Reentry Service Engagement Among a Reentry Population with Co-occurring Mental Health and Opioid Use Disorders in Massachusetts Jails

Abstract

Aim: Co-occurring opioid use and mental health disorders (COD) are common among people with criminal legal involvement. Reentry is a vulnerable period with low treatment engagement, often resulting in relapse, reincarceration, and overdose. While both linkage and multicomponent COD wraparound interventions have supported reentry, little is known about which are most effective for treatment engagement post release. Methods: This quasi-experimental study included 293 nonrandomized persons involved in the criminal legal system enrolled in a multicomponent COD intervention (n=173) or a linkage only model (n=120) for treatment. Kaplan Meier Curves and Cox Proportional Hazards were computed to determine differences in engagement. Results: Engagement was significantly different between interventions (X2=58.33, P <.0001). We observed a 73.3% reduction in hazard of early discharge for participants receiving the multicomponent COD intervention as compared to the linkage only model (P<.0001) and a higher 12-month engagement rate (51.5%) compared to the linkage only model (20.8%). Conclusions: Future research should include a randomized controlled trial to examine factors that influence post-release engagement as well as treatment effects and outcomes. We suggest that programs consider both interventions and assess client reentry needs in advance of release to match to the best suited post-release COD treatment.