Click
here for the full review
Background
A number of policy directives are aimed at enabling people with
drug problems to live healthy, crime-free lives. Drug-using
offenders with co-occurring mental health problems represent a
group of people who access treatment for a variety of different
reasons. The complexity of the two problems makes the treatment and
rehabilitation of this group of people particularly
challenging.
Study characteristics
The review authors searched scientific databases and internet
resources to identify randomised controlled trials (where
participants are allocated at random to one of two or more
treatment groups) of interventions to reduce, eliminate, or prevent
relapse or criminal activity of drug-using offenders with
co-occurring mental illness. We included people of any gender, age
or ethnicity.
Key results
We identified eight trials (three of which are awaiting
classification) evaluating treatments for drug-using offenders with
co-occurring mental illness. The interventions included case
management via a mental health court, a therapeutic community and
an evaluation of motivational interviewing techniques and cognitive
skills (a person's ability to process thoughts) in comparison to
relaxation training. Overall, the combined interventions were not
found to reduce self report drug use, but did have some impact on
re-incarceration rates, but not re-arrest. A specific analysis of
therapeutic community interventions did subsequently reduce
re-incarceration but proved to be less effective for re-arrest and
self report drug use. Two single studies evaluating case management
via a mental health drug court and motivational interviewing and
cognitive skills did not show significant reductions in criminal
activity and self report drug use respectively. Little information
is provided on the costs and cost effectiveness of such
interventions and trial evaluations focusing specifically on the
needs of drug misusing offenders with co-occurring mental health
problems are required.
Quality of the evidence
This review was limited by the lack of information reported in this
group of trials and the quality of the evidence is unclear. The
evidence is current to March 2013.
