Skip to main content

Integrated Treatment for Jail Recidivists with Co-occurring Psychiatric and Substance Use Disorders

Abstract

Jail recidivists with serious mental illness and substance use disorders were treated in an in-custody setting and then randomly assigned to either a high fidelity Integrated Dual Disorders Treatment program (103 participants) or to service as usual (79 participants). Outcomes were tracked an average of 18 months from program entry at the termination of the initial incarceration. A reduction in jail days from baseline to study period was significant for both groups. The pre to post reduction for arrests and total convictions was significant in the experimental group but not the control group. However, during the study period, differences between experimental and control groups in arrests, convictions and jail days were not statistically significant. Experimental participants had lower study period psychiatric inpatient and crisis utilization and greater outpatient utilization than did control group participants. The groups did not differ with regard to total institutional days. Experimental group attrition was relatively high.

This is a preview of subscription content, access via your institution.

FIGURE 1
FIGURE 2
FIGURE 3

References

  • Abram K. M., Teplin L. A. (1991) Co-occurring disorders among mentally ill jail detainees. Implications for public policy. American Psychologist 46(10):1036–1045

    PubMed  Article  CAS  Google Scholar 

  • Aos S., Phipps P., Barnoski R., Lieb R. (2001) The comparative costs and benefits of programs to reduce crime, Version 4.0. Washington State Institute for Public Policy, Olympia

    Google Scholar 

  • Arboleda-Florez J., Holley H. L. (1988) Criminalization of the mentally ill: Part II. Initial detention. Canadian Journal of Psychiatry 32(2):87–95

    Google Scholar 

  • Barker S., Barron N., McFarland B. H., Bigelow D. A. (1994) A community ability scale for chronically mentally ill consumers: Part I. Reliability and validity. Community Mental Health Journal 30(4):363–383

    PubMed  Article  CAS  Google Scholar 

  • Barrowclough C., Haddock G., Tarrier N., Lewis S. W., Moring J., O’Brien R., et al. (2001) Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders. American Journal of Psychiatry 158(10):1706–1713

    PubMed  Article  CAS  Google Scholar 

  • Belcher J. R. (1988) Are jails replacing the mental health system for the homeless mentally ill? Community Mental Health Journal 24(3):185–195

    PubMed  Article  CAS  Google Scholar 

  • Bond G. R., Salyers M. P. (2004) Prediction of outcome from the Dartmouth assertive community treatment fidelity scale. CNS Spectator 9(12):937–942

    Google Scholar 

  • Broner N., Lattimore P. K., Cowell A. J., Schlenger W. E. (2004) Effects of diversion on adults with co-occurring mental illness and substance use: outcomes from a national multi-site study. Behavioral Sciences and the Law 22(4):519–541

    PubMed  Article  Google Scholar 

  • Clark R. E., Ricketts S. K., McHugo G. J. (1999) Legal system involvement and costs for persons in treatment for severe mental illness and substance use disorders. Psychiatric Services 50(5):641–647

    PubMed  CAS  Google Scholar 

  • Clark R. E., Teague G. B., Ricketts S. K., Bush P. W., Xie H., McGuire T. G., et al. (1998) Cost-effectiveness of assertive community treatment versus standard case management for persons with co-occurring severe mental illness and substance use disorders. Health Services Research 33(5 Pt 1):1285–1308

    PubMed  CAS  Google Scholar 

  • Cosden M., Ellens J., Schnell J., Yamini-Diouf Y. (2005) Efficacy of a Mental Health Treatment Court with assertive community treatment. Behavioral Sciences and the Law 23(2):199–214

    PubMed  Article  Google Scholar 

  • De Leon G., Melnick G., Kressel D., Jainchill N. (1994) Circumstances, motivation, readiness and suitability (The CMRS Scales): predicting retention in therapeutic community treatment. American Journal of Drug and Alcohol Abuse 20(4):495–515

    PubMed  Article  Google Scholar 

  • Donald M., Dower J., Kavanagh D. (2005) Integrated versus non-integrated management and care for clients with co-occurring mental health and substance use disorders: a qualitative systematic review of randomised controlled trials. Social Science and Medicine 60(6):1371–1383

    PubMed  Article  Google Scholar 

  • Drake, R. E., & Brunette, M. F. (1998). Complications of severe mental illness related to alcohol and other drug use disorders. In M. Galanter (Ed.), Recent developments in alcoholism (Vol. 14, The Consequences of Alcoholism: Medical, Neuropsychiatric, Economic, Cross-Cultural, pp. 285–299). New York: Plenum Press

  • Drake R. E., Essock S. M., Shaner A., Carey K. B., Minkoff K., Kola L., et al. (2001) Implementing dual diagnosis services for clients with severe mental illness. Psychiatric Services 52(4):469–476

