A co-occurring disorders intervention for drug treatment court: 12-month pilot study outcomes

David Smelson (Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA)
Paige M. Shaffer (Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA)
Camilo Posada Rodriguez (Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA)
Ayorkor Gaba (Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA)
Jennifer Harter (Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA)
Debra A. Pinals (Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA)
Sheila C. Casey (Executive Office of the Massachusetts Trial Court, Boston, Massachusetts USA)

Advances in Dual Diagnosis

ISSN: 1757-0972

Publication date: 13 November 2020

Abstract

Purpose

Many individuals in drug treatment courts (DTCs) have co-occurring mental health and substance use disorders (COD), which can negatively impact treatment engagement, behavioral health and criminal justice outcomes. This paper aims to report results of DTC participants with a COD, who received a 12-month wraparound treatment intervention called MISSION-Criminal Justice (MISSION-CJ) alongside DTC to improve treatment engagement and behavioral health outcomes and reduce reincarcerations.

Design/methodology/approach

In this pre-post, single-group pilot, 48 clients enrolled and 81% completed 12-month follow-up assessments (N = 39) and weekly MISSION-CJ fidelity for type and intensity of services delivered. Generalized linear mixed models (GLMMs) were computed with a fixed term for fidelity (e.g. high or low MISSION-CJ), time and a fidelity x time interaction term.

Findings

Among participants, at 12 months, 81% of the participants remained engaged in treatment at study completion, and 89% had high MISSON-CJ fidelity. Clients demonstrated significant reductions from baseline to 12 months in average nights in jail (B = −0.1849511, p < 0.0344), mental health symptoms via the Behavior and Symptom Identification Scale (BASIS) total and subscale scores (B = −0.121613, p < 0.0186) and trauma symptoms on the PTSD Checklist-5 (PCL-5) (B = −0.928791, p < 0.0138). High MISSION-CJ fidelity further improved criminal justice, and behavioral health outcomes.

Originality/value

This was the first reported 12-month MISSION-CJ trial. While feasible to implement, given the design limitations, future research should include a large randomized controlled trial.

Keywords

Acknowledgements

This work was funded by two grants from the Substance Abuse and Mental Health Services Administration (#TI026128) and (#1H79TI081069).

Citation

Smelson, D., Shaffer, P.M., Posada Rodriguez, C., Gaba, A., Harter, J., Pinals, D.A. and Casey, S.C. (2020), "A co-occurring disorders intervention for drug treatment court: 12-month pilot study outcomes", Advances in Dual Diagnosis, Vol. 13 No. 4, pp. 169-182. https://doi.org/10.1108/ADD-08-2020-0016

Publisher

:

Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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