Sleep supplement melatonin prescribed to almost half of youth detainees in South Australia
Young people at Kurlana Tapa Youth Justice Centre were given melatonin, SA Health data showed. (ABC News: Stephanie Richards)
In short:
SA Health data shows 44 per cent of children detained at Kurlana Tapa Youth Justice Centre were prescribed melatonin.
A watchdog previously reported youths at the centre were sleeping sitting upright or contacting night staff persistently.
What's next?
A spokesperson for the service providing healthcare to youth detainees says there is no health advice advising against the use of melatonin in young people.
Almost half of incarcerated children at South Australia's youth detention centre have been prescribed a supplement to help them fall asleep, amid concerns about "unusual" night-time behaviours.
SA Health data provided to ABC News shows as of November 1 this year, approximately 44 per cent of detained children were prescribed melatonin.
The prescription-only supplement is used to reset people's body clocks to help them sleep and wake at the right times.
Australia's Therapeutic Goods Administration (TGA) recommends that melatonin only be prescribed to children with certain diagnoses — including autism spectrum disorder or Smith-Magenis syndrome — who have trouble sleeping.
But SA Health has told ABC News there is "no health advice advising against the use of melatonin in young people" and the supplement can be prescribed off-label.
'Large proportion' of detained children on melatonin
The use of melatonin at the Kurlana Tapa Youth Justice Centre in Adelaide has been brought to the attention of a federal parliamentary inquiry examining Australia's youth justice system.
Kurlana Tapa is SA's only youth prison, housing children aged 10 and older who are sentenced or remanded to detention.
Kurlana Tapa is SA's only youth prison. (ABC News: Stephanie Richards)
In a submission to the inquiry, a South Australian nurse wrote that a "large proportion" of children at the centre were prescribed melatonin due to poor sleep.
"There are a multitude of cumulative long-term affects and a wide range of deleterious health consequences that have been associated with poor sleep and sleep hygiene," she wrote.
"An increased risk of mental health issues, hypertension, diabetes, obesity, heart attack and stroke, are some of these."
The nurse works at Metropolitan Youth Health, a SA Health-funded service which provides healthcare to children in detention.
She wrote that poor sleep during incarceration could be caused by a lack of exposure to natural sunlight, limited activities of physical exercise, increased stress and a change in normal environment.
"Incarceration is exceptionally detrimental to the health of young Australians," she wrote.
Children engaging in 'unusual behaviours' due to poor sleep
It is not the first time concerns have been publicly raised about poor sleep at Kurlana Tapa.
Shona Reid has previously raised concerns about poor sleep among SA's youth detainees. (ABC News: Guido Salazar)
SA's youth detention watchdog, Training Centre Visitor Shona Reid, last year reported that a "significant proportion of the population on any given day" were taking melatonin.
"When young people cannot sleep, restrictions on radio and TV mean they are not able to distract themselves," Ms Reid wrote in her 2022-23 annual report.
"This has resulted in unusual behaviours, including young people reportedly sleeping sitting upright and persistently contacting night staff via the intercom for interactions."
Ms Reid told ABC News that young people in detention "consistently" talked to her about difficulties maintaining regular sleep and exercise.
"I am aware of the common use of a number of prescribed medications for children and young people at the Adelaide Youth Training Centre," she said.
"It's essential to consider how conditions within the centre play an active part in children requiring or being prescribed such medications."
'Concerning' rate of prescriptions
SA Health does not collect data on the rate of melatonin prescriptions across the general population.
Australian Medical Association SA president and general practitioner Dr John Williams said it was "concerning" that almost half of youth detainees had been prescribed the supplement, saying conditions inside detention could be partly to blame.
"[Incarceration] takes [children] out of their families, takes them out of their communities, takes them away from their normal schools and all of those normal activities," he said.
"Also, they don't have the same ability to exercise, the same exposure to normal light, and also they are just under a huge amount of stress."
Dr John Williams says TGA has not recommended melatonin for neurotypical children. ( ABC News: Ashlin Blieschke)
A spokesperson from the Department for Human Services, which operates Kurlana Tapa, said young people at the centre had "structured routines each day", including regular education classes and programs, planned outdoor activities and access to a gym and swimming pool.
"Cultural activities are also held regularly in the gardens, and young people have regular visits from family and relatives," they said.
Limited evidence about melatonin's effect on children
Dr Williams said while melatonin was "on the more benign end of the spectrum as far as drugs go to help with sleep", he had never personally prescribed melatonin to children, due to a lack of research.
"It's not recommended by the TGA for [neurotypical] children," he said.
"I know that it is used by some doctors … in some situations with children [if the doctors] have that experience and expertise.
"As a GP, I wouldn't be prescribing [melatonin] without discussing it with someone like a paediatrician or a psychiatrist."
Professor Sarah Blunden says there is no data on melatonin use in "typically developing children". (ABC News: Stephanie Richards)
Clinical psychologist and paediatric sleep specialist, Professor Sarah Blunden, told ABC News there was limited data to show whether melatonin was effective at helping children who do not have autism spectrum disorder, attention deficit hyperactivity disorder (ADHD) or Smith-Magenis syndrome.
"There are no … studies on typically developing children to help us understand whether melatonin is, in fact, safe and efficacious for those children,"she said.
"I do think from the anecdotal evidence that we're all seeing … that melatonin is a good product and should be better studied so that we can actually find out whether this is going to be good for these children.
"My gut feeling says it is, but we don't have data to prove that and that's worrying."
Melatonin prescribed 'in conjunction with sleep advice'
In a statement to ABC News, Metropolitan Youth Health (MYH) said melatonin was a "well recognised, first-line form of sleep management".
Asked if MYH was following the TGA guidelines at Kurlana Tapa, the spokesperson said: "Off-label prescribing is very common when treating vulnerable and complex populations such as children, pregnant women and palliative patients".
"There is no health advice advising against the use of melatonin in young people," they said.
"While melatonin can be prescribed to children with autism spectrum disorder and Smith-Magenis syndrome, it can also be prescribed off-label.
"MYH doctors only provide short-term melatonin prescriptions and always in conjunction with sleep advice."
Latest data shows on an average day in 2022-23, 32 South Australian children were in detention.
Of those, more than 90 per cent were being held on remand, meaning they had not been sentenced to a period of detention or found guilty of the alleged criminal changes for which they were detained.