    PubMed  Article  CAS  Google Scholar 

  • Drake R. E., McHugo G. J., Clark R. E., Teague G. B., Xie H., Miles K., et al. (1998) Assertive community treatment for patients with co-occurring severe mental illness and substance use disorder: a clinical trial. American Journal of Orthopsychiatry 68(2):201–215

    PubMed  Article  CAS  Google Scholar 

  • Drake R. E., Mueser K.T., Brunette M. F., McHugo G. J. (2004) A review of treatments for people with severe mental illnesses and co-occurring substance use disorders. Psychiatric Rehabilitation Journal 27(4):360–374

    PubMed  Article  Google Scholar 

  • Drake R. E., Xie H., McHugo G. J., Shumway M. (2004) Three-year outcomes of long-term patients with co-occurring bipolar and substance use disorders. Biological Psychiatry 56(10):749–756

    PubMed  Article  Google Scholar 

  • Epstein J., Barker P., Vorburger M., Murtha C. (2004) Serious Mental Illness and Its Co-Occurrence with Substance Use, 2002 (No. (DHHS Publication No. SMA 04–3905, Analytic Series A-24)). Substance Abuse and Mental Health Services, Administration Office of Applied Studies, Rockville, MD

    Google Scholar 

  • Farabee D., Shen H. (2004) Antipsychotic medication adherence, cocaine use, and recidivism among a parolee sample. Behavioral Sciences and the Law 22(4):467–476

    PubMed  Article  Google Scholar 

  • Fiander M., BurnsT., McHugo G. J., Drake R. E. (2003) Assertive community treatment across the Atlantic: comparison of model fidelity in the UK and USA. British Journal of Psychiatry 182:248–254

    PubMed  Article  Google Scholar 

  • Godley S. H., Finch M., Dougan L., McDonnell M., McDermeit M., Carey A. (2000) Case management for dually diagnosed individuals involved in the criminal justice system. Journal of Substance Abuse Treatment 18(2):137–148

    PubMed  Article  CAS  Google Scholar 

  • Gonzalez G., Rosenheck R. A. (2002) Outcomes and service use among homeless persons with serious mental illness and substance abuse. Psychiatric Services 53(4):437–446

    PubMed  Article  Google Scholar 

  • Greenberg M. (2002) Building bridges: synopsis of the literature on co-occurring disorders. RAND, Santa Monica

    Google Scholar 

  • Hasin D., Trautman K., Endicott J. (1998) Psychiatric research interview for substance and mental disorders: phenomenologically based diagnosis in patients who abuse alcohol or drugs. Psychopharmacology Bulletin 34(1):3–8

    PubMed  CAS  Google Scholar 

  • Health Canada. (2002) Best Practices: Concurrent Mental Health and Substance Use Disorders. Health Canada Publications Health Canada Ottawa, Ontario K1A 0K9

  • Hellerstein D. J., Rosenthal R. N., Miner C. R. (1995) A prospective study of integrated outpatient treatment for substance-abusing schizophrenic patients. American Journal on Addictions 4(1):33–42

    Article  Google Scholar 

  • Hoff R. A., RosenheckR. A., Baranosky M. V., Buchanan J., Zonana H. (1999) Diversion from jail of detainees with substance abuse: the interaction with dual diagnosis. American Journal on Addictions 8(3):201–210

    PubMed  Article  CAS  Google Scholar 

  • Judd P. H., Thomas N., Schwartz T., Outcalt A., Hough R. (2003) A dual diagnosis demonstration project: treatment outcomes and cost analysis. Journal of Psychoactive Drugs 35(Suppl 1):181–192

    PubMed  Google Scholar 

  • Lamb H. R., Weinberger L. E. (2001) Persons with severe mental illness in jails and prisons: a review. New Directions in Mental Health Services 90:29–49

    Article  Google Scholar 

  • LehmanA. F., Herron J. D., Schwartz R. P., Myers C. P. (1993) Rehabilitation for adults with severe mental illness and substance use disorders. A clinical trial. Journal of Nervous and Mental Disease 181(2):86–90

    PubMed  CAS  Article  Google Scholar 

  • Ley A., Jeffery D. P., McLaren S., Siegfried N. (2000) Treatment programmes for people with both severe mental illness and substance misuse. Cochrane Database of Systematic Reviews 36(2):CD001088

    Google Scholar 

  • Long J. S. (1997) Regression models for categorical and limited dependent variables. SAGE Publications, Thousand Oaks

    Google Scholar 

  • Martin S. S., Inciardi J. A., ScarpittiF. R., Nielsen A. L. (1997) Case management for drug involved parolees: it proved to be a hard ACT to Follow. In: Horton A. M. Jr. (ed) The effectiveness of innovative approaches in the treatment of drug abuse, Westport: Greenwood Press.

