Re-entry Needs Among a Population with Co-occurring Opioid Use and Mental Health Disorders in Massachusetts, USA Jails: Part of a National Plan to Address the Opioid Epidemic.

Introduction.Studies show that the release from jail is a vulnerable transition for individuals with opioid use disorder re-entering their communities. Less is known about individuals with co-occurring mental health and opioid use disor-ders (COD), particularly their specific needs following release.Objectives.To describe the needs of people with COD within two weeks of release jail.Methods.Baseline data from 155 individuals with COD were collected within two weeks of release from jail across 9 counties in Massachusetts. Univariate analyses were conducted to determine ba-seline needs. Results.The majority ofparticipants were male (78.7%), White (64.5%), and non-Hispanic (75.5%). The most relevant needs among participants were employment (88.4% were unemployed), opioid overdose prevention (67.7% had at least one non-fatal opioid overdose), mental health symptoms (participants reported anxiety or tension an average of 8.9 days in the past 30 days), and trauma support/treatment (71.6% reported at least one traumatic event in their lifetime). Conclusions.Individuals with COD re-entering their communities have critical needs that must be addressed upon release.Introducción.Estudios demuestran que el período después de que un individuo con desorden de uso de opioides sale de la cárcel es un período vulnerable. Poco se sabe sobre cuáles son las necesidades para personas que salen de la cárcel y tienen desórdenes concurrentes de salud mental y uso de opioides (COD). Objetivos.Describir las necesidades que presentan las personas con COD dentro de las dos semanas después de ser liberados de la cárcel. Metodología.Data de 155 individuos con COD fue recolectada dentro de las dos semanas posteriores a la liberación en 9 cárceles en Massachusetts. Se hicieron análisis univariados para determinar las necesidades. Resultados.La mayoría de los participantes eran hombres (78.7%), blancos (64.5%), y no hispanos (75.5%). Las necesidades más relevantes eran empleo (88.4% estaban desempleados), prevención de uso de opioides (67.7% dijeron haber tenido una sobredosis no mortal), salud mental (los participantes reportaron ansiedad o tensión un promedio de 8.9 días en los últimos 30 días) y apoyo sobre trauma (71.6% reportaron por lo menos una experiencia traumática en la vida). Conclusiones.Individuos con COD que están reingresando a sus comunidades presentan necesidades críticas que deben ser tratadas de forma rápida

Addressing Gender-Based Violence Using Evidence-Based Practices During COVID-19: The Case of Puerto Rico

As gender-based violence (GBV) surged during the COVID-19 pandemic, the 65th session of the Commission on the Status of Women (CSW65) called for member states, civil, and other stakeholders to consider the specific needs of women and girls in COVID-19 response and recovery efforts. Psychology provides scientific knowledge to help answer this call. Despite existing global guidance and psychological research to mitigate GBV, COVID-19 presents new challenges for consideration. This article summarizes existing GBV guidance/research and COVID-19 considerations, uses an illustrative case study to describe Puerto Rico’s application of GBV guidance/research during COVID-19, and provides preliminary policy and practice recommendations

Identifying strategies to advance equitable implementation of co-occurring mental health and substance use disorder treatment in drug treatment courts: A study protocol

Abstract Introduction: Behavioral health treatment disparities by race and ethnicity are well documented across the criminal legal system. Despite criminal legal settings such as drug treatment courts (DTCs) increasingly adopting evidence-based programs (EBPs) to improve care, there is a dearth of research identifying strategies to advance equitable implementation of EBPs and reduce racial/ethnic treatment disparities. This paper describes an innovative approach to identify community- and provider-generated strategies to support equitable implementation of an evidence-based co-occurring mental health and substance use disorder intervention, called Maintaining Independence and Sobriety through Systems Integration, Outreach and Networking-Criminal Justice (MISSION-CJ), in DTCs. Methods/design: Guided by the Health Equity Implementation Framework, qualitative interviews and surveys will assess factors facilitating and hindering equitable implementation of MISSION-CJ in DTCs among 30 Black/African American and/or Hispanic/Latino persons served and providers. Concept mapping with sixty Black/African American and/or Hispanic/Latino persons served and providers will gather community- and provider-generated strategies to address identified barriers. Finally, an advisory board will offer iterative feedback on the data to guide toolkit development and inform equitable implementation of MISSION-CJ within DTCs. Conclusions: The paper illustrates a protocol of a study based in community-engaged research and implementation science to understand multilevel drivers of racial/ethnic disparities in co-occurring disorder treatment and identify opportunities for intervention and improvements within criminal legal settings

Correlates of substance use among urban Latino immigrant high school freshmen: linguistic acculturation, friends' use, and sense of school belonging

Substance use in immigrant youth frequently has been associated with different aspects of acculturation. There is inconsistency in the literature, however, about the direction of these relationships. Furthermore, seldom has the role of acculturation been examined in the context of other common substance use correlates, such as peer use and relationship with parents. Finally, the possible contribution of sense of school belonging previously has not been considered along with acculturation, peer use, and parent relationships, in explaining substance use and intentions to use in immigrant adolescents. Thus, the current study examined the extent to which levels of language and cultural acculturation, years in the country, sense of school belonging, relationship with parents, and friends’ use would account for their use and intentions to use substances in a sample of 166 Northeastern ninth grade urban Latino immigrant adolescents. Regression analysis revealed that language acculturation, sense of school belonging, and friends’ use were significantly associated with adolescent substance use and intentions to use. Consistent with past research in the general adolescent population, Latino immigrant youth who had fewer friends who use substances and had higher levels of school bonding/sense of school belonging were less likely to report using substances and/or having intentions to use. Contrary to previous literature examining non-clinical immigrant youth, the current study found that higher use of native language (low language acculturation) also predicted students’ use and intentions to use.Psy.DIncludes bibliographical references (p. 42-62)by Ayorkor L. Gab

