Friday, January 13, 2012
Independence F - I (Grand Hyatt Washington)
* noted as presenting author
Background: At any given time, over 1 million individuals with a serious mental illness (SMI) are incarcerated or are under some type of community corrections supervision (Skeem, Manchak, & Peterson, 2010). An estimated 76% of offenders with SMI meet criteria for a comorbid substance use disorder (James & Glaze, 2006).Once released to the community, offenders with SMI illness and comorbid substance use are significantly more likely than their non-mentally ill counterparts to be reincarcerated (Messina et al., 2004). Recently, mental health courts (MHCs) have developed with an overarching goal of reducing recidivism by offering an alternative voluntary court process and access to treatment in lieu of traditional sentencing. Substance use/misuse has been shown to be highly predictive of recidivism in SMI samples (Andrews & Bonta, 2003), however how comorbid substance use impacts MHC participants' recidivism has been unexplored. Thus, the purpose of this study was to assess the relationship between MHC participants' severity of substance use/misuse and subsequent legal recidivism (e.g., six month arrests, charges, and jail days). Methods: Characteristic and substance use data was collected through structured interviews with 148 legally competent adults diagnosed with schizophrenia, bipolar disorder, and/or major depression who had recently enrolled in a MHC. Among participants who endorsed using alcohol/other drugs, the Alcohol Use Disorders Identification Test (AUDIT; Saunders, Aasland, Babor, de la Fuente, & Grant, 1993) and the Drug Abuse Screening Test-20 (DAST-20; Skinner, 1982) were used to measure the severity of their substance use. Six-month post intake recidivism data were provided by the MHC program. Multiple regression analyses were conducted to assess substance use measures as predictive of legal recidivism. Results: Study participants were predominately male (62%), white (58%), and single (69%). Participants ranged in age from 18 to 64 (M = 36.56, SD = 11.81). Their highest completed educational grade spanned from 3 to 17 (M = 11.46, SD = 2.49), with one-half of the participants (49%) reporting having completed 11th grade or less of school. At six months post MHC opt-in, 67 (45%) of the participants had been rearrested. Their arrests (M =1.69, SD = 1.02) were significantly correlated with both AUDIT (r = .286, p = .001) and DAST (r = .252, p = .002) scores. Their number of criminal charges (M = 2.25, SD = 2.02) were significantly correlated with participants' AUDIT (r =.271, p = .001) and DAST (r = .197, p = .018) scores. Their month jail days (M = 3.33, SD =44.72) were not significantly correlated with AUDIT or DAST scores. The results of the regression analyses revealed that AUDIT scores emerged as the most significant predictor of subsequent arrests (F = 12.54, p = .001) and number of charges (F = 11.28, p = .001). Conlusions: In this study sample, problematic alcohol use was significantly predictive of subsequent MHC participant rearrest and number of charges. Findings suggest that MHC programs should consider assessing substance use and linking participants to integrated substance abuse and mental health treatment to better reduce legal recidivism of their participants.
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