Trauma and the Justice-Involved Veteran

This research focused on the experiences of veterans in two jail diversion programs, a traditional drug court and a new specialized variant of drug court, Veterans Treatment Court (VTC). VTC is similar to a traditional drug court with the addition of specialized components for veterans, including the addition of a Veterans Affairs (VA) justice outreach specialist, who serves as the conduit between the VA and the court. This new approach to intervention with justice-involved veterans has not previously been subject to empirical testing. In order to provide an empirical basis for the need of the VTC program and an understanding of the effects of this program, two sets of analyses were conducted. First, an analysis of seventy participants in a traditional drug court examined differences between matched pairs of veterans and civilians in regards to their drug and alcohol problems and psychiatric symptoms. Veterans were found to have significantly more severe lifetime drug histories than did their civilian counterparts, suggesting that veterans have different needs than civilians, which might be addressed in a specialized program. In the second study, 41 participants in a Veterans Treatment Court (VTC) were assessed on measures of psychopathology, substance abuse, and employment problems and interviewed regarding their trauma histories and experiences while in the program. Hierarchical linear regression analyses revealed the effects of differential traumas on the expression of treatment needs at intake, including psychological symptoms and substance abuse disorders. Combat trauma significantly, independently predicted post-traumatic stress disorder (PTSD), depression, and drug abuse symptoms at intake. While PTSD and depression were highest among those with the most severe combat exposure, drug abuse was highest among those exposed to moderate levels of combat. This suggests that even milder forms of combat exposure can have detrimental effects on functioning. Additionally, for PTSD, post-deployment trauma contributed in unique ways to symptoms above and beyond combat trauma, indicating that non-military stressors have deleterious effects on mental health among veterans. Overall, Veteran's Treatment Court participation was associated with reductions in mental health symptoms, drug abuse severity, and employment problems over time. The particular aspects of the program that contributed to this change did not differ by combat status and appeared to be additional access to services and a streamlined referral process to the VA, as well as increased participant motivation through judicial interactions and engagement with program staff. This study suggests the importance of providing trauma-informed care to ensure responsive treatment for justice-involved veterans, and underscores the notion that Veteran's Treatment Courts can be used to effectively treat the trauma-associated symptoms of combat and non-combat justice-involved veterans alike. The implications of the findings for future research and jail diversion programs development are discussed