Health and Justice最新文献

{"title":"Bridging crisis and care: exploring the role of behavioral health professionals in a police co-response model.","authors":"Rachel Oblath, Corinne A Beaugard, Carolina-Nicole Herrera, Cindy Xu, Sarah Syed, Christal Sadatis, Alison Duncan, Geneva Gann, Elizabeth Plange, Tasha Ferguson, Sarosh Khan, Faris Katkhuda, David C Henderson, Jenna Savage, Melissa S Morabito","doi":"10.1186/s40352-025-00381-1","DOIUrl":"10.1186/s40352-025-00381-1","url":null,"abstract":"<p><p>Police co-responder programs are collaborations between law enforcement and healthcare institutions where behavioral health professionals are embedded within police departments to support officers responding to incidents involving mental health and/or substance use. Research suggests that co-responder programs, which have existed for over 20 years in the United States and have become particularly popular in recent years, have the potential to decrease police use of force and divert individuals experiencing behavioral health crises from the criminal justice system. However, scant knowledge exists about the role of behavioral health professionals in these programs. This qualitative study examines nearly three years of clinical notes from the Boston Police Department's co-response program. Using an inductive approach incorporating aspects of grounded theory and thematic analysis, we analyzed notes from 4,111 co-response encounters between July 2019 and March 2022. Our study yielded a conceptual framework with three domains. First, behavioral health professionals interacted with a wide range of community members, including: police personnel; individuals experiencing behavioral health crises; family members of individuals in crisis; and healthcare and social services providers. Second, and through these interactions, behavioral health professionals assessed behavioral health symptoms, behavioral health history, and indicators of risk. Finally, and in response to their assessments, behavioral health professionals provided clinical supports, police assistance, and general assistance to multiple community members. Our findings suggest potential mechanisms by which co-response programs impact both police and behavioral health outcomes. Implications for practice, policy, and future research are discussed.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"72"},"PeriodicalIF":2.8,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12648995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining predictors of substance use and treatment adequacy among formerly incarcerated individuals with a history of opioid and cocaine use: research protocol.","authors":"Tawandra Rowell-Cunsolo, Meghan Bellerose, George Musa, Katherine Curtis, David Long, Elwin Wu, Keely Cheslack-Postava, Carl Hart","doi":"10.1186/s40352-025-00373-1","DOIUrl":"10.1186/s40352-025-00373-1","url":null,"abstract":"<p><strong>Background: </strong>Over 600,000 individuals are released from correctional institutions annually in the United States. Substance use disorders (SUDs) are highly prevalent in this population, and only a small proportion receive adequate treatment during incarceration. Post-incarceration, substance use increases considerably, and the risk of drug overdose is higher among formerly incarcerated individuals than among their counterparts in the general population, especially among individuals who use illicit opioids. However, significant gaps exist in our understanding of individual- and environment-level pathways of post-incarceration substance use, limiting treatment effectiveness. For those who receive substance use treatment services post-incarceration, research suggests that these services are not medically appropriate and/or responsive to their unique needs - thereby jeopardizing substance use outcomes.</p><p><strong>Objectives: </strong>The Addiction Treatment Adequacy Post-Incarceration (ATAP) Study aims to examine individual and environmental factors associated with changes in substance use and substance use treatment adequacy over a one-year period post-incarceration among formerly incarcerated individuals in New York City (NYC). We will examine the extent to which participants receive appropriate substance use treatment services, as recommended by their scores on the American Society of Addiction Medicine patient placement criteria (ASAM PPC).</p><p><strong>Methods: </strong>We will use innovative spatially informed multi-level modeling strategies to investigate individual- and environment-level factors that influence substance use among individuals released from correctional institutions and residing in the NYC metropolitan area. Guided by social ecological theory, this study will address the following specific aims: 1) Characterize substance use over a 12-month period (every three months) among 350 formerly incarcerated individuals who have been released in NYC during the past three years; 2) Identify individual (e.g., race, gender, income, mental health) and environmental (e.g., proximity to drug purchasing sites, neighborhood characteristics, residential mobility, access to treatment services) risk factors for drug use among formerly incarcerated individuals; and 3) Investigate discrepancies between ASAM PPC composite scores (a measure of addiction severity) generated and levels of substance use treatment.