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CDA 13-279
Justice-Involved Veterans: Mental Health and Substance Use Care of Young Adults
Andrea K. Finlay PhD
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, CA
Funding Period: August 2014 - July 2019

BACKGROUND/RATIONALE:
Veterans involved in the criminal justice system are a highly vulnerable population with multiple mental health and substance use disorder treatment needs. Criminal recidivism and homelessness are also common. Iraq and Afghanistan Veterans in particular often have complex health needs and will potentially be long-term Veterans Health Administration (VHA) patients. There is an urgent need to develop interventions that improve their entry to and engagement in mental health/substance use disorder treatment, so as to address their treatment needs and break the cycle of homelessness and recidivism.

OBJECTIVE(S):
This research aims to improve utilization of VHA care by: (1) Identifying predictors of entry to and engagement in VHA mental health/substance use disorder care among Iraq/Afghanistan justice-involved Veterans with a need for such care, (2) Evaluate Iraq/Afghanistan justice-involved Veterans' experiences connecting to VHA mental health/substance use disorder care, and (3) Develop and pilot-test an intervention to increase entry to/engagement in VHA mental health/substance use disorder care among Iraq/Afghanistan justice-involved Veterans.

METHODS:
This grant is based on Andersen's Behavioral Model and Life Course Theory. Objective 1 uses VHA administrative and survey data to identify delivery system and patient-level predictors of treatment use. Objective 2 uses qualitative interviews to evaluate Iraq/Afghanistan justice-involved Veterans' experiences connecting to VHA care. Objective 3 will be to develop and conduct a formative evaluation, and pilot-test an intervention to support Iraq/Afghanistan justice-involved Veterans in improving their entry to/engagement in VHA care.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
Promising avenues to accessing pharmacotherapy for opioid use disorder, include addressing legal or county restrictions against medications, stigma against justice-involved Veterans, and lack of information among community or criminal justice providers about VA resources to treat opioid use disorder may need to be addressed to improve access to pharmacotherapy. Increased access and use of these medications may improve Veteran health and other outcomes such as reduce criminal recidivism.

PUBLICATIONS:

