Providing Recovery Services for Offenders with Co-Occurring Disorders

Abstract

ABSTRACT Objectives: Providing adequate treatment and supervision for drug offenders with co-occurring disorders has been a challenge because they are usually not eligible for drug court and often fail to comply with the conditions of probation in other drug diversion programs. Here we report the results of a process evaluation of the Co-Occurring Disorders Court (CODC) implemented by the Superior Court of the County of Orange, California. Methods: Drug offenders who are chronically, persistently mentally ill and diagnosed with bipolar disorder, schizophrenia, or a major depressive disorder participated in an 18-month program that provides integrated treatment. Following evaluation by a psychiatrist and the drug court team (judge, public defender, probation officer, and mental health caseworker), they are placed on medication and referred to residential and/or outpatient drug treatment. During the program they are randomly drug tested and their progress is monitored by the drug court team; they receive sanctions for program noncompliance or rewards for program compliance. Results: In the first two years of operation the CODC admitted 72 offenders. The study findings indicate the majority of participants are being stabilized on their medications, which increases their treatment stay and improves their quality of life. At 6 months the participants show advances in social functioning, decreasing problems due to substance use, and productivity in the achievement of life goals. Conclusions: The results of the process evaluation indicate the program is achieving the stated objectives. The services provided to the CODC participants are well coordinated, offering continuity of care between the community and jail as well as extensive case management and supervision.