Prevalence of common psychiatric disorders among American Indian adolescent detainees.

OBJECTIVES: To examine the prevalence of common psychiatric disorders among adolescents detained on a Northern Plains reservation. METHODS: Prevalence data were gathered using lay interviewers administering structured diagnostic instruments based on DSM-III-R criteria to 150 youths booked into a reservation-based juvenile detention center from July 1995 through April 1996. RESULTS: Approximately 49% of the sample had at least one alcohol, drug, or mental health disorder; 12.7% had two disorders; and 8.7% had three or more disorders. The most common diagnoses were substance abuse/dependence (38%), conduct disorder (16.7%), and major depression (10%). Females were significantly more likely than males to have major depression and/or anxiety disorders and were significantly more likely to have three or more disorders. These rates were higher in comparison with general and Indian adolescent community samples. CONCLUSIONS: These American Indian adolescent detainees had a high prevalence of psychiatric disorders. Local juvenile justice systems should be vigilant for the presence of psychiatric disorders and appropriately connected with psychiatric services to address this considerable need. Careful psychiatric assessment is necessary to ensure a more coordinated community service response to juvenile delinquency.