A new study shows that youth arrested as juveniles with psychiatric
disorders that remain untreated, struggle with mental health and successful
outcomes well beyond adolescence.
Research from Northwestern Medicine shows nearly two-thirds of males and
more than one-third of females with one or more existing psychiatric
disorders when they entered detention, still had a disorder 15 years later.
The findings are significant because mental health struggles add to the
existing racial, ethnic and economic disparities as well as academic
challenges from missed school, making a successful transition to adulthood
harder to attain.
"Kids get into trouble during adolescence.Those from wealthier families also
use drugs and get into fights. But these situations are most often handled
informally by the school and parent, and don't culminate in arrest and
detention," said lead author Linda Teplin, Owen L. Coon Professor of
psychiatry and behavioral sciences at Northwestern University Feinberg
School of Medicine.
"These are not necessarily bad kids, but they have many strikes against
them. Physical abuse, sexual abuse and neglect are common. These experiences
can precipitate depression. Incarceration should be the last resort," said
Teplin, also a faculty associate with the University's Institute for Policy
Research.
The unprecedented longitudinal study reports on the prevalence, persistence
and patterns of behavioral and psychiatric disorders in youth up to 15 years
after they leave detention and whether outcomes vary by sex and
race/ethnicity.
Key findings show that despite a decrease in disorders over time, especially
among females, the prevalence of psychiatric disorders 15 years later was
still substantially higher than the general population.
Males fared significantly worse overall. Among youth with a disorder in
detention, 64.3% of males and 34.8% of females had one or more disorders 15
years later. Compared with females, males had more than three times the odds
of persisting with a psychiatric disorder over time.
"This may be because females, as they age, became more family-focused.
Positive social connections - having a stable partner, raising children,
establishing a family - are conducive to positive mental health," said study
co-author Karen Abram, professor of psychiatry and behavioral sciences at
Feinberg School of Medicine and associate director of the Program in Health
Disparities and Public Policy.
Fifteen years after youth left detention, disruptive behavior and substance
abuse disorders were the most common. Non-Hispanic whites had 1.6 times
greater odds of having behavioral disorders and more than 1.3 times greater
odds of having substance use disorders throughout the follow-up period
compared with African Americans and Hispanics.
"An unanticipated finding of the study was the lower rate of substance use
disorders in racial/ethnic minorities, despite the disproportionate
incarceration of these groups," Teplin said.
"Clearly, we must expand mental health services during detention and when
these youth return to their communities. We must also encourage
pediatricians and educators to advocate for early identification and
treatment of psychiatric disorders," Teplin said. "Unfortunately, in the
U.S., school systems are funded by local governments. Thus, our children may
be sentenced to a life of inequity because of their zip code."
"Prevalence, Comorbidity, and Continuity of Psychiatric Disorders in
Delinquent Youth After Detention: A 15-Year Prospective Longitudinal Study,"
will publish in JAMA Pediatrics at 11 a.m. EST, April 5, 2021.
In addition to Teplin and Abram, Northwestern co-authors include Lauren M.
Potthoff, David A. Aaby, Leah J. Welty and Mina K. Dulcan.
About the Northwestern Juvenile Project:
Seeing a gap in the research literature about the health needs and outcomes
of juvenile justice youth, the Northwestern Juvenile Project, a Northwestern
Medicine initiative, has been interviewing a randomly selected sample of
1,800 youth since the mid-1990s.
To date, the study has compiled epidemiological data from 16,372
face-to-face interviews, conducted from a median age of 15 at detention
through the median age of 31. The researchers assess 13 psychiatric
disorders and track the prevalence, patterns of multiple disorders and the
continuity of disorders over time. The study also focuses on gender and
racial/ethnic differences.
Project data has been used to analyze health issues, including firearm
violence, mortality, drug abuse and HIV/AIDS risk behaviors. Project data
also found that few participants achieved positive outcomes in adulthood,
such as finishing high school or finding steady employment.
Reference:
"Prevalence, Comorbidity, and Continuity of Psychiatric Disorders in
Delinquent Youth After Detention: A 15-Year Prospective Longitudinal Study,"
JAMA Pediatrics (2021).