disaggregated by sex and age group (10-14 and 15-19 years) for India and its states in 2019. To inform the IAHS of refinement or expansion in focus needed to improve adolescent health in India, we reviewed the extent to which the top 10 causes of disease burden are addressed in the IAHS, and the availability of and age- and sex-disaggregation in the service utilisation data for adolescents captured in the Adolescent Friendly Health Clinic monitoring information system (AFHC MIS) and Health Management Information System (HMIS). We also reviewed the availability of and age-and sex-disaggregation in the data capture at the population level for the IAHS outcome indicators in the data sources identified in the IAHS operational framework.

Findings

Females in the 10-14 and 15-19 years age groups suffered 6.75 million and 9.25 million DALYs, respectively, 39.1% and 44.2% of which were YLLs; the corresponding DALYs for males were 6.71 million and 9.65 million (42.3% and 41.1% YLLs), respectively. Within the 6 thematic areas of the IAHS, most strategies and indicators identified are for sexual and reproductive health followed by nutrition, and broadly these conditions accounted for YLDs and not YLLs in adolescents. Significant gaps in the IAHS in comparison to the disease burden for fatal diseases and conditions were seen across injuries, communicable diseases, and non-communicable diseases. Injuries accounted for 65.9% and 45.3% of YLLs in males and females aged 15-19 years, and 40.8% in males aged 10-14 years. Specifically, road injuries (15.3%, 95% UI 11.0-18.0) and self-harm (11.3%, 95% UI 8.7-14.2) accounted for most of the injury deaths in 15-19 years whereas drowning (7.7% 95% UI 5.8-9.6) and road injuries (6.9%, 95% UI 4.7-8.6) accounted for the most injury deaths in 10-14 years males. However, only self-harm and gender-based violence are specifically addressed in the IAHS with non-specific interventions for other injuries. Diarrhoea, lower respiratory infections, malaria, encephalitis, tuberculosis, typhoid, cirrhosis, and hepatitis are the other disease conditions accounting for YLLs and DALYs in adolescents but these are neither addressed in the IAHS nor in service provision under the AFHC MIS. There is no age- or sex-disaggregation in the cause of death data captured in the HMIS to allow an understanding of mortality in adolescents. For the IAHS outcome indicators at the population level, data capture for the 10-14 years irrespective of sex was largely missing from the population surveys and none of the surveys captured data for either females or males aged 15-19 years for physical inactivity and mental health indicators.

Interpretation

The considerable differences seen in the IAHS thematic focus as compared with the leading causes of fatal and non-fatal disease burden in adolescents in India, and in the availability of population-level data to monitor the outcome indicators of the IAHS can pose substantial limitations for improving adolescent health in India. The findings in this paper can be utilized by decision makers to refine action aimed at improving adolescent health and well-being.

Funding

Bill & Melinda Gates Foundation.

Non-communicable disease mortality in young people with a history of contact with the youth justice system in Queensland, Australia: a retrospective, population-based cohort study

BACKGROUND

Young people who have had contact with the criminal justice system are at increased risk of early death, especially from injuries. However, deaths due to non-communicable diseases (NCDs) in this population remain poorly described. We aimed to estimate mortality due to NCDs in people with a history of involvement with the youth justice system, compare NCD mortality rates in this population with those in the general population, and characterise demographic and justice-related factors associated with deaths caused by NCDs in people with a history of contact with the youth justice system.

METHODS

In this retrospective, population-based cohort study (the Youth Justice Mortality [YJ-Mort] study), we included all people aged 10-18 years (at baseline) charged with a criminal offence in Queensland, Australia, between June 30, 1993, and July 1, 2014. We probabilistically linked youth justice records with adult correctional records and national death records up to Jan 31, 2017. Indigenous status was ascertained from youth justice and adult correctional records, with individuals identified as Indigenous in either source classified as Indigenous in the final dataset. We estimated crude mortality rates and standardised mortality ratios (SMRs) for comparisons with data from the Australian general population. We identified risk factors for NCD deaths using competing-risks regression.

FINDINGS

Of 48 670 individuals aged 10-18 years (at baseline) charged with a criminal offence in Queensland, Australia, between June 30, 1993, and July 1, 2014, 11 897 (24·4%) individuals were female, 36 773 (75·6%) were male, and 13 250 (27·2%) were identified as identified as Indigenous. The median age at first contact with the youth justice system was 15 years (IQR 14-16), the median follow-up time was 13·4 years (8·4-18·4), and the median age at the end of the study was 28·6 years (23·6-33·6). Of 1431 deaths, 932 (65·1%) had a known and attributed cause, and 121 (13·0%) of these were caused by an NCD. The crude mortality rate from NCDs was 18·5 (95% CI 15·5-22·1) per 100 000 person-years among individuals with a history of involvement with the youth justice system, which was higher than among the age-matched and sex-matched Australian general population (SMR 1·67 [1·39-1·99]). Two or more admissions to adult custody (compared with none; adjusted sub-distribution hazard ratio 2·09 [1·36-3·22]), and up to 52 weeks in adult custody (compared with none; 1·98 [1·18-3·32]) was associated with NCD death.

