Mental Health Outcomes for Children: Associations to Parental Incarceration, Needed Mental Health Treatment, and the Positive Childhood Experiences

Background & Purpose: As of 2016, the most recent national DOJ data on parental incarceration, around 1.5 million children in the U.S. had incarcerated parents. Children of incarcerated parents have been shown to have mixed-results with respect to the mental health outcomes. This study aims to further explore the relationship between mental health outcomes for children ages 6 to 17 years for depression, anxiety, and behavior or conduct problems; with parental incarceration, accessibility of mental health treatment, and protective factors as independent measures.

Methods: Using the 2023 National Survey of Children’s Health (NSCH; N= 33, 638). We conducted three binary logistic regressions, one for each of the outcome measures of depression, anxiety, and behavioral/conduct problems. These were assessed as dichotomous variables (absent/present) based on the question “Has a doctor or other health care provider EVER told you that this child has...”. For parental incarceration, we used the NSCH’s adverse childhood experiences (ACEs) measure of parental incarceration assessed as (absent/present). For needed mental health treatment, we used the question “How difficult was it to get the mental health treatment or counseling that this child needed?”, measured on a 4 point-Likert scale ranging from it was not possible to obtain care to not difficult. Protective factors included based on the positive childhood experiences (PCEs); the 7 PCEs included were engaging in after-school activities, living in a safe neighborhood, having someone to share ideas with, having a mentor, volunteering or charity work, having a supportive neighborhood, and family resilience based on previous literature. Sociodemographic measures were also included in all models. After checking for missing data, any missing data was coded as missing, all regression models were run with (N=30,942).

Results: All three of our models were statistically significant (p<.001) after running logistic regression models. Parental incarceration was only associated with depression (OR= 1.79, p<.001) and behavioral or conduct problems (OR= 1.82, p<.001), while needed mental health treatment was found to be a statistically significant predictor across all models; depression (OR= 5.02, p<.001), anxiety (OR= 6.96, p<.001), and behavioral/conduct problems (OR= 6.46, p<.001). Several PCEs acted as protective factors, varying across models. Model 1 or depression had the highest instances of PCEs associated, including engaging in after-school activities (OR=.78, p<.001), living in a safe neighborhood (OR=.73, p<.001), having someone to share ideas with (OR=.77, p<.01, volunteering or charity work (OR=.74, p<.001), and family resilience (OR=.78, p<.05). Similar associations were found for behavioral problems; activities (OR= .62, p<.001), a safe neighborhood (OR=.80, p<.05), sharing ideas (OR=.25, p<.001), and volunteering (OR=.80, p<.001). Model 2 covering anxiety was significantly associated with having a supportive neighborhood (OR=.78, p<.05).

Conclusion & Implications: Mental health outcomes are a vital component of further research exploration for children of incarcerated parents. Our study identified higher odds ratios for each mental health outcome when mental health treatment needs were not met, furthermore including vital protective factors in future research can further substantiate preventative and interventive mental health services. Our findings support these efforts and align with previous research.