Complex early childhood experiences: Characteristics of Northern Territory children across health, education and child protection data

Mental health disorders, adverse childhood experiences and accelerated reoffending among justice-involved youth in Australia: A longitudinal recurrent event analysis

BACKGROUND

Mental health disorders and adverse childhood experiences (ACEs) are known risk factors for youth offending. However, most studies operationalize these factors as static and fail to distinguish between isolated reoffences and escalating patterns of criminal behaviour. The impact of mental health service engagement on interrupting cyclical, repetitive offending also remains unclear.

METHODS

We linked offending records (1994-2022) and mental health records (2001-2022) for 1556 justice-involved youth in New South Wales, Australia. The Prentice, Williams, and Peterson Gap Time model with time-varying effects was used to identify factors associated with accelerated reoffending during a five-year follow-up.

RESULTS

The median age at first conviction was 15 years for custody-supervised youth and 16 years for community-supervised youth. Among custody-supervised youth aged 14 to 17, the prevalence of ACEs, mental health disorders, and their co-occurrence were 69.6 %, 33.9 %, and 26.5 %, respectively, compared to 42.5 %, 30.8 %, and 14.8 % for community-supervised youth. Recurrent offences occurred in 64.8 % of custody-supervised youth and 52.1 % of community-supervised youth. Age, physical neglect, substance use disorders, and personality disorders demonstrated time-varying effects on reoffending risk. Additional risk factors included physical abuse, parental death, anxiety disorders, mood disorders, and previous incarceration. Mental health service contact was associated with reduced reoffending risk.

CONCLUSIONS

This study demonstrates the dynamic nature of criminogenic risk factors and the protective effect of mental health service engagement. Youth justice policymakers should prioritize regular mental health assessments and improved access to interventions for justice-involved youth to reduce recurrent offending and enhance public safety.

Associations between adverse childhood experiences and health service utilisation, prescription claims, and school performance during adolescence

Adverse childhood experiences (ACEs) can affect childhood development, often leading to detrimental outcomes in adolescence and adulthood. This study examined the characteristics of young people who experience ACEs, and the association between ACEs in childhood and health service use, prescription claims, and educational achievement in adolescence. This study utilised the Longitudinal Study of Australian Children (LSAC) Kindergarten Cohort, with biennial surveys from age 4 regarding health, social, and family domains. ACEs exposure during childhood (4-11 years) were centred on household dysfunction, including parental separation, parental substance abuse, parental mental illness, or domestic violence. LSAC survey data was linked to administrative health service and education data, which were used to determine number of health service claims, prescription claims, health service costs, and poor educational achievement during adolescence (12-19 years). Around 62% of the cohort experienced ≥1 ACE during childhood. Young people experiencing ACEs had higher odds of poor mental health and lower odds of a physical health condition in adolescence, however, ACEs were not associated with total health service claims, total prescription claims, or total health service costs in the same period. Exposure to one ACE compared to no ACEs resulted in higher odds of poor numeracy in Grade 7, and poor numeracy and poor reading achievement in Grade 9. There was inconsistent evidence of a dose-response relationship between ACEs and poor educational achievement. In this study, the association between ACEs and educational achievement, but not health service outcomes in adolescence may be due to accessibility factors. Future interventions could integrate health and social care services to better support families affected by ACEs.

Population attributable fractions of depression and anxiety among Aboriginal and Torres Strait Islander peoples: a population-based study

Background

Aboriginal and Torres Strait Islander peoples face an increased risk of common mental disorders, which may be associated with underlying socio-economic challenges, racism, and discrimination. This is the first study to calculate the population attributable fractions (PAFs) for depression and anxiety attributed to potentially modifiable risk factors such as health behaviour, social and cultural characteristics, and past adverse events among Aboriginal and Torres Strait Islander peoples aged ≥15 years.

Methods

This cross-sectional study examined the 2018-19 National Aboriginal and Torres Strait Islander Health Survey conducted by the Australian Bureau of Statistics. Logistic regression models were used to compute odds ratios (ORs). PAFs adjusted for communality were calculated using adjusted ORs and prevalence estimates for each risk factor.

Findings

This study included a weighted sample of 5362 individuals, with a mean age of 40.8 years (SD = ±17.2). Personal income below the national average (PAF = 13.4%; 95% CI: 12.4, 14.5), severed access to Indigenous cultural affiliations (PAF = 12.8%; 95% CI: 11.8, 13.8), central obesity (PAF = 7.2%; 95% CI: 6.4, 8.0), daily smoking (PAF = 5.9%; 95% CI: 5.2, 6.7) and severed access to Indigenous knowledge (PAF = 5.2%; 95% CI: 4.5, 5.8) were associated with 45% of depression cases. Personal income below the national average (PAF = 10.7%; 95% CI: 9.8, 11.7), limited access to Aboriginal Community Controlled Health Services (PAF = 10.6%; 95% CI: 9.7, 11.6), central obesity (PAF = 7.1%; 95% CI: 6.3, 7.9), severed access to Indigenous knowledge (PAF = 5.7%; 95% CI: 4.9, 6.4) and the experience of discrimination in the last 12 months (PAF = 4.7%; 95% CI: 4.0, 5.3) were associated with 39% of anxiety cases.

Interpretation

To reduce the burden of depression and anxiety disorder among Aboriginal and Torres Strait Islander peoples, addressing socio-economic and cultural harms that constrain healthy connections to people/kin, their rights, languages, land, and healthy food sources should be a priority.

Funding

This work was funded by a grant from the Commonwealth of Australia, represented by the Department of Health and Aged Care (Grant Activity 4-DGEJZ1O/4-CW7UT14).