Court Actors’ Perceptions of Barriers to Veterans’ Treatment Court Participation

Veterans’ treatment courts (VTCs) are problem-solving courts created to address the specific treatment needs of veteran defendants. Despite the favorable results of studies on the efficacy of VTCs to reduce recidivism, participation is voluntary, and not all eligible candidates elect to participate. The purpose of this study was to discover why defendants choose to opt out. A qualitative study was designed to learn from VTC coordinators, prosecuting attorneys


INTRODUCTION
Veterans' treatment courts (VTCs) continue to grow in number as the latest development in the problem-solving court movement. VTCs were created to address what appeared to be an inordinate number of United States (US) military veterans involved in the criminal justice system (Baldwin & Brooke, 2019). Supported by subsequent research on the overrepresentation of veterans in US jails and prisons (Bronson et al., 2015) and a link between military service and crime (Bennett et al., 2018;Lennon, 2020;Traynham et al., 2019), VTCs have rapidly proliferated to better service the needs of veteran offenders (Baldwin & Brooke, 2019). The VTC model incorporates mental health and substance abuse treatment, peer accountability, and community supervision to address the underlying issues empirically known to contribute to antisocial behavior. Despite favorable study results on the efficacy of VTCs, as well as overwhelmingly positive feedback from program participants, participation is voluntary, and some justiceinvolved veterans elect to opt out of VTC. There are a number of studies on VTC participants (Ahlin & Douds, 2016;Gallagher et al., 2017;Herzog et al., 2019;MacLeish, 2020), but what has not been accounted for is the rationale of veteran defendants who refused to participate in VTC according to a broader population of VTC actors. The purpose of this study was to discover the reasons why justice-involved veterans decline participation in VTC programs. Adams et al. (2019) and Ahlin and Douds (2020) relied on identity theory as a theoretical base for understanding why veteran defendants may resist participation in VTC, suggesting that the stigma of criminality may influence their decision to opt out. Their studies, however, sampled only VTC participants and not justice-involved veterans who, in fact, declined VTC in favor of traditional court processing. Furthermore, the lens of identity theory necessarily limited exploration of a potentially broad spectrum of participation barriers faced by veteran defendants. Therefore, general strain theory (GST) formed the theoretical framework of the present study as a more inclusive model for exploratory research. Derivative of sociologist Durkheim's strain theory, Agnew's (2001) GST contends that stressors increase negative emotions which, in turn, cause pressure for corrective actions that can result in criminal behavior. Strain can refer to any negative event or condition, or a negative emotional response, such as anger or frustration, to an event or condition (Agnew, 2001). For veterans who have turned to criminal behaviors as their means of coping with trauma and stress, GST offers a better understanding of why veteran defendants may find it difficult to seek or accept treatment. According to Morris et al. (2018), a defendant's readiness to seek or accept treatment influences treatment outcomes. A veteran may be unwilling or unable to abandon their maladaptive behaviors and that could serve as the primary reason why they refuse the treatment required of VTC program participation. The study by Morris et al. (2018), however, examined VTC participants only and did not explore the factors that influenced nonparticipants. Examining and understanding the factors that contribute to veterans' decisions to opt out of treatment can help VTC developers and practitioners design programs that address veteran concerns and potentially maximize participation in veterans' courts.
An additional factor for consideration is how veterans perceive VTC. Literature suggests that participants are overwhelmingly satisfied with their VTC experiences (Gallagher et al., 2017;Herzog et al., 2019). For those who did not report positively, programming was described as too rigorous and past negative experiences with the VA colored their perceptions of VTC (Gallagher et al., 2017;Herzog et al., 2019). While these sentiments may also reflect the views of veteran defendants who declined participation, only one study was found to include opt-out reasons, as reported by VTC coordinators (Baldwin, 2017). The lack of nonparticipant perspective in empirical studies on the topic of VTC participation attests to the difficulty of accessing this population, resulting in a knowledge gap.
The present study addressed this void and extended the knowledge in the discipline by surveying VTC coordinators, prosecuting attorneys, and public defenders to glean from their professional knowledge and experience what reasons veteran defendants give for refusing participation in these programs. Qualitative methods were employed to answer the following research question: What factors do veterans' treatment court actors identify as the reasons why veteran defendants decline participation in VTC programs? The results from this study provide a better understanding of why veterans are not choosing the rehabilitative model of VTCs. Insights from this study can assist court administrators with improving the quality and attractiveness of their programs, thereby expanding their services to more veterans.

