Evaluating Health Services for Justice-Involved Veterans to Improve Policy and Practice

NIH RePORTER · VA · I01 · · view on reporter.nih.gov ↗

Abstract

Background: An estimated 181,500 veterans are incarcerated in prison or jail with thousands more arrested, involved in courts, or on probation or parole each year. These “justice-involved Veterans” have extensive medical and mental health disorders, housing instability, and an elevated risk for suicide and other mortality. Since 2007, the Veterans Health Administration (VHA) has operated the Veterans Justice Programs (VJP) to provide outreach, assessment, and case management for justice-involved Veterans in local courts, jails, and prisons, and to liaise with criminal justice partners. In fiscal year 2018, VJP provided services to 80,653 Veterans. Research on the link between VJP services and Veteran outcomes is hindered by a lack of systematic methods to assess VJP structures, processes and outcomes. VJP and Veteran-focused criminal justice initiatives continue to implement new features without the tools needed to measure, describe, and evaluate their components. To inform program planning and resource allocation, it is essential to know which structures and processes are linked to better outcomes for justice-involved Veterans. This explanatory sequential mixed methods study will develop a VJP program evaluation dashboard to determine gaps in VJP and VHA services for justice-involved Veterans. By using this dashboard, VJP leaders can develop policies and practices to improve healthcare, housing and mortality outcomes among justice-involved Veterans. Significance/Impact: Given the elevated risk mental health disorders, homelessness, and mortality for justice- involved Veterans, it is imperative that VHA provides services to address the needs of this population. This study responds to VA priorities to deliver effective and efficient care to Veterans, Veterans Treatment Court legislation, the Office of Research & Development priority to increase real-world impact of research, HSR&D priorities of mental health treatment and health equity, and the VJP priority to maximize successful outcomes among justice-involved Veterans. Innovation: VJP is at the forefront of partnering with non-VHA criminal justice and community agencies to serve justice-involved Veterans. This project breaks new ground by examining the full continuum of VJP/non- VHA partnerships and drawing lessons that can be applied to Veterans who receive services outside VHA. Specific Aims: The three aims are scientifically important and reflect extensive input from justice-involved Veterans and VJP leaders and staff: (1) Identify Veteran, VJP, VHA facility, and criminal justice factors that predict healthcare, housing and homeless services, and mortality outcomes for justice-involved Veterans; (2) Qualitatively evaluate Veterans’ and other key stakeholders’ perspectives of factors that explain successful healthcare, housing, and mortality outcomes among justice-involved Veterans; and (3) Develop a program evaluation dashboard of VJP services, VHA resources, and criminal justice factors that...

Key facts

NIH application ID
10315010
Project number
1I01HX003265-01A2
Recipient
VETERANS ADMIN PALO ALTO HEALTH CARE SYS
Principal Investigator
Andrea K Finlay
Activity code
I01
Funding institute
VA
Fiscal year
2022
Award amount
Award type
1
Project period
2022-01-01 → 2025-12-31