Drug-abusing Offenders with Co-morbid Mental Disorders: Gender Differences in Problem Severity, Treatment Participation, and Recidivism

Objective This study examined the gender differences in drug-related problems and predictors of recidivism among a sample of 1444 offenders with co-morbid drug abuse and mental disorders participating in California's Proposition 36 Program. Methods Background characteristics and problem severity in multiple key life areas were assessed at intake by using Addiction Severity Index, and drug treatment participation, mental health diagnoses and arrests were based on official records. Results Women demonstrated greater problem severity than men in family relationships, health, psychological health, and sexual and physical abuse history. Men on the other hand had greater criminal history, high rates of attention disorder, and psychotic disorder. More men than women were rearrested during the year after treatment admission. Logistic regression analyses showed that for the combined sample, male, young age, cocaine use (relative to methamphetamine), drug abuse severity, methadone treatment, arrest history and fewer prior treatment history were associated with higher recidivism at 12-month follow-up; lower education, cocaine use, and arrest history were related to women's recidivism, while young age, outpatient treatment, and arrest history were predictors of men's recidivism. Conclusion Although the specific type of mental disorder did not seem to be predictive of recidivism, the high rates of mental health disorder and arrest of this population is problematic. Intervention strategies taking into consideration gender-specific problems and needs can improve outcomes for both.