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Basic prevalence data have documented the high rates of behavioral health needs among adults in jail, but much of this work is ambiguous, often glossing over specific conditions such as personality disorders and certain types of substance use disorders (SUD) (e.g. alcohol use disorder, opiate use disorder, etc.). The work in this area has also asserted multiple conditions are “the rule, not the exception” (Scott, Lewis, & McDermott, 2006), but there is still a limited amount of information available regarding the relationship between specific combinations of mental health conditions, SUDs, and offending patterns among jail detainees. The current study drew on data collected with the Comprehensive Addictions and Psychological Evaluation – 5 (CAAPE–5) over the course of a year from a random sample of adults detained in a local jail. The sample consisted of 258 adults with nearly three quarters (74%) of the sample meeting criteria for a mental health condition in combination with a minimum of one SUD. Additionally, nearly one third (31%) met criteria for multiple severe SUDs. Bivariate results indicated detainees with a combination of mental health and SUD were more likely to be booked into the jail for felony (χ2 (2) = 6.35, p = .042) offenses and property (χ2 (2) = 6.56, p = .038) offenses relative to detainees who did not meet similar criteria. A series of multivariate logistic regression analyses demonstrated detainees who met criteria for specific mental health conditions (i.e. PTSD, depression, antisocial personality disorder (ASPD), or obsessive compulsive personality disorder (OCPD)) in conjunction with multiple SUDs were significantly more likely to be charged with a felony offense. Detainees with PTSD and multiple SUDs were also more likely to be booked into the jail on multiple prior occasions. These results demonstrate the need for systematic comprehensive behavioral health assessments in local detention facilities in the effort to reduce repeat jail admissions.

Co-Occurring Substance Use Disorders, Mental Health Conditions and Offending Patterns among Local Jail Detainees