METHODS
Study participants were recruited from one southeastern state. The Council of Accountability Court Judges (CACJ) for the selected state maintains a list of active VTC coordinators on its website. At the time of data collection, there were 27 coordinators' names and contact information listed on the CACJ website. All 27 coordinators were contacted via email and invited to participate in the study. Public defenders and prosecuting attorneys for the corresponding 27 jurisdictions were also solicited for participation. Attorney contact information was retrieved from the public defender, district attorney, and solicitor's office websites for each county or circuit court that had a VTC in its jurisdiction, as indicated by the CACJ website at the time of data collection. Data collection occurred over a 7-week period from February to April 2022 until a total of 33 surveys were completed, 11 for each of the 3 categories of respondents.
Three online surveys were developed by sampling relevant questions from instruments used in related peer-reviewed studies (see Ahlin & Douds, 2020;Baldwin, 2017;Herzog et al., 2019) and each adapted to address VTC coordinators, prosecutors, and public defenders (see Appendix). Included were several court demographic inquiries and one question regarding the influence of veteran-offender identity in participation decisions. Additional questions were included that allowed for alternative explanations of veteran defendant rationale, such as those factors accounted for by GST. Such questions asked coordinators and attorneys, based on their knowledge and experience, why eligible veterans declined VTC participation, what reasons eligible veteran defendants gave for opting out, and what changes to VTC programs they believed would result in more favorable outcomes for justice-involved veterans. The survey for VTC coordinators contained 14 questions. The surveys for prosecuting and defense attorneys each contained 13 questions. The surveys for each of the attorney participant groups were the same in content, but adapted to appropriately address each group. The only material differences between the coordinator and attorney surveys were the additional questions for coordinators about their personal military experience and the military experience of their VTC's judge, and a screening question for attorneys asking if they had experience representing or prosecuting veteran defendants. The instrument was reviewed by a field expert (VTC coordinator) to ensure content validity (see Appendix to review surveys).

RESULTS
This study was designed to discover the reasons why veteran defendants opt out of VTC. To protect a potentially vulnerable population, veteran offenders were excluded from this study. VTC coordinators were selected because they are reasonably expected to recognize the issues preventing participation in the program under their administration. Defense and prosecuting attorneys with experience working with veteran defendants and VTCs were also surveyed as a complementary source to corroborate data collected from VTC administrators. Participants were asked four substantive questions to include their perception of a veteran-offender identity conflict, what reasons they had been given by veterans for opting out of VTC, why they think veterans opt out, and what suggestions they had for improving VTC programming. Thematic analysis of manually coded qualitative responses uncovered multiple themes for each question.

DATA ANALYSIS
Survey responses were coded using open, axial, and selective coding. Thematic analysis requires reading each survey multiple times to look for main points, repeated keywords, and phrases that express the participant's perspective. Once all the codes from the responses were identified and text from the surveys labeled accordingly (open coding), the codes were combined into broader categories based on relatedness (axial coding). For example, the codes "too strict" and "too much work" found in responses were grouped under the category of program rigor. The codes "intensive housing options" and "do not live in circuit" found in responses to the same question were categorized as residency requirements. Topically related categories were then combined to form overarching themes (selective coding; see Maxfield & Babbie, 2018). To illustrate, the categories of program rigor and residency requirements were consolidated to form the theme of program requirements. This process was followed for all responses to each of the four open-ended questions asked of all participant groups until all codes had been attributed to a category and all categories further attributed to a broader theme. No discrepant cases were present in this study.

