Behavioral Health Differences in Criminal Behavior and Criminal Justice System Involvement Among Transition-Age Foster Youth

Background: Foster youth experience high levels of behavioral health problems often associated with histories of maltreatment and exposure to other risk factors (Havlicek et al., 2013). Furthermore, studies show that behavioral health problems may lead to a range of obstacles, including criminal engagement and legal involvement (Vaughn et al., 2008). However, few studies have examined differences between criminal behavior and justice system involvement from a health perspective. To help understand whether there are salient health issues associated with specific crime outcomes, this study compares the prevalence of behavioral health problems of foster youth at age 17 between two groups: 1) youth who report later criminal behavior (CB); and 2) youth who report later criminal justice system involvement (CJ). The study also examines associations between behavioral health problems and later crime outcomes, controlling for other covariates.

Methods: The analysis includes 616 CalYOUTH participants who participated in the Wave 3 interview. Predictors were measured at Wave 1 (age 17), and the outcomes were measured aggregating Waves 2 and 3 (age 19-21). Two outcome variables include 1) a total count of 11 binary measures of past-year CB (e.g., theft, assault), and 2) a binary measure of any CJ since last interview (i.e., arrest, incarceration, or conviction). Predictor variables included binary measures of 10 behavioral health diagnoses using the MINI-Kid (e.g., depression, PTSD, conduct disorder, drug use). Control variables included demographic characteristics, maltreatment history, pre-care family problems, and foster care characteristics. Poisson regression was used to estimate associations between the predictors and the count of CB. Binary logistic regression assessed associations between the predictors and the odds of CJ.

Results: Aggregating Waves 2 and 3, 42% of youth reported any past-year CB engagement (mean=1.3), and 24% reported any CJ since their last interview. When comparing these two groups (not mutually exclusive) in the prevalence of behavioral health issues at Wave 1, youth who reported any CJ had higher prevalence rates than did youth who engaged in CB for all 10 health issues (e.g., 40% vs. 27% for drug use). Regression results showed alcohol use and drug use significantly increased both the estimated count of later CB (b=0.48 and 0.46, respectively) and the odds of later CJ (OR=2.1 and 3.4, respectively); conduct disorder increased the odds of later CJ (OR=3.1). Additionally, living in group care increased the number of later CB. Being male, Black, and caregiver’s CJ increased the odds of later CJ, while months in care past age 18 reduced the estimated odds (all p<.05).

Conclusions and Implications: Many people face barriers to avoiding legal involvement due to their behavioral health (SAMHSA, 2015). For foster youth with behavioral health needs, it may reflect their untreated trauma, disruptions to routine and stability, prolonged separation from family, and lack of targeted treatments and supports. This study finds three salient issues of behavioral health for foster youth—alcohol use, drug use, conduct disorder—suggesting areas of improvement to risk assessment, casework management, resource alignment, and workers’ direct and constant engagement efforts to effectively support youth in specific health needs.