Tuesday, July 30, 2019

Wraparound Services Increase Benefits of Mental Health Courts, Study Finds

A program that offers integrated behavioral-health and criminal-justice services to individuals who are participating in mental health courts may help reduce recidivism and promote recovery among participants, a pilot study published in Psychiatric Services in Advance suggests.

Mental health courts divert people with mental health and/or substance use disorders who have been arrested from jail to court-monitored treatment referral and support.

Debra A. Pinals, M.D., of the University of Michigan Medical School and colleagues evaluated the impact of an intervention called Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking–Criminal Justice (MISSION-CJ) on individuals involved in a Massachusetts mental health court. MISSION-CJ offers a series of wraparound services including case management, in-community support, structured group treatment sessions designed to simultaneously treat co-occurring mental health and substance use disorders, peer support, vocational and educational support, trauma-informed care, and frequent coordination with probation officers.

A total of 97 mental health court participants who were found guilty in criminal court and who met criteria for a DSM-IV-TR axis I psychiatric disorder (for example, depression) and reported current or past substance use were included in the study. The researchers evaluated the participants using the Addiction Severity Index, the Behavior and Symptom Identification Scale-32, and the PTSD Checklist–Civilian Version at the start of the study and again six months later.

Participants were primarily male with an average age of 34, had spent an average of five years incarcerated, and had an average 14-year history of illegal drug use; 91% had experienced depression. The researchers found that after six months in MISSION-CJ, participants experienced a significant reduction in nights incarcerated, illegal drug use, trauma symptoms, and behavioral health symptoms.

The researchers acknowledged several limitations of the study, including the small sample size and the lack of a comparison group who did not receive MISSION-CJ.

Nonetheless, they concluded, “[T]his pilot study demonstrates that the MISSION-CJ intervention could be offered to mental health court participants … alongside the mental health court, with promising preliminary results. … Future studies comparing the effectiveness and cost-effectiveness of MISSION-CJ, usual mental health court processes, and any alternative interventions are needed to address the needs of this growing population.”

For related information, see the Psychiatric Services article “Improving the Evaluation of Adult Mental Disorders in the Criminal Justice System With Computerized Adaptive Testing.”

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