Youth Justice and Health: An argument against proposed changes to the Youth Criminal Justice Act 1ADOLESCENT HEALTH COMMITTEE, CANADIAN PAEDIATRIC SOCIETY | POSITION STATEMENT Youth Justice and Health: An argument against proposed changes to the Youth Criminal Justice Act AS Elliott, DK Katzman; Canadian Paediatric Society Adolescent Health Committee Summary The Canadian Paediatric Society is deeply concerned about the negative effects on the developmental, psychological and emotional health of young offenders if the Youth Criminal Justice Act is amended as proposed [1]. Canada currently has a youth justice system that reflects the United Nations (UN) Convention on the Rights of the Child, and acknowledges that youth (under 18 years) have not developed full moral and ethical responsibilities and cog- nitive abilities to process criminal intent. Changing Canada's youth crime law to achieve stiffer sentences for youth 14 years and older convicted of serious violent offences such as mur- der or manslaughter has the potential for serious negative consequences. There are also implications associated with no longer allowing publication bans on cases involving youth who commit violent crimes. Evidence shows that treating adolescents as adults in the Canadian criminal justice system puts them at serious health and human rights risks—including trauma, violence and abuse—and interferes with their cognitive, emotional and psy- chological development [2][3]. Studies show that rates of de- pression, anxiety disorders, attention deficit/ hyperactivity disorder (ADHD) and substance abuse are higher among youth in custody than among youth in the general population [4][5]. Evidence suggests that transferring youth to adult facili- ties generally leads to more recidivism—including violent crime—compared with youth retained in the juvenile justice system. The adult justice system is neither designed nor equipped to address the developmental needs of adolescents, which creates dangerous gaps in services, education, and healthcare. Thus, such transfers can do more harm than good [6]. Canada has ratified the UN Convention on the Rights of the Child, which explicitly deals with child-specific needs and rights and requires states to act in the best interests of the child. According to Article 37, “Children who break the law should not be treated cruelly. They should not be put in prison with adults, should be able to keep in contact with their families, and should not be sentenced to death or life imprisonment without possibility of release.” International law binds countries like Canada to respect the Convention. Developmental differences Sensible and effective public policy around youth justice must reflect the fact that adolescents are different from adults. The current Youth Criminal Justice Act (YCJA), which is based in evidence, supports rehabilitation and reintegration. It recog- nizes that society shares a responsibility to guide them into adulthood and to address their developmental challenges and needs. Evidence from developmental research clarifies that adoles- cents, because of their immaturity, should not be deemed as culpable as adults [2]. Adolescent traits that mitigate culpabili- ty include diminished decision-making capacity, susceptibility of peer influence, and unformed character [3]. Emerging neu- ro-scientific research reveals that young people’s brains are not fully developed to allow for adult-level reasoning and weighing of consequences. Executive functions, including de- cision-making, consideration of alternatives, planning, setting long-range goals, and organization of sequential behaviour, are associated with the prefrontal cortex, which does not fully mature until well beyond age 18 [7]. Adolescents in custody also require both physical and mental health assessments, and guidelines for both short- and long- term placement—as described in the CPS statement on health care standards for youth in custodial facilities [5]—should be followed. It is estimated that 70% of incarcerated adolescents may suf- fer from a mental disorder [8]. The significant needs of so many youth for mental health services will not be met in an already strained adult justice system. 2 | YOUTH JUSTICE AND HEALTH: AN ARGUMENT AGAINST PROPOSED CHANGES TO THE YOUTH CRIMINAL JUSTICE ACT Juvenile vs. adult facilities There is also evidence that adolescents released from adult fa- cilities are more likely to re-offend than those sentenced to ju- venile facilities [3][6]. Social context is critical for youth to successfully reach devel- opmental milestones, to transition to adulthood, and to stop committing crimes [2]. Being placed in an adult facility may have long-term consequences on a youth’s emotional and psy- chosocial development. Adult facilities are traditionally based on punishment, and turn prisoners into adversaries. Rehabili- tation programs are sparse, and older prisoners may be men- tors in crime for younger offenders. On the other hand, juvenile facilities recognize that adoles- cents have developmental needs. The staff-to-offender ratio is greater, staff