Integrating a Co-occurring Disorders Intervention in a Rural Drug Treatment Court: Preliminary 6-Month Outcomes and Policy Implications

Little research has focused on systematically integrating clinical treatment within drug court settings (a type of specialty court, and the most popular type of alternative to incarceration program). This is particularly important for rural drug courts serving participants with both co-occurring mental health and substance use disorders, as these participants often have difficulty engaging in care which is compounded by limited access to treatment services in their communities. This article reports on the preliminary outcomes and policy implications of integrating MISSION-Criminal Justice (MISSION-CJ), a co-occurring mental health and substance use hybrid wraparound treatment and linkage intervention, within a rural Massachusetts drug court. In this open pilot, 73 participants completed an intake and 80% completed a 6-month follow-up assessment. The participants were primarily Caucasian (83.6%), male (57.5%), reported substantial criminal justice histories with an average of 13.93 prior arrests, had extensive substance use and mental health histories, with 71% reporting opioid use, 74% had anxiety, and 68.5% depression at intake. Six-month data indicate statistically significant reductions in nights spent in jail, number of arrests, acute behavioral health symptoms, illicit drug use, as well as an increase in employment and securing stable housing. These data suggest that MISSION-CJ was feasible to implement within a rural drug court. MISSION-CJ is a unique intervention as it offers co-occurring disorders treatment and linkage services that work both within a specialty court setting and in the community. These findings pose critical policy implications as integrated services and a hybrid treatment model are considered to be best practice and may be optimal for rural drug courts where there are limited treatment and service resources.