Abstract

Adults in community supervision (i.e., probation or parole) face disproportionately higher rates of substance use disorders (SUDs) compared to the general population, with older adults facing heightened risks. Further, SUDs often co-occur with mental illness, yet few studies have examined co-occurring SUDs and mental illness (CODs) among adults in community supervision and how these experiences vary across the life course. This study utilized a statewide sample of all adults in community supervision between 2018 and 2019 (N = 33,079) to assess the effects of mental health on substance use risks and needs, and whether age moderates this relationship. Multilevel modeling was used to examine associations while controlling for variation across judicial circuits. Findings revealed that substance use risk and need varies across circuits, effects of mental health on substance use vary regionally, and older persons in community supervision exhibit the highest rates of COD treatment needs. Social workers may benefit from these findings, which suggest a need for increased awareness of potential co-occurring needs among older adults in supervision, and available community-based interventions to meet these needs. Research evaluating training and available resources in the delivery of care for those with CODs in supervision remains a serious need.

摘要

与普通人群相比，接受社区监督（即缓刑或假释）的成年人面临更高比例的物质使用障碍 (SUD)，其中老年人面临更高的风险。此外，SUDs 通常与精神疾病同时发生，但很少有研究调查社区监督中成年人的 SUDs 和精神疾病 (CODs) 同时发生，以及这些经历在整个生命过程中如何变化。这项研究使用了 2018 年至 2019 年全州范围内接受社区监督的所有成年人样本（N = 33,079) 以评估心理健康对物质使用风险和需求的影响，以及年龄是否调节这种关系。多级建模用于检查关联，同时控制司法电路之间的变化。调查结果显示，物质使用风险和需求因回路而异，心理健康对物质使用的影响因地区而异，社区监督中的老年人表现出最高的 COD 治疗需求率。社会工作者可能会从这些发现中受益，这表明需要提高对监督中老年人潜在共存需求的认识，并提供基于社区的干预措施来满足这些需求。评估培训和可用资源的研究仍然迫切需要为那些在监督下有 COD 的人提供护理。