Crime Prevention - Research Highlights 2017-H01-CP – Youth Mental Health, Mental Illness and Crime

Crime Prevention - Research Highlights 2017-H01-CP – Youth Mental Health, Mental Illness and Crime PDF Version (301 Kb)


Mental and emotional health and well-being of youth is a serious health issue in Canada that has several implications in the field of youth crime prevention as well as for the juvenile justice system. The Mental Health Commission of Canada (MHCC) reports that as much as 70% of people suffering from mental health illnesses have their onset during the years of childhood and adolescence (MHCC, 2015), and that the early onset of mental health problems and illnesses have lifelong consequences. Compelling evidence for this latter statement can be seen in Canada’s National Longitudinal Survey of Children and Youth, conducted between 1994 and 2008, which found that children who self-report emotional difficulties at ages four to eight were four times more likely to report depression eight years later (Canadian Institute for Health Information (CIHI), 2015). These statistics are also in line with the results of the Canadian Community Health Survey―Mental HealthFootnote1 which found that the likelihood of youth (age 15-24) coming into contact with police because of a mental or substance use disorder is significantly higher than for those aged 45 and above (Boyce, 2015).

According to the most recent reports of the MHCC (2017), in 2016, more than 7.5 million people in Canada were likely facing one of the common mental illness: major depression, bipolar disorder, alcohol use disorders, social phobia and depression (Ratnasingham et al., 2012 in MHCC, 2017b).  The same report also reveals that more than 900,000 adolescents ages 13 to 19 lived with a mental health problem or illness in Canada (MHCC, 2017a). For this group of population, substance use is the most frequent problem (9.9%), followed by anxiety (9%), mood disorders (5.2%), Attention Deficit Hyperactivity Disorder (ADHD) (3.9%), Oppositional Defiant Disorder (ODD) (1.9%) and conduct disorders (1.9%) (MHCC, 2017b).

These statistics show the need to better understand the links between mental illness and youth crime and the practices currently being used to serve the youth suffering from mental health disorders. As such, the purpose of this report is to examine the Canadian knowledge concerning youth suffering from mental health disorders and their involvement in crime, with particular interest in the age group 12-24, to highlight the important correlations between mental health and some specific crime issues and to identify the knowledge gaps.


Given that the term mental illness is derived from, and therefore so closely associated with, mental health disorders, the terms “mental illness” and “mental health disorders” are used interchangeably in the literature, and this is no exception to the literature analyzed for this report.  The following definitions provide clarification between the mental health concepts used in this report:

Mental Health

“A state of well-being in which the individual realized his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (WHO, 2016).Footnote2

Mental Illness

“Health conditions that are characterized by alterations in thinking, mood, or behaviour associated with distress and/or impaired functioning” (Public Health Agency of Canada (PHAC), 2015).

Mental Health Disorder

“A syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.”  (Diagnostic and Statistical Manual of Mental Disorders (DSM–V) (American Psychiatric Association (APA), 2013). See appendix A for certain key mental health disorders.

An important distinction to make is the difference between “mental health” and “mental illness”. Though these terms are at times confounded, they do not have the same meaning, as mental health is an integral part of well-being and realization, whereas mental illnesses are defined as alterations causing distress or impaired functioning, and do not encompass a person’s overall state of mind. For example, if a person is pessimistic and feeling sad, it does not mean they are suffering from a depressive disorder (unless these feelings significantly affect one’s capacity to function). Positive mental health, however, can increase certain protective factors of individuals (e.g. resiliency and self-esteem) which can mitigate the harms of mental illness; this makes mental health promotion important when considering mental illness (MHCC, 2015; Canadian Centre on Substance Abuse (CCSA), 2013). According to the WHO, sentiments such as cheerfulness, satisfaction, resilience, balance, and optimism are regarded as factors promoting positive mental health, whereas determinants such as poverty, social exclusion, stress, and discrimination lead to poor mental health (World Health Organization (WHO), 2016; Centers for Disease Control and Prevention (CDC), 2017; Canadian Mental Health Association (CMHA), 2014).

