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Position Statements
Health Services to Adolescents
in Adult Correctional Facilities
Background
Judicial and
correctional authorities have always been challenged with the
problem of adolescents committing crimes. Bolstered by
changing public attitudes toward adolescents accused of acts of
violent crime (i.e., murder, rape, drug offenses, robbery, and
aggravated assault), states are lowering the adult age limit
that allows adolescents to be tried and sentenced in adult
criminal court. The rise in the number of violent crimes
committed by adolescents, political pressures, and community
reaction have resulted in increased placement of adolescents in
adult correctional facilities. Incarcerating adolescents in
adult correctional facilities jeopardizes the long-standing
paradigm of protecting the innocence of youth by incarcerating
them separately from adults, maintaining their confidentiality,
providing them with specialized community-based services, and
ensuring that they participate in an individualized justice
system. Furthermore, incarcerating adolescents in adult
correctional facilities ignores the fact that the growth and
developmental changes that occur in adolescence are
substantially different from those that occur in adults. Adolescence is a period of rapid
physical, nutritional, cognitive, and social growth and
development. These changes are influenced by a variety of
factors including genetic, nutritional, environmental, family,
and social experiences. Adolescents are at an increased
risk for developing depressive symptoms and anxiety symptoms.
Associated with this can be an increased risk for
self-mutilating behavior, suicide attempts (National Coalition
of State Juvenile Justice Advisory Groups, 1993), psychotic
symptoms, and aggressive behaviors toward others. Confinement in any correctional facility can have a major impact
on the ultimate outcome on this developmental process. Adult facilities are not able to deal with these and other needs
of adolescents, and rarely are staff in adult facilities
trained or prepared to work with the problems unique to
adolescents. Juveniles in adult facilities are
five times more likely to be sexually assaulted, twice as likely
to be beaten by staff, and 50 percent more likely to be attacked
with a weapon than adolescents in a juvenile facility (Forst,
Fagan, & Scott, 1989). The same studies also indicate
a much lower rating of counseling programs’ efforts to improve
family relations and medical care in adult facilities.
Given these facts, it is imperative that correctional programs
caring for adolescents be designed specifically to meet their
needs. Position Statement
The National
Commission on Correctional Health Care believes the
incarceration of adolescents in adult correctional facilities is
detrimental to the health and developmental well-being of youth. The Commission realizes, nevertheless, that jurisdictions will
adjudicate youths as adults and incarcerate them in institutions
for adults. Therefore, due to the unique health service
needs presented by adolescents in adult correctional facilities,
the Commission recommends the following: Recommendations
- Adolescent health specialists,
including medical and mental health professionals, familiar
with correctional health care should be consulted in the
development of correctional policies and procedures dealing
with adolescent inmates.
- Correctional and health staff
who are responsible for the supervision and treatment of
adolescents should receive orientation and on-going training
regarding the unique health, developmental and educational
needs of youth.
- Facilities housing adolescents
should recognize their vulnerability in an adult setting.
Adolescents should be separated and provided opportunities
for appropriate peer interaction.
- There should be a mechanism
for referral to adolescent medical and mental health
specialists.
- The Commission advises that
the specific developmental and growth needs of an adolescent
population be addressed in a special needs treatment
planning process for inmates as described in the NCCHC jail
and prison standards on Special Needs Treatment Plans.
- Adolescent prisoners should
receive health care and health education in accordance with
the American Medical Association's Guidelines for Adolescent
Preventive Services
(GAPS). The NCCHC document,
Standards for Health Services in Juvenile Detention and
Confinement Facilities, provides guidelines that also will
be of assistance in this regard.
Adopted by the National
Commission on Correctional Health Care Board of Directors
May 17, 1998
References
American Medical Association. (1993). Guidelines for adolescent preventive services (GAPS).
Chicago, IL: Author. Forst, J., Fagan, J., &
Scott, B. T. (1989). Youth in prison and training
schools: Perceptions and consequences of the treatment-custody
dichotomy. Juvenile and Family Court Journal, 40, 1-4. National Coalition of State
Juvenile Justice Advisory Groups. (1993). Myths and
realities: Meeting the challenge of serious, violent, and
chronic juvenile offenders (1992 Annual Report). Washington, DC: Author. Office of Juvenile Justice and
Delinquency Prevention. (1997). Juvenile justice
reform initiatives in the states: 1994-1996. Washington,
DC: Author. Roush, D. W. (1996). Desktop Guide to good juvenile detention practice. Washington, DC: Office of Juvenile Justice and Delinquency
Prevention. United States Preventive Services
Task Force. (1989). Guide to clinical preventive
services. Baltimore: Williams & Wilkins.
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