THEMES
For those who reported a strong relationship between a defendant's conflict of identities and their decision to opt out of VTC, the themes were veteran identity and veteran as ideal citizen. For the question regarding the reasons they had been given by veteran defendants for choosing not to participate in VTC, five themes emerged. These themes included program requirements, readiness to change, alternatives, perceptions of programming and leadership, and reasons unknown. All of these themes were consistent with the findings of earlier related studies. For the question regarding their professional opinion as to the reasons why veteran defendants opt out, the same five themes emerged. A sixth theme, lack of awareness, also emerged and appears to be unique to this study. Regarding suggestions for improving VTC programming, the themes were expand eligibility, improve program/enhance benefits, raise awareness, reduce program intensity, and no suggested changes.

VETERAN-OFFENDER IDENTITY
To account for the common conclusion found in existing literature on the subject of veteran defendants that identity theory plays a role in the decision to participate in VTC, one survey question asked participants about their opinion regarding the conflicting identities of veteran and offender. For the survey question, "Some studies suggest that veteran offenders experience difficulty reconciling their veteran and criminal identities. What relationship, if any, do you see between this conflict of identities and the decision to opt out of VTC?", the response options provided were no relationship, weak relationship, strong relationship, I don't know, and other. Of the 33 responses, 49% of respondents reported they did not know. One respondent wrote, "I think it may have some impact I just don't know to what degree." This finding was not surprising considering the nature of the question. It is reasonable to assume that some VTC actors may not be positioned to answer psychologically personal questions about veteran defendants. A weak relationship was reported by 15% of respondents and another 15% indicated there is no relationship, with one respondent stating the following: While some of the veterans I have referred seem to want to underplay their service, I can't think of anyone who has chosen not to participate in VTC who has done so because of some tension between their military service and being charged with a crime.
Finally, 21% of respondents reported a strong relationship between veteran-criminal identity and VTC participation. The concepts of veteran identity and veteran as ideal citizen were presented as possibly influential in a veteran defendant's decision-making process.

Veteran Identity
The theme veteran identity emerged from the qualitative responses of participants who believe there is a strong relationship between veteran-offender identity and the choice to decline participation in a VTC program. In support of their selection that a strong relationship exists, one respondent wrote, "Some veterans do not consider themselves 'true' veterans once they get into a group where there are veterans who appear to have had more intense service assignments." This response suggests that some veterans may not view themselves as "real veterans" when compared with other veterans whose military experiences were more extreme than theirs. If this assertion is true, defendants with a low sense of veteran identity may decide to opt out of VTC because they do not consider themselves to be true veterans. Conversely, defendants with a strong sense of veteran identity may choose to participate in VTC out of a sense of pride or believing they are worthy of the special designation afforded to them by the VTC. For example, one respondent wrote, "When in the recovery community, I find that veterans often think they're above others in the recovery community and do not want to be categorized with civilians in recovery." This response suggests that defendants with a strong sense of veteran identity may be compelled to participate in VTC due to their unwillingness to be associated with civilian defendants.

Veteran as Ideal Citizen
The second theme to emerge from the qualitative responses from participants reporting a strong relationship between the veteran-offender conflict and its relationship to VTC participation is the concept of veteran as ideal citizen. This theme encapsulates the sentiment that reconciling a veteran identity with a criminal identity is difficult for veteran defendants to do. One respondent wrote, "Some veterans are typically prideful and struggle with distorted thinking due to perception of what a veteran stands for, it is nothing criminal but the ideal citizen. Anything adverse to law-abiding is frowned upon." The perception that some veteran defendants may have that a veteran is an ideal citizen could affect their willingness to participate in VTC. Veterans who see their criminal involvement as contrary to their concept of an ideal citizen may find it shameful to claim veteran status. The contradiction of veteran as ideal citizen and veteran as criminal may be too difficult for veteran defendants to overcome, prompting them to opt out of VTC.

