How do youth with emotional
and substance use problems
fare in the juvenile justice
system?
Objective
„
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To use a national sample of adolescents to
investigate the association between emotional
and substance use problems during adolescence
and involvement with the juvenile justice system
Focus on three types of involvement:
Alison Evans Cuellar, PhD
Mailman School of Public Health
Columbia University
New York, New York
„
Pinka Chatterji, PhD
Center for Multicultural Mental Health Research
Cambridge Health Alliance – Harvard Medical School
Somerville, MA
„
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Arrests before age 18
Convictions in juvenile court before age 18 (among
those arrested before age 18)
Detainment before age 18 (among those convicted
before age 18)
Motivation
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„
Ample evidence that youth with emotional and
substance use disorders are overover-represented in the
juvenile justice system
Can be explained by:
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„
„
Background
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„
Youth with emotional and substance use problems are more
likely to commit crimes or more likely to commit more serious
crimes
Youth with emotional and substance use problems are more
likely to be sanctioned conditional on committing a particular
crime
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Methods
J: Juvenile justice outcome
MH: Mental health measure
X: Observed personal characteristics
u: Unobserved personal characteristics
Past studies generally do not control for demographic characteristics
characteristics
and do not have a community control group
„
„
61% of males and 70% of females met DSM diagnostic criteria for any
mental disorder other than conduct disorder
17% of males and 21% of females met criteria for ADHD
19% of males and 28% of females met criteria for any affective disorder
disorder
51% of males and 47% of females met criteria for substance use disorder
disorder
J = b0 + b1 MH + b2 X + u + e
Previous work generally is based on small and specialized samples
samples –
typically, detained or incarcerated youth – which represent a
relatively small subsub-set of all youth involved in the justice system
„
In large, random sample of arrested and detained youth in Cook
County, IL (Teplin
(Teplin et al, 2002):
„
Public policy concern that the justice system is biased
against youth with these problems – but there have
been few systematic empirical tests of this claim
Use of the National Longitudinal Study of Adolescent Health (Add
Health) builds on work based on more specialized and smaller
samples
High prevalence of emotional disorders (other than conduct
disorder) among youth in the juvenile justice system relative to
youth in the community
„
Contribution of this Study
„
Adults with mental disorders are more likely to be arrested and
serve longer prison sentences than adults without mental illness
(Teplin,
Teplin, 1984; Ditton,
Ditton, 1999)
„
„
Control for many potential correlates of emotional/substance use
problems and juvenile justice involvement
Longitudinal data
Capture youth with subsub-threshold disorders and earlier or more limited
involvement with the juvenile justice system
„
Primarily interested in estimating b1
Standard estimation methods such as OLS can lead to biased estimates:
estimates:
„ if a problem of reverse causality exists (e.g. juvenile justice outcome
affects mental health) – although problem is limited by measurement of
MH at two points in time during adolescence
„ if unobserved characteristics (u) exist that influence both mental
mental health
and juvenile justice outcomes (e.g. u is correlated with J and MH)
MH)
Because of data limitations, we cannot address both of these issues
issues
directly. We address the problem of unobserved characteristics by using a
rich data source to proxy u to the extent possible.
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