Assessing the Mental Health/Offending Relationship Across Race/Ethnicity in a Sample of Serious Adolescent Offenders

• Author: Sarah El Sayed,Carol A. Schubert,Alex R. Piquero,Lindsay Pitzer,Nicole Leeper Piquero,Edward P. Mulvey
• DOI: 10.1177/0887403415575145
• Published date: 01 April 2016
• Date: 01 April 2016
• publishedBy: Sage Publications, Inc.

575145CJPXXX10.1177/0887403415575145Criminal Justice Policy ReviewEl Sayed et al.
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Criminal Justice Policy Review
2016, Vol. 27(3) 265 –301
Assessing the Mental Health/
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DOI: 10.1177/0887403415575145
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Race/Ethnicity in a Sample of
Serious Adolescent Offenders
Sarah El Sayed1, Alex R. Piquero1, Carol A. Schubert2,
Edward P. Mulvey2, Lindsay Pitzer2, and
Nicole Leeper Piquero1
Abstract
We examine the extent to which the relationship between mental health and substance
use problems and the risk of rearrest varies across race/ethnicity. Data from the
Pathways to Desistance, a longitudinal study of serious adolescent offenders, are used
to estimate the risk of rearrest over time. Results show that mental health (except
for substance use) does little, above and beyond traditional criminogenic risk markers
and control variables, to significantly increase or decrease the risk of rearrest, a
finding that was largely replicated across race/ethnicity. Some evidence emerged that
the mechanisms by which mental health/substance use disorders and criminogenic
risk interact to affect risk of rearrest operated differently across race/ethnic groups.
Mental health conditions may have some small relationship to rearrest, but this effect
is dwarfed by other more powerful risk factors such as antisocial history. Research is
needed assessing the conditions under which mental health is implicated in offending.
Keywords
mental health problems, substance abuse, recidivism, race/ethnicity, juveniles
The relationship between mental health and (juvenile) offending (Ostermann &
Matejkowski, 2014; Skeem, Manchak, & Peterson, 2011) has been of import to the
public, policy makers, and social scientists from a variety of disciplines for quite some
1University of Texas at Dallas, Richardson, USA
2University of Pittsburgh, PA, USA
Corresponding Author:
Alex R. Piquero, Program in Criminology, University of Texas at Dallas, 800 W. Campbell Rd., GR31,
Richardson, TX 75080-3021, USA.
Email: apiquero@utdallas.edu

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Criminal Justice Policy Review 27(3)
time (Elliott, Huizinga, & Menard, 1989; Greenwood, 2008; Grisso, 2008; Monahan,
1981). Of more significant concern has been the attention called to the proportion of
youths with mental health problems within juvenile facilities as these rates are vastly
disproportionate compared with youth in the general population (Abram et al., 2004;
Cauffman, 2004; Schubert, Mulvey, & Glasheen, 2011). And although much has been
learned regarding mental health issues among juvenile offenders (Grisso, 1999; Teplin,
Abram, McClelland, Dulcan, & Mericle, 2002; Wasserman, Ko, & McReynolds,
2004), there have been relatively few studies that have examined the implications of
mental health problems and long-term offending among adolescent offenders followed
into adulthood. Even less understudied has been the extent to which mental health
problems relate to offending in similar (or different) ways across race/ethnicity.
Accordingly, this article seeks to contribute much needed information regarding
race/ethnic variation in the longitudinal relationship between mental health problems
and offending in a sample of serious adolescent offenders followed from mid-adoles-
cence into early adulthood. Before we present the results of our analysis, we provide a
few summary remarks regarding the state of research on the mental health/offending
relationship in general as well as the lack of investigation across race/ethnicity.
Mental Health and Juvenile Offending
Many adolescents who stream through the juvenile justice system are burdened with a
mental health problem (Hoeve, McReynolds, Wasserman, & McMillan, 2013; Teplin
et al., 2002). For example, an evaluation of youth entering a Pennsylvania juvenile
detention facility determined that about 70% males and 81% females qualified for
having at least one mental health disorder (Cauffman, 2004). The reality is that youth
processed through the justice system are more likely to have at least one mental health
problem compared with those in the general population (Abram et al., 2004). Not sur-
prisingly, many studies have focused on the relationship between mental health issues
and negative life outcomes, such as juvenile offending (Peterson, Skeem, Kennealy,
Bray, & Zvonkovic, 2014; Schubert et al., 2011; Silver, Felson, & Vaneseltine, 2008;
Silver, Piquero, Jennings, Piquero, & Leiber, 2011; Teplin, Abram, McClelland, &
Dulcan, 2003). Studies have reported that youth with mental health problems are not
only at increased risk for offending in general (Copeland, Miller-Johnson, Keeler,
Angold, & Costello, 2007; Vander Stoep et al., 2000) but also tend to engage in more
serious offending in particular (Hoeve et al., 2013).
Importantly, some evidence suggests that there is variability within the larger spec-
trum of mental health problems that may be differentially related to specific forms of
offending. For example, Andrews and Bonta (2010) highlighted impulsivity, inatten-
tion, anger, and resentment as strong predictors of criminal recidivism. Schubert and
colleagues (2011) reported that for serious juvenile offenders, substance use disor-
ders are significantly related to antisocial activity and rearrest. Their findings are
supported by the literature that consistently reports a relationship between substance
use and delinquent acts (Farrington, 1989; Hoeve et al., 2013; Van Kammen, Loeber,
& Stouthamer-Loeber, 1991; Vaughn, Howard, Foster, Dayton, & Zelner, 2005).