</p><p><strong>Potential implications: </strong>The proposed research will identify substance use treatment gaps and influential factors that are amenable to intervention in the interest of informing effective responses to the current opioid crisis.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"70"},"PeriodicalIF":2.6,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a psychoeducational intervention for people with suicidal behavior in the prison environment. N'VIU project: a randomized control trial.","authors":"Quintí Foguet-Boreu, Manel Capdevila-Capdevila, Judit Pons-Baños, Lola Riesco-Miranda, Ana Sanjuan Torres, Marian Martínez García, Berta Framis-Ferrer, Saray Valdivieso Muñoz","doi":"10.1186/s40352-025-00383-z","DOIUrl":"10.1186/s40352-025-00383-z","url":null,"abstract":"<p><p>BACKGROUND: Suicide rates are higher in prison environments than those in the general population. Therefore, preventive activities are crucial. We aimed to evaluate the effectiveness of a psychoeducational group intervention in decreasing the number of suicidal behaviors in prisons. METHODS: We conducted a randomized controlled trial in nine prisons in Catalonia. Main outcome: total number of suicidal behaviors. Other variables: suicidal ideations, depressive and anxiety symptoms, and quality of life. The intervention group carried out 17 psychoeducation sessions and the control group received information. RESULTS: 171 individuals participated in the study, mean age of 34.9 years, 84.8% males. The intervention group (n = 85) reduced anxiety and depression and increased quality of life post-intervention (p < 0.05), with no changes in the control group (n = 86). Both groups reduced all suicide items except for the number of interrupted/aborted attempts and the percentage of people with non-suicidal self-injurious behavior, which improved only in the intervention group. In both groups, the absolute number of suicide attempts decreased (p > 0.05). CONCLUSIONS: The psychoeducational intervention had an impact on suicidal ideation observed in both groups, with a non-significant reduction in the number of suicide attempts. Furthermore, the intervention improved levels of anxiety, depression, and quality of life. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov on January 19, 2022 (NCT05195554). </p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"71"},"PeriodicalIF":2.8,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the association of transferring governance of correctional health care services with overdose and all-cause mortality: a retrospective cohort study in British Columbia, Canada.","authors":"Lisa McQuarrie, Dibbya Pravas Dasgupta, Tonia Nicholls, Ruth Elwood Martin, Katherine E McLeod, Stuart Kinner, Leigh Greiner, Maureen Olley, Kate Roth, Heather Palis, Ashok Krishnamoorthy, Amanda Slaunwhite","doi":"10.1186/s40352-025-00389-7","DOIUrl":"10.1186/s40352-025-00389-7","url":null,"abstract":"<p><strong>Background: </strong>In many jurisdictions world-wide, the government agency that manages prisons also provides prison health care services. However, the World Health Organization (WHO) and United Nations (UN) have recommended that health ministries provide prison health care. In Canada, the province of British Columbia (BC) transferred responsibility for correctional health services to the health ministry in accordance with this guidance. The objective of this study was to estimate the association between the transfer in BC and all-cause and overdose mortality within 1 year of release from prison.</p><p><strong>Methods: </strong>We used a retrospective cohort study design employing the difference-in-differences (DiD) method to compare mortality among formerly-incarcerated people in the pre- and post-transfer periods against a matched community control group to control for province-wide trends in mortality. The data source was a longitudinal linkage of administrative databases. The DiD effect was estimated with survival time-to-event models.</p><p><strong>Results: </strong>In the formerly-incarcerated group (N = 6912), all-cause (3.7% vs 2.6%) and overdose (2.7% vs 1.7%) mortality in the first-year post-release decreased from the pre-transfer period to the post-transfer period, while mortality risk changed little in the community control group (N = 6881) during this time period (all-cause: 0.7% vs 0.9%; overdose: 0.4% vs 0.4%). The transfer was associated with statistically significant reductions in the hazards of all-cause mortality (DiD HR: 0.52, 95% CI: [0.32, 0.83]) and overdose mortality (DiD HR: 0.51, 95% CI: [0.26, 0.99]) in the first-year post-release.