Research

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  September 2021

  Overview of the Criminal Legal System in Michigan: Adults and Youth

  This report sought to illustrate a comprehensive and objective snapshot of Michigan's adult and youth criminal/legal systems using data to provide a roadmap and baseline to assist stakeholders interested in advancing change within Michigan's adult and youth justice systems. When the authors started this project, they were aware that the lack of data would result in an incomplete picture of systems in the State. The culmination of this research and analysis confirmed just how much information is missing, and how much is unknown to the public and practitioners about Michigan's justice systems.

  Other

  Landscape report
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  August 2021

  Introduction to Harm Reduction Training, Post-Training Survey Results

  The contents of this document are the results of a post-training survey that followed an introductory training in Harm Reduction concepts provided to Michigan Certified Peer Recovery Coaches.

  Harm reduction

  Report
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  August 2021

  Harm Reduction Champions Group Pre-Training Survey Results

  The contents of this document are the results of a pre-training survey that preceded an in-depth, bi-weekly, 16-week training in Harm Reduction concepts provided to a group of Michigan Certified Peer Recovery Coaches.

  Harm reduction

  Report
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  July 2021

  Peer recovery services for persons returning from prison: pilot randomized clinical trial investigation of SUPPORT

  This pilot study assesses the effectiveness of peer support approaches. Access to peer recovery coaches within a well-established community reentry program was randomized. Despite high rates of attrition due to re-incarceration, death and program disengagement, results suggest that those who received peer recovery coach support in the reentry program had recovery-based improvements including improved self-reported mental and physical health and reductions in substance use behaviors. The treatment group also saw improvements in measures of treatment motivation and self-efficacy. Both groups saw similar positive trends in some outcomes likely due to the relative success of the well-established reentry program regardless of peer support coach inclusion.

  Harm reduction

  Publication
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  July 2021

  Community overdose surveillance: comparing substances collected from the death scene investigation to toxicology results

  This publication intends to assess whether stimulants and opioids are mixed prior to consumption or purposefully used simultaneously. Data were collected in Marion County, Indiana, from 45 fatal overdose cases involving heroin, fentanyl, methamphetamine or cocaine. Comparing toxicology reports with results from tested samples of substances found at the scene of overdose deaths involving opioids and stimulants revealed that deaths are largely the result of the co-use of opioids and stimulants, rather than use of stimulants combined with opioids. Key findings also indicate that fentanyl is not commonly mixed into stimulants, and there is an increase in the presence of fentanyl combined with heroin.

  Harm reduction

  Publication
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  July 2021

  Law enforcement and suicide calls for service: a mixed-methods study of suicide attempts and deaths

  This mixed-methods study explores suicide events captured in law enforcement (LE) call reports. Data was collected from reports in a Midwestern metropolitan county wherein LE responded to suicide incidents. Descriptive and bivariate analyses of quantitative data were used to assess differences between incident type (i.e. attempts vs. deaths). Findings revealed that suicide decedents tended to be male, older and had at least one intrapersonal issue as a precipitating factor. Qualitative sections illuminated themes across suicide attempts including self-harm as an autonomy seeking strategy; challenging claims of suicidality; and promising not to self-harm. Increasing the sophistication of call report documentation procedures would allow communities to deepen their understanding of how suicide manifests.

  Crisis response

  Publication
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  July 2021

  Medications and Recovery

  Recovery form opioid use disorder (OUD) is often a long process, with many potential roadblocks along the way. Support, understanding, and tools for growth--such as medications--are a large part of recovery for individuals with OUD, including those who come in contact with the criminal/legal system. However, opioid use disorder recovery is often limited by availability of evidence-based, research-supported medications for opioid use disorder (MOUD), which aid in the success of individuals seeking recovery. Hear from MOUD expert Dr. Janis Romanik on what recovery often looks like for individuals with OUD, how MOUD assists recovery, and why success is often dependent on factors such as the length of MOUD usage.

  Treatment ecosystems

  Video
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  July 2021

  Lost in Transition: The Behavioral Health Needs of Veterans in Eight County Jails

  In a booking sample across eight jails, this evaluative, cross-sectional study compared veterans to non-veterans by demographics, criminal/legal outcomes, behavioral health needs, and receipt of jail-based behavioral health and discharge planning services. Veterans were more likely to be male, older, to have received mental health services prior to their jail stay, and to misuse alcohol. They are less likely to have insecure housing and misuse drugs. No differences existed for length of stay in jail nor recidivism. Veterans were equally likely to receive jail-based behavioral health services, but less likely to receive discharge planning services. Practitioners in the criminal/legal and mental health systems need to collaborate and develop processes that successfully identify and link veterans to culturally-appropriate services.

  Diversion

  Publication
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  June 2021

  Gender, geography, and justice: behavioral health needs and mental health service use among women in rural jails

  This multi-jail study examines the behavioral health needs and service use in a sample of 3,787 individuals in jail, to compare women in rural jails to their gender and geography counterparts (rural men, urban women and urban men). Compared to urban women, rural men, and urban men, rural women had significantly higher odds of serious mental illness and co-occurring mental health and substance use disorders. Rural woman were nearly 30 times more likely to receive jail-based mental health services; however, a discrepancy between screened mental health need and jail-identified mental health need shows rural women are severely under-identified compared to their gender/geography counterparts. These findings suggest the need to improve behavioral health identification methods.

  Diversion

  Publication
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  June 2021

  Expanding naloxone distribution in county jails

  An effective method for reducing opioid overdose in the community is providing naloxone upon release from custody in county jail. Naloxone is an FDA-approved medication that is nearly 100% effective in reversing the effects of an opioid overdose. It is often administered nasally under the common brand Narcan®, and available in an injectable form as well. While it is considered a prescription medication, there is a "standing order" in place in Michigan and many states across the nation which allows access to naloxone without an individual prescription. Naloxone is safe, carries no risk for misuse, has no effect on an individual if opioids are absent, and still works for opioids even if other substances are present. The utility and safety of naloxone makes it a simple yet lifesaving tool for reducing overdoses involving opioids.

  Treatment ecosystems

  Toolkit