We described the change in drug overdoses during the COVID-19 pandemic in one urban emergency medical services (EMS) system. Data was collected from Marion County, Indiana (Indianapolis), including EMS calls for service (CFS) for suspected overdose, CFS in which naloxone was administered, and fatal overdose data from the County Coroner's Office. With two sample t tests and ARIMA time series forecasting, we showed changes in the daily rates of calls (all EMS CFS, overdose CFS, and CFS in which naloxone was administered) before and after the stay-at-home order in Indianapolis. We further showed differences in the weekly rate of overdose deaths. Overdose CFS and EMS naloxone administration showed an increase with the social isolation of the Indiana stay-at-home order, but a continued increase after the stay-at-home order was terminated. Despite a mild 4% increase in all EMS CFS, overdose CFS increased 43% and CFS with naloxone administration increased 61% after the stay-athome order. Deaths from drug overdoses increased by 47%. There was no change in distribution of age, race/ethnicity, or zip code of those who overdosed after the stay-at-home order was issued. We hope this data informs policy-makers preparing for future COVID-19 responses and other disaster responses.

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There are now more than 300 mental health courts in the United States; yet studies on their effectiveness in reducing criminal recidivism are relatively few, and most follow defendants after entry into the court, during their participation, and sometimes, for a short period following exit. Using a preenrollment-postexit design that follows participants of one mental health court for 2 years after exit, this article examines criminal recidivism of participants after they no longer receive the court’s services, supervision, and support. It investigates participant demographic, clinical, and criminal history and key arrest characteristics as well as process measures and graduation as predictors of two measures of recidivism, arrests, and postexit jail days. Its findings support the hypothesis that mental health courts can reduce criminal recidivism postexit and point to criminal history, time in mental health court, and graduation as the main influences on recidivism.

This article investigated criminal recidivism 1 year postexit from a mental health court (MHC), which has, unlike prior MHCs studied, relatively short periods of court supervision. It benefits from a federal pretrial services agency that screens all arrestees for mental illness and dedicates a specialized supervision unit (SSU) to provide supervision and services while on pretrial release to all screened positive, including MHC participants. We compared criminal activity prior to key arrest with criminal activity post court disposition in MHC participants (N = 408) and MHC-eligible mentally ill arrestees in SSU (N = 687) receiving the same supervision and services while controlling for possible confounders. The proportion of MHC participants arrested was significantly lower in the year after MHC exit and significantly lower than that of the comparison group. They also averaged fewer rearrests and had a longer time to rearrest. MHC graduates made the greatest gains and accounted for the recidivism differences between MHC participants and the comparison group. This study adds to the accumulating evidence of the effectiveness of MHCs in reducing recidivism among offenders with severe mental illness.

Sociologists have long-raised concern about disparate treatment in the justice system. Focal concerns has become the dominant perspective in explaining these disparities in legal processing decisions. Despite the growth of problem-solving courts, little research has examined how this perspective operates in non-traditional court settings. This paper used a mixed-method approach to examine focal concerns in a mental health court. Observational findings indicate that gender and length of time in court influence the court's contextualization of noncompliance. While discussions of race were absent in observational data, competing-risk survival analysis finds that gender and race interact to predict mental health court termination.

This study adds to the evidence that mental health courts can reduce criminal recidivism among offenders with mental illness and shows that this effect was sustained for two years, even though defendants were no longer being monitored by the court or receiving court-mandated treatment. The results show that the mental health court program studied had a greater impact on defendants who completed the program than on defendants who did not.

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Emergency department (ED)-based peer support programs aimed at linking persons with opioid use disorder (OUD) to medication for addiction treatment and other recovery services are a promising approach to addressing the opioid crisis. This brief report draws on experiences from three states' experience with such programs funded by the SAMHSA Opioid State Targeted Repose (STR) grants. Core functions of such programs include: Integration of peer supports in EDs; Alerting peers of eligible patients and making the patient aware of peer services; and connecting patients with recovery services. Qualitative data were analyzed using a general inductive approach conducted in 3 steps in order to identify forms utilized to fulfill these functions. Peer integration differed in terms of peer's physical location and who hired and supervised peers. Peers often depend on ED staff to alert them to potential patients while people other than the peers often first introduce potential patients to programming. Programs generally schedule initial appointments for recovery services for patients, but some programs provide a range of other services aimed at supporting participation in recovery services. Future effectiveness evaluations of ED-based peer support programs for OUD should consistently report on forms used to fulfill core functions.