Justice health needs assessment
People who have contact with the criminal justice system often have worse health outcomes than the general population. Many face multiple disadvantages at once.
The justice health needs assessment (JHNA) gives an overview of the health and wellbeing needs of people in Birmingham who are:
- in contact with the criminal justice system
- at risk of entering it
- at risk of re-entering it
Key findings
The following key factors are linked to increased vulnerability to contact with the criminal justice system (CJS) and poorer health outcomes:
- adverse childhood experiences
- school exclusion
- experience of the care system
- economic insecurity and insecure housing
- learning disability
- neurodivergence
- mental health needs
- substance misuse
- physical health needs and disability
- veteran status
- demographic inequalities – including age, sex and ethnicity
Key priorities
The assessment identifies the following priorities to address the needs of people at risk of, or in contact with, the CJS:
- governance, data and accountability are not yet well developed and need clear system ownership
- justice health is a health inequalities issue that often starts in childhood and is shaped by place
- neurodivergence, learning disability and suspected foetal alcohol spectrum disorder (FASD) are under-recognised – physical health, disability, sensory needs and frailty also need consistent minimum standards
- gender-specific health and wellbeing needs, and the needs of groups such as older people, veterans, migrants and LGBTQ+ people, are not fully recognised or addressed
- mental health needs, self-harm and suicide risk are common
- housing, poverty, digital exclusion and unstable resettlement increase health risks and contribute to reoffending
What this means
The findings show that the criminal justice system cannot be treated as separate from other services. It is part of a wider system that includes a large number of different services.
There is a clear need for shared responsibility for justice health in Birmingham. This should be supported by:
- stronger governance
- better use of data
- more joined-up care pathways
- trauma-informed and neurodivergence-aware practice
- long-term action on the wider factors that affect health
The report makes recommendations with the aim of:
- reducing inequalities
- improving health outcomes
- strengthening prevention
- supporting safer and healthier communities
Read the justice health needs assessment.
Page last updated: 19 May 2026
