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Mental Health and Substance Abuse Treatment
and Juvenile Crime
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Alison Evans Cuellar,1* Sara Markowitz,2
Anne M. Libby3
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1Department of Health
Policy and Management, Columbia University, New York, NY, USA
2Department of Economics, Rutgers University, Newark, NJ and
National Bureau of Economic Research, New York, NY, USA
3Department of Psychiatry, University of Colorado Health Sciences
Center, Denver, CO, USA
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* Correspondence to: Alison Evans Cuellar, Department of Health Policy
and Management, Columbia University, 600 W. 168th Street, 6th Floor, New York,
NY 10032, USA
Tel.: +1-212-305 2856
Fax: +1-212-305 3405
E-mail: ac2068@columbia.edu
Source of Funding: Partial support was provided by NIMH (K01 MH067086-01,
Cuellar, PI), the Institute for Child and Family Policy, Columbia University
(Cuellar, PI), the Cornwall Center for Metropolitan Studies Faculty Award for
Scholarly Research at Rutgers University, Newark (Sara Markowitz, PI), and by
a W.T. Grant Foundation Faculty Scholars Award (Libby, PI).
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The purpose of this paper is to examine the effectiveness
of mental health and substance abuse treatment in reducing crimes
committed by juveniles. This paper uses detention data in conjunction
with substance abuse and mental health treatment data on at-risk
youth in Colorado over a three-year period. Duration models are
used to examine the impact of treatment in delaying or preventing
this group of at-risk youth from engaging in criminal behavior.
Violent crimes are analyzed separately. The price of beer is also
included in all models to gauge the effectiveness of higher beer
prices in reducing crime, holding treatment constant. The analysis
finds that individuals who receive treatment have lower probabilities
of being detained for any offence. Also consistent with our theory,
higher beer prices lower the detention hazard. Accounting for the
unobserved heterogeneity makes the magnitude of these effects larger.
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Background and Study Aims: There is a large body of literature
examining the determinants of juvenile crime, which highlights economic,
family, peer, and educational factors associated with delinquency and
recidivism, and the important roles of social service and educational
systems. Two factors, substance abuse and mental illness are also potentially
important. The observed high correlations between crime, substance abuse
and poor mental health suggests that factors which reduce substance abuse
and improve mental health may also be effective in reducing criminal activities.
The purpose of this paper is to examine the effectiveness of mental health
and substance abuse treatment in reducing crimes committed by juveniles.
Methods: This paper uses detention data in conjunction with substance
abuse and mental health treatment data for youth enrolled in the Colorado
state foster care program over a three year period. Duration models are
used to examine the structural determinants of detention. We analyze the
impact of treatment in delaying or preventing this group of at-risk youth
from engaging in criminal behavior. Violent crimes are analyzed separately.
We also include the price of beer in all models to gauge the effectiveness
of higher beer prices in reducing crime, holding treatment constant.
Results: The analysis finds that individuals who receive treatment
have lower probabilities of being detained for any offence. Accounting
for the unobserved heterogeneity makes the magnitude of these effects
larger. Also consistent with our theory, higher beer prices lower the
detention hazard.
Conclusion: Results of this study suggest that expansion of health
services targeted at these youth may be effective at reducing crime. For
violent crime, where the literature shows that substance abuse plays a
significant role, stricter alcohol-regulatory policies may also be highly
effective.
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Received 21 November 2003; accepted 2 April 2004
Copyright © 2004 ICMPE