Prevalence in Canada

Mental Health and Children & Youth

Snapshot on Mental Health and Gender Differences

Mental Health and Indigenous Populations

Mental Health and Contact with Police

Using the 2012 Canadian Community Health Survey – Mental HealthFootnote4, Statistics Canada compiled mental health contact with the Canadian police in an effort to examine the frequency of contact that those with and without disorders have with police (Boyce, 2015). The data gathered was collected from people 15 years or older, and focused on specific reasons for police contactFootnote5. The findings of this survey demonstrate that (Boyce, 2015): 

Mental Health and the Correctional Service of Canada

There is very limited information on the statistics of youth suffering from mental health disorders within the Correctional Service of Canada. However, the information is less limited in terms of adults within the correctional system. According to the Correctional Service of Canada and the Office of the Correctional Investigator, research on adult mental health statistics in Canadian penitentiaries indicates that:

Risk And Protective Factors

According to the Canadian Centre on Substance Abuse, there are risk and protective factors linked to the development of mental illnesses (CCSA, 2013). Risk factors can be defined as characteristics or experiences faced by an individual that increases the likelihood that a mental health problem will develop (CCSA, 2013). Similar with the risk factors associated with a criminal trajectory, there is no single known risk factor for mental illness. Risk factors for future mental illnesses are thought to be the result of a complex interaction between biological (genetics), economical (e.g. lower-income family), social (e.g. victimization), and psychological (e.g. emotional difficulties) factors. These factors will vary amongst individuals and across various stages of life. However, these risk factors can be mitigated by protective factors, which are seen as characteristics or experiences that reduce the likelihood a mental health problem will occur (CCSA, 2013); examples of protective factors can range from strong family relationships to the youth having high self-esteem. No research study has been identified specifying and comparing the weight of risk and protective factors towards mental illness and how they interact to create an exponential effect.

It is worth noting that the risk and protective factors related to mental illness significantly overlap with those related to general antisocial behaviours, covering community, school, family, peer, and individual factors (CCSA, 2013; Day & Wanklyn, 2012).The similarities of the risk factors between crime and mental illness create the idea that the two social issues may be related; an important statement that will be covered in the next section. It should be noted that the research provided in the following section does not pertain solely to youth, but is generalized for adults and youth. When data is specific to youth, it is noted.

Links to Crime

In the international research for both youth and adults analyzed for this report, findings suggest that certain mental health disorders, such as substance use disorder, conduct disorder, and antisocial personality disorder were shown to have a significant correlation to offending and re-offending (Hoeve, McReynolds, & Wasserman, 2013; Murphy & Fonagy, 2012; Fazel et al. 2009; Heslop et al. 2011; Fridell et al. 2008; Maghsoodloo et al. 2012). Other disorders, such as Attention Deficit/Hyperactivity Disorder (ADHD), were also linked with future criminal involvement (Fletcher & Wolfe, 2009), however one of the studies showed that the link between ADHD and criminal involvement was not as strong as the link between its risk factors or correlated indicators (such as physical aggression and family adversity) and crime (Pingault et al. 2013). However, another study shows that of all crimes committed by people with a serious mental disorderFootnote8 in the US, only 7.5% of them were directly related to the disorder itself, implying that the connection between crime and mental illness should be expanded beyond the psychiatric symptoms to the risk factors of both criminality and mental illness, such as poverty and unemployment (Peterson et al. 2014). Before any firm conclusions can be made on the association of all mental disorders and crime, more standardized research considering multiple risk factors should be conducted.