INTERPRETATION

Young people with a history of contact with the justice system are at increased risk of death from NCDs compared with age-matched and sex-matched peers in the general Australian population. Reducing youth incarceration and providing young people's rights to access clinical, preventive, and restorative services should be a priority.

FUNDING

National Health and Medical Research Council.

Associations between significant head injury in male juveniles in prison in Scotland UK and cognitive function, disability and crime: A cross sectional study

BACKGROUND

Although the prevalence of head injury is estimated to be high in juveniles in prison, the extent of persisting disability is unknown and relationships with offending uncertain. This limited understanding makes it difficult to develop effective management strategies and interventions to improve health or reduce recidivism. This study investigates effects of significant head injury (SHI) on cognitive function, disability and offending in juvenile prisoners, and considers relationships with common comorbidities.

METHODS

This cross-sectional study recruited male juvenile prisoners in Scotland from Her Majesty's Young Offenders Institute (HMYOI) Polmont (detaining approximately 305 of 310 male juveniles in prison in Scotland). To be included juveniles had to be 16 years or older, fluent in English, able to participate in assessment, provide informed consent and not have a severe acute disorder of cognition or communication. Head injury, cognition, disability, history of abuse, mental health and problematic substance use were assessed by interview and questionnaire.

RESULTS

We recruited 103 (34%) of 305 juvenile males in HMYOI Polmont. The sample was demographically representative of juvenile males in prisons for young offenders in Scotland. SHI was found in 82/103 (80%) and head injury repeated over long periods of time in 69/82 (85%). Disability was associated with SHI in 11/82 (13%) and was significantly associated with mental health problems, particularly anxiety. Group differences on cognitive tests were not found. However the SHI group reported poorer behavioural control on the Dysexecutive Questionnaire and were more often reported for incidents in prison than those without SHI. Characteristics of offending, including violence, did not differ between groups.

CONCLUSIONS

Although SHI is highly prevalent in juvenile prisoners, associated disability was relatively uncommon. There was no evidence for differences in cognitive test performance or offending in juveniles with and without SHI. However, signs of poorer behavioural control and greater psychological distress in juveniles with SHI suggest that they may be at greater risk of recidivism and of potentially becoming lifelong offenders. This implies a need for remedial programmes for juvenile prisoners to take account of persisting effects of SHI on mental health and self-control and education and to improve their understanding of the effects of SHI reduce the likelihood of cumulative effects from further SHI.

Violence-Related Death in Young Australians After Contact With the Youth Justice System: A Data Linkage Study

Little is known outside of the United States about the risk of violence-related death among young people who have had contact with the youth justice system (justice-involved young people). We examined violence-related deaths among justice-involved young people in Queensland, Australia. In this study, youth justice records for 48,647 young people (10-18 years at baseline) who were charged, or experienced a community-based order or youth detention in Queensland, Australia (1993-2014) were probabilistically linked with death, coroner, and adult correctional records (1993-2016). We calculated violence-related crude mortality rates (CMRs) and age- and sex-standardized mortality ratios (SMRs). We constructed a cause-specific Cox regression model to identify predictors of violence-related deaths. Of 1,328 deaths in the cohort, 57 (4%) were from violence. The violence-related CMR was 9.5 per 100,000 person-years (95% confidence interval [95% CI] [7.4, 12.4]) and the SMR was 6.8 [5.3, 8.9]. Young Indigenous people had a greater risk of violence-related death than non-Indigenous people (cause-specific hazard ratio [csHR] 2.5; [1.5, 4.4]). Young people who experienced detention had more than twice the risk of violence-related death than those who were charged only (csHR 2.5; [1.2, 5.3]). We found that justice-involved young people have a risk of dying from violence that far exceeds that of the general population. The rate of violence-related death found in this study is lower than that in U.S.-based studies, which most likely reflects lower population level firearm violence in Australia. In Australia, young Indigenous people and those released from detention appear key groups to target for violence prevention efforts.

A comparative study of mental health status among left-behind, migrant, and local adolescents in China

OBJECTIVE

Influence of migration on mental impairments among adolescents has been well assessed. However, there lack empirical data on multiple mental health problems and comparisons of children who suffer from different parental migration. This study aims to compare the mental health status among left-behind adolescents (LBA), migrant adolescents (MA), and local adolescents (LA).