VETERAN REASONS FOR OPT OUT
With the assumption that factors beyond the explanation of identity theory are influential in a veteran defendant's VTC decision, survey participants were provided an opportunity to name additional influences affecting the VTC decisionmaking process. The following open-ended question was posed in the survey: What reasons have VTC-eligible veteran defendants offered as to why they do not wish to participate in VTC? The exploratory nature of this question allowed VTC actors to identify all of the reasons they had been presented with by defendants who opted out of their program. The dominant themes to emerge from the qualitative data regarding the reasons veteran defendants opt out of VTC were program requirements, readiness to change (RTC), alternatives, perceptions of programming and leadership, and reasons unknown.

Program Requirements
Of the 79 codes found in response to the question asking what reasons defendants gave for opting out of VTC, 38 (48%) referred to program requirements. The theme program requirements included the following response categories: program length, program rigor, program restrictions, medication requirements, drug screening requirements, residency requirements, felony conviction, court appearances, employment interference, and guilty plea. Regarding program rigor, multiple statements echoed the sentiment that program requirements were too strenuous. Respondents also stated the length of the program was a deterrent for eligible participants.The significant number of requirements and the sheer difficulty of completing VTC programs appear to influence the VTC decision-making process for eligible defendants.

Readiness to Change
RTC refers to a person's readiness to accept treatment for a substance use disorder. The theme RTC includes treatment and lifestyle change. Codes related to RTC represented 11% of the 79 total codes found in response to the survey question regarding veteran reasons for opt out. Concerns that veteran defendants simply were not ready to accept treatment for drug or alcohol dependency were expressed by 9 respondents. One respondent wrote, "We run into the problem of some thinking they don't need help for substance abuse or their mental health." Other respondents stated veteran defendants did not want to change their lifestyle, which they would certainly be required to do if they participated in a VTC program. Not feeling ready to stop using drugs or make a major lifestyle change could cause veteran defendants to decline VTC in favor of other options that do not require the same level of commitment.

Alternatives
The third theme to emerge from the qualitative data was alternatives and included the following categories: lesser punishment, other VA services, pretrial diversion, better offer, fight charges, want a trial, do time, traditional sentence, and prefer probation. This theme was represented by 17% of all responses to the survey question, indicating veteran preference for probation and other easier options. One respondent claimed, "The probation sentence is less strenuous than pleading into VTC and meeting our standards." Another respondent stated, "They would rather just do their time." Veteran defendants that are not ready to make the changes necessary to comply with VTC requirements may view alternatives such as probation as the less radical of changes and opt out of VTC for that reason.

Perceptions of Programming and Leadership
The fourth theme to emerge from survey responses was perceptions of leadership and programming. This theme included the following categories: distrust of Veterans Affairs (VA), nonuniform standard, not worth it, resources not given, no military experience, won't help, inability to identify, judge, and "zero defect" mentality. Of the 79 codes, 13% were related to how veterans perceive various aspects of VTC and its leadership. Responses addressed the lack of military experience among program leadership, distrust of VA, dislike of the VTC judge, and the inability of leadership to identify with the unique challenges faced by veterans. This finding is significant in that it highlights a number of systemic characteristics, possibly flaws, that are impacting participation decisions. Dissatisfaction with the VA is a longstanding grievance of veterans and its affiliation with VTC may be discouraging veterans from getting the treatment and benefits they need. Furthermore, court personnel without military experience may considerably hinder participation, as some respondents indicated.

Reasons Unknown
The last finding for this survey question was that 11% of respondents indicated they did not know why VTCeligible defendants declined to participate in VTC. This result emphasizes the existence of a knowledge gap on this subject and the importance of the present study to inform practitioners of the barriers to participation in VTC programs.

