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Published on: October 10, 2012
An Analysis of Sanctions and Respective Psychiatric Diagnoses in Veterans' Court
R Scott Johnson1, David P Graham2, Kristi Sikes2
1Drs. Johnson and Sikes are Residents, Dr. Graham is Assistant Professor of Psychiatry, and Dr. Stolar is Associate Professor of Psychiatry, Baylor College of Medicine, Houston, TX. Dr. Nelsen is the Psychiatrist of Forensic Programs, Minnesota Security Hospital, St. Peter, MN. Dr. Stolar is also Medical Director, Veterans' Court Treatment Program, Houston, TX. All (except Dr. Nelsen) are affiliated with the Michael E. DeBakey Veterans Affairs (VA) Medical Center, Mental Health Care Line and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX. In addition, Dr. Graham is affiliated with Neurorehabilitation: Neurons to Networks Traumatic Brain Injury Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, and the South Central Mental Illness, Research, Education and Clinical Center (MIRECC), Department of Veterans Affairs, Houston, TX. A preliminary poster of this material was presented at the 43rd annual meeting of the American Academy of Psychiatry and the Law, Montreal, Quebec, Canada, October 25-28, 2012, as well as the March, 2013 Midwest AAPL annual conference in Columbus, OH. rscottjohnson3@gmail.com.
Abstract:
This descriptive analysis is an examination of the extent to which a veteran's mental health diagnosis or the initial criminal charge committed before program enrollment relate to a greater propensity for sanctions, harsher sanctions, higher rates of relapse on substances, or overall program compliance. This is a retrospective descriptive analysis that focuses on those participants in the Harris County (Texas) Veterans' Court Program from June 2010 through April 2012 for whom the court had issued sanctions. The most clinically relevant association (p = .014) was found between veterans with substance use relapse and subsequent discharge from the program. Furthermore, the following four infractions were associated with a subsequent jail sanction: unexcused absence (p = .014), failure to complete a task (p = .010), substance use relapse (p = .001), and missing a hearing (p = .012). Given these findings, veterans with relapses in substance use during the course of the program are at greatest risk of noncompletion of the program and may represent a subpopulation of veterans who require greater or different types of assistance.
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