Sex and Race Differences in Mental Health Symptoms in Juvenile Justice: The MAYSI-2 National Meta-Analysis

doi:10.1097/CHI.0b013e318160d516

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 47, Issue 3, March 2008, Pages 282-290

https://doi.org/10.1097/CHI.0b013e318160d516 Get rights and content

ABSTRACT

Objective:

Studies have suggested a high prevalence of mental health symptoms among youths in the juvenile justice system, with the highest prevalence among girls and whites compared to boys and other races. This multisite, archival study examined whether sex and race differences, when they exist, were consistent across U.S. juvenile justice programs.

Method:

Data included scores on the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2) for 70,423 youths from 283 juvenile justice probation, detention, or corrections programs. A meta-analytic technique investigated the consistency of effect sizes for sex and race/ethnic differences across sites in self-reported mental health problems.

Results:

Across sites, girls on average were 1.8 (95% confidence interval 0.98-1.10) to 2.4 (95% confidence interval 2.38-2.48) times as likely as boys to have clinical elevations on all applicable MAYSI-2 scales except the Alcohol/Drug Use scale. On the Alcohol/Drug Use scale, a sex effect existed but only among younger youths. Whites were more likely to have clinical elevations than blacks or Hispanics; but surprisingly disparities varied across mental health categories and varied considerably across sites.

Conclusion:

At the aggregate level, 72% of girls and 63% of boys had a clinical elevation on at least one MAYSI-2 scale. Our meta-analytic technique indicated that the sex differences across sites were even larger than these numbers imply. Conversely and counter to existing evidence, race-related differences were generally small or nonexistent. Whites were more likely to have alcohol and drug problems and suicide ideation, but not more likely to have symptoms of depression, anxiety, or thought disturbance than blacks or Hispanics.

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Recent studies using various forms of the Diagnostic Interview Schedule for Children (DISC) suggest that about two thirds of youths involved with the juvenile justice system meet criteria for one or more psychiatric disorders, even after excluding conduct disorder.1, 2, 3, 4,

Sample

The sample was constructed from archival intake records consisting of data sets that were obtained from 283 sites in 19 states, including three types of juvenile justice programs: 141 intake probation offices from 7 states, 91 pretrial detention sites from 16 states, and 51 secure corrections sites from 12 states. In this report, each of the three types of programs is a gate, and each independent program is a site.

The initial data set consisted of 155,835 youths (cases). Cases were excluded

Sample Characteristics

Cases (N = 70,423) were fairly evenly distributed across gates, with 36% of the sample coming from intake probation, 42% from pretrial detention, and 22% from postadjudication correctional settings. About one fourth of the sample (22%) were girls and one third (30%) were younger youths (12-14 years). For race/ethnicity, 39% self-identified as white, 34% as black, and 24% as Hispanic (Table 1). Another 1% of cases were Asian and 3% were in the other race category, neither of which had large

DISCUSSION

This study examined the extent to which sex and race/ethnic differences in the reporting of symptoms of mental disorder among youths in juvenile justice generalized across the United States. Other studies have investigated rates of mental disorder in juvenile justice youths, but few have examined sex- and race-related differences in self-reported symptoms, and most were conducted in single facilities or states, rendering findings that could be site specific. We improved the extant literature by

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Article Plus (online only) materials for this article appear on the Journal's Web site:www.jaacap.com.

This study was funded by the William T. Grant Foundation. We thank Cristen Gabriele, M.A., and Valerie Williams, M.A., M.S., for their assistance with data management. We acknowledge the passing of our friend, colleague, and statistical genius, Dr. Steven Banks. This research is another example of his countless contributions to mental health services research. He will continue to live in our memories and our work.

Disclosure: Some royalties received from sales of the MAYSI-2 manual go to the National Youth Screening Assistance Project and are used for research activities pertaining to the MAYSI-2. The authors report no additional conflicts of interest.

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NEW RESEARCHSex and Race Differences in Mental Health Symptoms in Juvenile Justice: The MAYSI-2 National Meta-Analysis

ABSTRACT

Objective:

Method:

Results:

Conclusion:

Section snippets

ArticlePlus

Sample

Sample Characteristics

DISCUSSION

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Comorbid psychiatric disorders in youth detention

Arch Gen Psychiatry

Mental health and incarcerated youth: I. Prevalence and nature of psychopathology

J Child Fam Stud

Blueprint for Change: A Comprehensive Model for the Identification and Treatment of Youth With Mental Health Needs in Contact With the Juvenile Justice System [draft]

Psychiatric disorders in youth and juvenile detention

Arch Gen Psychiatry

Psychotherapy for Children and Adolescents: Directions for Research and Practice

ADHD and CD: Degree of diagnostic overlap and differences among correlates

J Am Acad Child Adolesc Psychiatry

Ontario Child Health Study: II. Six-month prevalence of disorder and rates of service utilization

Arch Gen Psychiatry

NEW RESEARCH
Sex and Race Differences in Mental Health Symptoms in Juvenile Justice: The MAYSI-2 National Meta-Analysis