Upload
alexandrina-james
View
214
Download
0
Tags:
Embed Size (px)
Citation preview
The relationship between substance abuse treatment and self-reported outcomes among
offenders with mental health problems and substance use problems
Natalie Durbeej Gumpert, C. H., Alm, C., Eriksson, Å., Berman, A. H., Kristiansson, M., &
Palmstierna, T.
Department of Clinical Neuroscience, Division of Forensic Psychiatry,
Karolinska Institutet, Sweden
Mental disorder, Substance Abuse, and Crime (MSAC)
A Swedish follow up-study that explores the association between utilization of substance abuse treatment and
- The risk of re-offending - Relapse into use of alcohol and/or drugs- Mental health problems
among offenders with mental health problems and substance use problems
Substance abuse treatment has been associated with reductions in re-offending, substance use and mental health problems (Gumpert et al., 2010; Grella et al., 2010; Holloway et al., , 2006; Prendergast et al., 2002)
19 april 2023Natalie Durbeej 2
19 april 2023Natalie Durbeej 3
Aim of the present study
To examine the relationship between register-based planned
outpatient treatment for substance use problems and self-
reported
a) Substance use
b) Mental health problems
c) Re-offending
among offenders with mental health problems and substance use problems.
Study design
19 april 2023Natalie Durbeej 4
Baseline n=207 Second follow-up n=149
Utilizationof planned outpatient treatment
for substance use problems (Official registry on health care utilization
in Stockholm County)
2009-12-31
First follow-up n=153
2006-01-01
“At least one visit to an outpatient clinic focusing on substance use problems”
Self-reported number of days with
*Substance use *Mental health problems
*Offending
(ASI-6)
Treatment utilizers
n= 48
Non-utilizers
n= 61
VS
Self-reportednumber of days with
*Substance use*Mental health problems
*Offending
(ASI-6)
n=109
Descriptives
2011-07-21 5
n = 109 mean age = 35 years (SD = 11.82)mean follow-up time = 17.8 months (SD = 8.45)
89%
11%
71%
29%
72%
28%
Outcome: planned outpatient treatment utilization in relation to substance use and mental health problems*
19 april 2023Natalie Durbeej 6
Time: p<.001Treatment: N.STime x Treatment: N.S
Time: N.STreatment: N.STime x Treatment: N.S
Time: p<.05Treatment: p<.1Time x Treatment: N.S
*During the past 30 days
Outcome: planned outpatient treatment utilization in relation to offending*
19 april 2023Natalie Durbeej 7
Time: p<.1Treatment: N.STime x Treatment: N.S
*During the past six months
Time: p<.001Treatment: N.STime x Treatment: N.S
Time: p<.1Treatment: N.STime x Treatment: N.S
Differences between improved and non-improved participants
19 april 2023Natalie Durbeej 8
Improved
over time
Non-improved
over time
VS
Participants who reduced their
1. Alcohol consumption
2. Mental health problems3. Violent offending
Participants who remained stable or increased their
1. Alcohol consumption
2. Mental health problems3. Violent offending
Differences between improved and non-improved participants
Participants who improved w.r.t. alcohol consumption had
- fewer ER-visits to substance abuse clinics- more days in inpatient treatment*(both planned and acute) - fewer years of regular and heavy alcohol consumption (during lifetime)
compared to non-improved participants (p<0.05)
19 april 2023Natalie Durbeej 9
*somatic-, psychiatric-, and substance abuse treatment
Differences between improved and non-improved participants
Participants who improved w.r.t. mental health problems
- had fewer ER-visits to substance abuse clinics- had more weeks of employment (during the past six months)
compared to non-improved participants (p<0.05)
Participants who improved w.r.t. violent offending
- were younger - had fewer years of regular amphetamine use (during lifetime)
compared to non-improved participants (p<0.05) 19 april 2023Natalie Durbeej 10
Factors that may be positively or negatively correlated with recovery of offenders with mental
health problems and substance use problems
19 april 2023Natalie Durbeej 11
+ Utilization of inpatient treatment
+ Employment
- Life-time use of alcohol and/or drugs
- Age
- ER-visits to substance abuse clinics
19 april 2023Natalie Durbeej 12
Topics for discussion
Does natural recovery over time play a role?
Institutional correction/contact with correctional system might have been beneficial
A need to explore effects of treatment in sub-groups among offenders with mental health problems and substance use problems
A need to further identify the factors that contribute to the recovery of these individuals
Thank you!
Natalie DurbeejDepartment of Clinical Neuroscience
Division of Forensic PsychiatryKarolinska Institutet