Integrating a Co-occurring Disorders Intervention in Drug Courts: An Open Pilot Trial
Little research has focused on systematically integrating clinical treatment within existing drug court procedures. This could be particularly useful for clients with substance use disorders, who comprise those on court dockets and often have co-existing mental health issues. This article reports on the preliminary outcomes of integrating MISSION-Criminal Justice (MISSION-CJ), a co-occurring mental health and substance use wraparound intervention, within two Massachusetts drug courts. In this open pilot, clients completed intake and 6-month follow-up assessments. The participants were primarily Caucasian (86%), male (82%), had at least 2 prior arrests, and received outpatient treatment for mental health (54%), alcohol use (51%), or drug use (88%) prior to enrolling in MISSION-CJ. Six-month follow-up data suggested that participants showed statistically significant reductions in average number of nights spent in jail, alcohol use, and drug use, as well as an increase in full time employment.
KeywordsAlternatives to incarceration Drug courts Co-occurring disorders treatment
We thank the Gavin Foundation, the University of Massachusetts, the Massachusetts Department of Public Health, Massachusetts Department of Mental Health and the Executive Office of the Trial Court for supporting this work. Co-author Mary-Kate Duffy is no longer affiliated with the University of Massachusetts Medical School.
This work was funded by a grant from the Substance Abuse and Mental Health Services Administration (1H79TI025074-03).
Compliance with Ethical Standards
Conflict of interest
The authors report no known conflicts of interest and certify responsibility for the manuscript submitted.
The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the University of Massachusetts, the Department of Public Health, the Department of Mental Health, or the Massachusetts Executive Office of the Trial Court or United States Governments.
This open pilot was reviewed by the University of Massachusetts Medical School’s Institutional Review Board and was determined to be program evaluation rather than human subjects research.
Research Involving Human Participants
This article does not contain any studies with human participants performed by any of the authors.
- Andrews, D. A., & Bonta, J. (2006). The psychology of criminal conduct (4th ed.). Newark, NJ: LexisNexis.Google Scholar
- Belenko, S. (2001). Research on drug courts: A critical review, 2001 update. New York, NY: National Center on Addiction and Substance Abuse, Columbia University. Retrieved October 5, 2016, from https://pdfs.semanticscholar.org/1450/f4776d89877366bd93b1a696c1040c30adae.pdf.
- Bonta, J., & Andrews, D. A. (2007). Risk-need-responsivity model for offender assessment and rehabilitation (Corrections Research User Report No. 2007-06). Ottawa, Ontario: Public Safety Canada. Retrieved January 23, 2017 from https://cpoc.memberclicks.net/assets/Realignment/risk_need_2007-06_e.pdf.
- Case, B., Steadman, H. J., Dupuis, S. A., & Morris, L. S. (2009). Who succeeds in jail diversion programs for persons with mental illness? A multi-site study. Behavioral Sciences & the Law, 27(5), 661–674.Google Scholar
- Chinman, M., George, P., Doughtery, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services, 65(4), 429–441. https://doi.org/10.1176/appi.ps.201300244.Google Scholar
- Chinman, M., Shoai, R., & Cohen, A. (2010). Using organizational change strategies to guide peer support technician implementation in the Veterans Administration. Psychiatric Rehabilitation Journal, 33(4), 269–277.Google Scholar
- Epperson, M. W., Wolff, N., Morgan, R. D., Fisher, W. H., Frueh, B. C., & Huening, J. (2014). Envisioning the Next Generation of Behavioral Health and Criminal Justice Interventions. International Journal of Law and Psychiatry, 37(5), 427–438.Google Scholar
- Fox, A. D., Maradiaga, J., Weiss, L., Sanchez, J., Starrels, J. L., & Cunningham, C. O. (2015). Release from incarceration, relapse to opioid use and the potential for buprenorphine maintenance treatment: A qualitative study of the perceptions of former inmates with opioid use disorder. Addiction Science and Clinical Practice, 10, 2.Google Scholar
- Knudsen, K. J., & Wingenfeld, S. (2016). A specialized treatment court for veterans with trauma exposure: Implications for the field. Community Mental Health Journal, 52(2), 127–135.Google Scholar
- Laub, J. H., & Sampson, R. J. (2001). Understanding Desistance from Crime. Crime and Justice, 28(1), 1–69.Google Scholar
- Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking (MISSION). Intervention summary retrieved on November 18, 2016 from the Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-based Programs and Practices. http://nrepp.samhsa.gov/ProgramProfile.aspx?id=38.
- McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., Pettinati, H., & Argeriou, M. (1992). The fifth edition of the addiction severity index. Journal of Substance Abuse Treatment, 9(3), 199–213.Google Scholar
- Ministry of Justice. (2013). Analysis of the impact of employment on re-offending following release from custody, using propensity score matching. Retrieved December 3, 2016, from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/217412/impact-employment-reoffending.pdf.
