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Wednesday, 18 April 2018

Leading health professionals call for an end to solitary confinement in youth jails

Written by Sally Wardle

The solitary confinement of children and young people in the justice system should be abolished, leading medics have said.

In a joint plea to the Government, the British Medical Association (BMA), the Royal College of Psychiatrists and the Royal College of Paediatrics and Child Health (RCPCH) called for an end to the practice.

Isolating young people in a cell or room - often for more than 22 hours per day - poses a serious risk to their long-term psychiatric health and development, the organisations said.

They urged the Government to provide adequate resources and staff in youth jails to meet the needs of detained children without resorting to solitary confinement.

The joint statement reads: "In light of its potential to cause harm, and in the absence of compelling evidence for its use, we call for an end to the use of solitary confinement on children and young people detained in the youth justice system.

"Additionally, following the recent findings of the Chief Inspector of Prisons, which condemned the youth secure estate as not safe to hold children and young people, we urge the government to take immediate action.

"Until solitary confinement is completely abolished, the youth secure estate must ensure that the health needs of those in solitary confinement are met."

In updated guidance issued to doctors working in the youth justice system, the BMA said doctors "should not be involved" in declaring a child "fit" for solitary confinement.

"The BMA opposes the use of solitary confinement on children and young people and believes that the practice should be abolished," it states.

"Until this has been achieved, doctors have an important role to play in seeking to minimise the harm to which children or young people are exposed."

Dr John Chisholm, medical ethics committee chairman at the BMA, said: "Solitary confinement has no place in the youth secure estate and must be immediately replaced with alternatives which can better provide for young people's health and needs.

"Until this harmful practice is abolished, there is a duty for authorities to ensure the health of those being detained are met and doctors aren't obstructed in their ethical duty to put their patient's needs above others."

He added that multiple studies have indicated solitary confinement is "counter-productive" for the behaviour of young people, and increases the risk of suicide and self-harm.

"Doctors working in these institutions are acutely affected by the competing aims of the secure environment and healthcare, and it's at the heart of the difficulties our members report to use when working in close proximity to solitary confinement," he said.

Dr Alison Steele, child protection officer for the RCPCH, added: "This change in practice is essential and needs to be adopted with urgency but in the meantime, it is imperative we meet the health needs of all young people in secure settings.

"All health staff have a role to play and paediatricians in particular, must ensure all information relating to the young person's health, with appropriate consent, is supplied to those looking after them."

A Ministry of Justice spokeswoman said: "The safety and welfare of young people held in custody is one of our highest priorities.

"When young people in custody are putting themselves or others at risk, segregation can be used as a last resort for limited periods of time when no other form of intervention is suitable.

"We are recruiting more than 100 new frontline YOI staff across the estate, to help support the rehabilitation of young offenders."

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