Young adults with childhood history of both parental incarceration and juvenile justice involvement were nearly three times more likely to have depression or post-traumatic stress disorder (PTSD) compared to peers without any experience with the criminal justice system, according to a study published in JAMA Network Open. They also were nearly twice as likely to have anxiety compared to young adults without childhood exposure to incarceration.

"This is a particularly vulnerable and understudied population. Incarceration impacts families across generations, and youth who had a parent in jail or prison more often find themselves in the juvenile justice system," says lead author Nia Heard-Garris, MD, MSc, a pediatrician at Ann & Robert H. Lurie Children's Hospital of Chicago and Instructor of Pediatrics at Northwestern University Feinberg School of Medicine. "Young adults with histories of both juvenile incarceration and parental incarceration as children had a strong association with poor mental health outcomes in young adulthood."

Five million U.S. children have had a parent incarcerated, and those children are estimated to be involved in the juvenile justice system at three times the rate of their peers without a history of parental incarceration.

To examine the association between childhood history of incarceration (parental incarceration plus juvenile justice involvement) and mental health outcomes, Dr. Heard-Garris and co-lead author, Kaitlyn Sacotte, MD, a former medical student at Northwestern University Feinberg School of Medicine and current pediatric resident physician at Oregon Health Science University, and colleagues, used data from the National Longitudinal Study of Adolescent Health to Adult Health.

Out of 13,083 participants, 1,247 (9 percent) had childhood history of parental incarceration, 492 (4.5 percent) had juvenile justice involvement, and 141 (1 percent) had a childhood history of both parental incarceration and juvenile justice involvement. Black individuals accounted for over 33 percent of participants who reported both parental incarceration and juvenile justice involvement, and Latinx participants accounted for over 17 percent.

"Our analyses highlight that a history of both parental incarceration and juvenile justice involvement occurs for 1 out of every 100 U.S. children overall and is disproportionally more common among youth of color," says Dr. Heard-Garris.

Although Black and Latinx individuals were more highly represented, researchers found that the group with dual incarceration exposure had higher odds of poor mental health outcomes that are independent of other factors, such as race or ethnicity, age, family structure, parental education, receipt of public assistance, and residence in the city, suburbs or rural areas.

The researchers additionally found that a history parental incarceration or juvenile justice involvement alone was also associated with worse mental health outcomes compared to peers without incarceration exposure.

"Currently parental incarceration is considered an adverse childhood experience, but juvenile justice involvement is not," says Dr. Heard-Garris. "Given the increased risk for poor mental health outcomes we found in our study, perhaps we should also consider juvenile justice involvement an adverse childhood experience and start screening youth for any incarceration exposure during typical healthcare visits. This would allow us to further support vulnerable patients by connecting them with appropriate resources."