- Pinals, D. A., Smelson, D., Sawh, L., Harter, J., Kline, A., & Ziedonis, D. (2014). The MISSION-CJ treatment manual. Worcester, MA: UMass Medical School.Google Scholar
- Piquero, A. (2010). Cost-benefit analysis for jail alternatives and jail. Report to Broward Sheriff’s Office Department of Community Control. Retrieved August 3, 2016, from http://criminology.fsu.edu/wp-content/uploads/Cost-Benefit-Analysis-for-Jail-Alternatives-and-Jail.pdf.
- Smelson, D., Kalman, D., Losonczy, M. F., Kline, A., Sambamoorthi, U., St. Hill, L., Castles-Fonseca, K., & Ziedonis, D. (2012). A brief treatment engagement intervention for individuals with co-occurring mental illness and substance use disorders: Results of a randomized clinical trial. Community Mental Health Journal, 48(2), 127–132.Google Scholar
- Smelson, D., Kline, A., Kuhn, J., Rodrigues, S., O’Connor, K., Fisher, W., Sawh, L., & Kane, V. (2013). A wraparound treatment engagement intervention for homeless veterans with co-occurring disorders. Psychological Services, 10(2), 161–167.Google Scholar
- Smelson, D., Losonczy, M., Ziedonis, D., Sussner, B., Castles-Fonseca, K., Rodrigues, S., & Kline, A. (2007). A brief community linkage intervention for veterans with a persistent mental illness and a co-occurring substance abuse disorder. European Journal of Psychiatry, 21(2), 143–152.Google Scholar
- Smelson, D., Pinals, D. A., Harter, J., Sawh, L., Kline, A., & Ziedonis, D. (2014). The MISSION-CJ participant workbook. Worcester, MA: UMass Medical School.Google Scholar
- Smelson, D., Pinals, D. A., Sawh, L., Fulwiler, C., Singer, S., Guevremont, N., Fisher, W., Steadman, H. J., & Hartwell, S. (2015). An alternative to incarceration: Co-occurring disorders treatment intervention for justice-involved veterans. World Medical & Health Policy, 7(4), 329–348. https://doi.org/10.1002/wmh3.168/abstract.Google Scholar
- Steadman, H. J., Peters, R. H., Carpenter, C., Mueser, K. T., Jaeger, N. D., Gordon, R. B., Fisler, C., Goss, S., Olson, E., Osher, F. C., Noether, C. D., & Hardin, C. (2013). Six Steps to Improve Your Drug Court Outcomes for Adults with Co-Occurring Disorders. SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation’s & National Drug Court Institute’s Drug Court Practitioner Fact Sheet, Vol. 8, No. 1. Retrieved September 27. 2016, from https://csgjusticecenter.org/mental-health/publications/six-steps-to-improve-your-drug-court-outcomes-for-adults-with-co-occurring-disorders.
- Substance Abuse & Mental Health Services Administration. (2006). “National Outcome Measures (NOMs) for Co-Occurring Disorders.” Substance Abuse & Mental Health Services Administration, U.S. Department of Health and Human Services. Retrieved December 14, 2016, from https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2012107168.xhtml.
- Substance Abuse and Mental Health Services Administration. (2010). GPRA Modernization Act of 2010. Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Retrieved from http://www.samhsa.gov/grants/gpra-measurement-tools/csap-gpra.
- Susser, E., Betne, P., Valencia, E., Goldfinger, S. M., & Lehman, A. (1997). Injection drug use among homeless adults with severe mental illness. American Journal of Public Health, 87(5), 854–856.Google Scholar
- Taxman, F. S., & Thanner, M. (2006). Risk, need, and responsivity (RNR): It all depends. Crime and Delinquency, 52(1), 28–51.Google Scholar
- Tomita, A., & Herman, D. (2015). The role of a critical time intervention on the experience of continuity of care among persons with severe mental illness following hospital discharge. Journal of Nervous and Mental Disease, 203(1), 65–70.Google Scholar
- Wolff, N. B., Frueh, C., Huening, J., Shi, J., Epperson, M. W., Morgan, R., & Fisher, W. (2013). Practice informs the next generation of behavioral health and criminal justice interventions. International Journal of Law and Psychiatry, 36, 1–10.Google Scholar
- Zarkin, G. A., Cowell, A. J., Hicks, K. A., Mills, M. J., Belenko, S., Dunlap, L. J., & Keyes, V. (2015). Lifetime benefits and costs of diverting substance-abusing offenders from state prison. Crime and Delinquency, 61(6), 829–850.Google Scholar
- Ziedonis, D., & Stern, R. (2001). Dual recovery therapy for schizophrenia and substance abuse. Psychiatric Annals, 31(4), 226–232.Google Scholar