METHODS

A total of 67,532 adolescents were investigated on depression, anxiety, sleep disturbance, and psychotic-like experiences (PLEs). The LBA were registered in Shenzhen's hukou (household register system) and are living in Shenzhen while their parent(s) has/have migrated to work elsewhere for over 6 months. MA, defined as adolescents who immigrated with parents from other places, are living but not registered in Shenzhen hukou. LA referred to adolescents who were registered in Shenzhen hukou and are living with their parents. Social-demographics, family function, and school climate were also evaluated as influential factors.

RESULTS

The prevalence of overall mental health problems was 37.4 % for LBA, which was higher than that of MA (27.9 %) and LA (27.1 %). Females, adolescents with chronic physical illness, and with family history of mental disorders are all contributed to the increased occurrence of mental health issues. Poorer family function and school climate were also negatively associated with mental health among the three types of adolescents.

CONCLUSION

LBA is at a higher risk for poor mental health than other adolescents. Interventions that promoting family function and improving school climate may be helpful, especially for girls with chronic physical illness, or with family history of mental disorders.

Role of Adipose Tissue microRNAs in the Onset of Metabolic Diseases and Implications in the Context of the DOHaD

The worldwide epidemic of obesity is associated with numerous comorbid conditions, including metabolic diseases such as insulin resistance and diabetes, in particular. The situation is likely to worsen, as the increase in obesity rates among children will probably lead to an earlier onset and more severe course for metabolic diseases. The origin of this earlier development of obesity may lie in both behavior (changes in nutrition, physical activity, etc.) and in children's history, as it appears to be at least partly programmed by the fetal/neonatal environment. The concept of the developmental origin of health and diseases (DOHaD), involving both organogenesis and epigenetic mechanisms, encompasses such programming. Epigenetic mechanisms include the action of microRNAs, which seem to play an important role in adipocyte functions. Interestingly, microRNAs seem to play a particular role in propagating local insulin resistance to other key organs, thereby inducing global insulin resistance and type 2 diabetes. This propagation involves the active secretion of exosomes containing microRNAs by adipocytes and adipose tissue-resident macrophages, as well as long-distance communication targeting the muscles and liver, for example. Circulating microRNAs may also be useful as biomarkers for the identification of populations at risk of subsequently developing obesity and metabolic diseases.

Language disorder and internalizing mental health problems in youth offenders: A systematic review

BACKGROUND

The prevalence of language disorder in youth offenders far exceeds rates reported in community samples. Youth involved in the justice system are also at increased risk of a range of psychiatric disorders, including internalizing mental health problems (i.e., anxiety, depression). However, the frequency with which these co-occur in this population is not known. Understanding the co-occurrence of language disorder with anxiety and depression in youth offenders may contribute to more coordinated and targeted support for these vulnerable youth.

AIMS

To explore the co-occurrence of language disorder and anxiety and depression in youth offenders.

METHODS & PROCEDURES

A systematic literature search of six databases (CINAHL, ERIC, Medline, PyscINFO, PubMED, Scopus) was conducted (September 2021) using key search terms relevant to the systematic review question. Study inclusion criteria were: (1) original research published in English; (2) youth up to 21 years of age involved in the justice system; and (3) reported outcomes on language and anxiety and/or depression. All included studies were appraised using the Joanna Briggs Critical Appraisal tool checklist relevant to study design. Due to the heterogeneity of included studies, data synthesis was narrative.

MAIN CONTRIBUTION

Eight studies met the eligibility criteria. A range of measures was used to assess language abilities across samples. Only two studies directly addressed the relationship between language disorder and internalizing mental health problems; both found no significant correlation.

CONCLUSIONS & IMPLICATIONS

Although the results did not support a significant relationship between language disorder and internalizing mental health problems in youth offenders, the two appear to occur comorbidly as evidenced by heightened rates of both in the included samples. This review highlights the need for more robust studies aimed to better understand this relationship. Stronger evidence may contribute to increased collaborative speech pathology and psychology services which might increase youth offenders' accessibility and engagement in intervention programmes (e.g., cognitive-behaviour therapy; interpersonal skills training; individual counselling).

WHAT THIS PAPER ADDS

What is already known on this subject The markedly high rates of language disorder in youth involved in the justice system have been widely reported. It is also known that externalizing mental health problems often bring youth in contact with the justice system. Though there is some information about the prevalence of internalizing mental health problems in this population, the co-occurrence of language disorder and internalizing mental health problems has not been examined as widely. What this study adds to existing knowledge This study aimed to identify the frequency of co-occurrence of language disorder and anxiety and/or depression in youth offenders. Although the results did not support a significant relationship between language disorder and internalizing mental health problems in this population, results of the review provide evidence of heightened rates of both. This study also provides a summary of the various measures used to assess language and internalizing mental health in youth offenders across the eight studies included in this review. What are the potential or actual clinical implications of this work? It is possible that the tests and sub-tests used to identify language disorders and internalizing mental health problems were not sensitive enough to identify the full extent of youth offenders' needs. Identifying the presence of language disorders and internalizing mental health problems and recognizing the impact these may have on the communication and behaviours of an individual can better inform staff and therapists as they engage and interact with youth in the justice system.