In terms of the association between crime and comorbidity, a term used to describe multiple disorders present in one person simultaneously or sequentially (National Institute on Drug Abuse, 2011), there is also limited research, making it difficult to make formal conclusions about their relationship. Studies have demonstrated that comorbidity does increase the odds of offending and violence (Coker et al. 2014; Fazel et al. 2009), and in these cases, substance use disorders were disproportionately representedFootnote9. In the Fazel study, it was found that the excess risk created by a schizophrenic disorder was mediated by the risks imposed by the substance abuse disorder, and that the risks associated with comorbidity closely resembled the risks of the population with only a substance abuse disorder (Fazel et al. 2009). A similar finding was identified in the Coker study, as the majority of associations between psychiatric diagnoses and arrest-related crime became non-significant after conduct disorder diagnoses were removed from the sample (Coker et al. 2014). Further research is needed to make a formal conclusion on whether comorbidity increases the chances of offending for those suffering from disorders already heavily associated with crime, such as conduct or substance abuse disorders.

Mental Illness and Violent Offending

Mental Illness and Victimization

Mental Illness and Youth Gangs

Mental Illness and Cyberbullying

Mental Illness and Substance Use

Mental Illness and Other Important Social Issues

Given that certain social issues have an impact on mental health and crime, we should consider the following social issues:

Cost Considerations

There are few studies that analyze the economic impacts of mental health problems, and techniques used to provide the cost estimations vary within these studies. For example, over the past decade, four major Canadian studies have analyzed the costs of mental health problems and their implications on the economy on a national basis. Each study has used different cost components and methods (health economists distinguish between three types of costs: direct expenditures; indirect or spillover costs; and intangible costs). Indirect costs were measured differently between studies, and expenditures in the justice system due to mental health problems and illnesses were not calculated (MHCC, 2017b). These limitations considered, the following findings can help illustrate the relationship between mental health problems, illnesses, and the economy:   

Prevention and Intervention

While the National Crime Prevention Strategy through its funding programs has supported the implementation of crime prevention programs helping populations, including youth suffering from mental health disorders, these programs are primarily meant for crime prevention purposes, and outcomes of these programs are not structured to measure indicators in the mental health domain. However, because of the similarity between risk factors associated to crime and mental health disorders, it remains essential to promote prevention and early intervention for at-risk youth and their families. 

The potential cost savings of prevention programs can become extremely important in helping reduce the immense costs of mental health problems and mental illness. Because many of these issues begin in childhood or adolescence, investing in mental health promotion, prevention and early intervention are identified as key areas (Knapp et al. 2011; CIHI, 2015; Lesage, 2017 in MHCC, 2017a), both from a crime prevention and public health perspective.

Of the utmost importance, access to the proper mental health services (e.g. early problem identification, treatment, aftercare) and medication is the first step to help prevent criminal activity, especially violence, among those suffering from mental illness (Coker et al. 2014; Peterson et al. 2014; Kopel & Cramer, 2014; CMHA, 2011). In 2012, an estimated 1.6 million Canadians reported through the Community Health Survey that their need for mental health care was only partially met or not met at all; needs for medications were most likely to have been met, while counselling needs were the least likely to have been met; 36% reported that their need for counselling was not met at all or was only partially met” (Sunderland, 2013 in MHCC, 2017a).

Using standardized toolsFootnote14 to screen  and assess for mental health problems or risk factors affecting youth is also essential in order to tailor the appropriate treatment and identify their needs for services (Addiction and Mental Health Collaborative Project Steering Committee, 2015; BC Ministry of Health Living and Sport, 2009). According to the CCSA, prevention initiatives that address the appropriate risk and protective factors can be effective at reducing substance abuse and mental health problems, and can even produce cost savings (CCSA, 2013; Leschied, 2008).

