A Peer-Support, Group Intervention to Reduce Substance Use and Criminality Among Persons With Severe Mental Illness

TLDR

The study compared a community‑oriented group intervention with peer support plus standard treatment to standard treatment alone for reducing alcohol use, drug use, and criminal justice charges among adults with severe mental illness. In a 2×3 randomized trial of 114 participants, self‑report questionnaires and program databases assessed substance use and criminal justice contacts, and mixed‑models, repeated‑measures ANCOVA, and correlational analyses evaluated outcomes. The experimental group showed a significant reduction in alcohol use over time, while drug use and criminal justice charges declined in both groups, indicating that peer‑ and community‑based support may specifically lower alcohol consumption.

Abstract

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.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.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.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.