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• W1581278045 abstract "No child shall be deprived of his or her liberty unlawfully or arbitrarily. The arrest, detention or imprisonment of a child shall be in conformity with the law and shall only be used as a measure of last resort and for the shortest appropriate period of time. Article 37, United Nations Convention on the Rights of the Child1 The National Inquiry into Children in Immigration Detention was carried out by the Australian Human Rights Commission (then called the Human Rights and Equal Opportunity Commission) in 2002. It received over 340 submissions and visited all immigration detention centres in Australia. The inquiry found that children in Australian immigration detention centres had suffered numerous repeated breaches of their human rights. Australia's immigration detention policy notably failed to protect the mental health of children, failed to provide adequate health care and education, and failed to protect unaccompanied children and those with disabilities.2 The lack of response to the Inquiry findings attracted massive adverse publicity, including from the Royal Australasian College of Physicians (RACP) who developed a policy ‘Towards better health for refugee children and young people in Australia and New Zealand’. In July 2008, the government announced that children would no longer be held in immigration detention centres (see http://www.immi.gov.au/media/fact-sheets/82detention.htm). Australia's record with her indigenous Aboriginal and Torres Strait Islander children is scarcely better. Indigenous children are over-represented in the Australian prison population. In a 2003 survey of young people in custody in New South Wales, 43% were indigenous, compared with some 2.5% of the overall population.3 Māori youth are also over-represented in New Zealand prisons. It is hardly surprising that incarcerated adolescents usually come from disadvantaged backgrounds, have high rates of mental health problems, of substance abuse, often suffered physical or sexual abuse, and often have a parent in custody.3 Incarcerated indigenous adults and adolescents have always had high rates of suicide. Any suicide in custody is unacceptable, but the rates in the indigenous population are an international scandal. A Royal Commission into Aboriginal deaths which reported in 1991 made 339 recommendations (see http://www.naa.gov.au/naaresources/Publications/research_guides/pdf/black_deaths.pdf). By 2009, the States and Territories had acted on between 27 and 52% of the recommendations. Rates of incarceration of Aboriginal people and the number of deaths in custody continued to rise, peaking in 1997, when over 100 died in police or prison custody. Rates fell from 1997 to 2006 but there were still 74 Aboriginal deaths in custody in 2007 (http://www.creativespirits.info/aboriginalculture/law/royal-commission-aboriginal-deaths-in-custody.html). The reasons for the high rates of indigenous suicide in prison are complex and multifactorial. However, the stress of separation from supports of family and friends probably plays a major role. The adverse effects of solitary confinement have long been known. Prisoners tried and found guilty by the Doge of Venice would cross the Bridge of Sighs (Ponte dei Sospiri) from the Doge's palace to the dungeons and remained in solitary confinement until they died. Almost all went mad. In 1842, Charles Dickens visited a Philadelphia prison called Cherry Hill, opened in 1830 and used by the Americans as an international showpiece for methods of prisoner isolation. Dickens denounced as inhumane the so-called Separate System (or Philadelphia Plan) of day and night solitary confinement, which he felt caused more harm to prisoners than other prison systems.4 Recently, Atul Gawande described graphically and perceptively how human beings are social creatures and how prisoners often report that depriving them of human interaction is more traumatic than torture.5 What can paediatricians do? We can advocate for children as forcefully as possible, whenever we feel they are at risk. The issue of children in detention centres was a shining example of successful advocacy. We should be equally vocal about the risks to incarcerated indigenous youth. Dr Andrew Kennedy is chairing an RACP working party on ‘The health and well-being of incarcerated adolescents’ and their report will emphasize the need for best practice adolescent health care of adolescents in custody with some uniformity across the region. Incarcerated juveniles acquire sexually transmitted disease and blood-borne virus infections at an alarming rate. Specifically, the working party could stress the pressing need for at least a trial of needle and syringe exchange programmes, which have been successful in adult prisons overseas but are rare in Australia, while no country has sanctioned them for juveniles in detention. Catching hepatitis C virus or human immunodeficiency virus infection is not part of a person's sentence. We should be vociferous in our opposition to privatisation of prisons,6 which started in the 1980s in the USA and has spread to the UK and Australia (http://www.parliament.nsw.gov.au/prod/parlment/publications.nsf/key/ResearchBp200403). The raison d'etre for private prisons is economy not quality, and private prisons do not provide the nurturing, health-promoting and rehabilitative environment needed to help imprisoned adolescents. Finally, although diversionary programs as alternatives to detention in remote communities in the Northern Territory show promise, there is little strong evidence of improved outcomes and we should all be thinking how we might improve the evidence base to encourage alternatives to detention of juveniles." @default.
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• W1581278045 date "2010-11-01" @default.
• W1581278045 modified "2023-10-04" @default.
• W1581278045 title "Man's inhumanity to children" @default.
• W1581278045 cites W4236587248 @default.
• W1581278045 doi "https://doi.org/10.1111/j.1440-1754.2010.01903.x" @default.
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