South Australia's youth justice system is struggling to "deliver care in a setting designed for control," with outdated infrastructure, workforce shortages, and poor coordination of care undermining rehabilitation for some of the state's most vulnerable children.

A joint inspection of the Adelaide Youth Training Centre (AYTC), conducted by Training Centre Visitor, Shona Reid and Deputy Chief Psychiatrist Associate Professor Melanie Turner, found the facility was failing to meet the therapeutic and rehabilitation needs of children and young people in detention. Both have called for urgent reform.

While acknowledging the commitment of many staff, the report concluded the current system is not meeting the complex developmental, emotional, and psychological needs of children in custody.

"What we found is not a lack of intent, but a system struggling to deliver care in a setting designed for control," Ms Reid said.

"Real rehabilitation demands more than secure walls - it demands consistent care, continuity of relationships, and spaces that restore hope."

The inspection uncovered several key issues, including:

- Poor coordination of health care, with workforce shortages and unclear referral pathways delaying essential screenings.

- Use of prone restraint, a dangerous and banned practice in child mental health settings.

- Frequent disruption to education and therapeutic programs due to staff shortages.

- Outdated, institutional facilities that are harsh and retraumatising.

- Limited cultural safety and inclusion for Aboriginal children, including inadequate interpreter and culturally appropriate support.

"Children and young people within the AYTC are among our most vulnerable people in the state," Dr Turner said. "Being dislocated from family and kinship supports, we need to be aware that these are children who need the best input to assist them in their lives."

The report highlighted when children showed signs of distress, they were often locked in their rooms, searched, or ignored, rather than provided specialist care.

"I used drugs and alcohol on the outside, and when I'd get locked up, I'd be withdrawing," one young person said. "I don't think they got that, or what that does to you. I hope that's better now."

Another added, "The hardest thing was the strip searches."

Dr Turner said many staff recognised the high needs of children in their care, many of whom have experienced trauma and live with disabilities.

"Moving toward robust trauma-informed approaches and a focus on rehabilitation is what is needed to help these children exit, and not return, to the justice system," the Noongar woman said.

Although South Australia has one of the lowest youth detention rates nationally, Aboriginal and Torres Strait Islander young people remain incarcerated at more than 17 times the rate of non-Indigenous youth.

The report also raised concerns about the prolonged or repeated use of isolation and segregation, including for children with psychosocial disabilities.

Ms Reid's earlier inquiry this year found young people were often confined for long periods without the practice being formally recorded as isolation, obscuring the true extent of the issue. The number of recorded isolations - both staff-ordered and self-requested - rose by 50 per cent in 2024.

"In effect, the experience of the child is isolation, but administratively, it's not labelled that," the Eastern Arrernte woman told National Indigenous Times.

"When we isolate children, it stops them going to school; when we isolate children, it stops them getting their mental health and needs met; when we isolate them, rehabilitation programs can't be accessed. It's shaming - children feel quite embarrassed. They're quite fearful. And it dehumanises them."

She argued the state has a duty to provide more than containment.

"Real rehabilitation demands more than secure walls - it demands consistent care, continuity of relationships, and spaces that restore hope," she said.

"When children are detained, our collective responsibility is to help them heal and rebuild, not to harden them. What we see inside youth detention should remind us that punitive approaches - whether through the justice system or new legislative responses - do not prevent reoffending; they entrench it."

The report calls for urgent action, including the creation of a 24/7 multidisciplinary health team, a reform of behaviour management practices, redesign of facilities to reflect trauma-informed principles, and stronger accountability and oversight mechanisms.

"If we want safer communities, we must invest in evidence-based rehabilitation and cultural, educational, and mental health supports, not simply harsher laws," Ms Reid said.