Abstract
BackgroundTherapeutic diversion courts seek to address justice-involved participants’ underlying problems leading to their legal system involvement, including substance use disorder, psychiatric illness, and intimate partner violence. The courts have not addressed systemic hurdles, which can contribute to a cycle of substance use disorder and recidivism, which in turn hinder health and wellness. The study purpose is to explore the systemic issues faced by women participants in drug treatment court from multiple perspectives to understand how these issues may relate to health and wellness in their lives.MethodsQualitative thematic framework analysis of five separate focus groups consisting of female drug treatment court participants, community providers, and court staff (n = 25). Themes were mapped across the socio-ecological framework and contextualized according to social determinants of health.ResultsNumerous systemic factors impacted women’s access to treatment. Laws and legal policies (governance) excluded those who could potentially have benefitted from therapeutic court and did not allow consideration of parenting issues. Macroeconomic policies limit housing options for those with convictions. Social policies limited transportation, education, and employment options. Public policies limited healthcare and social protection and ability to access available resources. Culture and societal values, including stigma, limited treatment options.ConclusionsBy understanding the social determinant of health for women in drug treatment court and stakeholder’s perceptions, the legal system can implement public policy to better address the health needs of women drug court participants.
Highlights
Therapeutic diversion courts seek to address justice-involved participants’ underlying problems leading to their legal system involvement, including substance use disorder, psychiatric illness, and intimate partner violence
Therapeutic courts seek to address the underlying problems leading to justice involvement, including substance use disorders, psychiatric disorders, and intimate partner violence
In the analysis for this manuscript, we further identified a framework for the systemic barriers and facilitators as the World Health Organization (WHO) Social Determinants of Health model (Solar and Irwin 2010)
Summary
Therapeutic diversion courts seek to address justice-involved participants’ underlying problems leading to their legal system involvement, including substance use disorder, psychiatric illness, and intimate partner violence. Therapeutic courts seek to address the underlying problems leading to justice involvement, including substance use disorders, psychiatric disorders, and intimate partner violence. DTC is designed to help a substance-abusing justiceinvolved individual link with care and stop abusing drugs (Rossman et al 2011; Wenzel et al 2001). To achieve these goals, DTCs engage with community partners that provide services targeting the behavior the legal system hopes to change with the use of “legal leverage.”. Legal leverage can take many forms including DTC, probation, alcohol monitoring systems and short-term incarceration, which aim to encourage behavior change in the individual to prevent harm to him/herself and the
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