Abstract
Background: Adolescents involved with child protection and youth justice systems carry a greater burden of mental health problems, but little is known about how this risk differs by patterns of involvement, especially amongst Aboriginal children who are over-represented in these systems.
Objective: Describe patterns of child protection and youth justice involvement among Aboriginal and non-Aboriginal adolescents in the Northern Territory (NT) of Australia associated with a higher prevalence and incidence of mental health-related hospitalisations.
Method: A retrospective cohort study was developed using a whole-population repository of linked administrative data. The cohort consisted of 14,972 adolescents who turned 10 between 2004 and 2009, inclusive. Odds (OR) and incidence rate ratios (IRR), estimated using zero inflated negative binomial regression, were used to determine if there was a higher prevalence and incidence, respectively, of mental health-related hospitalisations associated with different levels of child protection and youth justice involvement.
Results: An increasing gradient of prevalence and incidence of mental health-related hospitalisations was observed with increasing levels of child protection and youth justice involvement. Adolescents who experienced out-of-home-care (OOHC) (OR = 12.06; 95 % CI = 5.64–25.53) and detention (OR = 11.82; 95 % CI = 3.06–45.15) experienced the highest prevalence of mental health-related hospitalisations. After adjustment, only OOHC was associated with a higher incidence of hospitalisations (IRR = 2.67; 95 % CI = 1.73–4.11). Substance misuse was the most common diagnosis among adolescents with child protection or youth justice involvement who were hospitalised.
Implications: The findings suggest adolescents with child protection and youth justice involvement are at greater risk of hospitalisation for mental health issues. Trauma-informed services in the child protection and youth justice systems require better coordination and integration to assess and respond to complex mental health issues, especially for those who have been placed in OOHC and/or detention. The over-representation of Aboriginal adolescents exposed to child protection, youth justice, and mental health-related hospital admissions reinforces the need for such services to also be culturally safe and responsive.
| Original language | English |
|---|---|
| Article number | 106771 |
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Children and Youth Services Review |
| Volume | 145 |
| DOIs | |
| Publication status | Published - Feb 2023 |
Bibliographical note
Funding Information:This work was supported by a grant provided by the NT Government Department of Territory Families, Housing and Communities and the Child and Youth Development Research Partnership (CYDRP) between the Menzies School of Health Research and the NT Government Departments of Health, Education, Territory Families, and Attorney General and Justice.
Funding Information:
We would like to thank members of the Child Youth and Development Research Partnership (CYDRP) Steering Committee for their support and oversight. We thank SA NT DataLink for their diligent work linking the individuals in the CYDRP repository as well as all data custodians for supplying the data that comprises the repository. The views expressed in this publication are those of the authors and not necessarily those of the government departments who have supplied the data and supported the study. Research data for this article. The study datasets contain sensitive personal information and are held on a secure cloud-based server with restricted access. Access requires the approval of the ethics committee and data custodians.
Publisher Copyright:
© 2022 Elsevier Ltd
