Treating Co-Occurring Substance Use and Mental Disorders Among Jail Inmates

Study Overview
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Brief Summary
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Treatment adaptation and implementation study for adult jail inmates with co-occurring substance use disorders.

Detailed Description
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We will adapt dual-diagnosis motivational interviewing and integrated group therapy for jail inmates with co-occurring substance use and mental health disorders and to evaluate the feasibility of implementing the adapted interventions and associated research and communication protocols.

Official Title
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Treating Co-Occurring Substance Use and Mental Disorders Among Jail Inmates

Conditions
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Co-occurring Mental and Substance Use Disorders, Crime, Criminogenic Thinking, Implementation, Adaptation

Intervention / Treatment
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* Behavioral: Dual-diagnosis motivational interviewing (DDMI)
* Behavioral: Integrated group therapy (IGT)
* Behavioral: Jail and community-based behavioral health services


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: (1) drug or alcohol abuse or dependence and SMI (major depressive disorder; depressive disorder not otherwise specified [NOS]; bipolar disorder I, II, or NOS; schizophrenia spectrum disorder; schizoaffective disorder; schizophreniform disorder; brief psychotic disorder; delusional disorder; or psychotic disorder NOS); (2) resident of Wake County and detained in The Jail; (3) >18 years of age; (4) able to speak/read English; and (5) able to provide informed consent. Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: DDMI-IGT<br>Subjects randomized to the experimental condition will receive adapted versions of dual-diagnosis motivational interviewing ([DDMI] one session before release from jail) and integrated group therapy ([IGT] 12 community-based sessions over a 2-month period). | Behavioral: Dual-diagnosis motivational interviewing (DDMI)<br>* DDMI is an evidence-based adaptation to motivational interviewing. DDMI incorporates an integrated framework and accommodates cognitive impairments and disordered thinking associated with co-occurring substance use and mental disorders.<br>Behavioral: Integrated group therapy (IGT)<br>* IGT is an evidence-based practice for treating co-occurring disorders. IGT focuses on relapse prevention by reducing substance use and stabilizing psychiatric symptoms.<br>|
| Active Comparator: Usual care<br>Subjects randomized to the usual care condition will receive jail and community-based behavioral health services. | Behavioral: Jail and community-based behavioral health services<br>* Existing behavioral health service programs<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptability | Client Satisfaction Questionnaire-8, Narrative Evaluation of Intervention Interview | Study months 21 through 34 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of Adapted Interventions | How successfully can the adapted interventions be implemented (Focus Group interviews) | Study months 21 through 34 | 
| Fidelity | DDMI and IGT Adherence Forms | Study months 21 through 34 | 
| Substance use | Addiction Severity Index | Study months 20 through 30 | 
| Psychiatric symptoms | Brief Psychiatric Rating Scale | Study months 20 through 30 | 
| Health status | SF-12 | Study months 20 through 30 | 
| Service use | Epidemiological Catchment Area Interview | Study months 20 through 30 | 
| Externalizing behaviors | Triarchic Psychopathy Measure | Study months 20 through 30 | 
| Quality of life measure | Heinrichs-Carpenter Quality of Life Scale, Plus | Study months 20 through 30 | 
| Arrest | Self-report and official jail records | Study months 20 through 30 | 
| Treatment preferences | Visual analog ranking of 8 different aspects of treatment | Study months 20 through 30 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Jail, co-occurring disorders, implementation, acceptability, feasibility, fidelity