VTC ACTORS' PERCEIVED REASONS FOR OPT OUT
Participants were asked, "In your professional opinion, what are the reasons why VTC-eligible veteran defendants opt out of participation in your VTC?" This question was related to the last question and posed to prompt respondents to critically consider the reasons for opt-out beyond what they had been told by defendants. This question produced similar results as the related question, with one exception. Of the 93 total codes found in responses to this question, 50% were related to program requirements, including time commitment and program rigor. RTC was represented by 17% of all codes and also included treatment and lifestyle change as was found in the related question. Alternatives accounted for 16% of codes and included the categories of first offender treatment and prefer probation. Perceptions of programming and leadership represented 11% of codes and reasons unknown totaled 4%. The finding that was not present in the related question was the theme lack of awareness, which accounted for 2% of responses.

Lack of Awareness
Lack of awareness referred to practitioners' inability to identify program candidates in a timely manner, or at all, as well as veteran defendants' ignorance of VTC as an option. Regarding defendants being unaware of VTC, one respondent wrote, "They often times don't know about the program until they have already resolved their case." A lack of awareness that VTC exists or is an option is not equivalent to opting out, yet the result is the same. Veteran defendants who are not made aware of the resources available to them do not have the opportunity to decide which court processing option is best for their needs. The theme lack of awareness emerged from the qualitative responses of both defense and prosecuting attorneys but not from VTC coordinator responses. The additional perspective of attorneys with experience working with veteran defendants contributes to knowledge on the subject by illuminating another barrier to participation not accounted for by existing research.

PROPOSED CHANGES
The court actors surveyed for this study were offered the opportunity to provide their suggestions on how to increase participation in VTC. Survey participants were asked the following open-ended question: What changes to your VTC do you believe would result in increased participation? Responses from 33 participants yielded 54 codes, which were consolidated into 5 themes including expand eligibility, improve program/enhance benefits, raise awareness, reduce program intensity, and no changes.

Expand Eligibility
Of the 54 codes, the most prevalent response was the proposal to expand eligibility, accounting for 37% of responses. The theme expand eligibility included the following categories: evaluation process, non-VA eligibility, mental health, substance use disorder (SUD) not required, allow violent charges, accept low/at risk, include misdemeanors, allow gun charges, domestic violence (DV) intervention, and services for at-risk veterans. Regarding expanding eligibility to include at-risk defendants, one respondent proposed the following: "Some services for at-risk veterans, such as those who have committed a misdemeanor that would not qualify for VTC but have not yet committed a felony." Some VTCs only allow participants with both a mental health disorder and a SUD.
Respondents proposed expanding eligibility to those who have a mental health disorder only and not a SUD. For example, one respondent wrote, "Have more treatment options for veterans who do not have a drug/alcohol addiction, and just need mental health treatment." Expanding eligibility is the most popular change respondents would make to increase participation in their VTC program. Proposals to expand eligibility address the issue that not enough veteran defendants qualify for VTC participation. This is a legitimate concern because, in addition to a lack of interest in participation due to program requirements, RTC, alternatives, perceptions of leadership and programming, and a lack of awareness, participation is even further limited by stringent eligibility requirements.

Improve Program/Enhance Benefits
The second recommendation for increasing VTC participation was to improve the program and enhance its benefits, accounting for 24% of responses. This included making the program more efficient, providing housing assistance, and offering more sophisticated job placement. The decision to opt out of VTC may be influenced by the absence of benefits that would make participation in a lengthy and rigorous program worthwhile and more attractive than the alternatives.

