Abstract
The purpose of this study was to examine the history of arrests among dually diagnosed patients entering treatment, compare groups with different histories on use of treatment and mutual-help groups and functioning, at intake to treatment and six-month, one-year, and two-year follow-ups, and examine correlates and predictors of legal functioning at the study endpoint. At treatment intake, 9.2% of patients had no arrest history, 56.3% had been arrested for nonviolent offenses only, and 34.5% had been arrested for violent offenses. At baseline, the violent group had used the most outpatient psychiatric treatment and reported poorer functioning (psychiatric, alcohol, drug, employment, and family/social). Both arrest groups had used more inpatient/residential treatment and had more mutual-help group participation than the no-arrest group. The arrest groups had higher likelihood of substance use disorder treatment or mutual-help group participation at follow-ups. Generally, all groups were comparable on functioning at follow-ups (with baseline functioning controlled). With baseline arrest status controlled, earlier predictors of more severe legal problems at the two-year follow-up were more severe psychological, family/social, and drug problems. Findings suggest that dually diagnosed patients with a history of arrests for violent offenses may achieve comparable treatment outcomes to those of patients with milder criminal histories.
Highlights
An increased risk for violent crime has been identified among individuals with dual substance use and mental health disorders, compared with general populations or persons with only mental health diagnoses [1,2,3]
The sample was enrolled using the following procedure: patients entering outpatient mental health treatment and identified by program staff as having dual substance use and psychiatric disorders and as cognitively competent to provide informed consent were invited to participate in the study
Addiction and mental health treatment providers recognize that they are involved in the risk management of patients who might pose a threat to public health and safety through engagement in violence [11, 43]
Summary
An increased risk for violent crime has been identified among individuals with dual substance use and mental health disorders, compared with general populations or persons with only mental health diagnoses [1,2,3]. Little is known about how dually diagnosed individuals with a history of violent crime fare when they enter treatment. To fill this gap, this study compared three groups of dually diagnosed patients: those arrested for violent offenses, those with a history of arrest for nonviolent offenses only, and those with no history of arrest. Research suggests that significant proportions of treated mental health patients report a history of having been arrested for violent and especially nonviolent offenses. This history is associated with more risk of hospitalization, and more participation in mutual-help groups.
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