Deaths in young people involved in the youth justice system (YJ-Mort) study
Professor Stuart Kinner
Young Australians who come into contact with the youth justice system are a profoundly marginalised population with greatly reduced chances for life and health. Young Indigenous Australians are over-represented in this system by a factor of 17. The aim of this study is to better understand the incidence, timing, causes, context and risk factors for preventable death in young people who come into contact with the youth justice system.
Using data linkage, the records of all youth justice clients in Queensland (1993-2014) have been linked with adult correctional records, the National Death Index and the National Coroners Information System. We have estimated crude mortality rates and standardised mortality ratios for all causes and specific causes (suicide, drug overdose and external injury) in the full cohort and in important subgroups (e.g., Indigenous vs. non-Indigenous). We have identified risk and protective factors for death in the cohort, including testing for a dose-response relationship between youth detention, adult incarceration and mortality risk. For unnatural deaths occurring from 2001-2014, we have abstracted detailed information on key health morbidities, precipitating factors and system contacts in the weeks preceding death from the National Coronial Information System.
Analyses of these data are focussing on key targets for prevention, including potential system-level reforms to improve identification and management of those at greatest risk. In the last year of the project we will convene a Delphi (expert consensus) panel to consider the merits of a suite of proposed preventive interventions and policy reforms.
Despite evidence of profound marginalisation, complex health problems and a markedly increased risk of preventable death in young offenders, this is the first study, globally, to rigorously and comprehensively examine mortality outcomes in young offenders.
The aims of the project are to:
- Describe the incidence, timing, causes, context and risk factors for mortality in young Indigenous and non-Indigenous people who had contact with the youth justice system in Queensland from 1 July 1993 to 30 June 2014.
- Inform targeted prevention and policy reform by identifying key psychosocial risk factors, health morbidities, precipitating factors and service contacts in those who have died, through detailed interrogation of coronial records held by the National Coroners Information System.
- Identify specific interventions and policy reforms that have the potential to reduce mortality in young people involved in the youth justice system, by combining the findings from Aims 1 and 2 with a systematic review and Delphi panel (consensus) approach involving key stakeholders from government, non-government and community-controlled health sectors.