Substance use, mental health, chronic medical conditions and criminal justice contact in a nationally representative sample

Purpose The amount of overlap between criminal justice practices and public health is growing and more research is needed to guide new initiatives. This study was designed to assess the relationships between various chronic medical conditions, substance use severity, mental health indicators and criminal justice contact using the National Survey on Drug Use and Health. Design/methodology/approach Analyses were conducted in three stages to comprehensively examine the relationships between various indicators of physical health, mental health, substance use severity and criminal justice contact. Findings Results demonstrate indicators of substance use severity surpass physical and mental health conditions as stronger determinants of any criminal justice contact, as well as repeated interactions with police. In addition, combinations of multiple conditions increase the likelihood of criminal justice involvement, but substance use remains a consistent factor contributing to the strongest associations. These findings highlight the importance of capitalizing on the initial point of criminal justice contact to address substance use to prevent further and subsequent involvement in the system. Research limitations/implications Criminal justice initiatives based on least harm solutions require evidence to support public health-oriented approaches. The unique approach to examining the intersection of criminal justice practices and health provided in this study can be used to inform alternates to arrest. Practical implications The least harmful practices should be adopted to address health conditions at the time of criminal justice contact. These practices should focus heavily on injection drug use as a primary factor associated with the prior arrest. Practices designed to divert arrestees with health conditions away from jails are needed. Law enforcement practices can significantly benefit from public health-oriented approaches. Originality/value Criminal justice initiatives based on least harm solutions require evidence to support public health-oriented approaches. The unique approach to examining the intersection of criminal justice practices and health provided in this study can be used to inform alternates to arrest.