</p><p><strong>Conclusions: </strong>This study provides empirical evidence in support of WHO and UN guidance and indicates that the delivery of correctional health services by community health authorities may reduce deaths, particularly overdose deaths, among people released from correctional centres.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":" ","pages":"3"},"PeriodicalIF":2.8,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12809955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying racialized administrative and criminal legal burdens for obtaining gender-affirming identification documents among transgender groups: a qualitative analysis.","authors":"Kathryn Nowotny, Callan Hummel, Beaux Ramos, Jasmine McKenzie, Ashley Mayfaire, Kim-Phuong Truong-Vu, Charlton Copeland","doi":"10.1186/s40352-025-00375-z","DOIUrl":"10.1186/s40352-025-00375-z","url":null,"abstract":"<p><p>BACKGROUND: Identification documents like passports, driver’s licenses, and birth certificates are a cornerstone of citizenship and an important sociolegal determinant of health. Gender-affirming identification is a vital form of gender affirmation for many transgender people, preventing discrimination, stigma, and violence. The objective of this study was to document the administrative and criminal legal burdens for obtaining gender-affirming identification. METHODS: Qualitative trajectories documenting the name change process for 61 transgender people were created via a community-engaged mixed-methods approach. Data were collected in Miami, Florida, USA October 2022 to June 2023 and were analyzed using an inductive analytical approach. RESULTS: Of the 61 people intending to complete the name change process, 33 successfully filed with the courts and 28 dropped out of the process before filing. People living in poverty, people who were unhoused or unstably housed, and people with criminal legal records were systematically pushed out of the name change process. Among petitioners who file the onerous name change paperwork, discretion at the clerk and judicial level can cause additional administrative burdens. CONCLUSIONS: Barriers to gender-affirming IDs are one critical way transgender people experience intersecting forms of structural oppression and social marginalization. Streamlining the name change process at the local level is one structural intervention that can alleviate discriminatory practices by police, healthcare providers, and others, thereby reducing health inequities. </p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"69"},"PeriodicalIF":2.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12628517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The public health consequences of officer discretion in arrests affecting LGBTQ+ communities in the United States: a scoping review.","authors":"Esmeralda J Rubalcava Hernandez, John L Bayhi, Caitlin Herron, Shabrina Dew, Whitney Margaritis, LaKenya S DeBerry, Marcela Nava","doi":"10.1186/s40352-025-00378-w","DOIUrl":"10.1186/s40352-025-00378-w","url":null,"abstract":"<p><p>BACKGROUND: LGBTQ + communities in the United States disproportionately experience policing practices that involve high officer discretion, contributing to wide-ranging health disparities. These interactions, often involving low-level offenses or perceived violations, introduce significant subjectivity that can reinforce racial, gender, and sexual bias. While the broader health effects of criminal-legal involvement have been studied, the specific public health consequences of these discretionary enforcement practices remain underexplored, particularly among LGBTQ + populations.​. METHODS: Guided by Arksey and O’Malley’s framework and reported in accordance with PRISMA-ScR, we first submitted an Open Science Framework protocol, then we searched six databases for peer-reviewed empirical studies examining the health impacts of police discretion on LGBTQ + populations in the contiguous United States. Because the term “discretionary arrest” is rarely used in published literature, studies were included if discretion was described in participant narratives or author analysis. Studies were analyzed through a holistic health lens encompassing physical, mental, emotional, and spiritual well-being. RESULTS: Four empirical studies met inclusion criteria. Thematic synthesis revealed eight cross-cutting themes: (1) health impacts from policing, (2) racialized enforcement patterns, (3) discretion in arrest outcomes, (4) criminalization of gender expression and identity, (5) sexual risk and surveillance, (6) social withdrawal and isolation as coping, (7) mistrust in public systems, and (8) intersectional marginalization. Black, Latine, transgender, and gender-expansive individuals were most frequently targeted and harmed.