Paediatricians in the Northern Territory see the dire effects of entrenched structural racism on Aboriginal children on a daily basis.

The disadvantages are inarguably most profound for children and young people caught in a criminal justice system that emphasises adult punishments over age-appropriate support and rehabilitation.

Since the election of the Country Liberal Party government in the Territory almost one year ago, their “tough on crime” policies — initiated as the first order of business and vigorously upheld — have led to strikingly worsening dangers for children as young as 10 years old held in detention. This includes legislation (now passed as the NT Youth Justice Act) allowing the use of dogs to subdue children, plus reintroducing the use of spit hoods that are ”likened to torture” and “could result in death or permanent disability”.

In response, Selena Uibo, First Nations woman and Labor Opposition leader in the NT, has said, “Almost every one of these measures … spit hoods, dog control, mechanical restraints, were either explicitly condemned or ruled out by the [2017] Royal Commission… and the advice of experts."

The following letter from NT paediatricians was sent to the Northern Territory chief minister on 30 July. It is of profound relevance nationally.

Hon. Mrs Lia Finocchiaro MLA

Chief Minister of the Northern Territory

Darwin NT 0800

Chief.minister@nt.gov.au

30th July 2025

Dear Mrs Finocchiaro,

As paediatricians committed to safeguarding the well-being and health of children and protecting them from child abuse across the Northern Territory, we write to express our deep concern regarding the following:

1. **Reinstating the use of spit hoods in youth detention.**This poses a real and unacceptable risk of asphyxiation or other medical event which could result in death or permanent disability. Children in detention in the NT have a high burden of medical co-morbidities, including the highest rates of rheumatic heart disease in the world and chronic lung disease placing them at greater risk of harm. Spit hood use will also result in psychological harm amounting to child abuse, which will have significant acute and long term mental health effects on children who already have very high rates of psychiatric and cognitive disabilities. Spit hood use was banned following the Royal Commission into juvenile justice and child protection in the Northern Territory in 2017, has been likened to torture [and defined as such by the RANZCP], and has been implicated in prisoner deaths interstate. There is no justification for their use, and we are concerned they will only result in harm.
2. The inadequate access to comprehensive paediatric care including neurodevelopmental assessments for children in the justice system contravening the recommendations of peak paediatric organisations including the Royal Australian College of Physicians.
3. Removing the principal of detention as a last resort. This will result in increasing numbers of incarcerated children, thereby criminalising a significant proportion of adolescent Territorians, whose broad ranging disadvantage across the spectrum is already overrepresented.

Incarceration during childhood, a critical developmental period, disrupts cognitive growth, social learning, and emotional regulation. Children in detention are frequently victims of child abuse including exposure to domestic violence, neglect, and exposure to drug and alcohol abuse and have experienced poverty, neglect, homelessness, and significant periods in out of home care. Such adversity significantly impairs neurodevelopment; and many children in detention have a cognitive age and ability far younger than their chronological age.

We understand from neuroscience that adolescence is a developmental period which offers a window of opportunity to promote positive connections, to protect from harm and to provide safety, and to offer opportunities for learning and therapeutic care, which if sustained, will promote positive, longstanding neural pathways and behaviours. The converse occurs in detention, where there are extremely limited opportunities for children to learn improved behavioural patterns and to develop emotional regulation, due to the harsh punitive measures (where children are often treated as adults), and the high rates of undiagnosed mental health problems. As well as the high rates of mental illness, including self-harm, suicidal risk, and social adversity of children entering prison, incarceration itself further compounds mental illness, intensifies past and current traumas, and thereby exacerbates disability. Incarceration results in limited social and cultural supports and connections, and denies young people access to their families, as well as to cultural engagement and education, which is integral to identity forming and creating a sense of purpose or inclusion in community. Additionally, incarceration of children and adolescents is likely to result in high rates of emergency department and hospital presentations due to children presenting with injuries from assaults, self-harm, and psychiatric presentations including suicide risk. This will overburden the already stretched health care system and the workers who care for these children.

Through incarceration and the use of measures such as spit hoods, we are punishing our most vulnerable children rather than caring for and rehabilitating them. Evidence shows that incarceration exacerbates trauma and entrenches young people deeper in cycles of reoffending and antisocial behaviour. Incarceration results in diminishing alternatives and opportunities to integrate as healthy, functioning young people and adults in their Northern Territory communities. Incarceration will not make our communities safer.

Indigenous children are astonishingly over-represented in the justice system, incarcerated younger and are less likely to be offered appropriate diversional options than non-Indigenous children. The current youth justice system further entrenches systemic racism and inequality and violates Australia’s commitment to international human rights standards.

There is no evidence that criminalising a child’s behaviour deters an individual from offending; this in fact does the opposite and entrenches criminal behaviour for that young person and for their Northern Territory community. This will not make our communities safer.

