Evaluating the Efficacy of County Programming for Jail Detainees with Substance Use Disorder and/or Serious Mental Illness – A Qualitative Study

There is an overrepresentation of individuals with substance use disorder (SUD) and serious mental illness (SMI) in the criminal legal system in the United States (US). The government of a medium-sized county in the southeastern United States provides programs and services for this population both in the county jail and in the community. This study evaluates whether these programs and services are effective at promoting recovery from these conditions, the reasons for their efficacy, and suggestions for improvement from the point of view of those held in the county detention facility. Focus groups were conducted with participants who had been detained in the jail in the past 5 years. The transcripts were coded using a codebook based on the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) recovery framework. Thematic analysis revealed 5 central themes: (1) existing programs are very effective at promoting recovery, for those who can access them, (2) the jail environment itself does not promote recovery, (3) people with similar lived experiences are the most effective individuals to promote recovery, (4) jail intake and discharge coordination processes are critical opportunities to decrease rearrests and facilitate recovery, and (5) the community resources that provide holistic services are the most effective. These findings emphasize the need to strengthen individualized resource connection at release, expand diversion programs, enhance behavioral health education for correctional staff, incorporate more licensed peer supporters, and prioritize investment in community behavioral health services.