systematizing recovery management in the criminal justice system integrating justice and health to...
TRANSCRIPT
Systematizing Recovery ManagementSystematizing Recovery Managementin the Criminal Justice Systemin the Criminal Justice System
Integrating Justice and Health to Lower Integrating Justice and Health to Lower Recidivism among Drug-Involved OffendersRecidivism among Drug-Involved Offenders
Melody M. Heaps, PresidentTASC (Treatment Alternatives for Safe Communities)
Chicago, Illinois
Presented at the Recovery SymposiumPhiladelphia, Pennsylvania
May 2, 2008
THE ABOMINATIONTHE ABOMINATION
• The U.S. has less than 5% of the world’s population, but our incarcerated population makes up almost 25% of the world’s incarcerated population
• An African-American child born today has an estimated 33% chance of being under the jurisdiction of the criminal justice system some time in his or her life
• More than 3 times as many African Americans live in prison cells as in college dorms
Crisis: Incarcerating AddictionCrisis: Incarcerating Addiction
• The solution = a “No Entry” approach to incarceration for drug-involved offenders
– Prevents or provides early intervention
– Provides treatment alternatives to incarceration
– Provides a recovery-oriented system of care
Crisis: Incarcerating AddictionCrisis: Incarcerating Addiction
(BJS: Harrison & Beck, 2006; Mumola & Karberg, 2006; Karberg & James, 2005 / SAMHSA, 2007)
Estimated Rates of Substance Use Disorders in Criminal Justice Populations
General Population Probation Jail Prison
Parole or Supervised
Release
9% 40% 68% 45-53% 37%
• The prevalence of people with substance use disorders involved in the criminal justice system is exponentially higherexponentially higher than in the general population
Crisis: Incarcerating AddictionCrisis: Incarcerating Addiction
• Across the nation…
– 41% of state prisoners in 2004 were behind bars for non-violent drug or property offenses = 515,000 people515,000 people
– 59% of federal prisoners in 2006 were behind bars for non-violent drug or property offenses = 103,766 people103,766 people
– TOTAL = 618,766 people618,766 people
(BJS: Sabol, Couture, & Harrison, 2007)
Crisis: Incarcerating AddictionCrisis: Incarcerating Addiction
• 700,000 people released from prison each year
• Within 3 years of release…
– 68% rearrested
– 52% returned to prison
(BJS: Sabol & Harrison, 2007; BJS: Langan & Levin, 2002 / PDOC, 2006 / IDOC, 2005)
Recovery-Oriented System of CareRecovery-Oriented System of Care
• Recovery-Oriented System of Care (ROSC)Recovery-Oriented System of Care (ROSC) is the most effective approach to addressing the crisis of incarcerating addiction
• Without a mechanism and/or infrastructuremechanism and/or infrastructure to manage the implementation of a ROSC in criminal justice populations in a systemic, widespread manner, significant progress will not occur
Recovery-Oriented System of CareRecovery-Oriented System of Care
• Recovery management within a ROSC means treating addiction as a lifelong process, shifting focus of care from…
1. episodes of acute care / treatment, to
2. symptom stabilization, to
3. client-directed management of lifelong recovery
Recovery-Oriented System of CareRecovery-Oriented System of Care
• One episode of treatment (the norm, if any treatment at all)…
1. only represents the acute-care phase
2. can occur more than once
3. must be integrated into a larger system of care
Recovery-Oriented System of CareRecovery-Oriented System of Care
• Recovery management within a ROSC combines traditional acute-care treatment with:– Pre-recovery support services to enhance
treatment readiness
– In-treatment recovery support services to enhance the strength and stability of recovery initiation
– Post-treatment recovery support services to enhance the durability and quality of recovery maintenance
Recovery-Oriented System of CareRecovery-Oriented System of Care
• A continuum of carecontinuum of care supports ongoing recovery within a ROSC
