Youths with a parent in prison, juvenile justice history three times likely to get depression, PTSD than peers
Young adults with a childhood history of both personal involvement in the juvenile justice system as well as a parent in jail are nearly three times more likely to have depression or post-traumatic stress disorder (PTSD) compared to peers without any such experience. They are also nearly twice as likely to have anxiety compared to young adults without childhood exposure to the criminal justice system, says a new study.
“Exposure to both parental incarceration (imprisonment) and juvenile justice involvement was associated with a greater risk of depression, anxiety, and post-traumatic stress disorder,” says the study published in JAMA Network Open.
According to researchers, the findings suggest that exposure to the criminal justice system during childhood places individuals at risk of poor mental health outcomes in early adulthood.
“This is a particularly vulnerable and understudied population. Incarceration impacts families across generations and youth who had a parent in jail or prison more often find themselves in the juvenile justice system. Young adults with histories of both juvenile incarceration and parental incarceration as children had a strong association with poor mental health outcomes in young adulthood,” says lead author Nia Heard-Garris, a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago and Instructor of Pediatrics at Northwestern University Feinberg School of Medicine.
According to Dr. Heard-Garris, currently, parental incarceration is considered an adverse childhood experience, but juvenile justice involvement is not. “Given the increased risk for poor mental health outcomes we found in our study, perhaps we should also consider juvenile justice involvement an adverse childhood experience and start screening youth for any incarceration exposure during typical healthcare visits. This would allow us to further support vulnerable patients by connecting them with appropriate resources,” she says.
To examine the association between childhood history of incarceration (parental incarceration plus juvenile justice involvement) and mental health outcomes, the research team analyzed data from the National Longitudinal Study of Adolescent Health to Adult Health.
“Approximately 6.6 million individuals are under the supervision of the US adult correctional system. As a result, 5 million US children have had a resident parent incarcerated. Parental incarceration has long-term, negative health consequences that are independent of underlying racial/ethnic and socioeconomic disparities. Parental incarceration is also strongly associated with juvenile justice involvement. Youth affected by parental incarceration is estimated to be involved in the juvenile justice system at three times the rate of their peers without parental incarceration. In 2017, more than 800,000 US youth younger than 18 years were arrested,14 and 53,000 were held in correctional facilities. Juvenile justice involvement is independently associated with poor health outcomes into adulthood,” says the study.
The analysis included 12,379 participants, who were in grades 7 to 12 in 1994-1995 and who were 24 to 32 years old at follow-up in 2008. Of the participants, 1,247 had a childhood history of parental incarceration, 492 had juvenile justice involvement, and 141 had a childhood history of both parental incarceration and juvenile justice involvement. Black individuals accounted for over 33% of participants who reported both parental incarceration and juvenile justice involvement, and Latinx participants accounted for over 17%.
The study did not account for the nature of offenses contributing to parental incarceration or involvement in the juvenile justice system or the duration of childhood exposure to the criminal justice system.
The analysis shows that young adults with parental incarceration only had a higher prevalence of depression (23.7%), anxiety (18.5%), and suicidal thoughts (10%), whereas those with juvenile justice involvement only had the highest prevalence of PTSD (6.1%) and mental health counseling (14.3%). Individuals with parental incarceration plus juvenile justice involvement had a somewhat higher prevalence of suicide attempts (3%). Besides, 22.2% of young adults with parental incarceration plus juvenile justice involvement reported depression, and 12.4% reported receiving mental health counseling.
“With 22.2% of young adults with parental incarceration plus juvenile justice system reporting depression and 12.4% receiving mental health counseling, there still may be unmet mental health needs in this population. This may explain the higher odds of suicide attempts in the population exposed to juvenile justice involvement compared with the individuals without parental incarceration or juvenile justice involvement or JJI exposure,” says the study.
The analyses, says Dr. Heard-Garris, highlight that a history of both parental incarceration and juvenile justice involvement occurs for 1 out of every 100 US children overall and it is disproportionally more common among the youth of color.
The researchers say that while Black and Latinx individuals were more highly represented, they found that the group with dual exposure (parental incarceration and juvenile justice involvement) had higher odds of poor mental health outcomes that are independent of other factors, such as race or ethnicity, age, family structure, parental education, receipt of public assistance, and residence in the city, suburbs or rural areas. The researchers additionally found that a history of parental incarceration or juvenile justice involvement alone was also associated with worse mental health outcomes compared to peers without incarceration exposure.
“Our findings suggest that dual exposure (parental incarceration plus juvenile justice involvement ) in childhood is associated with increased risk of depression, anxiety, and PTSD in young adulthood. Although childhood exposure to both parental incarceration and juvenile justice involvement may not contribute to additional risk, there may be differential susceptibility to adverse mental health outcomes depending on the type of justice exposure experienced during childhood,” the findings state.
According to the research team, since individuals who experience parental incarceration and juvenile justice involvement during childhood have an increased risk of mental health concerns in adulthood, these associations suggest that policymakers should consider the multiple avenues through which children are affected by the criminal justice system and the “intergenerational health risks such contact perpetuates.” These findings also generate additional questions as to the timing or emergence of mental health conditions in this group, they add.
The researchers say clinical, advocacy, and policy efforts that prioritize reducing the impact of the US criminal justice system on children may yield substantive improvements in the mental well-being of those individuals.
“Future studies should evaluate whether pediatric screening for criminal justice-related exposures followed by early mental health interventions may mitigate some of the precursors for adult mental health conditions. In particular, integrating routine screening for parental incarceration and juvenile justice involvement within the typical healthcare visit for youth may reduce stigma. Screening can also allow healthcare professionals, who focus on children and young adults, to refer families for additional services for unmet needs, such as housing and food insecurity, which are known to disproportionately affect this justice-involved population and also may have implications for adult mental health,” the researchers recommend.