Journal Articles

  1. Pang EQ, Coughlan M, Bonaretti S, Finlay A, Bellino M, Bishop JA, Gardner MJ. Assessment of Open Syndesmosis Reduction Techniques in an Unbroken Fibula Model: Visualization Versus Palpation. Journal of Orthopaedic Trauma. 2019 Jan 1; 33(1):e14-e18.
  2. Song SY, Goodman SB, Suh G, Finlay AK, Huddleston JI, Maloney WJ, Amanatullah DF. Surgery Before Subspecialty Referral for Periprosthetic Knee Infection Reduces the Likelihood of Infection Control. Clinical orthopaedics and related research. 2018 Oct 1; 476(10):1995-2002.
  3. Finlay AK, McGuire J, Bronson J, Sreenivasan S. Veterans in Prison for Sexual Offenses: Characteristics and Reentry Service Needs. Sexual abuse : a journal of research and treatment. 2019 Aug 1; 31(5):560-579.
  4. Stimmel MA, Rosenthal J, Blue-Howells J, Clark S, Harris AHS, Rubinsky AD, Bowe T, Finlay AK. The impact of substance use disorders on treatment engagement among justice-involved veterans with posttraumatic stress disorder. Psychological Services. 2018 Apr 30.
  5. Tsai J, Finlay A, Flatley B, Kasprow WJ, Clark S. A National Study of Veterans Treatment Court Participants: Who Benefits and Who Recidivates. Administration and policy in mental health. 2018 Mar 1; 45(2):236-244.
  6. Finlay AK, Harris AHS, Rosenthal J, Blue-Howells J, Clark S, Flatley B, Timko C. Justice Involvement and Treatment Use Among Rural Veterans. Rural mental health. 2018 Jan 1; 42(1):46-59.
  7. Rebolledo BJ, Bernard JA, Werner BC, Finlay AK, Nwachukwu BU, Dare DM, Warren RF, Rodeo SA. The Association of Vitamin D Status in Lower Extremity Muscle Strains and Core Muscle Injuries at the National Football League Combine. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2018 Apr 1; 34(4):1280-1285.
  8. Timko C, Flatley B, Tjemsland A, McGuire J, Clark S, Blue-Howells J, Blonigen D, Rosenthal J, Finlay A. A Longitudinal Examination of Veterans Treatment Courts' Characteristics and Eligibility Criteria. Justice research and policy : journal of the Justice Research and Statistics Association : JRP. 2017 Nov 13; 17(2):123-136.
  9. Goodnough LH, Finlay AK, Huddleston JI, Goodman SB, Maloney WJ, Amanatullah DF. Obesity Is Independently Associated With Early Aseptic Loosening in Primary Total Hip Arthroplasty. The Journal of arthroplasty. 2018 Mar 1; 33(3):882-886.
  10. Finlay AK, Ellerbe LS, Wong JJ, Timko C, Rubinsky AD, Gupta S, Bowe TR, Burden JL, Harris AHS. Barriers to and facilitators of pharmacotherapy for alcohol use disorder in VA residential treatment programs. Journal of substance abuse treatment. 2017 Jun 1; 77:38-43.
  11. Finlay AK, Stimmel M, Blue-Howells J, Rosenthal J, McGuire J, Binswanger I, Smelson D, Harris AH, Frayne SM, Bowe T, Timko C. Use of Veterans Health Administration Mental Health and Substance Use Disorder Treatment After Exiting Prison: The Health Care for Reentry Veterans Program. Administration and policy in mental health. 2017 Mar 1; 44(2):177-187.
  12. Tsai J, Flatley B, Kasprow WJ, Clark S, Finlay A. Diversion of Veterans With Criminal Justice Involvement to Treatment Courts: Participant Characteristics and Outcomes. Psychiatric services (Washington, D.C.). 2017 Apr 1; 68(4):375-383.
  13. Harris AH, Bowe T, Hagedorn H, Nevedal A, Finlay AK, Gidwani R, Rosen C, Kay C, Christopher M. Multifaceted academic detailing program to increase pharmacotherapy for alcohol use disorder: interrupted time series evaluation of effectiveness. Addiction science & clinical practice. 2016 Sep 15; 11(1):15.
  14. Finlay AK, Binswanger I, Timko C, Rosenthal J, Clark S, Blue-Howells J, McGuire J, Hagedorn H, Wong JJ, Van Campen J, Sox-Harris AH. Receipt of pharmacotherapy for alcohol use disorder by male justice-involved U.S. Veterans Health Administration patients. Criminal justice policy review. 2016 Apr 18; doi: 10.1177/0887403416644011.
  15. Finney JW, Amundson EO, Bi X, Cucciare MA, Eisen SA, Finlay AK, Halvorson MA, Hayashi K, Owens DK, Maisel NC, Timko C, Weitlauf JC, Cronkite RC. Evaluating the Productivity of VA, NIH, and AHRQ Health Services Research Career Development Awardees. Academic Medicine. 2016 Apr 1; 91(4):563-9.
  16. Timko C, Finlay A, Schultz NR, Blonigen DM. Dually Diagnosed Patients with Arrests for Violent and Nonviolent Offenses: Two-Year Treatment Outcomes. Journal of addiction. 2016 Mar 28; 2016:6793907.
  17. Finlay AK, Harris AH, Rosenthal J, Blue-Howells J, Clark S, McGuire J, Timko C, Frayne SM, Smelson D, Oliva E, Binswanger I. Receipt of pharmacotherapy for opioid use disorder by justice-involved U.S. Veterans Health Administration patients. Drug and Alcohol Dependence. 2016 Mar 1; 160:222-6.
  18. Blonigen DM, Rodriguez AL, Manfredi LB, Britt J, Nevedal A, Finlay AK, Rosenthal J, Smelson D, Timko C. The availability and utility of services to address risk factors for recidivism among justice-involved veterans. Criminal justice policy review. 2016 Feb 10; DOI: 10.1177/0887403416628601.
  19. Glynn LH, Kendra MS, Timko C, Finlay AK, Blodgett JC, Maisel NC, Midboe AM, McGuire JF, Blonigen DM. Facilitating treatment access and engagement for justice-involved Veterans with substance use disorders. Criminal justice policy review. 2016 Feb 4; 27(2):doi: 10.1177/0887403414560884.
  20. Schultz NR, Blonigen D, Finlay A, Timko C. Criminal typology of veterans entering substance abuse treatment. Journal of substance abuse treatment. 2015 Jul 1; 54:56-62.
  21. Finlay AK, Binswanger IA, Smelson D, Sawh L, McGuire J, Rosenthal J, Blue-Howells J, Timko C, Blodgett JC, Harris AH, Asch SM, Frayne S. Sex differences in mental health and substance use disorders and treatment entry among justice-involved Veterans in the Veterans Health Administration. Medical care. 2015 Apr 1; 53(4 Suppl 1):S105-11.
  22. Blodgett JC, Avoundjian T, Finlay AK, Rosenthal J, Asch SM, Maisel NC, Midboe AM. Prevalence of mental health disorders among justice-involved veterans. Epidemiologic Reviews. 2015 Jan 19; 37:163-76.
  23. Harris AH, Bowe T, Del Re AC, Finlay AK, Oliva E, Myrick HL, Rubinsky AD. Extended release naltrexone for alcohol use disorders: quasi-experimental effects on mortality and subsequent detoxification episodes. Alcoholism, clinical and experimental research. 2015 Jan 1; 39(1):79-83.
  24. Finlay AK, Smelson D, Sawh L, McGuire J, Rosenthal J, Blue-Howells J, Timko C, Binswanger I, Frayne SM, Blodgett JC, Bowe T, Clark SC, Harris A. U.S. Department of Veterans Affairs Veterans Justice Outreach Program: Connecting Justice-Involved Veterans with Mental Health and Substance Use Disorder Treatment. Criminal justice policy review. 2014 Dec 18; 1-20.
  25. Flanagan CA, Kim T, Pykett A, Finlay A, Gallay EE, Pancer M. Adolescents' theories about economic inequality: why are some people poor while others are rich? Developmental psychology. 2014 Nov 1; 50(11):2512-25.
Center Product

