Objectives: This study isolates the effects of mental health, substance use, and co-occurring disorders on three distinct dispositional outcomes: incarceration (i.e., jail/detention), non-incarcerative residential placement (i.e., treatment facility), and community sanctions (i.e., fines/restitution or probation). Methods: Using a sample of juvenile offenders from the Pathways to Desistance study (N = 617), a series of logistic regression models were estimated to test the joint and independent effects of mental health, substance use, and co-occurring disorders on the likelihood of detention versus non-incarcerative sanctions. A series of multinomial logistic regression models were estimated to assess whether these disorders increase the likelihood of out-of-home placement (i.e., non-incarcerative residential placement and incarceration) relative to community sanctions. Results: While having any disorder was associated with out-of-home placement, youth with substance use disorders had the greatest likelihood of receiving an out-of-home placement, including detention. Youth with co-occurring disorders were more likely to receive a non-incarcerative residential placement, whereas mental health disorders did not demonstrate a significant effect on adjudication. Conclusions: Youth with mental health, substance use, and co-occurring disorders are treated differently in juvenile court. Using a composite disorder measure and/or not considering various sanction types could mask the effects of such disorders on court outcomes
