Incarcerating Youth With Mental Health Problems

AuthorClair White
Published date01 October 2016
DOI10.1177/1541204015609965
Date01 October 2016
Subject MatterArticles
Article
Incarcerating Youth With
Mental Health Problems:
A Focus on the Intersection
of Race, Ethnicity, and
Mental Illness
Clair White
1
Abstract
Mental health problems among youth in the juvenile justice system are of particular concern given
their high prevalence rate. The current study applies attribution theory and focal concerns to
examine how mental health problems influence the judicial decision to commit youth to con-
finement. Furthermore, the study examines whether the effect of mental health problems is
conditioned by race and ethnicity, hypothesizing that minorities with mental health problems will
be treated more severely than Whites with mental health problems. Using administrative court
records from Maricopa County, AZ (n¼5,501), findings reveal that mental health problems
increased the likelihood of confinement, and this effect was moderated by race. Implications for
theory and policy are discussed.
Keywords
juvenile justice, mental health, race/ethnicity, court outcomes
Introduction
The juvenile justice system is often faced with the challenge of responding to youth who suffer from
mental health problems. Studies have demonstrated that a large proportion of youth processed
through the juvenile justice system suffer from mental health problems (Fazel, Doll, & Langstrom,
2008; Garland et al., 2001; Shufelt & Cocozza, 2006; Teplin, Abram, McClelland, Dulcan, &
Mericle, 2002; Teplin et al., 2006; Vincent, Grisso, Terry, & Banks, 2008; Wasserman,McReynolds,
Lucas, Fisher,& Santos, 2002). The high rates of mental health disorders among youth in the juvenile
justice system, compared to the general public, suggest detention centers and correctional facilities
for youth are serving as surrogate mental health hospitals (Cocozza & Skowyra, 2000; also see
1
George Mason University, Fairfax, VA, USA
Corresponding Author:
Clair White, George Mason University, 4400 University Drive, MS 6D12, Fairfax, VA 22030, USA.
Email: cwhite28@gmu.edu
Youth Violence and JuvenileJustice
2016, Vol. 14(4) 426-447
ªThe Author(s) 2015
Reprints and permission:
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DOI: 10.1177/1541204015609965
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Wilson, 2013). Furthermore, certain individuals are more likely to have unmet mental health needs
and have their needs met through the juvenile justice system, rather than the mental health system
(Cohen et al., 1990; Lyons, Baerger, Quigley, Joel, & Griffin, 2001; Rawal, Romansky, Jenuwine, &
Lyons, 2004; Rosenblatt, Rosenblatt, & Biggs, 2000; Stoep, Evans, & Taub, 1997; Thomas &
Stubbe, 1996).
An extensive amount of research has examined legal and extralegal factors, particularly racial
disparities, in decisions to process youth in the juvenile justice system, but little research has
explored the role of mental health problems (Cappon & Vander Laenen, 2013; Cauffman et al.,
2007; Leiber, Johnson, Fox, & Lacks, 2007). More specifically, research has found minorities are
treated more severely in the juvenile justice decision-making process leading to a disproportionate
number of minorities in the system (Kempf-Leonard, 2007; Piquero, 2008). Minorities with mental
health disorders also tend to have higher rates of unmet needs (Rawal et al., 2004); therefore, it is
important to understand how the juvenile justice system responds to these youth.
We rely on juvenile court data from an urban jurisdiction in Arizona to examine the role of mental
health problems in the disposition outcome to commit youth to a juvenile correctional facility and
the extent to which the effect of mental health problems differs by the race or ethnicity. Attribution
theory (Albonetti, 1991) and the focal concerns perspective (Steffensmeier, Ulmer, & Kramer, 1998)
provide a framework to assess the relevancy of factors, such as race/ethnicity or mental health, in the
processing of offenders and court outcomes. Although the current study does not provide a direct test
of these theories, attribution theory and focal concerns provide a framework to understand decision
making in the justice system.
The disposition outcome to commit youth to a correctional institution versus community super-
vision is examined because it has implications for the juvenile justice system’s obligation to provide
treatment and the extent to which the juvenile justice system ensures services are completed (Grisso,
2004). Specifically, the juvenile justice system is more responsible for providing treatment services
to a youth in correctional confinement and is better able to monitor the progress of the treatment.
Finally, youth with mental health disorders who are committed to correctional confinement may
be perceived as more dangerous than those who receive community supervision.
Background
Youth and Mental Health Problems
A substantial body of research has assessed the prevalence of mental health disorders among youth
in the juvenile justice system, particularly detention. Research has generally found consistent esti-
mates that 65–70%of youth in the juvenile justice system have at least one mental health disorder
(Fazel et al., 2008; Garland et al., 2001; Shufelt & Cocozza, 2006; Teplin et al., 2002, 2006; Vincent
et al., 2008; Wasserman et al., 2002). This can be compared to a prevalence rate of 20%for the gen-
eral public of adolescents with mental health problems (Kazdin, 2000). In a more recent review,
Shufelt and Cocozza (2006) found that 70.4%of youth in 29 programs met criteria for at least one
mental health disorder and 79%of those had two or more diagnoses. In addition, roughly one in five
youth in the juvenile justice system suffer from a serious mental health disorder, and the rate of men-
tal health disorders among youth remains about 60%even after conduct disorder is removed of pre-
valence rates (Cocozza & Skowyra, 2000).
In regard to differences across demographic groups, females in the juvenile justice system tend to
have higher rates of mental health disorders (Shufelt & Cocozza, 2006; Teplin et al., 2002; Vincent
et al., 2008; Wasserman, McReynolds, Ko, Katz, & Carpenter, 2005), and rates of mental health dis-
orders tend to be higher among White juveniles (Teplin et al., 2002). Few research studies have been
designed to compare rates of mental health disorders across racial/ethnic groups in the juvenile
White 427

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