Raise Awareness
The third theme to emerge from the qualitative responses from VTC actors when asked for their recommendations on how to expand participation was raise awareness. Raise awareness accounted for 18% of responses and pertains to case referrals, data on VTC efficacy, educating veteran defendants on VTC benefits, a better understanding of veteran issues by attorneys, and community awareness. Raising awareness also included making attorneys more knowledgeable of veteran defendant needs. One respondent recommended the following: "More understanding by defense and prosecution of the issues specific to veterans that lead to criminal conduct." A problem respondents reported was that cases were not always identified for referral. This finding was expected considering respondents indicated a lack of awareness was responsible in part for veteran defendants not choosing VTC. Raising awareness among prosecuting attorneys, defense attorneys, and veteran defendants of the program and its benefits will at least afford eligible veterans the opportunity to make an informed court processing decision.

Reduce Program Intensity
The fourth recommendation was that VTCs reduce program intensity. Reduce program intensity accounted for 6% of the 54 codes found in responses to this survey question. The programmatic aspects included within this theme were program length, outpatient services, and program requirements. Respondents proposed shortening the program and making it less intense, reducing requirements, and offering less intensive outpatient services. As reported earlier, the length and rigor of programming, including outpatient services, and number of eligibility requirements characteristic of VTCs are barriers to participation. Reducing the intensity of one or more aspects of programming as survey respondents suggested may result in increased participation, which would ultimately serve the goal of treating all veteran defendants ready to accept the help of VTC.

No Changes
The fifth theme to emerge from responses regarding recommendations for increasing VTC participation was no changes. Of the 54 codes found in response to this survey question, 15% indicated no wish to make program changes. When prompted to explain their response, survey participants reported that they would not make any changes to the VTC in their jurisdiction because their program already received sufficient resources, worked well, or was successful.

DISCUSSION
According to 33 respondents, the most reported reasons for opting out of VTC were program requirements, RTC, alternatives, and perceptions of programming and leadership. In a separate and related survey question regarding their professional opinion of the reasons for opt out, respondents indicated that a lack of awareness was also responsible. Respondents were asked to indicate their understanding of the relationship between the conflicting identities of being both a veteran and a criminal, and the VTC participation decision. Nearly half of respondents did not know if a relationship existed. For responses in support of a strong relationship between veterancriminal identity and the decision to opt out of VTC, the most common themes were veteran identity and veteran as ideal citizen. These findings support earlier studies suggesting the psychological aspects of militarization, such as the existence and prevalence of a veteran identity, are influential in a veteran defendant's decision to decline VTC participation.
The dominant theme found in responses to the reasons why veterans opt out of VTC was program requirements. This theme is consistent with Baldwin's (2017) study, which found that over 37% of VTC coordinators indicated that veteran defendants declined participation in their VTC due to program rigor. The demands of VTCs are extensiveregular court attendance, mental and substance abuse treatment, mentorship meetings, drug screens, housing and job requirements, etcetera. For veteran defendants already struggling with daily self-maintenance, the added strains of VTC participation may prove too great for consideration. That helps to explain the findings of the present study, with 17% of respondents reporting that alternatives are a factor in whether defendants choose VTC. The concept of alternatives as a reason why veterans opt out of VTC is also supported by the findings of Baldwin's research, which found that nearly 9% of respondents reported veteran defendants opted out because they believed they could get a better deal in criminal court. As respondents in the present study indicated, probation and first offender services often available to veteran defendants are less strenuous and, therefore, more attractive options. The significance of the finding that program requirements are the primary reason why eligible candidates opt out of VTC lies in the knowledge that they can be reformed to encourage participation.
The finding of this study that 13% of VTC actors believe perceptions of leadership and programming factor into a defendant's decision to decline participation in VTC is supported by earlier research. Herzog et al. (2019) and Baldwin (2017) reported on the importance of veteran defendants' perceptions of the VTC judge and the impact of negative VA experiences relative to the VTC participation decision. The present study also revealed that perceptions of the VTC judge and VA are influential, as well as the appearance of a nonuniform standard, and the belief that VTC personnel cannot identify with the unique challenges veterans face. These perceptions speak to a sense of injustice that veterans may feel and, consistent with GST, may be indicative of strain characteristics that cause negative emotions and are most likely to lead to crime (Agnew, 2001). Another important finding of Baldwin's study was that 27% of the 79 VTC coordinators surveyed indicated they did not know why eligible veterans opted out of their program. This finding was confirmed by the present study, although to a lesser extent, which found that 11% of respondents did not know why eligible candidates opted out of VTC. These results highlight the need for program evaluations to learn what is impeding participation.