attitude more therapeutic, and more programs are available that lead to better outcomes, and reduced recidi- vism [2][9]. Deterrence and denunciation Among the proposed changes to the Youth Criminal Justice Act, deterrence and denunciation would be principles guid- ing the sentencing of young offenders. Additionally, anyone 14 years and older who is convicted of murder or another se- rious, violent crime would no longer remain anonymous. These concepts of deterrence and denunciation are not sup- ported by developmental theory. Adolescents lack “future ori- entation”: They tend to focus on the here and now and are less likely to think about future consequences. Because ado- lescents may discount risks and calculate rewards differently than adults, they cannot be held accountable to the same de- gree. Adolescents are more impulsive and tend to take more risks [2]. Scott et al found that “little evidence supports the claim that adolescents are deterred from criminal activity by the threat of harsh sanctions.”[2] The proposed measures to hold young offenders accountable to their victims and the larger community, and to ensure that violent or serious repeat offenders 14 years and over are tried as adults, are not based in evidence and have actually been shown to increase recidivism. The literature does not support these proposed changes, which may in fact lead to even worse outcomes for these youth [6]. Recommendations The Canadian Paediatric Society recommends the following: • The federal Youth Criminal Justice Act should not be amended as proposed. • International law binds Canada to respect the UN Con- vention on the Rights of the Child and explicitly states that children should not be put in prison with adults. Youth should only serve their sentence in a facility that is exclusively limited to youth. • The federal government should work with provincial/ter- ritorial governments to establish a national youth crime prevention strategy, including early detection and treat- ment of mental and behavioural health issues that might otherwise lead to criminal activity. • Youth convicted of a crime and incarcerated should be provided developmentally -appropriate mental and physi- cal health care, as well as rehabilitation and educational services, consistent with Canada’s commitment to the UN Convention of the Rights of the Child. • Health professionals—along with other youth-serving sec- tors including education and child protection services— should assume a more active role in advocating for youth in the criminal justice system. • Any future amendments to the Youth Criminal Justice Act must consider the rights of youth and their mental, physical, developmental, and educational needs. References 1. Minister of Justice, House of Commons Canada, Bill C-4, An Act to amend the Youth Criminal Justice Act and to make consequential and related amendments to other Acts. First Reading, March 16, 2010. 2. Scott ES, Steinberg L. Adolescent Development and the Regulation of Youth Crime. Project Muse. The Future of Children 2008;18:15-33. 3. Steinberg L. Introducing the Issue. Project Muse. The Fu- ture of Children 2008;18:3-14. 4. Canadian Institute for Health Information Improving the health of Canadians: Mental health, delinquency and crimi- nal activity. (Accessed May 19, 2011). 5. Frappier JY, Sacks D; Canadian Paediatric Society, Adoles- cent Health Committee. Health care standards for youth in custodial facilities. Paediatr Child Health 2005;10:287-9. 6. Hahn R, McGowan A, Liberman A, et al. Effects on Vio- lence of Laws and Policies Facilitating the Transfer of Youth from the Juvenile to Adult Justice System. A Report on Recommendations of the Task Force on Community Preventive Services. MMWR 2007;56:1-11. 7. Giedd JN. The teen brain: Insight from neuroimaging. J Adolesc Health 2008;42:335-43. 3ADOLESCENT HEALTH COMMITTEE, CANADIAN PAEDIATRIC SOCIETY | 8. Kutcher S, McDougall A. Problems with access to adoles- cent mental health care can lead to dealings with the crimi- nal justice system. Paediatr Child Health 2009;14:15-8. 9. Lipsey MW, Wilson DB, Cothern L. Effective Intervention for Serious Juvenile Offenders. U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention. Juve- nile Justice Bulletin. April 2000. ADOLESCENT HEALTH COMMITTEE Members: Franziska Baltzer MD; Johanne Harvey MD; De- bra K Katzman MD; Stan Lipnowski MD (board representa- tive); Jorge Pinzon MD (chair); Danielle Taddeo MD (2003-2009) Liaison: Margo Lane MD, CPS Adolescent Health Section Principal authors: April S. Elliott MD; Debra K Katzman MD Also available at www.cps.ca/en © Canadian Paediatric Society 2013 The Canadian Paediatric Society gives permission to print single copies of this document from our website. For permission to reprint or reproduce multiple copies, please see our copyright policy. Disclaimer: The recommendations in this position statement do not indicate an exclusive course of treatment or procedure to be followed. Variations, taking in- to account individual circumstances, may be appropriate. Internet addresses are current at time of publication.