Children's behavior is impacted by genetic, social and environmental factors. In 2002, more than 110,000 youths dwelled daily in juvenile detention and correctional facilities across the U.S. and, among them, more than two-thirds had a diagnosable mental disorder and approximately 20 percent had a serious mental health disorder (NCMHJJ, 2005). Research shows that many of these offenders experience psychosocial and educational problems (Brown, Borduin and Henggeler, 2001), psychological trauma including depression, post-traumatic stress disorder, anxiety, anger, dissociation, severe personality disorders emerging in childhood and sexual problems (Avinger and Jones, 2007; Spilsbury et al., 2007; Vizard et al., 2004). Other research findings demonstrate that nearly two-thirds of boys and three-fourths of girls in juvenile detention have at least one psychiatric disorder, illustrating how common these problems are among detained youths (Ankarsater et al., 2007; Teplin et al., 2002). More studies analyzing youths' offending behavior and describing their unmet needs for mental health services would contribute to a better understanding of their conditions and temper the increasing public support for more stringent laws regarding indictment, conviction and incarceration of juveniles (Deitch et al., 2009; Ghetti and Redlich, 2001). Additionally, in-depth studies using psychological reports focusing specifically on this particular population are needed. The gap in the literature can be attributed to difficulties related to sampling, data collection and access to the incarcerated offenders. It may also be due to researchers' inclination to study other phenomena such as gang membership and substance, physical or sexual abuse experienced by offenders diagnosed with mental health and behavior disorders. The current study contributes in-depth information on the personal, social, psychological and psychiatric characteristics as well as the family structure and functioning of this particular subset of juvenile offenders.
Researchers agree that no single risk factor leads children to delinquency. It is reported that being a witness to or victim of community violence is associated with criminal behavior as well as a variety of behavioral, emotional and cognitive-functioning problems (Eitle and Turner, 2002; Scarpa, 2001; Spilsbury et al., 2007). Also, disruptions to parenting and family processes might contribute to juvenile delinquency (Gainer et al., 2007; Radosh, 2002; Smith and Farrington, 2004; Stewart et al., 2002). Other findings suggest that the concentration of offenders in families and family criminality could be used to predict boys' delinquency (Farrington et al., 2001). The incarceration of both parents, particularly that of the mother, leads to parenting disruption. Radosh (2002) reported that in 1999, there were about 87,000 women incarcerated in the U.S. and estimates indicated that 80 percent of them had dependent children at the time of incarceration. In 1999, there were at least 126,100 children with jailed mothers and many more had fathers in prison (Radosh, 2002). Parents' incarceration affects children as it deprives them of the emotional attachment and supervision they need. Children subjected to inadequate supervision and discipline are likely to manifest anti-social behavior and affiliate with deviant peers (Nesbitt, Lombe and Linsey, 2007; Stewart et al., 2002).
Farrington et al. (2001) and Smith and Farrington (2004) studied continuities in anti-social behavior and parenting across family generations: concentration of offenders in families; family criminality in the prediction of boys' delinquency; and the extent to which criminal relatives predict a boy's delinquency. Their findings suggest that the number of arrested individuals in a family is a predictor of a boy's delinquency; there are intergenerational continuities in anti-social behavior (Smith and Farrington, 2004); and that both a father's and mother's convictions were significantly related to having a child with a high level of disruptive behaviors.
A linkage between the effects of child abuse and violence among adolescents has been established as well (Benda and Corwyn 2002; Farmer and Pollock, 2003; Moses, 1999). In a sample of sexually abused and sexually abusing children, Farmer and Pollock (2003) found that half of the sexually abused youths had sexually abused another child at some stage. The consequential damages of the abuse may be so pervasive that adult sexual abuse survivors report that recovery is possible but healing is not (Anderson and Hiersteiner, 2008). Other research findings link alcohol or illicit drug use with juvenile offending behaviors (Bergen et al., 2004); Brecklin and Ullman, 2001; Kingree and Phan, 2002). Welte, Zhang and Wieczorek (2001) found that there is a causal relationship between substance use and criminal offending behavior.
Studies suggest that violent adolescent offenders' problems should be viewed in holistic terms (Dembo and Schmeidler, 2003) because youths are on one hand influenced by distal contextual risk factors such as community, school violence, family disruptions, physical abuse, sexual abuse, neglect and substance abuse; and on the other hand by proximal risk factors such as lack of supervision, the multiple consequences of abuse and the youths' levels of emotional disturbance and intellectual and functioning abilities. These distal and proximal risk factors are cumulative and interactive as they operate in several areas (Wasserman et al., 2002). Determining which yield the most consequential damage to children would contribute to a more effective early identification of children at risk for delinquency and prompt early and efficient professional intervention (Farrington, 2005; Lay et al., 2005).
Recognizing the dearth of in-depth information on adolescent offenders exhibiting mental health symptoms and violent behaviors, this study examines detailed psychological and social information on a sample of juvenile offenders being considered for a diversion program.
Procedures, program and participants. This research is a secondary analysis using data collected from full psychological evaluation reports of 88 juvenile offenders who were being considered for entrance into a Northeast Ohio diversion/treatment program for violent offenders with mental health problems. This pilot treatment program was part of a statewide grant to provide treatment-based diversion services to youths with histories of violent offenses who were thought to have had mental health problems underlying these offenses. The program was jointly sponsored by the Ohio Department of Youth Services, the Ohio Department of Job and Family Services, the Ohio Department of Mental Health and the Office of Criminal Justice Services.
Juvenile offenders in this study were referred for evaluation by juvenile courts in Lorain County, Ohio. The Bellefaire Jewish Children's Bureau, a social agency located in the Cleveland area, completed a written psychological evaluation of each juvenile based on a series of interviews and assessments. Licensed psychologists tested each youth and presented results of their assessments in individual reports. These written reports included standardized test scores, diagnoses from the Diagnostic and Statistical Manual of Mental Disorders, historical information, and narrative and clinical conclusions. Also included in these reports was information generated from interviews with biological parents, adoptive parents or step-parents, other relatives, school officials, and social service and mental health professionals. The...