1. Introduction
Children may be deprived of liberty for a variety of reasons and, although these reasons
are often not explicitly related to their health status, it remains likely that those deprived
of liberty will be distinguished by a high burden of ill health. This is, in part, because the
social and structural drivers of deprivation of liberty overlap with the determinants of
health. For example, young people who use alcohol or other drugs may be at increased risk
of experiencing justice-related detention for offences related to the behavioural effects of
substance use (e.g., disinhibition, aggression), or in relation to criminal charges for drug
possession, use, or trafficking.1 Risky substance use in young people is also associated
with poor mental health, injury, and infectious disease related to both disinhibited
behaviour (e.g., unsafe sex) and injecting drug use.2 Therefore, one might expect children
and adolescents in justice-related detention to be at increased risk of poor mental health,
injury-related morbidity (including traumatic brain injury; TBI) and infectious disease.
Indeed, recent systematic reviews have documented a high prevalence of mental disorder3
and infectious disease4 among justice-involved young people, although to date there has
been no overarching review of their health status at the global level.
There is also good reason to suspect that children deprived of liberty for other reasons may
be at increased risk of poor health. Children in immigration detention often come from
settings distinguished by civil and political unrest, or war, and may experience inadequate
nutrition, limited access to appropriate healthcare, and/or exposure to environmental risk
factors for poor health. Experiences of trauma in their home country and/or during the
often arduous journey to immigration detention may have resulted in or compounded
mental health problems.5 Similarly, children held in detention in the context of armed
conflict or national security may have experienced significant trauma, and may have been
injured in conflict.6 In settings of civil unrest and armed conflict, disruption to healthcare
1
Matthew D. Phillips, ‘Assessing the Impact of Drug Use and Drug Selling on Violent Offending in a Panel of Delinquent Youth’, Journal
of Drug Issues, Vol. 42(3), 2012, pp. 298-316.
2 Dan I. Lubman, Leanne Hides, Murat Yücel & John W. Toumbourou, ‘Intervening early to reduce developmentally harmful substance
use among youth populations’, The Medical Journal of Australia, Vol. 187(7), 2007, pp. S22-26; Fiona M. Gore, Paul J. N. Bloem, George C.
Patton, Jane Ferguson, VéroniqueJoseph, Carolyn Coffey, Susan M. Sawyer & Colin D. Mathers, ‘Global burden of disease in young people
aged 10-24 years: a systematic analysis’, The Lancet, Vol. 377(9783), 2011. pp. 2093-2102.
3 Seena Fazel, Helen Doll & Niklas Långström, ‘Mental disorders among adolescents in juvenile detention and correctional facilities: a
systematic review and metaregression analysis of 25 surveys’, J Am Acad Child Adolesc Psychiatry, Vol. 47(9), 2008, pp. 1010-1019.
4 Stuart A. Kinner, Kathryn Snow, Andrea L. Wirtz, Frederick L. Altice, Chris Beyrer & Kate Dolan, ‘Age-specific global prevalence of
hepatitis B, hepatitis C, HIV and tuberculosis among incarcerated people: A systematic review’, Journal of Adolescent Health, Vol. 62(3),
2018, pp. S18-26.
5 Mina Fazel, Ruth V. Reed, Catherine Panter-Brick & Alan Stein, ‘Mental health of displaced and refugee children resettled in high-income
countries: risk and protective factors’, The Lancet, Vol. 379(9812), 2012, pp. 266-282; Annette A. M. Gerritsen, Inge Bramsen, Walter Devillé,
Loes H. M. van Willigen, Johannes E. Hovens & Henk M. van der Ploeg, ‘Physical and mental health of Afghan, Iranian and Somali asylum
seekers and refugees living in the Netherlands’, Social Psychiatry and Psychiatric Epidemiology, Vol. 41(1), 2006, pp. 18-26.
6 John Pearn, ‘Children and war’, Journal of Paediatrics and Child Health, Vol. 39(3), 2003, pp. 166-172.
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