Outcomes for offenders with concurrent substance abuse and mental health disorders

Concurrent disorder is defined as the co-occurrence of both a substance abuse and mental disorder (MD). Relative to the general population, substance abuse and mental disorders are more common among offenders, and the prevalence of concurrent disorders may also be greater.

Concurrent substance abuse and mental disorders have detrimental effects on individuals’ social functioning and productivity. The objective of this study was to examine how concurrent disorders are associated with various correctional outcomes among offenders.

A substance abuse diagnosis was determined by high scores on the Alcohol Dependence Scale and the Drug Abuse Screening Test. Offender files were coded for evidence of a mental diagnosis by a registered mental health professional. Four groups were identified: offenders with concurrent disorders (n = 116), substance abuse only (n = 269), MD only (n = 50), and neither disorder (n = 280). The profiles, institutional outcomes and release outcomes of these groups were compared.

Offenders in the concurrent disorders group had highest risk and need ratings and more extensive criminal histories than the other groups. The groups, however, did not differ in their completion rates for correctional program assignments.

Offenders with concurrent disorders were more likely to have incurred both serious and minor institutional charges than other groups. The rates of admissions to segregation were also highest for the concurrent disorders group.

Controlling for factors associated with reoffending, the concurrent disorders group was still nearly two times (1.86) more likely to reoffend than the neither disorder group, and had the greatest hazard of reoffending compared to the other groups.

For many of the outcomes, the substance abuse group was most similar to the concurrent disorders group.

The outcomes of offenders with concurrent disorders are generally poorer than those of offenders with substance abuse or mental disorders alone. Substance abuse appears to be a major contributor to the poorer outcomes of the concurrent disorders group more so than mental disorder.

Correctional interventions that focus on substance abuse and also integrate mental health treatment may be necessary for offenders with concurrent disorders. This is in agreement with the current literature that recommends an integrated treatment approach.

Wilton, G. & Stewart, L.A. (2012). Outcomes for Offenders with Concurrent Substance Abuse and Mental Health Disorders. Research Report R-277. Ottawa ON: Correctional Service of Canada.

To obtain a PDF version of the full report, contact the following address: research@csc-scc.gc.ca

Prepared by: Geoff Wilton