Risk–need–responsivity and its application in behavioral health settings: A feasibility study of a treatment planning support tool

The risk–need–responsivity (RNR) model suggests several key practices for justice‐involved populations under correctional supervision. Behavioral health treatment planning aligned with RNR principles for offender populations with co‐occurring mental health and substance use disorders (CODs) could be one method for integrating RNR into clinical care. To explore a unique approach to working with behavioral health and RNR principles, the authors implemented a mixed‐methods feasibility study of the acceptability, usability, and utility of a newly developed RNR treatment planning support tool (RNR TST). The tool was implemented in a re‐entry program serving adults with co‐occurring mental health and opioid use disorders. Chart reviews of RNR TSTs (N = 55) and a focus group (N = 14 re‐entry clinical staff) were conducted. Ninety‐six percent of the RNR TSTs incorporated the use of a validated risk–need assessment and 70% of the RNR TSTs were semi‐complete to complete. Focus group interviews highlighted behavioral health staff perspectives on the acceptability, usability, and utility of the RNR TST. This novel RNR TST has the potential to assist behavioral health providers in integrating RNR principles into treatment planning. Further development and testing are needed to determine its impact on client care and outcomes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167089/1/bsl2499.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167089/2/bsl2499_am.pd

Implementation of MISSION-Criminal Justice in a Treatment Court: Preliminary Outcomes Among Individuals With Co-occurring Disorders

OBJECTIVE: Mental health courts provide an alternative to incarceration and address both mental health and criminal justice needs. Many individuals within these treatment courts also have co-occurring substance use disorders. This pilot study examined the preliminary effectiveness of Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking-Criminal Justice (MISSION-CJ), an intervention that targets co-occurring disorders and criminal justice risk factors within a mental health court. METHODS: Participants (N=97) were enrolled in mental health court and MISSION-CJ community wraparound services. RESULTS: Participants were primarily male with an average age of 34, had spent an average of more than 5 years incarcerated, and had an average of 13.94 years of illegal drug use; 91% had experienced depression. Preliminary 6-month outcomes showed significant reduction in nights incarcerated (p \u3c 0.002), illegal drug use (p \u3c 0.003), trauma symptoms (p \u3c 0.004), and behavioral health symptoms (p \u3c 0.006). CONCLUSIONS: Preliminary findings suggest promise for delivery of MISSION-CJ to participants in a mental health court

Evaluating the implementation of a prisoner re-entry initiative for individuals with opioid use and mental health disorders: Application of the consolidated framework for implementation research in a cross-system initiative

Given the interrelated nature of opioid use, criminal justice interaction, and mental health issues, the current opioid crisis has created an urgent need for treatment, including medication assisted treatment, among justice-involved populations. Implementation research plays an important role in improving systems of care and integration of evidence-based practices within and outside of criminal justice institutions. The current study is a formative qualitative evaluation of the implementation of a cross-system (corrections and community-based) opioid use treatment initiative supported by Opioid State Targeted Response (STR) funding. The purpose of the study is to assess the fit of the Consolidated Framework for Implementation Research (CFIR) to a cross-system initiative, and to identify key barriers and facilitators to implementation. The process evaluation showed that adaptability of the clinical model and staff flexibility were critical to implementation. Cultural and procedural differences across correctional facilities and community-based treatment programs required frequent and structured forums for cross-system communication. Challenges related to recruitment and enrollment, staffing, MAT, and data collection were addressed through the collaborative development and continuous review of policies and procedures. This study found CFIR to be a useful framework for understanding implementation uptake and barriers. The framework was particularly valuable in reinforcing the use of implementation research as a means for continuous process improvement. CFIR is a comprehensive and flexible framework that may be adopted in future cross-system evaluations

Embedding a Co-occurring Disorders Rehabilitation Intervention in Veterans Courts: A Pilot Study with Male Veterans

Veterans treatment courts (VTCs) have expanded dramatically despite their limited empirical base. This pilot study examined MISSION-Criminal Justice (CJ), a co-occurring disorders wraparound intervention, delivered alongside two VTCs. Baseline data from 26 male veterans enrolled in two VTCs and MISSION-CJ, and 6-month follow-up data for 18 of the 26 veterans, are presented. Veterans on average were 37.5 years old, 85% Caucasian, had significant histories of criminal justice involvement (14.3 lifetime arrests), had an average of 14.7 years of alcohol use and 9.3 years of illicit drug use, and roughly three-quarters reported mental health symptomatology. At 6-month follow-up, veterans demonstrated improvements in behavioral health, substance use, and criminal justice outcomes. This study demonstrated promising preliminary outcomes of MISSION-CJ in VTCs. A randomized controlled trial is a critical next step to examine whether these outcomes remain consistent with a more rigorous design