Clinical and Criminal Justice Outcomes in the Samhsa Funded Jail Diversion and Trauma Recovery (JDTR) Program for Veterans

Background/Purpose:  The overrepresentation of persons with mental illness involved in the criminal justice system is a critical problem.  While veterans are not disproportionately represented in the criminal justice system, incarcerated veterans have higher rates of mental illness than non-veterans who are incarcerated, a trend that is likely to continue given the rates of PTSD, depression and traumatic brain injury (TBI) in returning combat veterans.

Federal, state and local governments have supported new initiatives to support veterans with mental illness who become involved in the criminal justice system, including the SAMHSA funded Jail Diversion and Trauma Recovery Program (JDTR), which utilized veteran peer interventions. 

Currently, there is no published research about the effectiveness of veteran peers in improving criminal justice and clinical outcomes for veterans with trauma experience.  The aim of this study, therefore, was to evaluate the effectiveness of JDTR and answer the question about whether JDTR and peer mentors, in particular, significantly improved clinical and criminal justice outcomes for veteran offenders with trauma related mental illness.

Methods:  This study used secondary data collected as part of the JDTR program evaluation and employed a one-group, pretest-posttest research design to assess criminal justice and clinical outcomes.  Clinical data measured at the time of enrollment in JDTR were compared with clinical data measured at six months.  Arrest data one year prior to enrollment in JDTR were compared to arrest data one year after enrollment in JDTR.  A qualitative analysis was also conducted using a questionnaire to assess peer mentee perceptions of the importance of the peer relationship in the mentee's future success and to explore what factors were considered important qualities that constituted a veteran peer relationship.

Results:  Results showed significant improvements in clinical outcomes, including reductions in PTSD symptoms, depression symptoms and function difficulty scores, but no improvement in criminal justice outcomes or reductions in re-arrest rates.  Results also showed a positive correlation between pre-enrollment arrests and post-enrollment arrests, but no correlation between baseline PTSD sum severity scores or other baseline symptom severity scores and re-arrest rates.  Qualitative results showed participants overwhelmingly viewed their assigned veteran peer mentor as a "peer" and rated them as "very important" to their future success.  Improvements in avoidance and numbing and depression symptoms also suggest peer interventions may be effective in improving responsivity to evidence-based criminal justice interventions.  

Conclusion and Implications:  Findings are consistent with research on "first generation" forensic mental health interventions that shows improvements in clinical outcomes do not result in reductions in recidivism. Findings also support research that shows mental illness is better understood as a responsivity factor, not risk factor for crime.   Study limitations, however, prevent the drawing of conclusions regarding the potential effectiveness of veteran peer interventions improving criminal justice outcomes.  The implication of this study, therefore, would be to use these findings to assist with the design, development and implementation of "second generation interventions" that focus on reducing recidivism.  Further research on peer interventions and their role in improving responsivity and criminal justice outcomes is recommended.