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Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants

BACKGROUND: Therapeutic diversion courts seek to address justice-involved participants’ underlying problems leading to their legal system involvement, including substance use disorder, psychiatric illness, and intimate partner violence. The courts have not addressed systemic hurdles, which can contr...

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Autores principales: Morse, Diane S., Silverstein, Jennifer, Thomas, Katherine, Bedel, Precious, Cerulli, Catherine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607061/
https://www.ncbi.nlm.nih.gov/pubmed/26478853
http://dx.doi.org/10.1186/s40352-015-0026-2
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author Morse, Diane S.
Silverstein, Jennifer
Thomas, Katherine
Bedel, Precious
Cerulli, Catherine
author_facet Morse, Diane S.
Silverstein, Jennifer
Thomas, Katherine
Bedel, Precious
Cerulli, Catherine
author_sort Morse, Diane S.
collection PubMed
description BACKGROUND: Therapeutic diversion courts seek to address justice-involved participants’ underlying problems leading to their legal system involvement, including substance use disorder, psychiatric illness, and intimate partner violence. The courts have not addressed systemic hurdles, which can contribute to a cycle of substance use disorder and recidivism, which in turn hinder health and wellness. The study purpose is to explore the systemic issues faced by women participants in drug treatment court from multiple perspectives to understand how these issues may relate to health and wellness in their lives. METHODS: Qualitative thematic framework analysis of five separate focus groups consisting of female drug treatment court participants, community providers, and court staff (n = 25). Themes were mapped across the socio-ecological framework and contextualized according to social determinants of health. RESULTS: Numerous systemic factors impacted women’s access to treatment. Laws and legal policies (governance) excluded those who could potentially have benefitted from therapeutic court and did not allow consideration of parenting issues. Macroeconomic policies limit housing options for those with convictions. Social policies limited transportation, education, and employment options. Public policies limited healthcare and social protection and ability to access available resources. Culture and societal values, including stigma, limited treatment options. CONCLUSIONS: By understanding the social determinant of health for women in drug treatment court and stakeholder’s perceptions, the legal system can implement public policy to better address the health needs of women drug court participants.
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spelling pubmed-46070612015-12-01 Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants Morse, Diane S. Silverstein, Jennifer Thomas, Katherine Bedel, Precious Cerulli, Catherine Health Justice Research Article BACKGROUND: Therapeutic diversion courts seek to address justice-involved participants’ underlying problems leading to their legal system involvement, including substance use disorder, psychiatric illness, and intimate partner violence. The courts have not addressed systemic hurdles, which can contribute to a cycle of substance use disorder and recidivism, which in turn hinder health and wellness. The study purpose is to explore the systemic issues faced by women participants in drug treatment court from multiple perspectives to understand how these issues may relate to health and wellness in their lives. METHODS: Qualitative thematic framework analysis of five separate focus groups consisting of female drug treatment court participants, community providers, and court staff (n = 25). Themes were mapped across the socio-ecological framework and contextualized according to social determinants of health. RESULTS: Numerous systemic factors impacted women’s access to treatment. Laws and legal policies (governance) excluded those who could potentially have benefitted from therapeutic court and did not allow consideration of parenting issues. Macroeconomic policies limit housing options for those with convictions. Social policies limited transportation, education, and employment options. Public policies limited healthcare and social protection and ability to access available resources. Culture and societal values, including stigma, limited treatment options. CONCLUSIONS: By understanding the social determinant of health for women in drug treatment court and stakeholder’s perceptions, the legal system can implement public policy to better address the health needs of women drug court participants. Springer Berlin Heidelberg 2015-06-17 /pmc/articles/PMC4607061/ /pubmed/26478853 http://dx.doi.org/10.1186/s40352-015-0026-2 Text en © Morse et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Research Article
Morse, Diane S.
Silverstein, Jennifer
Thomas, Katherine
Bedel, Precious
Cerulli, Catherine
Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants
title Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants
title_full Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants
title_fullStr Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants
title_full_unstemmed Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants
title_short Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants
title_sort finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607061/
https://www.ncbi.nlm.nih.gov/pubmed/26478853
http://dx.doi.org/10.1186/s40352-015-0026-2
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