The issue of co-occurring disorders is of concern to the Criminal Justice field, including drug courts. To assess the potential co-occurrence of substance use- and mental health-related diagnoses, the Psychiatric Diagnostic Screening Questionnaire and similar instruments was administered to suburban drug court clients. Based on the screening, one quarter to one half of the 108 participants would be referred for follow-up for a mental health issue; women would be referred at a greater rate than men. There is a need to develop appropriate, brief mental health screening instruments for use in drug court settings so that clients can receive necessary services.

Background: Drug court interventions produce positive results—especially among mandated populations. Many criminal justice-involved persons, including drug court enrollees, have cooccurring substance abuse and childhood trauma disorders associated with psychological dysfunction. Given the coercive nature of mandated drug court treatment, it is important to understand whether childhood trauma and psychological functioning influence perceived coercion to enter treatment. Objectives: The purpose of this study was to describe the degree to which adverse childhood trauma and psychological functioning were associated with six domains of perceived coercion— self, family, legal, financial, health, and work—among a population of drug court enrollees. Methods: Data from 54 enrollees in a drug court pilot study were used to examine the relationship between childhood trauma, psychological functioning, and perceived coercion. Results: The pilot study data showed that psychological dysfunction and traumatic experiences in childhood were associated with higher perceived coercion to treatment, explaining 29% of the variance in coercion, controlling for gender and pre-arrest alcohol and drug use. Results indicated that the associations between psychological dysfunction and trauma were driven by non-legal types of coercion. In particular, childhood trauma was correlated with family ( r = .32), financial ( r = .32), and health ( r = .47) types of coercion. Conclusions: Based on these preliminary findings, drug court practitioners are urged to assess perceived coercion, in addition to the behavioral health and childhood trauma of their clients, and to utilize non-legal types of coercion such as family, health, and financial impact to enhance treatment engagement.

Drug court judges enforce mandated treatment through a series of rewards and graduated sanctions as compliance with mandated treatment and retention are crucial to successful graduation for participants. A study of 600 graduates from drug court details self-report data of motivations and perceptions offenders shared about their experience in drug court. Clients rated different factors related to their entry into, retention in, and graduation from drug court. Upon graduation, clients rated the opportunity to avoid jail as a key factor in their decision to enter drug court and positive improvements in their life as significant in their decision to remain. This research provides important information on the drug court experience from those clients who successfully graduated.

Drug court research is often challenged by study attrition. In this study, researchers attempted to predict study completion using variables traditionally associated with treatment attrition. Findings showed that participants who reported a need for additional help to resolve legal problems and who reported accessing outpatient treatments were more likely to complete the study at the three-month follow-up. The study also demonstrated a relationship between trauma-related symptoms and study attrition. Although sample size was a limitation with these pilot data, researchers are urged to examine attrition and increase efforts to engage drug court enrollees in research studies, especially those with trauma-related symptoms.

This study explored the influence of 2 different types of social support on alcohol use in the context of drug court. Data from a drug court enrollee pilot study were analyzed using a series of simultaneous regression analyses. Results demonstrated that having a greater number of unconditional support providers was associated with a decrease in alcohol use from prearrest to postarrest. Having a greater number of directive support providers was associated with an increase in alcohol use from prearrest to postarrest. These findings indicated that different types of social support might mitigate or promote problematic alcohol use after arrest.