  1. Hecht MI, Hanks D, Finlay A. Podcast: Justice Involved Veterans. 2018 Jun 24. 2 (9). Available from: https://www.hsrd.research.va.gov/news/podcasts/default.cfm.
  2. Finlay AK. Veterans in Veterans Justice Outreach: Mental health and substance use disorder diagnoses and treatment use. Presentation for Veterans Justice Outreach: Specialists National Call, VA Office of Public and Intergovernmental Affairs (OPIA). 2015 Jan 23.
  3. Finlay AK. Justice-involved Veterans: Mental health and substance use disorder treatment conditions and utilization of care after prison incarceration. Health Care for Re-entry Veterans (HCRV) Program: Specialists National Call, VA Office of Public and Intergovernmental Affairs (OPIA). 2015 Jan 12.
  4. Finlay AK. Justice-involved Veterans: Mental health and substance use disorder treatment conditions and utilization of care after prison incarceration. Presentation on the VHA Health Care for Reentry Veterans Specialists National Call. 2015 Jan 12.
CYBR

  1. Finlay AK, Blue-Howells J. Homeless and Justice-Involved Veterans: What does the Research Tell us? Connecting Research to Practice [Cyberseminar]. VA National Center on Homelessness among Veterans. 2018 Jun 12.
  2. Moore E, Finlay AK, Stimmel M. Female Veterans in the Criminal Justice System. [Cyberseminar]. 2016 Jul 26.
  3. Finlay AK, Rosenthal J. Justice-involved Veterans: Mental health and substance use disorder diagnoses and treatment use. Career Development Award Enhancements Initiative (CDAei). [Cyberseminar]. 2015 Mar 10.
Conference Presentations