School Performance and Young Adult Crime in a Brazilian Birth Cohort

Poor school performance may increase the risk of crime and violence via effects on self-esteem, risky behaviours, peer networks, and perceived stakes in society. Despite very high rates of violence in Latin America, no longitudinal research has addressed this issue in the region. Two aspects of educational performance (grade repetition and school completion) were examined during adolescence in a population-based Brazilian birth cohort study (n = 3584). Violent and non-violent crime were measured at age 22 years in confidential self-reports; sociodemographic, family, and individual confounders were measured between birth and age 11 years, and potential mediators were measured at age 18 years. The prevalence of violent and non-violent crimes at 22 years was 8.2% and 3.3%, respectively, referring to acts in the previous twelve months. For youth repeating school grades three times or more, the odds of violent crime were 2.4 (95%CI: 1.6-3.6) times higher than for those who had not repeated any school grade. Youth completing school had a lower risk for both violent (OR = 0.5; 95%CI: 0.4-0.7) and non-violent crime (OR = 0.3; 95%CI: 0.2-0.5), compared to those who did not finish school by the expected age. The protective effect of completing school was independent of the number of grades previously repeated. In conclusion, repeating school grades was associated with increased risk for crime; however, successfully managing to complete school by the expected age was an important protective factor against crime, even after multiple grade repetitions.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40865-022-00214-x.

Relational security: The impact of facility design on youth custodial staffs' practices and approaches

BACKGROUND

Constructive relationships between staff and young people in custody are a vital component of a therapeutic youth justice approach, which extends to the maintenance of a safe and secure environment (i.e., relational security). Despite the growing recognition that the physical environment of a facility impacts the procedures within a youth justice environment, as well as the relationships between staff and young people, there is a dearth of research in this area.

AIMS

We investigated youth custodial staffs' views on, and approaches to, establishing relationships with young people while maintaining safety and security. The current study reports on the impacts and challenges highlighted by staff relating to the design of the facility.

METHODS

We interviewed a total of 26 custodial staff members working at a Youth Justice facility in Melbourne, Australia. The semi-structured interviews were audio recorded and transcribed. NVivo 12 was used for thematic analysis. Two researchers (SO and PT) coded one transcript independently, iteratively creating a coding template using a thematic analysis approach. Once the final set of broad themes was constructed, the transcripts were re-examined, and narrower themes were identified.

RESULTS

Thematic analysis revealed that a total of 14 staff (53.8%) identified the design of the custodial facility as impacting upon their ability to practice relational security. Identified design aspects included: unit size, quiet and private spaces, communal areas, green and outside spaces, ambience and spatial characteristics, spatial differentiation, facility and unit lay-out.

CONCLUSION

Youth custodial staff identified design aspects of a youth custodial facility that either promoted or impeded the ability to practice relational security approaches. The current study highlights the importance of carefully considering facility design given its impact upon staff-young people relationships, procedures and ways of working within these custodial facilities.

Supporting young people's cognition and communication in the courtroom: A scoping review of current practices

BACKGROUND

A recent meta-analysis suggested that the majority of young people in contact with the criminal justice system have cognitive and/or communication impairments. Over the past 20 years, recognition of these complex needs has resulted in support measures being put in place in courtrooms across the globe. It is therefore timely to review evidence for the efficacy of these measures.

AIMS

This scoping review evaluates evidence on support measures employed to facilitate access to court proceedings for individuals with cognition and communication impairments, and considers how this evidence might inform future research and practice.

METHODS

Research databases were searched for studies that: directly or indirectly involved a population with a form of functional impairment and/or diagnosed neurodevelopmental disorder; and refer to support delivered to remove barriers or support access to courtroom processes.

RESULTS

Searches identified 3,318 distinct articles. Following review, 37 papers were identified for inclusion. The papers were published between 1993 and 2019, with the majority being published since 2010 (n = 23). The majority of papers were from the United Kingdom (n = 26); other countries represented were Australia (n = 1), Canada (n = 3), New Zealand (n = 2), UK papers don't necessarily state which countries involved (n = 2) Scotland specifically state Scotland only and the United States (n = 3). No papers met the criteria for an experimental research design.

CONCLUSIONS

Whilst the high level of need in this population is well established, which support measures are most effective in enabling engagement in court processes is not currently clear. More robust evaluative research is therefore required to establish the most effective methods of support. Despite this lack of evidence regarding outcomes, both young people and professionals generally view support measures favourably. There is an increasing onus on professionals to adapt their practice rather than to support/enhance the cognition and communication skills of young people.

