Mental illness lingers years after juvenile detention, especially among whites

David Heitz

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We’ve known for a long time that a large percentage of incarcerated youths struggle with mental disorders and substance abuse problems.

But now we know the troubles continue upon release from the system, especially among whites. An original investigation into the matter appeared online Wednesday in JAMA Psychiatry, a publication of the Journal of the American Medical Association.

The research, conducted by Linda Teplin and colleagues from the Northwestern University Feinberg School of Medicine, followed up on 13 psychiatry conditions diagnosed among incarcerated youth.

The conditions included major depression, mania, dysthymia, hypomania, generalized anxiety disorder (GAD), panic disorder, posttraumatic stress disorder (PTSD), attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), antisocial personality disorder (ASPD), alcohol use disorder, and drug use disorder.

Study examined post-freedom mental health

“Focusing on sex and racial/ethnic differences, we examined the prevalence of psychiatric disorders, including patterns of comorbidity, and the continuity of psychiatric disorders over time,” the authors explained.

The study included more than 1,800 youths who were detained in a juvenile justice facility. Almost two-thirds of males and more than a third of females with an existing disorder still had a psychiatric disorder 15 years after their release. Substance use and behavioral disorders were more common among non-Hispanic White youths than Hispanic and Black youths.

“This study’s findings suggest that persistent psychiatric disorders may complicate the transition from adolescence to adulthood among youths who have been detained in a juvenile justice facility; the pediatric health community should advocate for early identification and treatment of disorders among this population,” the authors emphasized. “Previous studies have found that one-half to three-quarters of youths detained in juvenile justice facilities have one or more psychiatric disorders.”

The study participants all were part of the Cook County, Ill. (Chicago) juvenile justice system.

White males most likely to have substance abuse disorder

“Although prevalence and comorbidity of psychiatric disorders decreased as the 1,829 participants aged, 52.3 percent of males and 30.9 percent of females had at least one or more psychiatric disorders 15 years post-detention,” the study’s authors reported. “Among participants with a disorder at baseline, 64.3 percent of males and 34.8 percent of females had a disorder 15 years later. Compared with females, males had 3.37 times the odds of persisting with a psychiatric disorder 15 years after baseline.

“Compared with black participants and Hispanic participants, non-Hispanic white participants had 1.6 times the odds of behavioral disorders and greater than 1.3 times the odds of substance use disorders throughout the follow-up period. Behavioral disorders and substance use disorders were the most prevalent 15 years after detention.”

There were varying degrees of severity between the two sexes. “As they aged, males fared worse than females: 15 years after detention, more than half of males had a disorder compared with less than one-third of females,” the authors revealed. “Males had more than three times the odds of persisting with disorders 15 years after detention….”

As for the women?

“Females may fare better than males because they are more likely to have adolescent-limited trajectories of offending,” the authors explained. “Moreover, as they age, females are more likely to engage in prosocial activities and relationships and to seek and receive mental health services.”

Early detection, mental health treatment needed

Teplin et. al. said pediatric doctors should push for early detection and treatment of mental and substance abuse disorders within the juvenile justice system.

“This study’s findings suggest that persistent psychiatric disorders may complicate the transition from adolescence to adulthood, which is already challenging for youths involved in the juvenile justice system, many of whom are from racial/ethnic minority groups and low-income backgrounds,” the authors concluded.

Incarcerated youth have a much different adolescence than their free peers. “Involvement with the juvenile justice system may impede developmental trajectories by limiting youths’ opportunities to attain normative adult milestones, such as establishing careers, gaining economic and residential independence, and starting families,” the authors explained.

“For youths involved in the juvenile justice system, many of whom are from racial/ethnic minority groups and low-income backgrounds, transitioning from adolescence to young adulthood may be further complicated by psychiatric disorders, which are associated with negative psychosocial outcomes, especially if untreated.”

The sample included 1,172 men and 657 women. More than 1,000 were black (55 percent), 524 were Hispanic (29 percent), 296 were non-Hispanic white (16 percent), and four identified as other race/ethnicity. The median age was 15 years.

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I have been in the news business more than 30 years, spending much of my career at some of the best newspapers in the country. Today, I specialize in Denver local news, health reporting, social justice issues, addiction/recovery/mental health news, and topics surrounding homelessness and human trafficking.

Denver, CO
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