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.

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.