AAP: Incarcerate youths only as ‘last resort,’ especially during pandemic
In a revised policy statement and new guidance, the AAP recommended against incarcerating adolescents involved in the justice system in most cases, recommending that they be entered into community-based programs instead, especially during the COVID-19 pandemic.
“Incarceration of adolescents is a last resort and only for offenders who have committed serious crimes and cannot be safely placed in a community-based program,” Mikah C. Owen, MD, MPH, FAAP, clinical assistant professor at UC Davis Health in Sacramento, California, and colleagues wrote in the revised policy statement.
The policy statement “describes racial bias and overrepresentation of youth of color in the justice system, reviews the health and mental health status of justice-involved youth, and identifies advocacy opportunities for juvenile justice reform,” they wrote.
In separate guidance, the AAP made related recommendations specific to the pandemic, including that youths “who can be safely cared for in their home communities” be released from custody.
The AAP noted that COVID-19, “like other medical conditions rooted in the social and environmental determinants of health,” has disproportionately affected disenfranchised people.
According to the AAP, approximately 43,600 children under the age of 18 years are held in youth detention centers in the U.S. on any given day. COVID-19 has been detected at “alarmingly high rates” in U.S. detention settings.
Because of the pandemic, facilities have cut back on visitations and programs for incarcerated adolescents, leaving them more vulnerable, Owen said.
“These are kids and young people who for the vast majority of their lives have experienced significant trauma from a young age,” Owen told Healio.
In the statement, Owen and colleagues said pediatricians play a critical role when promoting the health and well-being of youths involved in the justice system.
“Even if you don't work in a detention facility, you may come across young people who are impacted by the justice system, and have opportunities to advocate for them,” Owen said.
Owen said social distancing in detention facilities may not be possible because of the size of the building, the amount of youths present and the type of place youths are being held.
“If you are going to do social distancing, what does that look like and if that ends up looking like practices that are very similar to isolation, all traits and findings suggest that can be pretty harmful to young people,” he said. “If that social distancing were to look like isolation in solitary confinement, then I think that it's important to make sure that young people can be released to make sure that they're not experiencing those kinds of conditions and experiences.”
In addition to recommending that facilities release any youths who can be safely cared for in their communities, the AAP said juvenile justice agencies should create transition plans for these youths “that ensure their basic needs, including health insurance coverage.” Among its other recommendations, it said juvenile justice agencies should develop a response plan for COVID-19 and ensure that youths and their families are notified of suspected and confirmed cases “in a timely manner.” – by Ken Downey Jr.
References:
AAP. Responding to the needs of youth involved with the justice system during COVID-19 pandemic. https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/responding-to-the-needs-of-youth-involved-with-the-justice-system--during-the-covid-19-pandemic/. Accessed May 18, 2020.
Owen MC, et al. Pediatrics. 2020;doi:10.1542/peds.2020-1755.
Disclosures: The authors report no relevant financial disclosures.
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