Investigating Mental Health Implications for Drug Court Participants

• Published date: 01 July 2021
• Date: 01 July 2021
• DOI: 10.1177/0306624X20928031
• Author: Sara L. Dolan,Sindhu Shivaji,Alexis M. Humenik
• Subject Matter: Articles

Article

Investigating Mental

Health Implications for

Drug Court Participants

Alexis M. Humenik

1

,

Sindhu Shivaji

1

and Sara L. Dolan

1

Abstract

Drug Court Treatment (DCT) Programs seek to integrate substance abuse treat-

ment into the criminal justice system by providing a structured environment for

offenders who engage in treatment in lieu of incarceration. DCT has shown suc-

cesses in reducing drug/alcohol use, recidivism, and cost, but the impact of DCT on

non-substance-related mental health outcomes is less clear. This study evaluated

mental health correlates within a DCT sample through analyses of participants’

pre-entry and pre-graduation Minnesota Multiphasic Personality Inventory—

Second Edition (MMPI-2) profiles. When diagnostic information was available,

mood disorders had the highest comorbidity with alcohol/substance use diagnoses.

Comparisons across administrations of the MMPI-2 indicated significant differences

among mean scores on 6 Clinical scales, and mean profile elevation scores

significantly decreased. Results suggest a significant presence of mental health comor-

bidities in DCT programs, and significant mental health improvements were seen for

graduates, suggesting the utility of DCT for treating mental health problems in addi-

tion to substance use.

Keywords

Drug Court Treatment (DCT), mental health, substance abuse

1

Baylor University, Waco, TX, USA

Corresponding Author:

Sara L. Dolan, Department of Psychology and Neuroscience, Baylor University, One Bear Place #97334,

Waco, TX 76798, USA.

Email: Sara_Dolan@Baylor.edu

International Journal of

Offender Therapy and

Comparative Criminology

2021, Vol. 65(9) 1077–1096

!The Author(s) 2020

Article reuse guidelines:

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DOI: 10.1177/0306624X20928031

journals.sagepub.com/home/ijo

As specialty courts, such as Drug Court Treatment (DCT) programs, become

more popular, it is important to examine the myriad of ways these services can

positively impact society. Beyond the well-known effects of mitigating substance

use and saving taxpayer dollars through reduced substance-related recidivism

(Marlowe, 2010), DCTs can have a positive impact on participants’ mental

health. The current study is among the f‌irst to examine the relationship between

DCT program participation and improvement in mental health functioning.

Since the early 1980s, changing U.S. drug policies have contributed to the

rapidly increasing incarceration rates for substance-related offenses (Belenko

et al., 2007). Between 1970 and 2004, harsher criminal sanctions aimed at pro-

moting the “war on drugs” resulted in a 400% increase in incarceration admis-

sions, with substance users contributing to an approximately 60% increase in

federal inmate populations and a 30% increase in state inmate populations

(DeMatteo et al., 2011; Harrison & Beck, 2005). As governing and legal

groups continue to seek methods to reduce maintenance costs for jails and

prisons, interest is growing in programs aimed at deferred adjudication of

repeat substance use offenders to treatment and community programs (Peters

et al., 2012, 2015). However, a signif‌icant obstacle in the deferred adjudication

model is the effective management of individuals who have comorbid mental

and substance use disorders (CODs).

A major contribution to the national trend of prison, jail, and probation

growth can be attributed to arrest rates and increased recidivism for drug-

involved offenders (Peters et al., 2012, 2015). Substance users are often repeat-

edly cycled through the legal and correctional system as a result of untreated

substance use disorders and consequent drug-related crime charges. Those who

experience chronic distressing psychiatric symptoms may utilize illicit substances

as a maladaptive coping strategy aimed at mitigating unwanted symptoms

(Peters et al., 2015). Mental health disorders are common among those with

substance use disorders, those engaged in substance abuse treatment programs,

and especially in populations of offenders diagnosed with co-occurring sub-

stance use disorders (Peters et al., 2012, 2015); Mental illness rates are 3 to 4

times higher in prison and 4 to 6 times more likely in jail than in the general

population (Peters et al., 2012, 2015). Notably, 34% of female offenders and

17% of male offenders have demonstrated symptoms congruent with a non-

substance-related psychiatric diagnosis, including a major depressive disorder, a

bipolar disorder, a schizophrenia spectrum disorder, or post-traumatic stress

disorder (PTSD; Steadman et al., 2013). In addition, 70% to 74% of those

with non-substance-related diagnoses have also been diagnosed with a co-

occurring substance use disorder (Steadman et al., 2009, 2013).

It is evident that CODs serve as a potential moderating factor in understand-

ing the recidivism rates of substance users within the legal system. Individuals

with CODs are not only more likely to have frequent legal diff‌iculties but also

more likely to experience homelessness, f‌inancial diff‌iculties, lack of social

1078 International Journal of Offender Therapy and Comparative Criminology 65(9)