Characterizing a sample of veterans with co-occurring disorders referred to a court-based jail diversion program

OBJECTIVES: To describe a sample of veterans with co-occurring mental health and substance use disorders (COD) receiving MISSION DIRECT-VET (MDV) jail diversion services. METHODS: MDV is a 12-month evidence-based wraparound intervention delivered by trained case manager and peer support specialist teams in four Massachusetts courts. Between 2009 and 2012, 159 veterans were screened and 66 veterans completed baseline evaluations which included the ASI-Lite, BASIS 24, PTSD Checklist, and GPRA assessments. RESULTS: The sample was predominantly male (94%), white (85%), and over forty percent completed some college (44%). The average age of the sample was 40, and we observed an increasing number of returning Iraq/Afghanistan war veterans throughout the study period (56%). Several participants reported using alcohol (33%), marijuana (17%), and street opioids (10%) daily before arrest. More than half had a prior history of inpatient (56%) and outpatient (59%) substance abuse treatment and nearly all reported symptoms of hyper-arousal (98.3%) and numbing (98.3%). More than one-third (35%) of participants had their first arrest before age 18. A majority (64%) experienced physical violence and almost one-fifth (18%) were sexually assaulted before 18. Additional baseline and risk factor data will be included in the poster presentation. CONCLUSIONS: Similar to CDC's Adverse Childhood Experiences (ACE) study, our findings suggest negative experiences early in life may influence future morbidity, mortality and quality of life outcomes among Veterans with COD involved in the criminal justice system. Findings from this preliminary evaluation have the potential to guide development of diversion programs for returning veterans.