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El Sayed et al.
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Furthermore, juveniles who experience comorbidity with other mental health ill-
nesses are at an even greater risk for antisocial activity (Copeland et al., 2007;
Schubert et al., 2011). Although these studies are informative, there remain several
gaps in the mental health/juvenile offending literature, including whether mental
health interacts with other specific risk factors to increase the likelihood of offending.
Furthermore, the relationship between mental health problems and offending needs to
be examined across race/ethnicity and in particular, among youth of color in the juve-
nile justice system (see Karnik et al., 2010; Rawal, Romansky, Jenuwine, & Lyons,
2004).
Mental Health and Juvenile Offending Across Race/
Ethnicity
There is little argument that, independently, race and mental health are two of the most
important issues in the juvenile justice system (Desai, Falzer, Chapman, & Borum,
2012). Yet, the relationship between them has not received much empirical scrutiny
(cf. Wierson & Forehand, 1995). This gap in the literature is important on many fronts,
but specifically because of the overrepresentation of minority youth in the juvenile
justice system (Desai et al., 2012; Leiber, 2002; Piquero, 2008; Piquero & Brame,
2008). Unfortunately, data constraints have precluded much race/ethnic-specific anal-
yses of the mental health/juvenile offending relationship. Moreover, as the following
will demonstrate, the few studies that do exist tend to report mixed results (Colins et
al., 2013; Colins et al., 2010; Desai et al., 2012; Langrehr, 2011; Rawal et al., 2004;
Vaughn et al., 2005; Vaughn, Wallace, Davis, Fernandes, & Howard, 2008). As an
example, Colins and colleagues (2013) utilized a sample of detained youth to examine
whether their self-reported mental health problems predicted violent and property
recidivism. The authors reported no race/ethnic difference in violent crime but found
variation with property crime recidivism. These findings speak to the significance of
focusing on race/ethnic differences as well as assessing potential variation across
crime types. Unfortunately, very few studies examine how race/ethnicity moderates
the relationship between mental health problems and offending (Colins et al., 2013;
Colins et al., 2010; Vaughn et al., 2005; Vaughn et al., 2008).
Some studies, for example, find a difference in mental health problems between
White and Black juvenile offenders. Langrehr (2011) reported that White juvenile
offenders were more likely to be diagnosed with internalizing disorders compared
with Black juvenile offenders, whereas Vaughn and colleagues (2008) concluded that
although Blacks are less likely to be diagnosed with a mental health problem com-
pared with Whites, they are more likely to report delinquency. These findings indicate
that there may be variance in mental health problems between Whites and Blacks, and
furthermore, that the different life experiences of each group can create altered paths
to criminal activity. It may not be the presence of mental health illnesses alone that
influence reoffending but other risk factors that are also present with the disorders,
such as substance-related disorders (e.g., Wilson & Wood, 2014).

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Criminal Justice Policy Review 27(3)
When studying the race/ethnicity-moderated relationship among samples of
detained juvenile offenders, the evidence is both scant and mixed. In one study, Desai
and colleagues (2012) found that although racial minorities were overrepresented in
detention facilities, they had significantly lower violence risk compared with Whites.
Furthermore, the overrepresentation of minorities was not explained by the presence
of a mental illness, suggesting that having mental disorders does not solely explain
why there are more minorities within...