Risk and protective factors for early dropout from telephone monitoring for individuals with drug convictions in community mental health centers in Japan.

Introduction: Individuals involved with the criminal justice system face challenges in receiving and maintaining substance use disorder (SUD) treatment and support. Although telephone monitoring (TM) could reduce these barriers, data on TM for community-dwelling individuals involved with the criminal justice system and research on individuals who drop out of TM are scarce. We examined the factors associated with dropping out early from the Voice Bridges Project, which provides TM for individuals on probation for drug-related convictions through community mental health centers in Japan.
Methods: Participants (n = 546) were individuals aged ≥20 years with methamphetamine-related convictions who were on probation. Univariate analyses examine the associations between one-year follow-up status and baseline variables, and multivariate Cox proportional hazards regression analyses identify the risk and protective factors associated with dropping out. Stratified analyses report results based on sex and halfway-house residency.
Results: The one-year dropout rate was 43.6 % (n = 238). Multivariate analysis identified two risk factors for dropping out-halfway-house residency and suicide attempts in the past year, and two protective factors-higher education and the current use of SUD services. Sex-stratified analyses showed that halfway-house residency was a risk factor for both men and women. Attempted suicide was a risk factor for women. Conversely, higher education and current use of SUD services were protective factors for men.
Conclusions: Our results identify unique risk factors for women, such as a recent history of suicide attempts, and distinctive protective factors for men, including higher education and current use of SUD services, emphasizing the importance of sex-specific approaches. Furthermore, the study reveals that irrespective of sex, vulnerable individuals, such as halfway-house residents, are at a higher risk of dropping out from TM.
Competing Interests: Declaration of competing interest Toshihiko Matsumoto received financial support for this research from the Ministry of Health, Labour and Welfare, Japan. Shiori Tsutsumi received financial support for this research from the Japan Science and Technology Agency and Keio University. The authors declare that although they received funding as mentioned above, this financial support did not influence the outcomes, interpretation, or presentation of the research findings. The research was conducted independently, and the views expressed in this paper are those of the authors and not necessarily those of the funding agencies.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)