A Case-control Analysis of Significant Mental Health Risk Factors Among Children in Conflict with the Law in Mumbai, India

Background: There is a significant body of evidence on the various psychosocial and psychiatric correlates of juvenile offending. However, few Indian studies shed light on which mental health correlates are the most concerning compared to the general population. This study examined several risk factors for juvenile offending including attention-deficit hyperactivity disorder, aggression, self-esteem, non-suicidal self-injury, relations with family, childhood trauma, learning difficulties, and substance use in comparison with age, sex, and socioeconomic-status-matched community-based controls. Method: The study was conducted at a juvenile detention center and government-run school in Mumbai, India. Participants aged 13-17 years ( n = 158, 79 each in case and control groups) were evaluated using a structured, self-reported questionnaire consisting of the Conners-3-self-report (short form), Rosenberg self-esteem scale (RSES), and questions on self-harm, substance use, and childhood physical and sexual abuse. Data were analyzed using SPSS version 20.0. Results: Adolescent offenders reported significantly higher rates of non-suicidal self-injury (58.2% compared to 12.6% in the control group; P < .001), substance use (57.0% compared to 10.1%; P < .001), childhood physical abuse (48.1% compared to 16.5%; P < .001) and learning difficulties (51.9% compared to 26.6%; P = .002) and scored lower on the RSES ( P < .001). Attention-deficit hyperactivity disorder ( P = .184) and aggression ( P = .164) were not statistically significant. On regression analyses, self-esteem (adjusted odds ratio [aOR] = 0.73; P < .001), non-suicidal self-injury (NSSI) (aOR = 4.07; P = .017), and substance use (aOR = 3.88; P = .022) emerged as significant predictors of juvenile offending. Conclusion: Further research, screening, and targeted interventions are needed to mitigate adverse psychiatric and psychosocial outcomes among adolescent offenders.