​. CONCLUSIONS: Officer discretion in the decision to arrest functions as a structural determinant of health and a key target for policy and intervention. Findings underscore the urgent need for community-led, trauma-informed, LGBTQ+-affirming interventions. With only four studies meeting inclusion, interpretations should remain cautious and context-specific. Community-academic partnerships can prioritize harm reduction and guide structurally grounded health-justice interventions that curb discretionary arrest and improve access to LGBTQ+affirming care. </p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"68"},"PeriodicalIF":2.8,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring reasons and motivations for suicide attempts in prison before and during the SARS-CoV-2 pandemic.","authors":"Leonel da Cunha Gonçalves, Laurent Gétaz, Patrick Heller, Kelly Gonçalves, Judith Sultan, Diane Golay, Anja J E Dirkzwager, Hans Wolff, Stéphanie Baggio","doi":"10.1186/s40352-025-00380-2","DOIUrl":"10.1186/s40352-025-00380-2","url":null,"abstract":"<p><strong>Background: </strong>Suicide attempts represent a critical public health concern in prison settings, where rates are substantially higher than in the general population. The COVID-19 pandemic introduced additional stressors, yet little is known about its impact on suicide attempts among detained persons. This study aimed to identify the underlying reasons and motivations for suicide attempts in a Swiss pre-trial prison and to examine changes before and during the pandemic. We analyzed 205 suicide attempts by 125 detained persons between 2016 and 2021. Data were collected from clinical and prison records. Reasons and motivations were extracted using content analysis. Population-averaged logistic regression models were used to examine differences between periods.</p><p><strong>Results: </strong>Suicide attempts were associated with health-related and personal issues (85%), prison-related problems (76%), and interpersonal conflicts (61%). Psychological distress, juridical issues, and conflicts with correctional officers were the most common reasons. Motivations included protest against the institution (39%), desire to die (18%), escape (11%), and help-seeking (7%). There was an increase in health-related and personal problems during the pandemic, particularly dissatisfaction with medical care (+104%), physical pain (+181%), and psychological distress (+18%), while help-seeking motivations decreased (-72%). Psychiatric morbidity and self-harm history were associated with these outcomes. Sample characteristics remained largely stable across periods.</p><p><strong>Conclusions: </strong>This study highlights the multifaceted nature of suicide attempts in prison and the impact of the COVID-19 pandemic on health-related and personal issues. While preventive measures were essential for infection control, they may have increased psychological distress, and reduced medical resources likely exacerbated clinical needs. These findings underscore the importance of balancing public health measures with continuous access to care during public health emergencies.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"67"},"PeriodicalIF":2.6,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12607183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The weight of words: a scoping review of depression and suicidal ideation among 911 call takers and dispatchers.","authors":"Deepika Rani, Gillian Foley, Camryn Lynn, Doug Johnson, Tim William, Marcella Siqueira Cassiano","doi":"10.1186/s40352-025-00376-y","DOIUrl":"10.1186/s40352-025-00376-y","url":null,"abstract":"<p><strong>Background: </strong>Communicators in public safety, such as 911 telecommunicators, emergency medical dispatchers, and police and fire dispatchers, frequently deal with distressing calls, traumatic narratives, and high-stakes decisions. Despite not being physically present at crisis scenes, these experts endure psychological stress on par with first responders. This scoping review examines the prevalence and determinants of depression and suicidal ideation among public safety communicators and their co-occurrence, summarizes the occupational and personal risk factors contributing to these outcomes, and evaluates proposed mitigation strategies.</p><p><strong>Results: </strong>The research indicates that depression is reported at elevated rates in this workforce, ranging from 8.4% to 73%, depending on the population and the sensitivity of the instrument, based on 11 quantitative studies published between 1995 and 2025. Although less studied, suicidal ideation appears to be significantly higher in this group compared to the general population. Contributing factors include indirect trauma exposure, shift work, emotional suppression, organizational neglect, and a history of trauma. The frequent co-occurrence of depression and suicidal ideation supports the Interpersonal Theory of Suicide as a relevant explanatory framework.</p><p><strong>Conclusions: </strong>Despite accumulating evidence, research is methodologically limited due to cross-sectional designs, inconsistent screening tools, and sample homogeneity. Existing interventions, such as peer support, debriefing, and trauma-informed training, are inconsistently applied and under-evaluated. The findings highlight a pressingneed for longitudinal research, targeted interventions, and workplace reforms that take into account the unique psychological burdens associated with communicator roles. Addressing depression and suicide risk among these professionals is critical to ensuring both workforce well-being and the continued effectiveness of public safety systems.