Examining Network Factors Among Treatment Court Participants

Background: Treatment courts (TCs) were developed to divert some people with mental illnesses and substance use problems from serving lengthy stays in prison to community-based treatment and services. Most treatment courts provide a variety of mental health, substance use, and social services to participants during the TCs. Outcomes such as future arrests and drug use have been extensively studied but the role of social networks during this treatment experience is not well understood. Research involving social network factors suggests that a variety of social network factors may play a role in promoting positive outcomes. The influence of social network factors on mental health is documented, although not extensively. Some research does conclude that social networks can influence the mental health treatment experience and adherence but evidence beyond this is limited. The purpose of this research is to explore the baseline mental health and network factors among a group of people entering TCs in one county in the Midwestern United States. Two research questions were explored: (1) how do mental health factors relate to perceived network support and control? (2) how does perceived self-efficacy relate to mental health and network factors? In addition to these two questions, participants’ mental health background, periods of homelessness, and substance use history are described.

Methods: Using an exploratory, non-experimental research design participant anxiety and depression were measured using the GAD-7 and PHQ-9 within four to six weeks of entering TC. Network factors including support and control offered by friends, family, and court and service providers was also examined using several standardized measures. Background factors including homelessness, history of drug use, and history of suicide were also collected. Thirty participants were recruited from four TCs – mental health, drug treatment, veterans, and driving while intoxicated (DWI). Participants in this county are in TCs, on average, 12 to 14 months and the majority of participants enter due to felony charges. Participants in this study ranged in age from 27 to 63. Approximately 70% identified as White and one third as women. Data were analyzed using descriptive statistics and bivariate analyses in R software.

Results: Approximately 75% of the sample had some form of employment; however, annual income for all participants, regardless of work status, were under the federal poverty level. Three fourth of the sample reported at least one period of homelessness with their first episode occurring as young as five years old. Mental health and self-efficacy were significantly related to perceived social support and control from network members. Although networks were, on average, fairly small (between three and four people), network members had high rates of drug use, stress, and perceived support.

Conclusion and Implications: This preliminary work on networks of participant in TCs helps identify the myriad services this population may need as they take part in court programs. Additional work is needed to determine if services offered to address social networks and housing instability impact health, mental health, criminal justice, and quality of life outcomes following court participation.