An Examination of Access and Barriers to Co-Occurring Disorders Treatment in a Rural Jail

Rural jails face unique challenges in screening and providing treatment for a steadily increasing percentage of the United States population with mental health and substance use disorders. Since many of these individuals will recycle through the criminal justice system, prompt identification and connection to treatment are paramount in stopping the revolving door of incarceration for drug-driven crime. The current study reports findings from an evaluation of a rural jail-based justice mental health initiative in South Carolina utilizing 4,966 eligible arrests, with 153 of these arrests eventually leading to treatment. Analysis centers on the assessment of pathways and barriers to substance misuse and mental health treatment, with a pointed focus on early disorders screening, enabling speedy referral for recovery services and connection to treatment. In addition to flow diagrams outlining pathways to treatment, binary logistic regression examined participant characteristics disparities observed in screening, referrals, and treatment. Results indicate the most frequent route to treatment is actuarial post-arrest disorders screening, an essential first step toward treatment. Important findings include that only 38.4% of referrals result in treatment participation, having an arrest history meaningfully increased the likelihood of an in-jail screening, and referred justice-involved males were far less likely to enroll in treatment than female arrestees.