Intervention for Justice-Involved Homeless Veterans With Co-Occurring Substance Use and Mental Health Disorders:...

Area of Science:

• Mental Health Services Research
• Criminal Justice Interventions
• Veteran Health

Background:

• US Veterans Affairs mental health residential rehabilitation treatment programs (MH RRTPs) serve homeless veterans.
• Veterans with co-occurring mental health and substance use disorders and criminal legal involvement need targeted interventions to reduce recidivism risk.

Purpose of the Study:

• To evaluate the Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking Criminal Justice (MISSION-CJ) intervention's impact on criminal recidivism and health outcomes.
• To examine the mechanisms influencing these outcomes.
• To qualitatively assess the implementation of MISSION-CJ.

Main Methods:

• A hybrid type 1 randomized controlled trial involving 226 veterans in MH RRTPs, randomized to enhanced usual care (EUC) or MISSION-CJ.
• Intervention includes 6 months of services (3 months in MH RRTP, 3 months post-discharge).
• Data collection at baseline, 6, and 15 months using regression models, mediation analysis, and thematic analysis for qualitative data.

Main Results:

• 118 veterans enrolled as of March 2025, randomized to MISSION-CJ (n=58) or EUC (n=60).
• 23 qualitative interviews completed; participants are undergoing treatment and follow-up.
• Full findings on effectiveness, implementation, and scalability are expected by 2026.

Conclusions:

• The MISSION-CJ intervention, if proven effective, could be a valuable addition to MH RRTPs.
• It may help address risk factors associated with recidivism in vulnerable veteran populations.