We, as paediatricians, know that if young people who have experienced trauma have access to safety, protection from ongoing trauma, and trauma informed care with involvement of their families and community, they have a real prospect of thriving in, and contributing to our wonderful Territory.

We, the undersigned paediatricians strongly urge the Northern Territory Government to;

1. Permanently ban spit hoods from use in Youth Detention centres in the Northern Territory due to the significant risk of harm and death.
2. Provide early neurodevelopmental assessment and access to multidisciplinary health and education supports in detention as well as provide ongoing community access to care after the period of detention, to support the well being and development of young people, to enable stronger community connections and contribution.
3. Prioritise therapeutic, community-based diversionary alternatives which are grounded in culturally safe and trauma-informed approaches.

We respectfully request an urgent meeting to discuss these concerns and we look forward to your response and the opportunity to discuss how we can work together to uphold our mutual commitment to the health, protection and well-being of children in the Northern Territory, both now, and into the future.

Yours sincerely,

Dr Catherine Boyd BSc(Med), MBBS(Hons), PhD, FRACP

General Paediatrician

 

On behalf of Northern Territory Paediatricians:

Dr Paul Bauert OAM FAMA BSc MBBS FRACP, General Paediatrician

Dr Louise Woodward MBBS FRACP, General Paediatrician

Dr Sophie Dunn FRACP MD BBiomed

Dr Rosie Rock MBBS FRACP, General Paediatrician

Prof Peter S Morris MBBS FRACP PhD, General Paediatrician

Dr Sarah Watson BSc (Biomed), BMBS, FRACP PEM FACEM

Dr Fiona Kay MBBS FRACP, Community Paediatrician

Dr Jennifer Yan MBBS FRACP, General Paediatrician/Infectious Diseases Specialist

Dr Katherine Jarosz MBBS FRACP, General Paediatrician

Dr Nicholas Fancourt MBHL MBCHP FRACP PhD, General Paediatrician

Dr Kathryn Roberts MBBS BMedSci FRACP MPH&TM PhD, General Paediatrician

Dr James Dowler MBBS FRACP MPH, General Paediatrician

Dr Dhanusya Sivananthan MBBS FRACP General Paediatrician

Dr Anna Lithgow MBBS FRACP, General Paediatrician

Dr Louise Martin MBBS FRAB General Paediatrician

Dr Matt Scholar MBBS LLB FRACP General Paediatrician

Dr Nerida Moore BECon/BSocSC(Hons) BMed MIPH PhD FRACP General Paediatrician

Dr Josh Francis MBBS FRACP, General Paediatrician/Infectious Diseases Specialist

Dr Angela Titmus BSci(Med)(Hons) MBBS(Hons) MPH FRACP PhD, Paediatric Endocrinologist

Dr Te-Yu Hung MBBS FRACP, General Paediatrician/Infectious Diseases Specialist

Dr Lauren Adorni-Braccesi MBBS, FRACP General Paediatrician

Dr Nishani Nithianandan MBBS, BMedSc Paediatric Fellow

Dr Annabel Barton General Paediatrician FRACP MD

Dr Bianca Middleton MBBS FRACP MPH, Community Paediatrician

Dr Carolyn Marshall MBBS FRACP, General Paediatrician

Dr Zayna Adamu MBBCh(Hons) DipPaeds FRACP, General Paediatrician

Dr Joanne Clarke MBChB Senior Paediatric Registrar

Dr Patricia Ly FRACP MMBS General Paediatrician

Dr Julia Smith Paediatrician FRACP MD BBioMed

Dr Aodhamair Lenagh-Maguire MBBS Senior Paediatric Registrar

Dr Lara Clegg MD BSc Paediatric Registrar

Dr Rose Devereaux MBBS Senior Paediatric Registrar

Dr Ashley McCarthy, General Paediatrician

Dr Hilary Hardefeldt, General Paediatrician and Paediatric Cardiologist

Dr Erin Grace, General Paediatrician and Neonatologist

Dr Tina Abi Abdullah, General and Emergency Paediatrician and

Dr Jennifer Melvin, General Paediatrician

Dr Marissa LOH MD BSc MMed LTCL, Paediatric Registrar

Dr Andrew Wallace, Paediatric Advanced Trainee, MD, MPH, Paediatric Registrar

Dr Nadia Hassan MBBS, MPH, Paediatric Fellow

Dr Madeleine Batchelor MD MPH BBMED, Paediatric Registrar

Dr Jamie Hullick BBMS, MD, Paediatric Registrar

Dr Nashwa Saad, Paediatric Registrar

Dr Edward Justo, Paediatric Registrar

Related story: Is the Northern Territory Government knowingly endangering First Nations children and young people?

 

The views expressed in this article may or may not reflect those of Pearls and Irritations.