Do macroeconomic shocks in the local labor market lead to child maltreatment and death?: Empirical evidence from Japan

BACKGROUND

Japan is facing a rapid increase in the number of reported child maltreatment cases. Child maltreatment has long-term consequences for the victims, and unemployment rate is considered a strong predictor of it. However, only few studies have analyzed the causal relation between child maltreatment and the unemployment rate-particularly the effects of the latter on the former-in Japan.

METHODS

Using prefecture-level longitudinal data from 2005 to 2016, we employed a fixed effects instrumental variable estimation. The estimation included a weighted average of the national unemployment rate across industries by industrial structures in 2005 as an instrument to identify the causal effects.

RESULTS

The average local unemployment rate changed by approximately 50% from the peak to the bottom in the sample period. A 50% increase in local unemployment rates increased the number of reported child neglect cases and child deaths by 80% and 70% (statistically significant at the 5% level), respectively. Further, it increased cases of death due to external causes, unintentional injuries, and unintentional drowning by 146%, 217%, and 315% (statistically significant at the 5% level), respectively.

CONCLUSION

The local unemployment rate is a risk factor for child maltreatment, resulting in children's death, especially as a result of unintentional drowning-the common cause of death due to child neglect. When the local unemployment rates rise, governments should allocate more financial and human resources for preventive measures to combat child deaths caused by neglect.

Interventions to reduce suicidal thoughts and behaviours among people in contact with the criminal justice system: A global systematic review

BACKGROUND

People who experience incarceration die by suicide at a higher rate than those who have no prior criminal justice system contact, but little is known about the effectiveness of interventions in other criminal justice settings. We aimed to synthesise evidence regarding the effectiveness of interventions to reduce suicide and suicide-related behaviours among people in contact with the criminal justice system.

METHODS

We searched Embase, PsycINFO, MEDLINE, and grey literature databases for articles published between 1 January 2000 and 1 June 2021. The protocol was registered with PROSPERO (CRD42020185989).

FINDINGS

Thirty-eight studies (36 primary research articles, two grey literature reports) met our inclusion criteria, 23 of which were conducted in adult custodial settings in high-income, Western countries. Four studies were randomised controlled trials. Two-thirds of studies (n=26, 68%) were assessed as medium quality, 11 (29%) were assessed as high quality, and one (3%) was assessed as low quality. Most had considerable methodological limitations and very few interventions had been rigorously evaluated; as such, drawing robust conclusions about the efficacy of interventions was difficult.

INTERPRETATION

More high-quality evidence from criminal justice settings other than adult prisons, particularly from low- and middle-income countries, should be considered a priority for future research.

FUNDING

This work was funded by the Australian government's National Suicide Prevention Taskforce. RB is supported by a National Health and Medical Research Council (NHMRC) Emerging Leader Investigator Grant (EL2; GNT2008073). MW is supported by a NHMRC Postgraduate Scholarship (GNT1151103). SF was funded by the NIHR HTA Programme (HTA Project:16/159/09).

Circumstances and toxicology of violence-related deaths among young people who have had contact with the youth justice system: a data linkage study

Background

Young people who have had contact with the youth justice system have an increased risk of dying from violence. Examining the context of violence-related deaths is essential in informing prevention strategies. We examined the circumstances and toxicology of violence-related deaths among young people who have had contact with the youth justice system in Queensland, Australia.

Methods

This data linkage study linked youth justice records from Queensland, Australia (30 June 1993-1 July 2014) on 48,670 young people to national death and coroner records (1 July 2000-1 January 2017). Circumstances and toxicology of deaths were coded from coroner’s records. We calculated the incidence of violence-related deaths that were reported to a coroner. Fisher’s exact tests were used to examine crude differences in the circumstances and toxicology of violence-related death, according to sex and Indigenous status.

Results

There were 982 deaths reported to a coroner in the cohort. Of which, 36 (4%) were from violence-related causes (incidence: 6 per 100,000 person-years, 95% confidence interval: 4-8). People who died from violence were most frequently male (n = 28/36; 78%), and almost half were Indigenous (n = 16/36; 44%). The majority of violence-related deaths involved a weapon (n = 24/36; 67%), most commonly a knife (n = 17/36; 47%). Compared to men where the violent incident was most frequently preceded by an altercation (n = 12/28; 43%), for women it was frequently preceded by a relationship breakdown or argument (n < 5; p = 0.004). Substances most commonly present in toxicology reports were cannabis (n = 16/23; 70%) and alcohol (n = 15/23; 65%).

Conclusions

Therapeutic alcohol and other drug programs, both in the community and detention, are likely important for reducing violence-related deaths among young people who have had contact with the youth justice system. The majority of violence-related deaths among women were in the context of intimate partner violence, indicating the urgent need for interventions that prevent intimate partner violence in this population. Diversion programs and increased investment in health and social services may reduce the overrepresentation of Indigenous people in the youth justice system and in violence-related deaths.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12244-z.

