Health professionals should do more to prevent children ending up in custody, BMA says

BMJ 2014; 349 doi: (Published 04 November 2014) Cite this as: BMJ 2014;349:g6619
  1. Jacqui Wise
  1. 1London

Vulnerable children and teenagers are continually let down by health and social care services, and it is inevitable that many end up in the criminal justice system, warns the British Medical Association.

Its new report, Young Lives Behind Bars, says that many young people in custody come from chaotic backgrounds and are often the victims of violence, abuse, or neglect.1 It recommends that health professionals carry out early screening and identification of risk factors such as mental health problems, including postnatal depression, and substance misuse among parents and other carers.

In the 12 months to March 2013 2780 people aged under 18 were placed in custody in England and Wales. The average length of time spent in custody was 85 days. The report says that 24% of boys and 49% of girls aged between 15 and 18 in custody have been in care. Three quarters have lived with someone other than a parent, and 40% were homeless in the six months before entering custody.

The report highlights the fact that around 60% of children in custody have significant speech, language, or learning difficulties, 25-30% are learning disabled, and up to 50% have some form of learning difficulty. More than a third of children in custody had been given a diagnosis of a mental health disorder.

The report recommends that commissioners should develop high quality mental health services for those in youth custody as a key priority, because of the high rates of mental illness, suicide, and self harm among young offenders.

John Chisholm, chair of the BMA’s medical ethics committee, said, “Many of these young people come from chaotic home lives, often characterised by violence, abuse, or neglect, and are not thriving socially, emotionally, or physically.

“Long before they reach detention they are among the most vulnerable individuals in our society and have been continually let down by the individuals and agencies whose job it is to care for them and support them.”

He added, “Despite their high level of need, inadequacies in the systems that these children pass through sadly mean that they often fall between the cracks, and time spent in custody becomes an almost inevitable consequence.”


Cite this as: BMJ 2014;349:g6619


View Abstract

Sign in

Log in through your institution

Free trial

Register for a free trial to to receive unlimited access to all content on for 14 days.
Sign up for a free trial