Racial/Ethnic Disproportionality in Psychiatric Diagnoses and Treatment in a Sample of Serious Juvenile Offenders

J Youth Adolesc. 2017 Jul;46(7):1424-1451. doi: 10.1007/s10964-016-0573-4. Epub 2016 Sep 24.


Psychiatric disorder prevalence has been shown demonstrably higher among justice-involved adolescents than youth in the general population. Yet, among arrested juveniles, little is known regarding racial/ethnic differences in disorder prevalence, the role of trauma exposure in the diagnosis of behavioral disorders, or subsequent psychiatric treatment provided to adolescents with such diagnoses. The current study examines racial/ethnic disparity in psychiatric diagnoses and treatment of behavioral disorders associated with delinquency, controlling for traumatic experiences, behavioral indicators, and prior offending among serious juvenile offenders. Logistic regression is employed to explore the racial/ethnic disproportionality in behavioral disorder diagnoses and psychiatric treatment provision among 8763 males (57.7 % Black, 11.8 % Hispanic) and 1,347 females (53.7 % Black, 7.6 % Hispanic) admitted to long-term juvenile justice residential placements in Florida. The results indicate Black males are 40 % more likely, and Black females 54 % more likely to be diagnosed with conduct disorder than Whites, even upon considerations of trauma, behavioral indicators, and criminal offending. Black and Hispanic males are approximately 40 % less likely to be diagnosed with ADHD than White males, with no racial/ethnic differences for females. Importantly, Black males are 32 % less likely to receive psychiatric treatment than White males, with no differences between White and Hispanic males, or any female subgroups. Traumatic exposures increased the odds of oppositional defiant disorder and ADHD, but not conduct disorder for males, though adverse childhood experiences were unrelated to behavioral disorder diagnoses among females.

Keywords: Conduct disorder; Juvenile offenders; Mental health; Racial/ethnic disparity; Trauma.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Antisocial Personality Disorder / diagnosis
  • Antisocial Personality Disorder / ethnology
  • Antisocial Personality Disorder / psychology
  • Antisocial Personality Disorder / rehabilitation
  • Black or African American / psychology*
  • Black or African American / statistics & numerical data*
  • Conduct Disorder / diagnosis
  • Conduct Disorder / ethnology
  • Conduct Disorder / psychology
  • Conduct Disorder / rehabilitation
  • Criminals
  • Cross-Sectional Studies
  • Female
  • Florida
  • Health Status Disparities
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Juvenile Delinquency / ethnology*
  • Juvenile Delinquency / legislation & jurisprudence
  • Juvenile Delinquency / psychology*
  • Juvenile Delinquency / rehabilitation
  • Life Change Events
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / ethnology*
  • Mental Disorders / psychology*
  • Mental Disorders / rehabilitation
  • Prevalence
  • White People / psychology*
  • White People / statistics & numerical data*