A peer-support, group intervention to reduce substance use and criminality among persons with severe mental illness.
OBJECTIVE
This study compared the effectiveness of two interventions in reducing alcohol use, drug use, and criminal justice charges for persons with severe mental illnesses: first, a community-oriented group intervention with citizenship training and peer support that was combined with standard clinical treatment, including jail diversion services, and second, standard clinical treatment with jail diversion services alone.


METHODS
A total of 114 adults with serious mental illness participated in a 2 x 3 prospective longitudinal, randomized clinical trial with two levels of intervention (group and peer support for the experimental condition and standard services for the control) and three interviews (baseline, six months, and 12 months). Self-report questionnaires assessed alcohol and drug use, and program databases assessed criminal justice contacts. The authors used a mixed-models analysis to assess alcohol and drug use, repeated-measures analysis of covariance to assess criminal justice charges, and correlational analyses to assess the relation between intervention participation and outcome variables.


RESULTS
The experimental group showed significantly reduced alcohol use in comparison with the control group. Further, results showed a significant group-by-time interaction, where alcohol use decreased over time in the experimental group and increased in the control group. Drug use and criminal justice charges decreased significantly across assessment periods in both groups.


CONCLUSIONS
Of the outcomes, only decreased alcohol use was attributable to the experimental intervention. Although this may be a chance finding, peer- and community-oriented group support and learning may facilitate decreased alcohol use over time.
Rowe
Michael
M
Department of Psychiatry, Yale School of Medicine, 319 Peck St., Building 6W, Suite 1C, New Haven, CT 06513, USA. michael.rowe@yale.edu
Bellamy
Chyrell
C
Baranoski
Madelon
M
Wieland
Melissa
M
O'Connell
Maria J
MJ
Benedict
Patricia
P
Davidson
Larry
L
Buchanan
Josephine
J
Sells
Dave
D
D000328:Adult; D000437:Alcoholism / Q000517:prevention & control*; D003415:Crime / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology; D008875:Middle Aged; D010379:Peer Group; D011446:Prospective Studies; D012657:Self-Help Groups; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States