Date of Conferral

2018

Degree

Ph.D.

School

Human Services

Advisor

James Castleberry

Abstract

Researchers have suggested that jails and prisons in the United States are becoming the new mental health clinics, contributing to the phenomenon of mass incarceration and costing upwards of $15 billion per year in public revenue. The problem is no conclusive evidence exists that treatment in these custodial environments is more effective than that provided by noncustodial programs; especially for substance users. Additionally, the continuing incarceration of people with mental health problems by the hundreds of thousands poses a difficult ethical dilemma regarding why this population does not receive noncustodial or hospital treatment instead. The study addressed the research question of whether there is a significant difference in individual patient treatment plan completions that points to differences in the effectiveness of custodial and noncustodial mental and substance use disorder treatment programs. The study was guided by self-determination theory. Archival data reported through the Statewide Maryland Automated Tracking System comparing the number of complete and incomplete treatment plans of 1 custodial (n = 940) and 1 noncustodial (n = 534) mental health treatment program in Maryland, were analyzed using a Pearson's chi-square test of independence .The analysis showed that while custodial treatment plans were more effective, both custodial and noncustodial had high failure rates, and custodial plan success may be limited to the period within custody. This study may impact social change by informing justice policy and lawmakers about the need for continued research to provide effective interventions for substance users that transcends custodial boundaries.

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