Impact of County-level health infrastructure on participation in a reform effort to reduce the use of jail for individuals with mental health disorders.

Background: The national Stepping Up Initiative has attracted over 500 counties interested in reducing the use of jail for individuals with mental health disorders. This paper identifies socioeconomic, criminal legal, and health care factors that predict the likelihood of counties joining Stepping Up.

Results: After performing variable selection, logistic regression models were performed on 3,141 U.

The relationship between community public health, behavioral health service accessibility, and mass incarceration.

Background: The relationship between healthcare service accessibility in the community and incarceration is an important, yet not widely understood, phenomenon. Community behavioral health and the criminal legal systems are treated separately, which creates a competing demand to confront mass incarceration and expand available services. As a result, the relationship between behavioral health services, demographics and community factors, and incarceration rate has not been well addressed.

What Matters More in Explaining Drug Court Graduation and Rearrest: Program Features, Individual Characteristics, or Some Combination.

This study examines the program- and individual-level factors that impact the success of drug court clients in terms of: (1) graduation; and (2) not being arrested while participating in the court program. The data consist of 848 individuals in nine drug courts. This paper discusses how different individual- and program-level factors impact the success of drug court participants.

Drivers of County Engagement in Criminal Justice-Behavioral Health Initiatives.

Several large, county-level initiatives are underway to improve behavioral health care for justice-involved clients. Unfortunately, only about a quarter of counties participate in these efforts, leaving justice-involved populations at risk of poor mental health, substance use, and judicial outcomes. This study examined characteristics of 2,922 U.

What Makes or Breaks Evidence-Based Supervision? Staff and Organizational Predictors of Evidence-Based Practice in Probation.

Research on staff and organizational factors that affect receptivity, adoption, feasibility, and utilization of innovations in justice settings is limited. This study uses survey data from 349 employees in one probation agency to assess how staff and perceived organizational factors influence attitudes related to evidence-based practices (EBPs) and their self-reported use. Staff characteristics, including education and knowledge about EBPs, and perceptions of the organization, including cynicism about the organization's ability to change, predicted EBP outcomes.

Multilevel Matching in Natural Experimental Studies: Application to Stepping up Counties.

Among many approaches for selecting match control cases, few methods exist for natural experiments (Li, Zaslavsky & Landrum, 2007), especially when studying clustered or hierarchical data. The lack of randomization of treatment exposure gives importance to using proper statistical procedures that control for individual differences. In this natural experimental study, which has a hierarchical structure, we plan to evaluate the efforts of 455 counties across the United States to make targeted efforts to improve mental health services and reduce jail utilization over time.

Protocol for a quasi-experimental, 950 county study examining implementation outcomes and mechanisms of Stepping Up, a national policy effort to improve mental health and substance use services for justice-involved individuals.

Background: The criminal justice system is the largest provider of mental health services in the USA. Many jurisdictions are interested in reducing the use of the justice system for mental health problems. The national Stepping Up Initiative helps agencies within counties work together more effectively to reduce the number of individuals with mental illness in jails and to improve access to mental health services in the community.

Fostering MOUD use in justice populations: Assessing the comparative effectiveness of two favored implementation strategies to increase MOUD use.

Coaching is a favored strategy for the implementation of medications for opioid use disorder (MOUD), yet research has not adequately tested or assessed coaching dosages and mediums for overall effectiveness, nor have coaching doses been widely studied within criminal justice settings (CJS). Scaling up the use of MOUD, particularly in CJS, presents a challenge given the stigmatization of substance use disorder, funding for MOUD, availability and capacity of community-based treatment providers, leadership support, and the historical preference for behavioral therapy-based treatment practices. The University of Wisconsin's Center for Health Enhancement and Systems Studies (CHESS) and George Mason University's Center for Advancing Correctional Excellence! (ACE!) are conducting a randomized controlled trial to determine the optimal combination and dosages for two different coaching strategies to disseminate MOUD in justice-involved populations; those strategies are the NIATx model for process improvement and Extension for Community Healthcare Outcomes (ECHO) model.