International migration of unaccompanied minors: trends, health risks, and legal protection

The global population of unaccompanied minors-children and adolescents younger than 18 years who migrate without their legal guardians-is increasing. However, as data are not systematically collected in any region, if collected at all, little is known about this diverse group of young people. Compared with adult migrants, unaccompanied minors are at greater risk of harm to their health and integrity because they do not have the protection provided by a family, which can affect their short-term and long-term health. This Review summarises evidence regarding the international migration and health of unaccompanied minors. Unaccompanied minors are entitled to protection that should follow their best interests as a primary consideration; however, detention, sometimes under the guise of protection, is a widespread practice. If these minors are provided with appropriate forms of protection, including health and psychosocial care, they can thrive and have good long-term outcomes. Instead, hostile immigration practices persist, which are not in the best interests of the child.

Epidemiology, Risk Factors, and Prevention of Suicidal Thoughts and Behaviour in Prisons: A Literature Review

Suicide is a global public health concern that affects all echelons of society, albeit not equally so. Compared with adults in the general population, incarcerated offenders are at increased risk to consider, attempt, and die by suicide, which represents a substantial burden of morbidity and mortality in prisons worldwide. This review synthesises recent literature pertaining to the epidemiology, risk factors, and prevention of suicidal thoughts and behaviour among prisoners, and outlines a framework which emphasises the interplay between individuals (importation) and their surroundings (deprivation). The available evidence suggests that prison-specific stressors may exacerbate risk of suicide in an already vulnerable population characterised by complex health and social care needs. Emerging data point to differential mechanisms through which prisoners come to think about suicide and subsequently progress to suicidal behaviour. As risk of suicide is determined by a complex web of synergistically interacting factors, its management and prevention demands a cross-sectoral policy and service response that includes targeted interventions aimed at high-risk prisoners in combination with population strategies that promote the health and wellbeing of all people in prison.

Building Resilience Through Sport in Young People With Adverse Childhood Experiences

Interventions focused on young people at risk of anti-social and criminal behaviour frequently involve physical exercise and/or participation in sporting activities as a primary vehicle to bring about behavioural change in both the short to medium term. Anecdotal evidence suggests that sporting activities positively influence individual well-being alongside a sense of purpose and belonging centred around sporting clubs and activities. Empirically, participation in sport has been identified as a key resilience factor for young people with numerous Adverse Childhood Experiences (ACEs) and investment and policy initiatives target investment in these opportunities. However, the psychological mechanisms which underpin these improvements in well-being and building of resilience are less clearly articulated. This article will review current and developing research in this field to synthesise future applications of sport-related interventions with young people, with a particular emphasis on furthering understanding of the pathways to capacity building at individual and community level which sport and exercise can generate.

Self-reported and general practitioner recorded indicators of lifetime health up to age 48 according to offender type in the Cambridge Study in Delinquent Development

BACKGROUND

Previous research has suggested that people with a history of offending have worse health compared to non-offenders, but it is less clear whether all types of offenders are at similar health risks. In a New Zealand birth cohort study, Moffitt evidenced three main offending trajectories-life-course-persistent (LCP), adolescence-limited (AL) and late-onset (LO) offending, subsequently confirmed in other substantial longitudinal studies.

AIMS

Our aim was to explore the relationship between these offending trajectories and both self-reported (SR) and general practitioner (GP) (primary care) recorded health indicators.

METHODS

Self-reported medical data at age 48 were obtained for 394 men followed since age 8 years in the Cambridge Study in Delinquent Development. In addition, medical records were obtained from GPs for 264 of them. Health indicators from both sources were compared between each of the three established trajectories of offenders across the life course-LCP, AL, LO and the non-offenders.

RESULTS

LCP offenders were found to have over twice the likelihood of disabling medical conditions according to both self-report and GP records. They were also more likely to have GP records indicating mental health problems and treatment for them. According to GP records alone, the LO offenders were also more likely to have mental health problems. The health of AL offenders appeared to be no different from that of the crime-free controls.

CONCLUSIONS

Our findings add weight to the growing evidence that LCP offending and offending that only occurs relatively late in life are likely to be the indicators of generally unhealthy and disrupted lives. This suggests that if lifestyle is to change for the better, interventions are likely to be needed for health as well as antisocial behaviour.

Associations between significant head injury and persisting disability and violent crime in women in prison in Scotland, UK: a cross-sectional study

BACKGROUND

The prevalence of head injury is estimated to be as high as 55% in women in prison and might be a risk factor for violent offending, but evidence is equivocal. The extent of persisting disability is unknown, making decisions about service needs difficult. The UN recognises vulnerabilities in women in prison, but does not include head injury. This study aimed to investigate relationships among head injury, comorbidities, disability, and offending in women in prison.