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"66"},"PeriodicalIF":2.6,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12595646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A legal quagmire: the need for a public health approach to the competency crisis.","authors":"Erin McCauley, Zaire Cullins, Katherine LeMasters","doi":"10.1186/s40352-025-00379-9","DOIUrl":"10.1186/s40352-025-00379-9","url":null,"abstract":"<p><p>Competency to stand trial is a legal construct in the United States whereby an individual's capacity to meaningfully and knowingly function in a legal proceeding, typically for those with mental or developmental disabilities or dementia, is questioned. The competency determination and restoration process often leads to unnecessary and excessive incarceration of those with disabilities without treatment for the underlying cause of competency concerns, often worsening health and leading to repeated incarceration. Yet, this crisis is rarely considered from a public health lens. Further, the number of individuals entangled in this legal process has risen dramatically in recent years, with 130,000 competency evaluations being conducted annually. We review what is known about this topic from legal studies, provide case studies of individuals failed by this process, and outline the responses that criminal legal systems and local and state governments have had to this crisis (e.g., increase in jails' competency beds, diversion programs). We conclude that the competency process is a public health crisis which merits both study by public health researchers and a public health response.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"65"},"PeriodicalIF":2.6,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12595709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situational confidence and recovery capital among justice-involved adults receiving medications for opioid use disorder in a jail-based setting.","authors":"Elizabeth O Obekpa, Xulei He, Alejandro Betancur, Kathryn R Gallardo, Serena A Rodriguez, Sheryl A McCurdy, J Michael Wilkerson","doi":"10.1186/s40352-025-00377-x","DOIUrl":"10.1186/s40352-025-00377-x","url":null,"abstract":"<p><strong>Background: </strong>Justice-involved individuals with opioid use disorder (OUD) face heightened relapse risks during the reentry period. While medications for opioid use disorder (MOUD) are effective, long-term recovery also depends on psychological and structural supports, including situational confidence (perceived ability to resist substance use in high-risk situations) and recovery capital (the internal and external resources that support recovery).</p><p><strong>Methods: </strong>This cross-sectional study examined situational confidence and its association with recovery capital among 107 justice-involved adults receiving MOUD in an urban jail in Texas. Participants completed the Brief Situational Confidence Questionnaire (BSCQ) and the 10-item Brief Assessment of Recovery Capital (BARC-10). Mental health and substance use were assessed using the PHQ-9, GAD-7, AUDIT, and ASSIST. Bivariate associations were examined using chi-square and Fisher's exact tests, and a multivariable logistic regression model was used to assess factors associated with high situational confidence (BSCQ ≥ 80%).</p><p><strong>Results: </strong>Participants had a mean age of 38.9 years (SD = 0.4); most were male (74.0%), non-Hispanic Black or other race/ethnicity (58.0%), and had a high school education or less (59.8%). A majority (66.4%) reported unstable housing in the 30 days prior to incarceration. Fewer than half (44.9%) reported high situational confidence, with a mean score of 67.6 (SD = 26.9). Higher recovery capital was strongly associated with high situational confidence (aOR = 2.66; 95% CI: 1.52-4.96). Depression (aOR = 0.36; 95% CI: 0.16-0.78), sexual minority status (aOR = 0.14; 95% CI: 0.01-0.78), and reliance on informal income-generating activities (\"hustling\") (aOR = 0.30; 95% CI: 0.10-1.01) were associated with lower situational confidence.</p><p><strong>Conclusions: </strong>Recovery capital is a strong predictor of situational confidence among justice-involved individuals receiving MOUD. Interventions that enhance recovery capital, including access to employment, housing, and social support, integrate mental health care, and provide tailored support for marginalized subgroups, may improve recovery outcomes during incarceration and reentry. Brief, validated tools like the BSCQ and BARC-10 may help identify individuals at greater relapse risk and guide more targeted, equity-informed reentry planning.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"64"},"PeriodicalIF":2.6,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}