title: Complex health needs in the youth justice system: a survey of community-based and custodial offenders.
abstract: OBJECTIVE
  Estimate the prevalence and annual frequency of health risk indicators in young people serving community-based orders (CBOs) and custodial orders in the state of Victoria, Australia.
  
  
  METHODS
  Cross-sectional survey of 242 young people serving CBOs and 273 serving custodial orders in Victoria in 2002-2003. Validated measures included the Composite International Diagnostic Interview for substance dependence, Short Mood and Feelings Questionnaire for depression, and Psychosis Screening Questionnaire for psychosis symptoms. Prevalence estimates were adjusted for sampling bias and age- and sex-adjusted for between-group comparisons. Prevalence estimates were applied to 2010-2011 Victorian youth justice data to estimate annual frequencies at the state level.
  
  
  RESULTS
  The prevalence of substance dependence, poor mental health, and risky sexual behavior was high in both groups. Age- and sex-adjusted prevalence estimates were generally higher among those serving custodial orders; however, extrapolating prevalence estimates to statewide youth justice data generally resulted in higher estimated annual frequencies among CBOs. For example, the estimated prevalence of any substance dependence was 66% (95% confidence interval [CI], 60-72) in those serving custodial orders and 34% (95% CI, 26-42) in CBOs, but the estimated frequency of substance dependence in CBOs in 2010-2011 was 970 (95% CI, 750-1,180), compared with 490 (95% CI, 450-530) in those serving a custodial order.
  
  
  CONCLUSIONS
  There is a compelling case for scaling up health services for young offenders in custody and in the community, and for routinely monitoring the health of young offenders serving custodial and community orders.
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; School of Medicine, University of Queensland, Brisbane, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: s.kinner@unimelb.edu.au.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Kinner
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Coffey
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Sawyer
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Hearps
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Patton
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003153:Community Health Services / Q000458:organization & administration; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007604:Juvenile Delinquency / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014739:Victoria / Q000453:epidemiology
keywords: Adolescent; Detention; Drug dependence; Health services; Incarcerated; Juvenile justice; Mental health; Sexual health