Dr Emaediong Akpanekpo1, Prof Tony Butler1
1School of Population Health, UNSW Sydney, New South Wales, Australia, Australia
Biography:
Public Health Physician and Fellow of the Royal Society of Public Health (FRSPH) enrolled in a PhD programme at the School of Population Health, University of New South Wales (UNSW). Research focuses on health and justice outcomes for youth in the New South Wales criminal justice system. Career spans 8+ years in population health and epidemiology, addressing health disparities in vulnerable populations. Previously held key roles including Clinical Data Lead at 54Gene, leading national-level execution and advising on data strategy during the Covid-19 pandemic. Research interests include social determinants of health and youth mental health.
Abstract:
Background: Justice-involved adolescents have a higher risk of psychiatric disorders and mortality than their non-justice involved peers.
Objectives: We estimated incidence rates of psychiatric disorders and mortality rates after initial contact with the justice system, compared mortality rates between those with and without incident psychiatric disorders, and identified demographic factors associated with these outcomes.
Methods: Data from 1,556 adolescents in New South Wales, Australia were linked to several NSW data collections (1994 – 2022) including Reoffending Database (ROD), Admitted Patients Data Collection (APDC), Mental Health Ambulatory Data (MH-AMB) and the Registry of Births, Deaths and Marriages (RBDM). Adolescents with mental disorders at baseline (n = 152) were excluded from the analyses.
Results: The median age at baseline was 15 years. Psychiatric disorders were diagnosed in 42.7% of the cohort, with an incidence rate of 3.42 disorders per 100 person-years. The overall mortality rate was 0.20 per 100 person-years. Individuals with psychiatric disorders experienced higher mortality rates compared to those without (0.28 vs 0.14 per 100 person-years). Female sex (aHR 1.66, 95% CI: 1.32 – 2.09) and socioeconomic disadvantage (aHR 1.09, 95% CI: 1.01 – 1.18) were associated with increased risk of diagnosis. Conversely, a decreased risk (aHR 0.92, 95% CI: 0.88 – 0.97) was observed with increasing age. Indigenous adolescents had a higher risk of death following a psychiatric disorder diagnosis (aHR 3.57, 95% CI: 1.72 – 7.44).
Conclusion: Early mental health screening, culturally appropriate interventions, and ongoing support are necessary for adolescents involved in the criminal justice system.