Characteristics of Adolescent Psychiatric Inpatients Involved with the Juvenile Legal System

Youth involved with the juvenile legal system (JLS) have high rates of behavioral health concerns requiring higher levels of care, yet few studies have examined the unique characteristics of JLS-involved youth who present to these settings. This study examined the demographic and clinical characteristics of youth admitted to an inpatient psychiatric unit, comparing those with and without JLS involvement. The sample included 829 adolescents (M^age = 14.96, Range = 11-18 years) admitted to an inpatient psychiatric unit. As part of routine care, adolescents completed self-report measures assessing demographics, adverse childhood experiences, interpersonal functioning, psychological symptoms, substance use, and suicidal thoughts and behaviors. Information on previous hospitalizations, length of stay, and readmissions within six months was obtained from the electronic health record. JLS-involved youth were more likely to identify as male, Black/African American, Hispanic/Latine, and American Indian/Alaska Native, and to report child welfare involvement than non-JLS-involved youth. Clinically, JLS-involved youth were more likely to have a prior inpatient admission, experience longer hospital stays, and report higher levels of adverse childhood experiences, anger, and substance use. JLS-involved youth were less likely to report lifetime nonsuicidal self-injury. JLS-involved youth also reported lower suicidal ideation; however, this difference did not remain significant after adjusting for sex assigned at birth. Rates of suicide attempts did not differ between groups. Overall, these findings suggest that JLS-involved youth constitute a clinically distinct subgroup of psychiatrically hospitalized youth whose needs may require tailored treatment approaches.