Do Mental Health Services Disrupt the Delinquency Pipeline Among Latino, African American and Caucasian Youth in the Child Welfare System?

Introduction: Previous research has found a positive association between the occurrence of child maltreatment and subsequent juvenile delinquency (Ryan, et al., 2007).  However, the strength of this relationship is disparate among subgroups of maltreated youth. Demographic factors, such as gender, race/ethnicity, and age; child welfare characteristics (behavioral problems, multiple placement moves, type of maltreatment); and environmental factors (poverty, urbanicity) have been identified as risk factors for delinquency (Chiu, et al., 2011; Rodriguez, 2013). The protective influence of mental health service utilization, and the moderating role of race/ethnicity in mental health service use in decreasing juvenile delinquency are not well understood. The present study extends prior research by addressing two research questions: (1) To what extent do demographics, child welfare characteristics, mental health service use, and environment influence delinquent outcomes?; and (2) Does race/ethnicity moderate the relationship between mental health service use and delinquent outcomes, controlling for demographic, child welfare, and environmental factors?

Methods: Data are from the NSCAW II-cohort, a nationally representative sample of children investigated for maltreatment between 2008- 2009. The selected sample included youth (n=727), ages of 12-17 at Wave 2 (18-months post investigation). Youth reported how many times they engaged in 36 delinquent acts during the past six months via the Self- Report of Delinquency questionnaire. Presence of behavioral symptoms was assessed by caregivers via the Child Behavior Checklist. Caregivers reported whether youth utilized inpatient or outpatient mental health services in the past 18 months. Urban areas were defined as counties with greater than 50% of the population living in catchment areas. Poverty was calculated as the percentage of children under the age of 18 living below the poverty level within each county. Socio-demographics, maltreatment history, and data on placement moves were gathered from case records. Step-wise linear regression was used. Demographics were entered in the first model. Child welfare (model 2), service use (model 3), and environmental (model 4) factors were then added. The product term for service use and race was created to test moderation effects.

Results: On average, youth engaged in 1.5 delinquent acts. Approximately 35% of youth had behavioral problems, but only 26% received mental health services. Compared to Caucasian youth, African American youth engaged in significantly more delinquent acts, controlling for child welfare, service use, and environmental factors. A positive relationship between SEB outcomes and delinquent acts was detected. Finally, the interaction model showed service use significantly decreased delinquency among African Americans.  

Discussion: The disproportionate contact that racial/ethnic minority youth in foster care have with the juvenile justice system may not be a function of their individual clinical behaviors, but of underlying systems-level issues. Findings reveal how systems may play a pivotal role in ensuring youth, particularly African Americans, utilize mental health services to reduce delinquent behavior. Thus, it is imperative we strengthen systems’ capacity to ensure that all children receive the mental health services they need. Providers need access to valid, reliable, and efficient tools to screen for and assess factors that are likely to disrupt the delinquency pipeline.