Transitions between jail and community-based treatment for individuals with co-occurring disorders

Abstract

Objective: This study assessed transitions to community mental health services among individuals with co-occurring disorders upon release from jail. Methods: Data from jail and public mental health systems in Wayne County, Michigan, were merged to identify 677 individuals diagnosed as having a serious mental illness and substance use disorder who had been jailed a total of 1,774 times over 48 months starting in 2003. Results: Only 33% of incarcerations (N= 573) were followed by communitybased treatment; 44% (N=803) were followed by treatment during a subsequent incarceration, and 23% (N=398) by no treatment. Generalized estimating equations found that individuals with schizophrenia and substance dependence were the most likely to obtain community treatment. Conclusion: By integrating discharge planning, community mental health providers and jails may ensure a continuum of care that facilitates treatment engagement, limits repeated incarcerations, and improves well-being.