Vulnerable Populations: Drug Court Program Clients

Speck, Patricia M.; Connor, Pamela D.; Hartig, Margaret T.; Cunningham, Patricia D.; Fleming, Belinda

doi:10.1016/j.cnur.2008.04.009

Cited by 8 publications

(7 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When interacting with health care providers, victims of trauma may perceive that they are being judged for their lifestyle, homelessness, addictions or other risky behaviors, or for their gender identity, age, race, ethnicity, sexual orientation, or other aspects of social identity 18. Such patient perceptions can create a population of “never-served” persons who choose to avoid health care or to not disclose a history of drug or alcohol use to health care providers whom they perceive as judging them 19…”

Section: Judgment and Bias Exacerbate Traumatic Stressmentioning

confidence: 99%

CE: Trauma-Informed Care in Nursing Practice

Dowdell

Speck

2022

AJN, American Journal of Nursing

Self Cite

View full text Add to dashboard Cite

Over the past 30 years, researchers have found that childhood trauma and its subsequent stress have a strong and cumulative effect on health in adulthood. Trauma in childhood often leads to mental health problems, skeletal fractures, and early death from conditions such as heart disease, cancer, lung disease, and liver disease. Compounding the effects of traumatic stress, health care systems often create a population of “never-served” persons who avoid health care settings because they've been subject to judgment and marginalization. Trauma-informed care (TIC) is a skill underutilized by health care providers and organizations, yet nurse ethics and respect for human rights require us to care for all patients equally without judgment, including those living with the stress of complex trauma. The TIC approach respects human rights and supports nursing ethics, promoting a welcoming, inclusive environment in health care systems and patient–provider relationships that eschews implicit and explicit bias toward patients, regardless of presentation or personal circumstances. TIC foundational principles guide the application of the nursing process using patient-centered care to create safety, the first principle in TIC. Here, the authors discuss the application of these core principles in nursing through a deidentified case study.

show abstract

Section: Judgment and Bias Exacerbate Traumatic Stressmentioning

confidence: 99%

CE: Trauma-Informed Care in Nursing Practice

Dowdell

Speck

2022

AJN, American Journal of Nursing

Self Cite

View full text Add to dashboard Cite

show abstract

“…The public health literature examining problem-solving courts’ impact on health and well-being focuses on four main areas (1) the role of healthcare professionals and how they can optimally support court participants [58–60]; (2) how the connection between courts and health and social services can be strengthened [61]; (3) how to improve treatment initiatives [62–64]; and (4) healthcare related experiences of court participants [65]. The public health literature also emphasizes the important role crosscutting Universal Health Coverage plays for low-income court participants, especially in the United States [66].…”

Section: Introductionmentioning

confidence: 99%

Court as a health intervention to advance Canada’s achievement of the sustainable development goals : a multi-pronged analysis of Vancouver’s Downtown Community Court

et al. 2019

View full text Add to dashboard Cite

BackgroundThe increase in problematic substance use is a major problem in Canada and elsewhere, placing a heavy burden on health and justice system resources given a spike in drug-related offences. Thus, achievement of Sustainable Development Goal (SDG) Target 3.5 to ‘Strengthen the prevention and treatment of substance abuse’ is important for Canada’s overall realization of the SDGs, including SDG 3 (Good Health and Wellbeing). Since 2008, Vancouver’s Downtown Community Court (DCC) has pioneered an innovative partnership among the justice, health and social service systems to address individuals’ needs and circumstances leading to criminal behaviour. While researchers have examined the DCC’s impact on reducing recidivism, with Canada’s SDG health commitments in mind, we set out to examine the ways health and the social determinants of health (SDH) are engaged and framed externally with regard to DCC functioning, as well as internally by DCC actors. We employed a multi-pronged approach analyzing (1) publicly available DCC documents, (2) print media coverage, and (3) health-related discourse and references in DCC hearings.ResultsThe documentary analysis showed that health and the SDH are framed by the DCC as instrumental for reducing drug-related offences and improving public safety. The observation data indicate that judges use health and SDH in providing context, understanding triggers for offences and offering rationale for sentencing and management plans that connect individuals to healthcare, social and cultural services.ConclusionsOur study contributes new insights on the effectiveness of the DCC as a means to integrate justice, health and social services for improved health and community safety. The development of such community court interventions, and their impact on health and the SDH, should be reported on by Canada and other countries as a key contribution to SDG 3 achievement, as well as the fulfillment of other targets under the SDG framework that contain the SDH. Consideration should be given by Canada as to how to capture and integrate the important data generated by the DCC and other problem-solving courts into SDG reporting metrics. Certainly, the DCC advances the SDGs’ underlying Leave No One Behind principle in a high-income country context.

show abstract

“…Because the DC literature uses multiple terms for drug addiction, it is important to note that a newer mental health term, substance use disorder (American Psychiatric Association, 2012), will be used rather than the older terms: (a) addiction (Lessenger & Roper, 2002;Speck, Connor, Hartig, Cunningham, & Fleming, 2008); (b) drug addiction (Goldkamp, White, & Robinson, 2001;Nolan, 2002;Wolfer, 2006); (c) drug dependence (R. King & Pasquarella, 2009); (d) drug abuse (Bowser, Lewis, & Dogan, 2011;Harrison & Scarpitti, 2002;Prendergast, Hall, Roll, & Warda, 2008;Roll, Prendergast, Richardson, Burdon, & Ramirez, 2005;Shaffer, Hartman, Listwan, Howell, & Latessa, 2011;Wenzel, Longshore, Turner, & Ridgely, 2001); (e) drug use (Patra et al, 2010;Saum, Scarpitti, & Robbins, 2001;Turner et al, 2002); (f) substance abuse (Belenko, 2002;R. Brown, 2010aR.…”

