Youth Vulnerabilities within the Juvenile Justice System
Youth in the Juvenile Justice (JJ) System have a higher prevalence of mood and substance use disorders,1-2 trauma exposure,3 access to suicide means (e.g. firearms, illegal substances, etc.),4 and decreased family supervision.5-7
Teplin et al. found that 2/3 of male JJ youths (N=1172) , and 3/4 of female JJ youths (N=657) met criteria for at least one or more psychiatric disorders in their epidemiologic study sample on juvenile detainees;8 furthermore, approximately 14% of their female participants, and 11% of their male participants had both a major mental disorder in addition to a substance use disorder.9
The Office of Juvenile Justice and Delinquency Prevention released a bulletin in 2014 stating that 11% of JJ youth had attempted suicide, while 1 out of 10 had experienced suicidal ideation in the past 6 months. Attempts were found to be more prevalent among those that identified as female, as well as youths with anxiety disorders.10
The Center for American Progress (CAP) and Movement Advanced Project (MAP) surveyed seven JJ facilities and found 20% of JJ youth identified as LGBT or gender non-conforming, with 85% of these individuals belonging to a racial minority. This is a disproportionate amount of LGBT youths in the JJ system compared to the amount of in the general population (7-9%). CAP and MAP explain that this is likely due to the higher rates of incarceration for youths belonging to a racial minority group, with black youths representing 40% of JJ youth. Research has shown that LGBT youth are approximately 3 times more likely to attempt suicide than their heterosexual peers.11
Why should we care about screening for youth's suicide risk in the Juvenile Justice System?
Suicide rates increased by 24% among youth in the general population between 1999 and 2014.12 Suicide is the second leading cause of death among youth in the United States.13 Rates have risen 31% for boys since 2015, and doubled between 2007 to 2015 for girls. Stressful experiences, such as a recent arrest or incarceration, can be a precipitating factor triggering a suicidal crisis in a vulnerable person.14
Despite increased risk for suicide, JJ youth are not accessing behavioral and mental health services as needed according to both existing literature, and our prior work that we have done. Probation is an opportune area to make targeted efforts at detecting, and linking youths to appropriate behavioral and mental health care providers. 2-4% report a suicide attempt in the past month, and up to 18% report a lifetime attempt compared to the general population (3-9%).
Dr. Wasserman's prior work has found that repeat offenders are almost 3 times as likely to report a recent attempt. Youths that had recently attempted also had significantly more prior justice referrals; every referral increased their probability for a recent suicide attempt by approximately 25%. They were also more likely to be female, have major depressive disorder (37.9%), substance use disorder (55%) or have recent suicidal ideation (69%). Additionally, recent attempters were also more likely to be white, and the male recent attempters were older than the female recent attempters.1
- Wasserman, G.A., & McReynolds, L.S. (2006). Suicide risk at juvenile justice intake. Suicide and Life-Threatening Behavior, 36(2), 239-49.
- Abram, K.M., Teplin, L.A., Charles, D.R., Longworth, S.L., McLelland, G.M., & Dulcan, M.K.(2004). Posttraumatic stress disorder and trauma in youth in juvenile detention. Archives of General Psychiatry, 61(4), 403-410.
- Gould, M.S., Fisher, P., Parides, M., Flory, M., & Shaffer, D. (1996). Psychosocial risk factors of child and adolescent completed suicide. Archives of General Psychiatry, 53(12),1155-62.
- Gould, M.S., Greenberg, T., Velting, D.M., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 42(4), 386-405.
- Hoeve, M., Dubas, J.S., Eichelsheim, V.I., van der Laan, P.H., Smeenk, W., & Gerris, J.R.M. (2009). The relationship between parenting and delinquency: A meta-analysis. Journal of Abnormal Child Psychology, 37(6), 749-775.
- Ryan, J.P., Williams, A.B., & Courtney, M.E. (2013). Adolescent neglect, juvenile delinquency and the risk of recidivism. Journal of Youth and Adolescence, 42(3), 454-465.
- Brent, D.A., Baugher, M., Bridge, J., Chen, T. & Chiapetta, L. (1999). Age- and sex-related risk factors for adolescent suicide. Journal of the American Academy of Child and Adolescent Psychiatry, 38(12), 1497-505.
- Teplin, L.A., Abram, K.M., McClelland, G.M., Dulcan, M.K., & Mericle, A.A. (2002). Psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry, 59(12), 1133-43.
- Teplin, L.A., Abram, K.M., McClelland, G.M., & Dulcan, M.K. (2003). Comorbid psychiatic disorders in youth in juvenile detention. Archives of General Psychiatry, 60(11), 1097-1108.
- Abram, K.M., Choe, J.Y., Washburn, J.J., Teplin, L.A., King, D.C., Dulcan, M.K., & Bassett, E.D. (2014). Suicidal thoughts and behaviors among detained youth. Juvenile Justice Bulletin: Working for Youth Justice & Safety. Retrieved from https://www.ojjdp.gov/pubs/243891.pdf
- Center for American Progress/Movement Advance Project. (2016). Unjust: How the broken criminal justice system fails LGBTQ youth. Retrieved from http://www.lgbtmap.org/policy-and-issue-analysis/criminal-justice-youth
- Curtin, S. C., Warner, M., & Hedegaard, H. (2016). Increase in suicide in the United States, 1999–2014. NCHS Data Brief No. 241. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db241.htm
- National Institute of Mental Health. (November 2017). Suicide. Retrieved from https://www.nimh.nih.gov/health/statistics/suicide.shtml
- Annor, F., Wilkinson, A., & Zwald, M. (2017). Undetermined Risk Factors for Suicide among Youth Aged 10-17 years – Utah, 2017. Retrieved from http://health.utah.gov/vipp/pdf/Suicide/CDCEpi-AidReport.pdf.