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While incarceration rates continue to soar in the Northern Territory, experts warn mental health reform in the justice system is crucial for improving community safety in the long term. Last week, mental health professionals, legal experts, Aboriginal organisations and youth justice advocates gathered in Alice Springs for a major symposium to discuss their concerns about inadequate mental health support and diversion for young people in the criminal justice system. NT forensic psychiatrist Sarah Dorrington works across the territory's prisons and says there is an urgent need for reform. "That includes things like serious mental illness, but also substance use disorder, depression, anxiety, PTSD [and] cognitive disability. "Whatever condition you can think of, people in custody have it." Dr Dorrington, the spokesperson for the Royal Australian and New Zealand College of Psychiatrists, said college members were seeing more adults and young people in custody with major mental disorders and disabilities. "We need to do something differently to help these people," she said. Recognising the context For many young people who end up in the criminal justice system, life has been far from easy. They often come from socio-economic disadvantage, according to the Australian Institute of Health and Welfare, experiencing a range of vulnerabilities from a young age, including maltreatment, neglect, parental substance abuse and homelessness. Dr Dorrington said it was about stopping young people from entering the criminal justice system through early intervention. "These kids don't just start offending when they're 10 or 11 out of nowhere," Dr Dorrington said. "They've generally been in contact with government agencies, sometimes from birth, and so it is about early intervention with evidence-based approaches that work." She wants to see existing programs that provide mental health and wellbeing support and diagnosis provided by Central Australian Aboriginal Congress expanded. "Kids in remote communities aren't able to access these assessments, and there is a very long wait list," Dr Dorrington said. "It's a fantastic program, but it needs to be boosted so that it can reach all the children and even the adults that need it." Cost of being far from home Earlier this year, young people held in Alice Springs Youth Detention Centre, which is being repurposed into a women's prison, were permanently moved to the Holtze Youth Detention Centre in Darwin, with advocates raising serious concerns about their wellbeing so far from home. Dr Dorrington said she remains worried for young people from central Australia being held in Holtze, who have to travel back and forth for their court dates. "They struggle with being off country, without having their language support, without having their family being able to visit them," Dr Dorrington said. "It makes what is already a challenging environment, especially for someone with a disability, even more challenging." What's missing? Without accurate data, it is hard to make good policy. Australian Medical Association NT president John Zorbas said it was hard to know what kind of funding was necessary to tackle the gaps in mental health support in the justice system because the data was not readily available. Dr Zorbas wants a joint funding model for mental health care provision in prisons, similar to how hospitals are funded. He said a "whole of system" approach was necessary to stop children with mental disorders from ending up in prison or reoffending in the future. "That makes this a whole government issue in the same way we approach domestic violence. "If I work as a doctor in a hospital, or if I'm a police officer, or if I'm a teacher in school, I'm a mandatory reporter of domestic violence … we need to take that approach with youth justice." Driving long-term change Right now, in the NT, mental health diversion programs are not an option for young people who come before the courts. Dr Dorrington wants this to change and to see legislative reform to the NT's mental health legislation too, but recognises it is "a big project". "If it's identified that they have a mental illness, instead of going through the punitive system, they can instead be diverted into treatment, whether that's in a hospital or whether that's in the community," Dr Dorrington said. "They can have mental health treatment that actually addresses the causes of crime for that person."