LIMITATIONS
The first limitation of this study is that it relies upon the subjective experiences and views of VTC coordinators and attorneys rather than veteran defendants. Although this was done to protect a potentially vulnerable population, a sample of veteran defendants who opted out of VTC may have produced different results. While the findings of this study suggest that coordinators and criminal attorneys are knowledgeable of the obstacles veteran offenders encounter, it is possible that the factors influencing them to opt out were not communicated back to the VTC, prosecution, or defense counsel. It is also possible that VTC actors misinterpreted veteran defendant motivations and experiences, which could have resulted in their misrepresentation in this study.
A second limitation of this study is the potentially limited applicability of its findings. It is not known how the participant courts from one southeastern state compare with VTCs nationwide. Demographic data collected from respondents were restricted to ensure court anonymity and that, presumably, makes transferability determinations more difficult. Finally, the use of a survey to collect qualitative data is not ideal. Electronically administered surveys were chosen for this study, however, to maintain COVID-19 social distancing guidelines and as an asynchronous modality anticipated to elicit the greatest number of participants. Interviews are traditionally considered to be the preferred data collection tool of qualitative inquiry for their ability to produce detailed and thorough responses. The survey format is believed to have contributed to brief responses provided by a small number of participants.

CONCLUSION
The findings of the present study extend knowledge in the discipline in two significant ways. First, this study included multiple perspectives to gain the most comprehensive understanding of veterans' decision making. While related studies surveyed only VTC administrators, the present study also contained the views and experiences of prosecutors, solicitors, and public defense attorneys who served in jurisdictions with VTCs and who had experience prosecuting or representing veteran defendants. This was important for making well-informed recommendations to improve VTC programming. Second, including criminal attorneys as a population of the sample resulted in the discovery of an additional reason why veteran defendants do not participate in VTC. Responses from attorneys suggested a lack of awareness is at least partially responsible for nonparticipation. As respondents indicated, in some instances, defendants were not even aware VTC was an option, or they found out too late in the adjudication process. In other cases, eligible candidates were not identified by prosecution or defense and, therefore, the necessary referrals to VTC were never made. This result is of particular significance because it was not found in earlier studies on the subject, which sampled only VTC coordinators or program participants and not attorneys. Understanding that a lack of awareness may be responsible for diminished participation is important because it represents an obstacle that can be overcome by educating defense attorneys, prosecuting attorneys, and veteran defendants on VTC and its benefits.
This research study relied upon practitioners to make policy recommendations for VTC program improvement. The most common recommendation by VTC actors was to expand eligibility. Respondents stated that VTC should be an option for more veterans, including misdemeanants and defendants with only a mental health diagnosis. VTCs may even consider expanding eligibility to veterans with "other than honorable" and, possibly, dishonorable discharges on an individual or case-by-case basis. Respondents also recommended improvements to program efficiency, provision of housing and employment assistance, increased judicial involvement, reduced program intensity, and raised awareness of VTC among attorneys and defendants. The recommendations for offering housing assistance and more sophisticated job placement would specifically address practical obstacles veterans are known to experience when entering civilian life. Overall, implementing the changes recommended by practitioners may maximize benefits for participants, and remove common barriers to participation, thereby attracting more veteran defendants to VTC.

ETHICS AND CONSENT
This research study was approved by the Institutional Review Board of Walden University. Walden University's approval number is 02-11-22-1015034.