METHODS

In this cross-sectional study, women were recruited between Feb 2, 2018, and Sept 30, 2019, from four prisons across Scotland, UK: Her Majesty's Prison (HMP) Cornton Vale, Her Majesty's Young Offenders Institute Polmont, HMP Edinburgh, and HMP Greenock (detaining approximately 355 individuals at the time of recruitment). Women were included if they were aged older than 16 years, fluent in English, able to participate in face-to-face assessment and provide informed consent, and did not have a severe acute disorder of cognition or communication. Head injury, cognition, disability, mental health, and history of abuse and problematic substance use were assessed by interview. History of head injury was assessed with the Ohio State University Traumatic Brain Injury Identification method and disability was assessed with the Glasgow Outcome at Discharge Scale. Comparisons were made between women with and without a history of significant head injury.

FINDINGS

We recruited 109 (31%) of the 355 women in these prisons. The sample was demographically representative of the approximately 400 individuals in women's prisons in Scotland. Significant head injury (SHI) was found in 85 (78%) of 109 women, of whom 34 (40%) had associated disability. Repeat head injury was reported in 71 (84%) of the 85 women with SHI and, in most cases, this resulted from domestic abuse that had occurred over many years. Women with a history of SHI were significantly more likely to have a history of violent offences than those without a history of SHI (66 [79%] of 85 women in the SHI group vs 13 [54%] of 24 women in the no-SHI group had committed a violent offence; odds ratio [OR] 3·1, 95% CI 1·2-8·1). This effect remained significant after adjusting for current factors (3·1, 1·1-9·0), including comorbidities associated with post-traumatic stress disorder, and was no longer statistically significant after adjusting for historical factors (3·3, 1·0-10·9), such as abuse as a child or adult. Women with SHI had spent longer in prison than women without SHI after adjustment for current (rate ratio 3·4, 1·3-8·4) or historical (3·5, 1·3-9·2) risk factors.

INTERPRETATION

It is recognised that women in prison are vulnerable because of histories of abuse and problematic substance use; however, history of SHI needs to be included when developing criminal justice policy, interventions to reduce mental health morbidity, and assessment and management of risk of violent offending.

FUNDING

The Scottish Government.

Incidence of Early Police Contact Among Children With Emerging Mental Health Problems in Australia

IMPORTANCE

In adulthood and adolescence, mental health vulnerability is known to be associated with risk of criminal justice system contact as both a perpetrator and survivor of crime, but whether this association is apparent early in child development is unknown. Prevention of poor outcomes, including repeated contact with the criminal justice system, relies on the identification of vulnerability early in life and at the start of such contact.

OBJECTIVE

To ascertain whether children with emotional or behavioral problems and general developmental vulnerabilities are at an increased risk of subsequent contact with police as a person of interest, a survivor of crime, or a witness.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study used routinely collected data from the New South Wales Child Development Study in Australia. The cohort was composed of children who entered full-time schooling in New South Wales in 2009, had complete data for the emotional maturity domain of the Australian Early Development Census, and had no police contact before January 1, 2009. The children in the cohort were followed up until the age of 13 years. Data were analyzed from October 17, 2019, to May 13, 2020.

EXPOSURES

Emotional or behavioral problems and developmental risk profiles derived from the teacher-rated Australian Early Development Census.

MAIN OUTCOMES AND MEASURES

Incidence rates of police contact (as a person of interest, survivor of crime, or witness) were derived from the New South Wales Police Force Computerised Operational Policing System.

RESULTS

A total of 79 801 children (40 584 boys [50.9%]; 2009 mean [SD] age, 5.2 [0.37] years) were included. Children with teacher-identified emotional or behavioral problems at school entry had an incidence rate of police contact (for any reason) that was twice that of children without such problems (unadjusted hazard ratio [HR], 2.14; 95% CI, 1.94-2.37). Contact with police as a survivor of crime was most commonly recorded (7350 [9.2%]), but the strength of the association was greatest between emotional or behavioral problems and police contact as a person of interest (unadjusted HR, 4.75; 95% CI, 3.64-6.19). Incidence of police contact as a person of interest was high for children with a pervasive developmental risk profile (unadjusted HR, 13.80; 95% CI, 9.79-19.45).

CONCLUSIONS AND RELEVANCE

This study found an association of emerging emotional or behavioral problems and developmental vulnerabilities with increased risk of police contact for any reason among young children, suggesting that this well-known association in adults and adolescents can be identified at an earlier developmental stage. These findings support primary and secondary interventions to prevent police contact early in life and to target the earliest contacts with the criminal justice and educational systems.

Violence-related deaths among people released from incarceration: protocol for a systematic review

INTRODUCTION

Young people and adults released from incarceration have a risk of dying from violence that far exceeds that in the general population. Despite this, evidence regarding the incidence, elevated risk and predictive factors for violence-related deaths after release have not yet been synthesised. This information is important to inform the development of evidence-based approaches to effectively prevent deaths from violence in this population. This systematic review will synthesise the literature examining the crude mortality rates (CMRs), standardised mortality ratios (SMRs) and predictive factors for violence-related deaths among people released from incarceration.