  1. Frayne SM, Phibbs CS, Berg E, Friedman SA, Yano EM, Washington DL, Saechao FS, Finlay AK, Hoggatt K, Hamilton AB. One foot in the door and one foot out: Attrition among women community care users who have recently joined the VA. VA National Meeting: Examining the New Landscape of Care in the Community for Veterans. Paper presented at: VA HSR&D Field-Based Examining the New Landscape of Care in the Community for Veterans Meeting; 2016 Aug 8; Arlington, VA.
  2. Stimmel M, McGuire J, Rosenthal J, Rubinsky A, Blue-Howells J, Finlay AK. Justice-involved veterans with posttraumatic stress disorder: Understanding the impact of co-occurring substance use disorders on treatment engagement. Paper presented at: International Association of Forensic Mental Health Services Annual Conference; 2016 Jun 21; New York, NY.
  3. Finlay AK. Mental health and substance use disorder diagnoses and treatment use among veterans in Veterans Treatment Courts. Skills Building Workshop: Identification of and Response to the Treatment Needs of Justice Involved Veterans. Presented at: Justice For Vets Annual Vet Court Con; 2016 Jun 1; Anaheim, CA.
  4. Finlay AK, Binswanger I, Timko C, Rosenthal J, Clark S, Blue-Howells J, McGuire J, Hagedorn H, Wong J, Van Campen J, Sox-Harris AH. Receipt of pharmacotherapy for opioid use disorder by justice-involved U.S. Veterans Health Administration patients. Drug and Alcohol Dependence. Paper presented at: Academic and Health Policy Conference on Correctional Health; 2016 Mar 18; Baltimore, MD.
  5. Finlay AK, Bowe T, Sox-Harris AH. Changes in receipt of pharmacotherapy for opioid use disorder among veterans from fiscal years 2012-2013. Paper presented at: Addiction Health Services Research Conference; 2015 Oct 15; Marina del Rey, CA.
  6. Finlay AK. Justice-involved Veterans: Mental health and substance use disorder diagnoses and treatment use. Invited talk. Presented at: Justice For Vets Annual Vet Court Con; 2015 Jul 28; Washington, DC.
  7. Blonigen DM, Rodriguez A, Nevedal A, Smelson D, Finlay A, Rosenthal J, Timko C. A Qualitative Analysis to Identify Provider Perceptions of Gaps in the Implementation of Best Care Practices to Reduce Recidivism among Justice-Involved Veterans. Presented at: VA HSR&D / QUERI National Meeting; 2015 Jul 10; Philadelphia, PA.
  8. Bi X, Phibbs CS, Saechao FS, Finlay AK, Maisel N, Hamilton A, Frayne SM. Turning 65: A tipping point in women Veterans’ use of VA primary care. Poster session presented at: VA HSR&D / QUERI National Meeting; 2015 Jul 9; Philadelphia, PA.
  9. Finlay AK, Harris A, Blue-Howells J, Rosenthal J, McGuire J, Binswanger I. Receipt of pharmacotherapy for opioid use disorder: Comparing Justice-involved Veterans with Other Veterans. Poster session presented at: VA HSR&D / QUERI National Meeting; 2015 Jul 8; Philadelphia, PA.
  10. Bi X, Phibbs CS, Saechao FS, Finlay AK, Maisel N, Hamilton AB, Frayne SM. Turning 65: A tipping point in women Veterans’ use of VA primary care. Poster session presented at: AcademyHealth Annual Research Meeting; 2015 Jun 14; Minneapolis, MN.
  11. Finlay AK, Harris A, Blue-Howells J, Rosenthal J, McGuire J, Binswanger I. Receipt of pharmacotherapy for opioid use disorder: Comparing Veterans in Veterans Justice Programs with other Veterans. Poster session presented at: AcademyHealth Annual Research Meeting; 2015 Jun 14; Minneapolis, MN.
  12. Finlay AK, Saechao FS, Berg E, Rosenthal J, McGuire J, Clark S, Hamilton AB, Bi X, Frayne SM. Gender differences in new and established users in the Veterans Justice Outreach program. Poster session presented at: AcademyHealth Annual Research Meeting; 2015 Jun 14; Minneapolis, MN.
  13. Bi X, Phibbs CS, Saechao F, Finlay AK, Maisel N, Hamilton A, Frayne SM. Turning 65: A tipping point in women Veterans’ use of VA primary care. Presented at: AcademyHealth Gender and Health Interest Group Annual Meeting; 2015 Jun 13; Minneapolis, MN.
  14. Schultz NR, Finlay AK, Blonigen DM, Timko C. History of violence: Two year outcomes of dually diagnosed Veterans. Poster session presented at: Western Psychological Association Annual Convention; 2015 May 1; Las Vegas, NV.
