Study data published in JAMA Network Open indicate a significantly increased risk for poor mental health outcomes among adults with childhood exposure to the criminal justice system.

Investigators abstracted data from the US National Longitudinal Survey of Adolescent to Adult Health, a nationally representative study that followed adolescents from high school into adulthood. Wave 1, conducted in 1994 to 1995, comprised in-home interviews of 18,924 adolescents aged 12 to 19 years. In 2008, wave 4 interviews were completed for 13,861 initial respondents from wave 1. In wave 4, respondents reported exposure to parental incarceration (PI) and juvenile justice involvement (JJI) before age 18 years.

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As primary outcome measures, data on adult mental health were also collected in wave 4. Logistic regression models were used to examine associations between mental health outcomes and childhood exposure to the criminal justice system.

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Odds ratios (ORs) for mental health outcomes were calculated for each exposure group compared with for control individuals with no PI or JJI exposure. Analyses were adjusted for sociodemographic factors, including family structure, parental education, receipt of public assistance, and geographic classification of residence.

The analytic sample comprised 12,379 individuals with complete data for both wave 1 and wave 4. Hispanic and non-Hispanic black participants had disproportionately higher childhood exposure to the criminal justice system.

Specifically, black participants accounted for 23.8% of those reporting childhood PI, 20.0% of those reporting JJI only, and 33.1% of those reporting both PI and JJI compared with just 12.9% of those reporting neither exposure. Similarly, Hispanic participants accounted for 17.6% of the PI and JJI exposure group but comprised only 11.3% of the group without PI or JJI.

In adjusted analyses, individuals with any history of justice system exposure had significantly worse mental health outcomes than their counterparts without exposure. Individuals exposed only to PI had higher odds of depression (adjusted OR [aOR], 1.88; 95% confidence interval [CI], 1.44-2.45), anxiety (aOR, 1.73; 95% CI, 1.35-2.20), and suicidal thoughts (aOR, 1.55; 95% CI, 1.19-2.02) compared with individuals without any childhood PI or JJI exposure.

Exposure to JJI alone was also associated with higher odds of depression (aOR, 2.53; 95% CI, 1.79-3.59), anxiety (aOR, 1.72; 95% CI, 1.20-2.45), posttraumatic stress disorder (aOR, 3.50; 95% CI, 2.11-5.81), and suicide attempts (OR, 2.89; 95% CI, 1.27-6.60) compared with controls. Individuals with PI and JJI exposure had the highest odds of depression (aOR, 2.80; 95% CI, 1.60-4.90), anxiety, (aOR, 1.89; 95% CI, 1.08-3.31), and posttraumatic stress disorder (aOR, 2.92; 95% CI, 1.09-7.82).

Compared with control individuals, participants with JJI exposure (aOR, 2.34; 95% CI, 1.64-3.32) and PI plus JJI exposure (aOR, 2.08; 95% CI, 1.01-4.27) were also more likely to have received mental health counseling.

These data underscore the known association between mental health outcomes and exposure to the US criminal justice system. As a study limitation, the investigators noted that the self-report nature of the data collection may have resulted in an underreporting of mental health issues. Further study on the effects of mental health interventions for children after criminal justice-related exposures is warranted. The investigators also endorsed “clinical, advocacy, and policy efforts” as a means of reducing the effects of the US criminal justice system on children.


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 Netw Open. 2019;2(9):e1910465.