The physical and mental health of young people in detention: A global scoping review

Introduction: Adolescents detained within the criminal justice system are distinguished by complex health problems, health risk behaviours, and high rates of premature death. We undertook a global synthesis of the evidence regarding the health of this population.

Theory/Methods: We searched Embase, PsycINFO, ERIC, 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 that a) reported the prevalence of at least one health outcome in adolescents (aged <20 years) in detention, and b) were published between January 1980 and June 2018. Reference lists of published review articles were scrutinised for additional relevant publications.

Results: 231 articles (194 primary research, 37 reviews) were included, with most primary research (173; 89%) conducted in high-income countries. A high prevalence of health problems and risks was reported in detained adolescents including mental (3%-72%) and substance use disorders (37%-62%), suicidal behaviour (4%-43%), learning difficulties (10%-32%), infectious diseases (0%-25%), and sexual and reproductive conditions (pregnant by age 19 years: 20%-37%; abnormal cervical screening test result: 16%).

Discussion/Conclusions: Adolescents in detention are distinguished by poor physical and mental health. Complex co-morbidity requiring integrated care pathways is normative in this population.

Lessons learned: As many causes of poor health are strongly linked to contact with the criminal justice system, strategies to address these factors could reduce both rates of adolescent detention and adolescent health inequalities.

Limitations: Most evidence comes from high-income countries, despite most of the world’s adolescents living in low-to-middle-income countries.

Suggestions for future research: Improving the screening and detection of mental and physical disorders, providing appropriate interventions during detention, and optimising transitional health care following release from detention will maximise the health outcomes of these vulnerable adolescents.