Core Intervention Strategies for Youth Suffering from Mental Illness

For this section, the core strategies identified by Leschied (2008) are directed at youth suffering from mental health disorders at-risk of offending, whereas other core examples are for youth suffering from mental health disorders. Although these other examples have been effective in the field of crime prevention, the literature did not acknowledge their relation to prevention programs for youth who are suffering from a mental health disorder and are at-risk of crime:

Examples of Evidence-Based Interventions and Programs Addressing Mental Health Issues

Several meta-analyses and reviews identified by the American Psychological Association (APA) Task Force on evidence-based practice with children and adolescents have shown that prevention programs for youth can reduce rates of later behavioural, social, academic, and psychological problems in the participants (APA, 2008). Within these programs and other social development initiativesFootnote16, there have been evidence-based interventions for mental disorders that have been effective in preventing and treating affected youth.

For the purpose of this report, only few examples of evidence-based interventionsFootnote17 followed by pre-packaged programs are presented.  Depending on the severity and the disorders that need to be prevented and/or treated, different psychosocial prevention or treatment interventions can be applied:

Below are some examples of effective programs that have demonstrated positive results on improving mental health disorders as well as certain crime issues. Due to a lack of outcome evaluations of these programs within the Canadian context, findings from these programs are from outcome evaluations that were conducted in the United-StatesFootnote18:

While delivering evidence-based interventions by appropriately trained staff is seen as a best practice, there are other interventions that have shown promising results in preventing and treating children and youth suffering from mental health disorders. An example of that is the mentoring for children with emotional and behavioural disordersFootnote23. This mentoring intervention was designed to provide positive role models and supportive relationships that facilitate educational, social, and personal growth. Results suggest that mentoring services for children with emotional and behavioural disorders may decrease externalizing and internalizing behaviour problems beyond the contribution of other mental health services (Jent & Niec, 2006). In addition, maternal caregivers of mentored children reported higher levels of perceived parenting social support when compared to maternal caregivers of wait-listed children (Jent & Niec, 2006).

To conclude this section on prevention and intervention, it is important to mention the literature and programs oriented towards mental health promotion in children and youth. Literature on effective prevention and mental health promotion programs have emphasized the following areas of focus: resiliency and protective factors, creating supportive environments, reducing stigma, addressing the social determinants of health, social inclusion,  connectedness, and social and emotional learning (Murphy et al., n.d.). As such, increasing social connectedness, positive parenting style, physical health, and mental health literacy are just some examples of key domains where promotion programs, both from a public health as well as crime perspectives, can intervene positively.


As seen from the information reviewed in this report, knowledge on the relationship between mental illness and youth crime is not conclusive. The overrepresentation of mentally ill individuals in the correctional system may have been partially explained, however, the similarity of risk factors between youth with mental health disorders and youth at risk of crime is evidence of the potential weight carried by these experiences or life events when it comes to social perversion. We should also consider the link between mental illnesses and victimization; and that conduct and substance abuse disorders have a clearer association with criminality, but there is not enough information to clearly answer questions related to the relationship between mental illness and crime.

In order to begin answering these questions, there must be more research performed on the links between mental disorders and criminal activity. For example, this report could not make specific conclusions about youth crime and mental illness, as there is a lack of available studies concentrating on the link between mental illness and criminal activity in the context of youth. Therefore, most of the conclusions made in this report needed to be broadened to mental illness and crime, regardless of age (unless otherwise specified). Furthermore, factors such as the standardization of definitions within the paradigm of mental illness; studying symptoms of illnesses and their respective links to criminality; and the acknowledgement of the weight of risk factors of mental illness when linked to crime are also very important issues that need consideration in future research if we truly seek to deepen our understanding of the relationship between mental illness and criminal activity. 

Finally, the presence of risk factors for criminal activity within the lives of youth suffering from mental disorders presents an opening for intervention before offending can take place. Combined with the proper services and intervention, crime prevention programs can positively impact the lives of these at-risk youth, giving them a chance to alter their future.

