Mental Health for Adults Who Experienced the Criminal Justice System During Childhood

September 24, 2019

Link to Research Article

Article Citation

Heard-Garris N, Sacotte KA, Winkelman TNA, et al. Association of Childhood History of Parental Incarceration and Juvenile Justice Involvement with Mental Health in Early Adulthood. JAMA Network Open. 2019;2(9):e1910465. doi: 10.1001/Jamanetworkopen.2019.10465.

PRN Podcast Episode 3

It all started with conversation between pediatricians and a question. "How often are we asking our (patient) families about incarceration?" PRN sits down with lead author Nia Heard-Garris, MD, MSc, to discuss the motivation behind the reserach, the surprising scope of justice involvement for kids, and how physicians can approach this topic in their work. Listen to the latest PRN Podcast here.  

First Dose

Parental incarceration (PI) and juvenile justice involvement (JJI) during childhood are independently associated with mental illness during young adulthood. In this study, the authors used a national dataset (Add Health) to understand how often youth experience PI and JJI, and whether the combined experience is also associated with mental health concerns. Overall, 1.2% of youth who were 15 years old in 1994-95 experienced both PI and JJI. Adjusted for sociodemographic factors, young adults with a history of PI and JJI were significantly more likely to have a diagnosis of depression (adjusted odds ratio 2.80; 95% CI 1.60-4.90), anxiety (1.89; 1.03-3.31), and posttraumatic stress disorder (2.92; 1.09-7.82).

Key Points to Remember

  • Approximately 5 million US children have experienced PI. In 2017, more than 800,000 youth <18 years old were arrested and 53,000 were held in correctional settings.

  • While PI is recognized formally as an adverse childhood experience associated with higher risks of adult physical and mental health morbidity, JJI is not, although JJI and PI are known to be strongly associated.

  • In this study of 13,083 participants followed from age 15 to 28 years, 9.1% experienced PI during childhood, 5.2% experienced PI after age 18 years, 4.5% had JJI exposure only, and 1.2% experienced PI and JJI under age 18.

  • PI and JJI were disproportionately frequent among non-Hispanic Black youth.

  • Among young adults with PI and JJI exposure, 22.2% had been diagnosed with depression, 13.5% with anxiety, 9.0% with suicidal thoughts, 5.6% with posttraumatic stress disorder, and 3.0% with a suicide attempt.

  • Compared with PI only and JJI only, combined exposure to PI and JJI was associated with similarly high risks of mental health concerns, rather than being additive.

Summary Author

Matthew M. Davis, MD, MAPP

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