  15. Schultz N, Blonigen DM, Finlay AK, Timko C. Veterans’ criminal history severity and one-year treatment outcomes. Poster session presented at: Western Psychological Association Annual Convention; 2015 Apr 30; Las Vegas, NV.
  16. Schultz NR, Blonigen DM, Finlay AK, Timko C. Severity of Criminal Offending among Veterans in Substance Use Disorder Treatment. Presented at: Western Psychological Association Annual Convention; 2015 Apr 30; Las Vegas, NV.
  17. Finlay AK, Binswanger I, Frayne SM, Harris A. Receipt of pharmacotherapy for opioid use disorder: Comparing justice-involved Veterans with other Veterans. Presented at: Academic and Health Policy Conference on Correctional Health; 2015 Mar 19; Boston, MA.
  18. Finlay AK, Binswanger I, Harris A, Frayne S. Gender differences in diagnosis and treatment access among justice-involved Veterans. Presented at: Academic and Health Policy Conference on Correctional Health; 2015 Mar 19; Boston, MA.
  19. Finlay AK, Smelson D, Sawh L, Timko C, McGuire J, Rosenthal J, Blue-Howells J, Clark SC, Binswanger I, Bowe T, Stimmel M, Frayne S, Harris A. Justice-involved Veterans: Mental health and substance use disorder conditions and utilization of care after prison incarceration. Presented at: American Society of Criminology Annual Meeting; 2014 Nov 21; San Francisco, CA.
  20. Schultz NR, Finlay AK, Blonigen DM, Timko C. Arrest history, treatment utilization, and mutual-help group attendance among dually diagnoses Veterans. Presented at: American Society of Criminology Annual Meeting; 2014 Nov 21; San Francisco, CA.
  21. Finlay AK, McGuire J, Rosenthal J, Blue-Howells J, Binswanger I, Smelson D, Sawh L, Timko C, Blodgett JC, Bowe T, Harris A, Clark SC, Asch S, Frayne S. Gender differences in mental health and substance use disorders among justice-involved Veterans after prison incarceration. Poster session presented at: American Society of Criminology Annual Meeting; 2014 Nov 20; San Francisco, CA.
  22. Schultz NR, Finlay AK, Blonigen DM, Timko C. Typology of criminal offending and treatment utilization among Veteran patients entering substance use disorder treatment. Poster session presented at: American Society of Criminology Annual Meeting; 2014 Nov 19; San Francisco, CA.
  23. White HR, Finlay AK, Pardini D. Racial differences in the association between trajectories of regular marijuana use and types of offending. Poster session presented at: American Society of Criminology Annual Meeting; 2014 Nov 19; San Francisco, CA.
  24. Finlay AK, Bowe T, Harris AHS. Access to and engagement in substance use disorder specialty treatment: Comparing Veterans exiting prison and other Veterans. Poster session presented at: Addiction Health Services Research Conference; 2014 Oct 16; Boston, MA.
  25. Finlay AK, Stimmel MA, Bowe T, Harris AHS. Justice-involved veterans: Mental health and substance use disorder conditions and utilization of care after prison incarceration. Poster session presented at: Addiction Health Services Research Conference; 2014 Oct 16; Boston, MA.
  26. Harris A, Hagedorn H, Gifford E, Boden M, Finlay A, Gordon A, Maisto S, Ilgen M, Oliva E, Rosen C, Norma S. A method to set implementation priorities: what should we study and why? Poster session presented at: Addiction Health Services Research Conference; 2014 Oct 16; Boston, MA.
  27. Stimmel MA, Harris AHS, Bowe T, Finlay AK. Co-occurring post-traumatic stress disorder and substance use disorders among Veterans exiting prison. Poster session presented at: Addiction Health Services Research Conference; 2014 Oct 16; Boston, MA.
  28. Sox-Harris AH, Bowe T, Del Re A, Finlay AK, Oliva E, Rubinsky A. Quasi-Experimental Effects of Extended Release Naltrexone in US Veteran Health Administration Patients with Alcohol Use Disorders. Paper presented at: Addiction Health Services Research Conference; 2014 Oct 15; Boston, MA.


DRA: Mental, Cognitive and Behavioral Disorders, Substance Abuse and Addiction
DRE: Technology Development and Assessment
Keywords: none
MeSH Terms: none