The 130th Annual Meeting of APHA

5187.0: Wednesday, November 13, 2002 - 3:15 PM

Abstract #47632

Psychiatric comorbidity and not completing jail-based substance abuse treatment

Thomas M. Brady, PhD, Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Parklawn Bldg, 5600 Fishers Lane, Suite 16-105, Rockville, MD 20857, (301) 443-9049, tbrady@samhsa.gov and Christopher P. Krebs, PhD, Health, Social, and Economics Research Unit: Crime, Justice Policy, and Behavior Program, Research Triangle Institute, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, NC 27709-2194.

Many jail inmates have a history of mental illness, substance use, and drug-related crime. This paper assesses the effect of psychiatric comorbidity on retention in jail-based substance abuse treatment. Methods: Secondary data from five jail-based substance abuse treatment programs were studied using descriptive and multivariate analyses. Using discharge status as an outcome variable, our hypothesis was that offenders who enter jail-based substance abuse treatment and self-report a history of mental health treatment will have higher rates of not completing treatment than those who do not have a history of mental health treatment. In a multinomial logistic regression, program termination and voluntary exit were analyzed as separate events. Results: Of the offenders who reported a history of mental health treatment and had data for discharge status, 36.0% did not complete treatment; 20.3% who reported no history of mental health treatment did not complete treatment. In the multivariate analysis, controlling for age, sex, race, education, and program, the odds of an offender with a history of mental illness being terminated from treatment were nearly three times that of those with no such history (OR 2.7; 95% C.I. (1.3, 5.4); CHI-SQ 7.227). However, there was not a strong association between self-reported history of mental health treatment and voluntary exit. Discussion: The data suggest that psychiatric comorbidity may be an important correlate of program termination in jail-based substance abuse treatment and particular approaches should be developed in conjunction with jail-based substance abuse treatment to accommodate patients with a history of psychiatric comorbid disorders.

Learning Objectives:

  • At the end of this presentation, the participant in this session will be able to

    Presenting author's disclosure statement:
    I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

    Mental Health Treatment and the Criminal Justice System

    The 130th Annual Meeting of APHA