More than half of people incarcerated before the age of 18 go on to be reincarcerated as adults, with bipolar disorder and substance use disorders significantly increasing the odds of recidivism, according to a study issued in the Journal of the American Academy of Psychiatry and the Law.
“Press coverage of the incarceration of children and adolescents comes in the context of long-standing concerns over the personal and societal cost of the threefold increase in U.S. incarceration rates since the 1980s,” wrote Alec Buchanan, M.D., Ph.D., at Yale School of Medicine in New Haven, Conn., and colleagues. “…[T]he further detention of many of these children and adolescents when they become adults raises questions concerning the effectiveness of deterrence and the unwanted effects of incarceration. From a psychiatric perspective, it raises the question also of the extent to which mental ill-health contributes to the risk of subsequent incarceration.”
Buchanan and colleagues analyzed the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III), a nationally representative, in-person survey of noninstitutionalized adults conducted in 2012 and 2013. Researchers included responses from the 36,293 participants for whom data on childhood incarceration was available and examined their parental history, upbringing, demographics, social factors, and mental illness and substance use to pinpoint ties to recidivism as adults.
Researchers found that 1,543 adults in the NESARC-III sample (4.3%) were in a jail, prison, or juvenile detention center before age 18; when extrapolated to the entire population, this amounts to 10 million current U.S. adults who were incarcerated as children. Almost half had a psychiatric disorder (excluding personality disorders) and nearly two-thirds had substance use disorder during their lifetime.
Among those incarcerated as children, 863 (56%) were subsequently incarcerated as adults. The risk of adult reincarceration increased with length of time spent incarcerated as a child (48% for less than one week versus 63% for longer periods).
In addition to antisocial personality disorder—a risk factor identified in previous criminological research—bipolar disorder and substance use disorder were also independently associated with adult reincarceration. Other reincarceration risk factors that had been previously identified included not graduating college, parental drug use and imprisonment, and childhood and lifetime homelessness.
“The point of release is already known to be a time of vulnerability, particularly with regard to opiate overdose, and these results suggest that coordinating community substance use services when people reenter the community from prison may also have the longer-term benefit of preventing further incarceration,” Buchanan and colleagues wrote.
For related information, see the Psychiatric News article “Incarcerated Individuals With Mental Illness Need More of Psychiatry’s Attention.”
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