Family Incarceration and Mental Health Among 101,417 Affected Families: A Systematic Review and Multilevel Meta-Analysis.

Most if not all previous evidence focused primarily on psychological disorders of prisoners/ex-prisoners, whereas the secondary trauma symptoms across the whole family await clarification. The present systematic review and meta-analysis aimed to investigate the associations between exposure to family incarceration and psychiatric symptoms and moderators of the associations. This systemic review and meta-analysis followed PRISMA guidelines (CRD42023495095). Studies on the mental health of family incarceration from inception to March 4th, 2024 were searched in PsycINFO, PubMed, and Medline. Methodological quality was assessed. Meta-analysis of correlation coefficients r with the random-effects model was performed using "metafor" package in R. Fifty-three studies (34 non-duplicate samples, 2005-2024) with 101,417 people experiencing family incarceration across eight countries were included in the final synthesis. Participants aged 2 to 99 years. Most (96.23%) were conducted in high-income countries (i.e., Australia, Finland, Ireland, Sweden, the US, and the UK), with 3.77% in Mexico and Poland. Over half were longitudinal studies with follow-up periods from 2 to 53 years. Exposure to family incarceration was positively associated with psychiatric symptoms. Stronger effect sizes were found between incarceration and substance abuse disorder and externalizing disorders. Incarceration relates to secondary trauma symptoms in the long run among the affected families especially for children, African Americans in the US, and middle-income countries. Family-based intervention should be made to target the whole family with priorities on substance abuse disorder and externalizing disorders.