Section: Substance Use Disorder As a Public Health Problemmentioning

confidence: 99%

“…Substance use disorder is a major public health problem that affects society. Specific public health problems associated with substance use disorder include: (a) low birth weight infants and premature birth (Ladhani, Shah, & Murphy, 2011;Pinto et al, 2010); (b) motor vehicle accidents (Li et al, 2012; National Institute on Drug Abuse, 2010); (c) homicides (Cretzmeyer, Sarrazin, Huber, Block, & Hall, 2003); (d) suicides (Marshall, Galea, Wood, & Kerr, 2011); (d) sexual abuse (Felitti et al, 1998); (e) child abuse (Dube et al, 2003;Swogger, Conner, Walsh, & Maisto, 2011); (f) cardiovascular diseases (Aryana & Williams, 2007; National Institute on Drug Abuse, n.d.; Romanelli & Smith, 2006), (g) hepatitis (Speck et al, 2008); (h) HIV/AIDS (Jarlais, 2010; National Institute on Drug Abuse, 2011a; Orwat et al, 2011); (h) mental illness (Druss et al, 2008;Hu, Kline, Huang, & Ziedonis, 2006); and (i) homelessness (Rhoades et al, 2011). While healthcare treatment for substance use disorder is limited (Hutchings & King, 2009), Drug Courts offer substance use disorder treatment through the criminal justice system to non-violent drug offenders.…”

Section: Substance Use Disorder As a Public Health Problemmentioning

confidence: 99%

“…The Shelby County DC program is government-operated serving urban, suburban, and rural adult clients in a tristate region. Of the 2,550 DC treatment programs in the United States (National Institute of Justice, 2011), the Shelby County DC is one of the top-performing one-hundred mentor courts in the United States that have met special performance criteria outlined in the national Key Components for Drug Courts (Bureau of Justice Assistance, 2004; Speck et al, 2008). The Shelby County DC has a 50 % graduation rate (Shelby County Drug Court, 2007) compared to the national 48 % graduation rate (R. Brown, 2010b), and a 37 % crime recidivism rate (Shelby County Drug Court, 2008) compared to the national crime recidivism rate ranging from 17 -31 % (Roman et al, 2003).…”

Section: Community Settingmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of Drug Court Client Graduation

Gill¹

View full text Add to dashboard Cite

Background: Substance use disorder in the United States adversely effects society by burdening the justice system with offender incarceration for drug-related crimes, it also strains in the healthcare system with costs in excess of $216 billion dollars for treatment of drug-related mental and physical illnesses. Many offenders of nonviolent crimes with substance use disorder have been diverted to Drug Court (DC) for year-long supervised community-based drug addiction treatment as an alternative to incarceration for non-violent drug-related crimes. Drug Court program outcomes, however, have been studied as a criminal justice intervention, rather than a primary care mental health intervention. The majority of DC program evaluation has focused on admission data and outcomes using univariate and bivariate analyses, rather than longitudinal data using multivariate analyses to identify multivariate predictors of DC graduation.Objective: The purpose of this study is to: (a) describe the Sample Severity for DC clients; (b) discuss the differences between Drug Court graduates and dropouts for Sample Severity, Drug Court Practices, and In-Program Behavior; and (c) develop a prediction model for Drug Court graduation.Methods: This is a descriptive longitudinal design using secondary data analysis of existing DC Shelby County DC data. Data were analyzed from Results: The sample consisted of 310 Shelby County DC clients, predominately male (80.0%), and African American (60.3%) with a mean age of 29.9 years. Most DC clients had a high school diploma or GED (54.5%) or no high school diploma or GED (41.9%). Thirty-four percent were employed at DC admission and worked an average of 10.4 hours per week. Marijuana (56.1%) and alcohol (15.5%) were the top two primary drugs of choice. To compare differences between DC graduates and dropouts, data were analyzed using t-tests or Chi-squared, as appropriate. There were (48.1%) graduates and fewer male graduates ( ² = 4.19, p = .041), and fewer African American graduates ( ² = 4.26, p = .039). There were more graduates who had a high school diploma/GED or a college degree than dropouts ( ² = 5.21, p = .022), and more DC graduates were employed at DC admission ( ² = 23.09, p = .001). Of the seven primary drugs of choice, there was only one significant difference with more graduates listing alcohol as their primary drug of choice than dropouts ( ² = 14.05, p = .002).Of the six DC programs, there were significant differences for four programs. There were fewer graduates who participated in the Outpatient program ( ² = 4.04, p = .039) and Residential program ( ² = 8.00, p = .004), more graduates in the Outpatient DUI program ( ² = 27.5, p = .001), and no graduates in the Early Assessment vi Intervention Treatment program ( ² = 5.66, p = 017). Graduates spent more days in DC programs (t-test = 15.17, p = .001), and participated in fewer DC programs (t-test = 2.17, p = .031). Of the ten treatment agencies, there were significant differences for only on agency that had no graduates ( ² = 4.70, ...

show abstract

Vulnerable Populations: Drug Court Program Clients

Cited by 8 publications

References 21 publications

CE: Trauma-Informed Care in Nursing Practice

CE: Trauma-Informed Care in Nursing Practice

Court as a health intervention to advance Canada’s achievement of the sustainable development goals : a multi-pronged analysis of Vancouver’s Downtown Community Court

Predictors of Drug Court Client Graduation

Contact Info

Product

Resources

About