34th AM (2023) - Poster Session-Barriers to Equitable Implementation of an Evidence-Based Co-Occurring Mental Health and Substance Use Disorder Intervention in Adult Drug Courts

Barriers to Equitable Implementation of an Evidence-Based Co-Occurring Mental Health and Substance Use Disorder Intervention in Adult Drug Courts

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This study examines the barriers to implementing an evidence-based intervention for individuals with co-occurring mental health and substance use disorders in Adult Drug Courts. The researchers used the Health Equity Implementation Framework (HEIF) to collect qualitative data from Drug Court participants, practitioners, and staff in Massachusetts. They aimed to identify both barriers and facilitators to implementing the intervention called MISSION-CJ.<br /><br />The study highlights the overrepresentation of people of color and those with co-occurring disorders in the criminal legal system. Despite efforts to incorporate evidence-based behavioral health interventions in this system, not all individuals are benefiting from them. Specifically, Black and Brown individuals with co-occurring disorders in Adult Drug Courts face poorer access to and engagement in evidence-based interventions.<br /><br />The researchers used a directed content analysis based on the HEIF domains to analyze the data. They identified several themes related to barriers to implementing the intervention. Participants from marginalized groups expressed a need for more inclusion and representation within the program to address their unique challenges. They also highlighted the importance of diversity among the staff to build trust and improve engagement.<br /><br />Moreover, participants felt that the existing model did not adequately address racial suffering, particularly among African Americans. They emphasized the need to acknowledge the impact of the criminal justice system on Black communities. Societal factors such as bias in referrals and experiences of discrimination were also identified as barriers to equitable implementation.<br /><br />The study concludes that there are multilevel barriers that hinder the equitable implementation of evidence-based interventions for co-occurring disorders in Drug Courts. Both participants and providers identified similar barriers and called for collaborative efforts to develop strategies that promote equitable implementation of care in criminal legal settings.<br /><br />Overall, this research sheds light on the specific challenges faced by marginalized individuals in accessing and benefitting from evidence-based interventions. It emphasizes the importance of addressing these barriers to ensure equitable implementation and improve outcomes for all individuals involved in Drug Courts.

Keywords

evidence-based intervention

co-occurring mental health

substance use disorders

Adult Drug Courts

Health Equity Implementation Framework

MISSION-CJ

overrepresentation

access and engagement

barriers to implementing

equitable implementation

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