Appendix A

Mental health disorders are grouped into categories in the DSM-V based on the similarity of symptoms, effects the disorders have on the person, and treatment response, among other things (APA, 2013). Though there are many disorder categories listed in the DSM-V, not all of them are of interest for this report, as they do not all share behaviours that are regarded as “associated” with crime, such as eating disorders. Certain key mental health disorder categories for this report include:

(from the Diagnostic and Statistical Manual of Mental Disorders, 2013)


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World Health Organization (WHO). Mental health: strengthening our response. Fact sheet No. 220. Retrieved from


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Research Highlights are produced for the Community Safety and Countering Crime Branch, Public Safety Canada. The summary herein reflects interpretations of the report authors’ findings and do not necessarily reflect those of the Department of Public Safety Canada.


  1. 1

    The 2012 Canadian Community Health Survey―Mental Health (CCHS―MH) survey collected data from people 15 years of age and older, living in the 10 provinces and asked respondents about both mental and substance use disorders. More specifically, the survey measured six disorders: depression, bipolar disorder, generalized anxiety disorder, alcohol abuse or dependence, cannabis abuse or dependence, and other drug abuse or dependence. Respondents were asked a series of questions about symptoms experienced, as well as the types of behaviours they engaged in. Based on their responses, respondents were classified in terms of whether they met the criteria for a specific mental or substance use disorder. All disorders discussed in this article are based on respondents who met the criteria for a disorder in the 12 months prior to the survey. However, some limitations need to be mentioned: this survey did not collect data from persons living on reserves or other Aboriginal settlements, full-time members of the Canadian Forces, the institutionalized population, and from Canadians living in the territories. Further, since this was a household survey, the homeless population was also out of scope. In addition, when referring to mental or substance use disorders, as well as contact with police, it is important to highlight the fact that the rates provided may underestimate the extent of these issues in Canada, since only selected disorders and selected types of contact with police were measured. Furthermore, certain disorders which have been found to be important contributors to people's interaction with police, such as antisocial personality disorder and fetal alcohol syndrome (MacPhail and Verdun-Jones 2013; Stewart and Glowatski 2014), were not captured by this survey. For more information, see Boyce (2015).

  2. 2

    This definition is also referenced by the Centers for Disease Control and Prevention (CDC) in the U.S, and the Canadian Mental Health Association (CMHA).

  3. 3

    Data are from the 2012 Aboriginal Peoples Survey. In this study, the Aboriginal populations considered were First Nations off reserve, Metis, and Inuit aged 26 to 59. The non-Aboriginal prevalence in this study was surveyed from the provinces only. For more information about the study, see Kumar (2016).

  4. 4

    See endnote 1 for the parameters of the 2012 Canadian Community Health Survey―Mental Health (CCHS―MH).

  5. 5

    Reasons for contact with police are: “traffic violations; being a victim of a crime; being a witness to a crime; being arrested; personal problems with emotions/mental health/substance use; or a family member's problems with emotions/mental health/substance use.” (Boyce, 2015)

  6. 6

    “Suspected mental or developmental disorders can include disorders such as: schizophrenia, depression, fetal alcohol syndrome, dementia, psychotic and neurotic illnesses, or sociopathic tendencies. Excludes accused persons for which information on suspected mental or developmental disorder was unknown. In 2013, information on suspected mental or development disorder was unknown for 13.3% (or 60 accused) of persons accused of homicide” (Boyce, 2015).

  7. 7

    Mental health needs in this context is defined as “having had at least one mental health treatment-oriented service or stay in a treatment centre during the previous six months” (Sapers & Zinger, 2016).

  8. 8

    The main disorders considered in this study were schizophrenia, bipolar disorder, and depression. In the study, symptoms of bipolar disorder were more closely related to direct crimes compared to symptoms of depression and schizophrenia. For more information, see Peterson et al. (2014).

  9. 9

    In the Coker’s study (2014), anxiety disorders, behavioural disorders, eating disorders, mood disorders, and substance abuse disorders were all assessed. The conclusions, however, do not indicate specific disorder combinations and their impact on crime. In this study, it is important to note that conduct disorders and substance use disorders were the most common disorders linked with crime.