    Google Scholar 

  • McCoy M. L., RobertsD. L., Hanrahan P., Clay R., Luchins D. J. (2004) Jail linkage assertive community treatment services for individuals with mental illnesses. Psychiatric Rehabilitation Journal 27(3):243–250

    PubMed  Article  Google Scholar 

  • McHugoG. J., DrakeR. E., Teague G. B., Xie H. (1999) Fidelity to assertive community treatment and client outcomes in the New Hampshire dual disorders study. Psychiatric Services 50(6):818–824

    PubMed  CAS  Google Scholar 

  • Mercer-McFadden C., Drake R., Clark R. E., Verven N., Noordsy D. L., Fox T. S. (1998) Substance Abuse Treatment for People with Severe Mental Disorders: A Program Manager’s Guide. New Hampshire-dartmouth Psychiatric Research Center, Concord, New Hampshire

    Google Scholar 

  • Mueser K. T., Essock S. M., DrakeR. E., Wolfe R. S., Frisman L. (2001) Rural and urban differences in patients with a dual diagnosis. Schizophrenia Research 48(1):93–107

    PubMed  Article  CAS  Google Scholar 

  • Mueser K. T., Noordsy D. L., Drake R. E., Fox L. B. (2003) Integrated Treatment for Dual Disorders: A guide to effective practice. Guilford Press, New York

    Google Scholar 

  • Pandiani J. A., Rosenheck R., Banks S. M. (2003) Elevated risk of arrest for Veteran’s Administration behavioral health service recipients in four Florida counties. Law and Human Behavior 27(3):289–298

    PubMed  Article  Google Scholar 

  • Pocock S. J., Clayton T. C., Altman D. G. (2002) Survival plots of time-to-event outcomes in clinical trials: good practice and pitfalls. Lancet 359:1686–1689

    PubMed  Article  Google Scholar 

  • Power K., Demartino R. (2004) Co-occurring disorders and achieving recovery: the substance abuse and mental health services administration perspective. Biological Psychiatry 56(10):721–722

    PubMed  Google Scholar 

  • Sacks S. (2000) Co-occurring mental and substance use disorders: promising approaches and research issues. Substance Use and Misuse 35(12–14):2061–2093.

    PubMed  Article  CAS  Google Scholar 

  • Schonlau M. (2003) Hotdeckvar. Retrieved September 15, 2003, from http://www.schonlau.net/hotdeckvar.html

  • Steadman H. J., Naples M. (2005) Assessing the effectiveness of jail diversion programs for persons with serious mental illness and co-occurring substance use disorders. Behavioral Sciences and the Law 23(2):163–170

    PubMed  Article  Google Scholar 

  • Substance Abuse and Mental Health Services Administration. (2002). Report To Congress on the Prevention and Treatment of Co-Occurring Substance Abuse Disorders and Mental Disorder, from http://www.samhsa.gov/reports/congress2002/index.html. Rockville, MD: SAMHSA.

  • Substance Abuse and Mental Health Services Administration. (2005) Co-Occurring Disorders: Integrated Dual Disorders Treatment Toolkit. Retrieved February 9, 2005, 2005, from http://www.mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/cooccurring/

  • Torrey W. C., Drake R. E., Cohen M. A., Fox L. B., Lynde D., Gorman P., et al. (2002) The challenge of implementing and sustaining integrated dual disorders treatment programs. Community Mental Health Journal 38(6):507–521

    PubMed  Article  Google Scholar 

  • Van Stelle K. R., Blumer C., Moberg D. P. (2004) Treatment retention of dually diagnosed offenders in an institutional therapeutic community. Behavioral Sciences and the Law 22(4):585–597

    PubMed  Article  Google Scholar 

  • Weisman R. L., Lamberti J. S., Price N. (2004) Integrating criminal justice, community healthcare, and support services for adults with severe mental disorders. Psychiatric Quarterly 75(1):71–85

    PubMed  Article  CAS  Google Scholar 

Download references

Acknowledgments

Funding for the services described here and the evaluation were provided by a California Mentally Ill Offender Crime Reduction Grant to the County of Alameda.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniel William Chandler Ph.D..

Additional information

Daniel Chandler is an Independent Research Consultant in Trinidad, CA, USA.

Gary Spicer, MBA is affiliated with Alameda County Behavioral Health Care Services, 2000 Embarcadero Cover, Suite 400, Oakland, CA.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Chandler, D.W., Spicer, G. Integrated Treatment for Jail Recidivists with Co-occurring Psychiatric and Substance Use Disorders. Community Ment Health J 42, 405–425 (2006). https://doi.org/10.1007/s10597-006-9055-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-006-9055-6

Keywords

  • co-occurring disorders
  • integrated dual disorders treatment
  • jail recidivism
  • randomized controlled trial