Hospitalisation following residential drug and alcohol treatment for young people with and without a history of criminal conviction

Abstract

Introduction and Aims:Adolescents who engage in both sub-stance abuse and crime have a greater risk of adverse health eventsthan those who engage in substance abuse alone. This study exam-ines the short and long-term effect of adolescent engagement in aresidential substance abuse treatment program on subsequenthospitalisations for all clients, and separately for those with and with-out a history of criminal conviction.Design and Methods:Data includes linked administrative records ofclients referred to the Program for Adolescent Life Management fromJanuary 2001 to December 2016 in New South Wales, Australia(n=3059). Post-treatment hospitalisation outcomes were designated aseither physical injury, mental health problem or organic illness. Treat-ment and control groups were matched on factors associated with pro-gram retention. Logistic and cox regression analyses examined theodds and rate of hospitalisation within one year, and up to 15 years,post-treatment for all clients, and stratified by prior conviction status.Results:Treatment was associated with significantly lower likeli-hood of hospitalisation for all outcomes within one year and up to15 years post-treatment. Reductions in the odds and rate ofhospitalisation for physical injury and mental health problem werelarger for young people with a prior criminal conviction. There wasan interaction between treatment and prior conviction on short-termhospitalisation for physical injury.Conclusions:Adolescents who engage in a residential drug andalcohol program appear to have a long-lasting reduction in the risk ofhospitalisation. This also appears to apply to those with a history ofcriminal conviction.Implications for Practice or Policy:Residential drug and alcoholtreatment programs, like Program for Adolescent Life Management,may be a useful public health strategy to help reduce the burden of dis-ease among adolescents with substance abuse problems, and includingthose who may be involved with the criminal justice system.Disclosure of Interest Statement:This research was supported byan Australian Research Council Linkage Projects funding grant(LP140100429) and the Ted Noffs Foundation. We acknowledge theNSW Ministry of Health and ACT Health for the provision of data forthis study and the NSW Bureau of Crime Statistics and Research forthe data provided from the Re-Offending Database. The Centre forHealth Record Linkage is acknowledged for their role in data linkage.We also acknowledge the staff and residents of the Ted Noffs Founda-tion programs and the members of the Aboriginal Advisory Committeefor their support and participation in the research. The AboriginalAdvisory Committee guided the study, with representatives of Aborigi-nal organisations, researchers, staff and young people who have com-pleted the program. The full investigator team for the AustralianResearch Council Linkage Grant is acknowledged for their contribu-tions to project governance and direction including investigatorsJoanne Bryant, Eileen Baldry and Marian Shanahan.