What health inequalities are young offenders and care experienced young people more likely to experience?

We’re pleased to see that the Commission for Young Lives has been established to prevent “vulnerable” young people from reaching crisis. In this blog post, AYPH’s Rachael McKeown explains why addressing young people’s health needs is central to supporting them to succeed in life and should be included in the development of a national strategy to support young people. Here, we summarise at the specific health inequalities experienced young offenders and care experienced young people.

The Commission for Young Lives is an independent commission, established by the former Children’s Commissioner for England, Anne Longfield. The aim of the commission is to “put forward a new settlement of policy and practice to prevent crisis and support marginalised young people so they can succeed”.

In November 2021, the commission launched a “call for evidence” to hear from experts about why some groups of young people are more likely to face adversity and what suggestions there are for better supporting them. The commission plans to use the findings to develop a national strategy to help young people to succeed. We wanted to make sure our voice was included in the conversation.

We worked with our colleagues in the Young People’s Health Partnership (YPHP) to share our views on the health needs of young people. We focused our response on care experienced young people and young offenders, who are more likely to experience poorer health outcomes than their peers. Our research revealed worrying health inequalities for these groups of young people.

Health inequalities faced by young offenders:

  • Learning disabilities. Over a quarter of children and young people in the youth justice system have a learning disability (Bryan, 2004).
  • Mental health. Rates of mental health problems are three times higher for those in the criminal justice system compared to the general population (Leon, 2002). The rate of suicide in boys aged 15-17 who have been sentenced and remanded in custody is 18 times higher than the rate of suicide in boys in the general population (Fazel et al., 2005). The experience of criminality, legal issues and detention is often stressful and potentially traumatic, which can be associated with higher rates of mental illness (Balmer et al., 2015).
  • Health behaviours. 64% of young prisoners report having drank alcohol on a weekly or daily basis before entering custody (Lennox, 2014), compared to 23% of all 15 year olds reporting having drunk alcohol in the previous week (NHS Digital, 2019). Adopting risky health behaviours in adolescence can have long-term impacts on behaviour and health across their lives.

Health inequalities faced by care experienced young people:

  • 60% of children who are looked after in England are reported to have emotional and mental health problems (NICE, 2013).
  • For looked after children in 2020, 90% had completed their annual health assessment and 88% were up to date with their immunisations, although older males were less likely to be up to date with their immunisations (Department for Education, 2021).
  • Female care leavers are three times as likely to become teenage mothers than young women who haven’t been in care (PHE, 2018).
  • Into adulthood, there are higher rates of premature mortality for care leavers than the general population (Sacker, A. 2021).

What we would like to see included in a national strategy to prevent crisis for groups of “vulnerable” young people

We want to see young people’s health and wellbeing needs embedded into the Commission’s strategy. In order to achieve this, we made a number of specific recommendations, including: focusing on prevention and public health approaches, improved data on groups of young people, and increased accessibility of young people’s services.

Our response

You can read our full response to the commission’s call for evidence here.

At AYPH, we are particularly interested in young people’s experiences of health inequalities. Through our Health Inequalities Programme, we are working on increasing the evidence-base and developing resources to support the reduction of young people’s health inequalities.

References

Balmer, N., Pascoe, P. & Hagell, A. 2015. Health inequality and access to justice: Young people, mental health and legal issues. London: Youth Access.

Bryan K. 2004. ‘Preliminary study of the prevalence of speech and language difficulties in young offenders’, International Journal of Language and Communication Disorders, 39(3), pp.391–400.

Department for Education. 2021. Children looked after in England including adoptions.

Fazel, S., Benning, R. & Danesh, J. ‘Suicides in male prisoners in England and Wales, 1978–2003’, The Lancet, 366(9493), pp.1301–2.

Lennox, C. 2014. ‘The health needs of young people in prison’, British Medical Bulletin, 112(1), pp.17-25.

Leon, L. 2002. The Mental Health Needs of Young Offenders. London: The Mental Health Foundation.

NHS Digital. 2019. Smoking, drinking and drug use among young people: England 2018. London: NHS Digital.

National Institute for Health and Care Excellence. 2013. Looked-after children and young people. Quality standard [QS31]

Public Health England. 2018. Teenage pregnancy prevention framework. London: PHE.

Sacker, A. 2021. The lifelong health and wellbeing trajectories of people who have been in care: Findings from the Looked-after Children Grown up Project.

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