Hospitalisation following therapeutic community drug and alcohol treatment for young people with and without a history of criminal conviction

Tyson Whitten; Jesse Cale; Sally Nathan; Sarita Bista; Mark Ferry; Megan Williams; Patrick Rawstorne; Andrew Hayen

doi:10.1016/j.drugalcdep.2022.109280

Hospitalisation following therapeutic community drug and alcohol treatment for young people with and without a history of criminal conviction

Drug Alcohol Depend. 2022 Feb 1:231:109280. doi: 10.1016/j.drugalcdep.2022.109280. Epub 2022 Jan 10.

Authors

Tyson Whitten¹, Jesse Cale², Sally Nathan³, Sarita Bista⁴, Mark Ferry⁵, Megan Williams⁴, Patrick Rawstorne³, Andrew Hayen⁴

Affiliations

¹ School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia; School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. Electronic address: tyson.whitten@adelaide.edu.au.
² School of Criminology and Criminal Justice, Griffith University, Gold Coast, Queensland, Australia.
³ School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
⁴ School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia.
⁵ Ted Noffs Foundation, Randwick, New South Wales, Australia.

PMID: 35030508
DOI: 10.1016/j.drugalcdep.2022.109280

Abstract

Introduction: This study examines the association between treatment in a therapeutic community for adolescents with drug and alcohol problems on hospitalisation outcomes up to 15 years later for all clients, and separately for those with and without a history of criminal conviction.

Method: A quasi-experimental design was used to examine the linked administrative health and criminal justice records for all adolescents admitted to the Program for Adolescent Life Management (PALM) from January 2001 to December 2016 (n = 3059) in Sydney, Australia. ICD-10AM codes were used to designate hospitalisation outcomes as either physical injury, mental health problems, substance use disorders, or organic illness. The treatment and comparison groups were matched on factors associated with program retention, resulting in a final sample of 1266 clients. We examined the rate of hospitalisation up to 15 years posttreatment for all clients and stratified by prior conviction status using Cox regression analyses.

Results: The treatment group had significantly lower rates of hospitalisation for a physical injury (HR = 0.77 [95% CI = 0.61-0.98]), mental health problem (HR = 0.62 [95% CI = 0.47-0.81]), substance use disorder (HR = 0.59 [95% CI = 0.47-0.75]), and organic illness (HR = 0.71 [95% CI = 0.55-0.92]). There was a significant interaction between treatment and prior criminal conviction status on rate of hospitalisation for physical injury, suggesting that the effect of treatment on physical injury was significantly greater for clients with a prior criminal conviction.

Conclusions: Adolescents who engage in a therapeutic community treatment program may have a long-lasting reduction in the risk of subsequent hospitalisation. This also appears to apply to those with a history of criminal conviction.

Keywords: Adolescence; Criminal conviction; Drug and alcohol treatment; Hospitalisation; Therapeutic community.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Criminal Law
Criminals*
Hospitalization
Humans
Mental Disorders* / therapy
Risk Factors
Substance-Related Disorders* / psychology
Substance-Related Disorders* / therapy
Therapeutic Community