  10. 10

    Severe or serious mental illnesses (or SMIs) are based on the age of the individual, their functional impairment, duration of the disorder, and the diagnoses. Examples of such disorders include schizophrenia and bipolar disorder.

  11. 11

    “Respondents stated that they “sometimes,” “often” or “always” have an emotional, psychological or mental health condition that may include anxiety, depression, bipolar disorder, substance abuse, anorexia, etc.” (Hango, 2016).

  12. 12

    The original paper does not directly define the term “peer victimization”. Based on several sources, it is possible to broadly define “peer victimization” as the experience of being targeted by physical, social, emotional or psychological harm from a peer. These activities include, but are not limited to, bullying and cyberbullying.

  13. 13

    In October 2016, the Canadian Observatory on Homelessness, in partnership with A Way Home Canada, released Without a Home: The National Youth Homelessness Survey. This study surveyed 1,103 young people experiencing homelessness from 47 different communities across 10 provinces and territories, providing the first national picture of youth homelessness in Canada. For more information, see Schwan et al. (2017).

  14. 14

    As an example of resources to help identify an appropriate risk assessment tool, the Ontario Centre of Excellence for Child and Youth Mental Health provides an online directory that profiles measures related to child and youth mental health and program evaluation. For more information, visit the website available at: In addition, for practitioners in the crime prevention domain as well as in the juvenile justice system, Vincent G. et al.’s book provides detailed information on risk assessment tools used in the criminal justice system. For more information see Vincent, G. et al. (2012), available at:

  15. 15

    Primary prevention programs focus on the onset of violence/offending for the youth suffering from a mental disorder. An example of a primary prevention program would be reducing the exposure of media violence to vulnerable youth suffering from a pre-existing emotional disorder. Secondary prevention programs target youth who have already developed a risk for violence/offending, but who have yet to participate in antisocial or violent behaviour. An example of a secondary prevention program would be programs directed at abuse survivors, assisting those suffering from PTSD, depression and suicidality. Tertiary prevention programs are focused on the youth who are already at risk of violence and crime, and who have already offended. An example of a tertiary prevention program would be a substance and alcohol abuse intervention program. (Leschied, 2008)

  16. 16

    The SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP) (US) is an evidence-based repository and review system designed to provide the public with reliable information on mental health and substance use interventions. For more information, consult the website at: (English only). Based on our knowledge, there’s no similar registry in Canada.

  17. 17

    Examples of evidence-based interventions are from the most rigid and high-quality evaluation studies where results are supported by at least one strong randomized-controlled trial (RCT). For instance, in Waddell et al. (2014)’s report, the authors searched for peer-reviewed literature to identify randomized-controlled trial (RCT) evidence for each of the major disorders: anxiety disorders including obsessive-compulsive disorder (OCD); attention-deficit/hyperactivity disorder (ADHD); substance use disorders; conduct disorder; major depressive disorder; autism spectrum disorders; bipolar disorder; eating disorders; and schizophrenia. For more information, see Waddell et al. (2014).

  18. 18

    This list consists of examples of mental heal promotion/mental disorder prevention programs, and is by no means all-inclusive.

  19. 19

    For more information about the Nurse-Family Partnership, consult their website at:

  20. 20

    For more information about the Promoting Alternative Thinking Strategies, consult their website at: and

  21. 21

    For more information about the Stop Now and Plan Program, consult their website at:

  22. 22

    For more information about the Multidimensional Family Therapy, consult their website at:

  23. 23

    This mentoring program included 30 youth (8-12 years old) receiving services in a mentoring program for a mental health population for at least eight weeks and the control group consisted of 30 children registered on a wait-list. Mentors met with the youth once a week for three hours. During that time, mentors engage in developmentally appropriate activities (e.g., playing games, sports) while working on specific goals. (Jent & Niec, 2006).

  24. 24

    Terms used in this paper such as drug dependence and substance abuse are no longer classified as distinct disorders within the DSM-V. The revised category, substance use disorders, captures the main criteria of these two previous disorders.

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