Predictors of Problem-Focused Coping Strategies Among Criminal Justice-Involved Adults with Co-Occurring Substance Use and Mental Health Disorders

Background and Purpose: Rates of mental health disorders, substance use disorders, and their co-occurrence are disproportionately higher among adults in the criminal justice system than among those in the general population. Holistic reentry programming is needed for this group and contemporary frameworks point to the need for effective coping strategies. However, much of the scholarly attention has focussed on negative coping strategies like substance use or illegal behaviors. Few studies have examined factors related to the utilization of positive, active forms of coping among this group. Thus, the current study examines predictors of problem-focused coping among a sample of reentering justice-involved adults with co-occurring substance use and mental health disorders.

Methods: Data includes those who met diagnostic criteria for co-occurring disorders from Phase 1 of the 5-Key Model for Reentry (N = 225), originally collected from 2018-2019 as a multisite randomized controlled trial of reentering justice-involved adults from 50 prisons across four states: Florida, Kentucky, Pennsylvania, and Texas. Data for this study was collected during incarceration prior to their scheduled release date. Problem-focused coping was measured as an eight-item scale (α = 0.95). Predictors included resources such as personal (physical role limitations, emotional well-being, and overall health), material (income, employment, and education), and social (relationship depth) coping resources. Risk factors included prior prison commitments and trauma history. Demographic measures included race/ethnicity, gender, and age. Multivariate linear regression models examined predictors of problem-focused coping.

Results: Personal coping resources including emotional well-being (b= 0.04, p<.01) and overall health (b= 0.04, p<.01) were significantly associated with elevated usage of problem-focused coping. For material resources, those with higher income reported significantly higher levels of engaging in problem-focused coping (b= 1.19, p<.05). Social coping resources including relationship depth with the person they are closest to (b= 0.12, p<.05) was also significantly associated with problem-focused coping. Compared to White individuals, African Americans (b= 1.52, p<.01) and other racial/ethnic groups that were not Hispanic (b= 2.25, p<.01) reported significantly higher levels of problem-focused coping.

Conclusions and Implications: Individuals with more positive perceptions of their general and emotional health, higher income, and stronger relationship depth were more likely to report higher utilization of problem-focused coping. To better deliver problem-focused coping skills, reentry interventions should also address other challenges to well-being, including physical and emotional health and interpersonal relationships. Additional research is needed to disentangle racial/ethnic differences in problem-focused coping among justice-involved adults with co-occurring disorders, including how experiences of discrimination may influence this relationship. Social workers can leverage findings highlighting strengths-based areas conducive to effective positive coping during reentry. This enables them to develop effective interventions that capitalize on individuals’ strengths, and provides needed resources to support the well-being of justice-involved adults with co-occurring mental health and substance use disorders.