Prevalence of mental health problems and service use among first-time juvenile offenders.

It is known that youth engaged in the juvenile justice system show high rates of psychiatric disorders. However, little is known about the course of those disorders over time, or about mental health service use on the part of children and families during justice system involvement. Boys and girls recruited from their first contact with juvenile court (n=75), at a mean age of 13.6 years, completed three waves of interviews, each consisting of a structured clinical interview and questionnaires regarding service use, family functioning, parental burden, parental psychopathology. High rates of psychiatric disorders were evident. Three quarters (n = 56) met criteria for a mood, anxiety or behavioral disorder by parent or child report. Despite the high prevalence of mental health concerns, relatively few youth (approximately 20%) were involved in mental health services in follow-up waves. The presence of ODD and higher levels of family communication problems were associated with involvement in mental health services. Although parents experienced burden associated with their child's mental health problems, burden was not a strong correlate of help-seeking. Mental health problems declined from the point of initial involvement with juvenile justice; only ODD symptoms showed stability over time. Low rates of engagement in mental health services are found for juveniles subsequent to their first contact with juvenile justice. ODD and family communication problems most influenced service engagement, while burden due to mental health problems did not. The results provide potential targets for efforts to enhance parental motivation towards service engagement.