Impact of mental health treatment history on drug court completion

Background: Currently, thousands of drug involved offenders are serving in programs nationwide where teams of drug court professionals (judges, prosecutors, and public defenders) typically assign them to a year long regimen of residential and outpatient treatment options, periodic drug testing, appearances before the judge and case management in lieu of jail and prison sentences. Despite this massive reallocation of treatment resources to drug courts, at best, overall completion rates in many programs seldom exceed fifty percent. Methods: Noting that many participants enter such programs with comorbid mental health diagnoses, we investigated the impact of this variable on completion in one urban, Midwestern drug treatment court. We conducted logistic regression analyses employing background screening data and data on drug court completion provided over the course of a three-year period by 138 drug treatment court participants. Models controlled for race/ethnicity, gender, age and the drug relatedness of the participants' criminal charges. Results: The overall rate of successful completion was 37% and 49% of the participants had a history of mental health treatment in an inpatient or outpatient setting. Those with a history of mental health treatment had .43 times the odds of program completion compared to others (95% confidence interval: .20, .91). Conclusions: Even though drug treatment court programs focus on substance abuse treatment, our findings suggest that increased attention to client mental health needs is warranted. As many clients have mental health treatment needs, future success of drug treatment court programs may hinge on their adoption of integrated service models.