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<p>Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking–Criminal Justice (MISSION-CJ) is a multicomponent intervention designed for individuals with co-occurring mental health and substance use disorders (COD). This study examined client engagement in MISSION-CJ when delivered alongside two Drug Treatment Courts (DTCs) and identified factors that predicted engagement. We further assessed whether predictors of engagement differed between the pre–COVID-19 public health emergency (PHE) and during the PHE. We hypothesized that overall engagement would be lower during the PHE due to service disruptions and that participants with greater behavioral and social needs would demonstrate lower engagement. Using a quasi-experimental, single-group open pilot design, we analyzed engagement data from 90 participants enrolled in MISSION-CJ. The sample was 64.1% male, 82.8% White, 67.8% unemployed, 83.9% unstably housed, with a mean age of 34&#xa0;years. Minority status, older age, and female gender were significant demographic predictors of higher engagement. Social determinants of health, including employment, housing stability, and comorbid chronic medical conditions, were also associated with greater engagement. Increased participation in telehealth sessions further predicted higher levels of engagement in MISSION-CJ overall and across program components. Engagement did not differ significantly between pre-PHE and PHE periods, suggesting that MISSION-CJ maintained stable client participation despite widespread service disruptions. These findings highlight the importance of demographic, social, and service delivery factors in shaping engagement and underscore the potential of telehealth to support COD treatment within DTCs. Future research should examine strategies to leverage these predictors to further improve engagement.</p>

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Predictors of Engagement in a Multicomponent Community-Based Intervention Alongside Drug Treatment Court for People with Co-Occurring Mental Health and Substance Use Disorders and Criminal-Legal Involvement

  • 期刊论文

  • 发表日期：

    2026年3月5日

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  • Paige Shaffer,
  • Michael Andre,
  • Abigail Helm,
  • Sheila Casey,
  • Cassandra Fitzpatrick,
  • David Smelson

摘要

Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking–Criminal Justice (MISSION-CJ) is a multicomponent intervention designed for individuals with co-occurring mental health and substance use disorders (COD). This study examined client engagement in MISSION-CJ when delivered alongside two Drug Treatment Courts (DTCs) and identified factors that predicted engagement. We further assessed whether predictors of engagement differed between the pre–COVID-19 public health emergency (PHE) and during the PHE. We hypothesized that overall engagement would be lower during the PHE due to service disruptions and that participants with greater behavioral and social needs would demonstrate lower engagement. Using a quasi-experimental, single-group open pilot design, we analyzed engagement data from 90 participants enrolled in MISSION-CJ. The sample was 64.1% male, 82.8% White, 67.8% unemployed, 83.9% unstably housed, with a mean age of 34 years. Minority status, older age, and female gender were significant demographic predictors of higher engagement. Social determinants of health, including employment, housing stability, and comorbid chronic medical conditions, were also associated with greater engagement. Increased participation in telehealth sessions further predicted higher levels of engagement in MISSION-CJ overall and across program components. Engagement did not differ significantly between pre-PHE and PHE periods, suggesting that MISSION-CJ maintained stable client participation despite widespread service disruptions. These findings highlight the importance of demographic, social, and service delivery factors in shaping engagement and underscore the potential of telehealth to support COD treatment within DTCs. Future research should examine strategies to leverage these predictors to further improve engagement.