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.

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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).

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Correspondence to David Smelson.

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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.

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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).

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