title: Health as a mediator of change in the trajectory of young people in contact with the criminal justice system.
abstract: Health care services in Juvenile Detention Centres have historically been provided by the criminal justice system. These health services have focused on assessment and treatment of presenting health problems and have been hampered by the lack of clinical algorithms and standardised protocols expected of health run services. There is now comprehensive information on the health needs and prevalence of ill health, both physical and mental, for the population of adolescents in contact with the criminal justice system. This information has led to a greater understanding of the causative relationship between disadvantage, trauma, ill health and behaviour judged to be criminal as well an understanding of the need for a population health approach to underpin intervention. Young people in contact with the criminal justice system in New South Wales were found to come from disadvantaged backgrounds, have significant physical and mental health problems as well as increased risk behaviours and their associated health sequelae. This prevalence data can be used to plan service delivery and shape a model of delivery. Paradoxically incarceration offers an opportunity to target high prevalence health presentations and to screen for emerging physical and mental health problems. The potential to ameliorate life long conditions that impact on personal quality of life, and personal and system economic costs are of importance. There is the potential for some health interventions, such as mental illness and drug and alcohol to have an impact on the trajectory and lethality of recidivist behaviour. More research is required to examine health interventions with the potential to positively impact on long-term health outcomes as well as re-offending.
authors.affiliation: Adolescent Health Justice Health, Matraville, NSW, Australia. cathrine.lynch@justicehealth.nsw.gov.au
authors.forename: Cathrine
authors.initials: C
authors.lastname: Lynch
authors.forename: Richard
authors.initials: R
authors.lastname: Matthews
authors.forename: Robyn
authors.initials: R
authors.lastname: Rosina
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D000328:Adult; D000367:Age Factors; D003153:Community Health Services; D003415:Crime / Q000517:prevention & control*; D003416:Criminal Law; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders; D009517:New South Wales; D011329:Prisoners; D011330:Prisons; D012307:Risk Factors; D012309:Risk-Taking; D012931:Social Environment