What are the impacts on health and well-being of mandatory non-custodial drug and alcohol treatment orders?
NESSIE has recently published two related research reviews on the impacts and experiences of mandatory non-custodial drug and alcohol treatment orders on health and wellbeing. You can find the full text of these reviews published in Health & Justice by clicking on the links below.
If you would like more details on why this topic is important, what research steps we took and how we involved people with lived experience, you can read our earlier blogs.
In this blog, we describe the key findings from each review.
What was the focus of the reviews?
People involved in the criminal justice system (justice-involved adults) often struggle with alcohol and drug issues. Traditionally, these individuals might receive short prison sentences that do not address the root causes of their behaviour, such as substance use problems or mental health issues. This lack of focused treatment can lead to repeat offences and a continuous cycle of re-entering the justice system.
The role of Non-custodial Treatment Orders
Non-custodial ‘treatment orders’ offer an alternative to custodial sentences. These court-mandated non-custodial programmes require individuals to undergo substance use treatment instead of serving time in prison. The goal is to tackle underlying health and substance use problems that contribute to criminal behaviour, ultimately aiming to reduce the likelihood of re-offending. Previous research has evaluated whether treatment orders help reduce re-offending rates but not the impact on health.
What did we do?
We searched multiple online databases to find research that has investigated the impact of treatment orders on health and well-being. We also wanted to know what barriers affected the use of treatment orders and what factors helped with their use in practice.
We included 36 studies (11 on the health impacts and 25 on experiences of treatment orders) and checked how well these studies were carried out.
We had very low confidence in our findings about health impacts because the reporting of the data was limited.
For the studies on experiences of treatment orders, our confidence in our findings was high for 7/13 findings with the rest being moderate (4/13) or low confidence (2/13). Very few studies had health and well-being as their main focus, and the research methods and treatment programmes were often poorly described. Most of the studies were conducted in the USA (9 on health impacts and 20 on experiences) and focused on drug programmes.
What did we find out?
We found that justice-involved adults thought that treatment orders led to better health outcomes and reduced substance use. However, they also reported negative impacts of treatment orders on mental health, such as increased stress when dealing with the demands of the programmes. These programmes show promise, but the evidence for improving health and well-being is still unclear, and more high-quality research is needed. Justice-involved adults need assistance to address challenging life circumstances together with treatment and social support to increase their engagement in treatment.
You can access the full publications for each review by following the links below:
This blog post used the University of Edinburgh large language model to assist with the creation of an early draft (based on our publications) which has subsequently been edited by Dr Katie Thomson.
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