Integrating a Co-occurring Disorders Intervention in Drug Courts: An Open Pilot Trial

Abstract

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.

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

References

  1. Andrews, D. A., & Bonta, J. (2006). The psychology of criminal conduct (4th ed.). Newark, NJ: LexisNexis.

    Google Scholar 

  2. Andrews, D. A., Bonta, J., & Hoge, R. D. (1990). Classification for effective rehabilitation: Rediscovering psychology. Criminal Justice and Behavior, 17(1), 19–52. https://doi.org/10.1177/0093854890017001004.

    Article  Google Scholar 

  3. 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.

  4. Binswanger, I., Stern, M. F., Deyo, R. A., Heagerty, P. J., Cheadle, A., Elmore, J. G., & Koepsell, T. D. (2007). Release from prison—A high risk of death for former inmates. The New England Journal of Medicine, 356, 157–165. https://doi.org/10.1056/NEJMsa064115.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  5. 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.

  6. Brown, R. T. (2010). Systematic review of the impact of adult drug-treatment courts. Translational Research, 155(6), 263–274. https://doi.org/10.1016/j.trsl.2010.03.001.

    Article  PubMed  PubMed Central  Google Scholar 

  7. 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.

    Article  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. 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.

    Article  Google Scholar 

  10. Draine, J., & Herman, D. B. (2007). Critical time intervention for re-entry from prison for persons with mental illness. Psychiatric Services, 58(12), 1577–1581. https://doi.org/10.1176/ps.2007.58.12.1577.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  Google Scholar 

  12. 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.

    Article  Google Scholar 

  13. 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.

    Article  Google Scholar 

  14. Laub, J. H., & Sampson, R. J. (2001). Understanding Desistance from Crime. Crime and Justice, 28(1), 1–69.

    Article  Google Scholar 

  15. 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.

  16. 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.

    CAS  Article  Google Scholar 

  17. 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.

  18. O’Connor, K., Kline, A., Sawh, L., Rodrigues, S., Fisher, W., Kane, W., Kuhn, J., Ellison, M., & Smelson, D. (2012). Unemployment and co-occurring disorders among homeless veterans. Journal of Dual Diagnosis, 9(2), 134–138. https://doi.org/10.1080/15504263.2013.778804.

    Article  Google Scholar 

  19. Peters, R. H., Kremling, J., Bekman, N. M., & Caudy, M. S. (2012). Co-occurring disorders in treatment-based courts: Results of a national survey. Behavioral Sciences & the Law, 30(6), 800–820. https://doi.org/10.1002/bsl.2024.

    Article  Google Scholar 

  20. 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 

  21. Piquero, A. (2010). Cost-benefit analysis for jail alternatives and jail. Report to Broward Sheriffs 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.

  22. 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.

    Article  Google Scholar 

  23. 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.

    Article  Google Scholar 

  24. 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.

    Article  Google Scholar 

  25. 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 

  26. 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.

    Article  Google Scholar 

  27. Steadman, H. J., Davidson, S., & Brown, C. (2001). Law and psychiatry: Mental health courts: Their promise and unanswered questions. Psychiatric Services, 52(4), 457–458. https://doi.org/10.1176/appi.ps.52.4.457.

    CAS  Article  PubMed  Google Scholar 

  28. 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.

  29. 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.

  30. 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.

  31. 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.

    CAS  Article  Google Scholar 

  32. Taxman, F. S., & Thanner, M. (2006). Risk, need, and responsivity (RNR): It all depends. Crime and Delinquency, 52(1), 28–51.

    Article  Google Scholar 

  33. 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.

    Article  Google Scholar 

  34. Trojano, M. L., Christopher, P. P., Pinals, D. A., Harnish, A., & Smelson, D. (2017). Perceptions of voluntary consent among jail diverted veterans with co-occurring disorders. Behavioral Sciences & the Law. https://doi.org/10.1002/bsl.299.

    Article  Google Scholar 

  35. 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.

    Article  Google Scholar 

  36. 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.

    Article  Google Scholar 

  37. Ziedonis, D., & Stern, R. (2001). Dual recovery therapy for schizophrenia and substance abuse. Psychiatric Annals, 31(4), 226–232.

    Article  Google Scholar 

Download references

Acknowledgements

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.

Funding

This work was funded by a grant from the Substance Abuse and Mental Health Services Administration (1H79TI025074-03).

Author information

Affiliations

Authors

Corresponding author

Correspondence to David Smelson.

Ethics declarations

Conflict of interest

The authors report no known conflicts of interest and certify responsibility for the manuscript submitted.

Disclosure

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.

Ethical Approval

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.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Smelson, D., Farquhar, I., Fisher, W. et al. Integrating a Co-occurring Disorders Intervention in Drug Courts: An Open Pilot Trial. Community Ment Health J 55, 222–231 (2019). https://doi.org/10.1007/s10597-018-0255-7

Download citation

Keywords

  • Alternatives to incarceration
  • Drug courts
  • Co-occurring disorders treatment