METHODS AND ANALYSIS

We searched key electronic health, social science and criminology databases (MEDLINE, PubMed, PsycINFO, Scopus, Web of Science, CINCH, Criminal Justice Abstracts) for peer-reviewed cohort studies published in English on 14^th September 2020. Our primary outcome of interest is violence-related deaths occurring in the community following release from incarceration. We will not restrict study eligibility by year of publication or age of participants. The Methodological Standard for Epidemiological Research (MASTER) scale will be used to assess the quality of included studies. If there are sufficient studies and homogeneity between studies, we will conduct meta-analyses to calculate pooled estimates of CMRs, SMRs or predictive factors for violence-related deaths. If there is a sufficient number of included studies, meta-regression will be conducted to examine the influence of subgroups and methodological factors on the CMRs, SMRs or predictive factors. If the studies do not report sufficient data, or if there is substantial heterogeneity, findings will be presented in a narrative form.

ETHICS AND DISSEMINATION

This review is exempt from ethics approval as it will synthesise findings from published studies that have already obtained ethics approval. Our findings will be disseminated through a peer-reviewed journal article, and national and international conference and seminar presentations.

TRIAL REGISTRATION DETAILS

This study is registered with PROSPERO (CRD42020209422).

Psychiatric morbidity among adolescents and youth involved with the juvenile justice system in sub-Saharan Africa: Systematic scoping review of current studies and research gaps

The current body of knowledge on the prevalence rate of psychiatric morbidity among adolescents and youth within the juvenile justice system in sub-Saharan Africa is yet to be systematically synthesized.. Consequently, African literature in the field has remained obscure, out of consideration in global discourses around the subject.; and incoherent to policy-makers. The situation has also hampered the identification of and filling of regional research-gaps in the field. The aim of this study, therefore, was to conduct a systematic scoping review of available data on psychiatric morbidity among adolescents and youth within the juvenile justice system in sub-Saharan Africa. The search was conducted using PubMed/MEDLINE, Science Direct, EMBASE, CINAHL and Psych Info. Additional searches were done in Google Scholar and African Journal Online (AJOL) databases. Twenty-six studies from 21 different research projects were identified. More than two-thirds were conducted in Nigeria and published within the last decade. Similar to what has been established around the world, the prevalence rate of psychiatric disorder was often very high, with a range of 59.7% - 63.0% among respondents. Key strengths of identified studies included use of standardized clinician-administered instruments for assessment and exploration of a wide range of psychiatric disorders. The main weaknesses in the studies included male gender-bias, lack of normative comparison groups, emphasis on custodial settings with little data on non-custodial systems, and considerable length of time-lag between the points of incarceration and psychiatric evaluation among the samples studied.. The study concluded that a modest number of studies have been conducted on psychiatric morbidity among justice-involved adolescents in sub-Saharan Africa, but there are still significant research gaps which could be bridged in order to aid context-appropriate interventions.

The health of adolescents in detention: a global scoping review

Adolescents detained within the criminal justice system are affected by complex health problems, health-risk behaviours, and high rates of premature death. We did a global synthesis of the evidence regarding the health of this population. We searched Embase, PsycINFO, Education Resources Information Center, PubMed, Web of Science, CINCH, Global Health, the Cochrane Database of Systematic Reviews, the Campbell Library, the National Criminal Justice Reference System Abstract Database, and Google Scholar for peer-reviewed journal articles, including reviews, that reported the prevalence of at least one health outcome (physical, mental, sexual, infectious, and neurocognitive) in adolescents (aged <20 years) in detention, and were published between Jan 1, 1980, and June 30, 2018. The reference lists of published review articles were scrutinised for additional relevant publications. Two reviewers independently screened titles and abstracts, and three reviewed full texts of relevant articles. The protocol for this Review was registered with PROSPERO (CRD42016041392). 245 articles (204 primary research articles and 41 reviews) were included, with most primary research (183 [90%]) done in high-income countries. A high lifetime prevalence of health problems, risks, and conditions was reported in detained adolescents, including mental disorders (0–95%), substance use disorders (22–96%), self-harm (12–65%), neurodevelopmental disabilities (2–47%), infectious diseases (0–34%), and sexual and reproductive conditions (pregnant by age 19 years 20–37%; abnormal cervical screening test result 16%). Various physical and mental health problems and health-risk behaviours are more common among adolescents in detention than among their peers who have not been detained. As the social and structural drivers of poor health overlap somewhat with factors associated with exposure to the criminal justice system, strategies to address these factors could help to reduce both rates of adolescent detention and adolescent health inequalities. Improving the detection of mental and physical disorders, providing appropriate interventions during detention, and optimising transitional health care after release from detention could improve the health outcomes of these vulnerable young people.