• Critical elements of a continuum of care:– Acute care / treatment
– Symptom abatement / ongoing counseling
– Employment
– Education / job training
– Family connection and support
– Housing
– Life management
Recovery-Oriented System of CareRecovery-Oriented System of Care
• Challenge of ROSC is creating a system in which recovery management is possible
– It must be organized in the broadest possible scale
– Treatment programs, community programs, and public systems must be working in concert
Recovery-Oriented System of CareRecovery-Oriented System of Care
• There needs to be a mechanism and/or mechanism and/or infrastructureinfrastructure to manage recovery management for the system =
• TASC
– Facilitates mandated reporting to public systems
– Manages clients’ movement through stages of recovery, from acute care to recovery in the community
A Model for ROSC: A Model for ROSC: Sheridan Reentry PrisonSheridan Reentry Prison
• 46% of Illinois prisoners in 2005 were behind bars for non-violent drug or property offenses = 20,541 people20,541 people
(IDOC, 2005)
A Model for ROSC: A Model for ROSC: Sheridan Reentry PrisonSheridan Reentry Prison
• Specialty drug treatment prison in Illinois
• Approximately 950 beds, expanding at Sheridan and in other facilities (SWICC)
• Designed to treat prisoner substance abuse and reduce recidivism
• Offers continuous substance abuse treatment and supportive services throughout the prison stay and after release
A Model for ROSC: A Model for ROSC: Sheridan Reentry PrisonSheridan Reentry Prison
• Continuum of services
– In-facility treatment (therapeutic community)
– Peer support
– Clinical reentry planning and case management (TASC)
– Parole supervision
A Model for ROSC: A Model for ROSC: Sheridan Reentry PrisonSheridan Reentry Prison
• The Sheridan model relies on the availability of recovery management support services following release– Halfway houses
– Treatment
– Employment
– Relationships with family and friends
– Job training / education
– Transportation
A Model for ROSC: A Model for ROSC: Sheridan Reentry PrisonSheridan Reentry Prison
• Recovery-management supportive services are undergirded by clinical case management throughout the recovery process (TASC)
A Model for ROSC: A Model for ROSC: Sheridan Reentry PrisonSheridan Reentry Prison
(Olson, Rapp, Powers, & Karr, 2007)
ReferencesReferencesFlaherty, R. (2006). Recidivism in Pennsylvania State Correctional Institutions 1999 - 2004. Pennsylvania Department of Corrections.
Retrieved April 27, 2008, from www.cor.state.pa.us/stats/lib/stats/recidivism.pdf.
Harrison, P. M. & Beck, A. J. (2006). Prisoners in 2005. Bureau of Justice Statistics Bulletin. U.S. Department of Justice, Office of Justice Programs. November 2006, NCJ 215092. Retrieved November 12, 2007, from http://www.ojp.usdoj.gov/bjs/pub/pdf/p05.pdf.
Illinois Department of Corrections. (2005). Department Data. Retrieved November 12, 2007, from http://www.idoc.state.il.us/subsections/reports/department_data/Department%20Data%202005.pdf.
Inciardi, J. (1996). A Corrections-based Continuum of Effective Drug Abuse Treatment. U.S. Department of Justice, Office of Justice Programs. National Institute of Justice. Retrieved November 12, 2007, from http://www.ncjrs.gov/pdffiles/contdrug.pdf.
Karberg, J. C. & James, D. J. (2005). Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002. U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Special Report. July 2005, NCJ 209588. Retrieved April 27, 2008, from http://www.ojp.usdoj.gov/bjs/abstract/sdatji02.htm.
Langan, P. A. & Levin, D. J. (2002). Recidivism of Prisoners Released in 1994. U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Special Report. June 2002, NCJ 193427. Retrieved November 12, 2007, from http://www.ojp.usdoj.gov/bjs/pub/pdf/rpr94.pdf.
Mumola, C. J. & Karberg, J. C. (2006). Drug Use and Dependence, State and Federal Prisoners, 2004. U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Special Report. October 2006, NCJ 213530. Retrieved November 12, 2007, from http://www.ojp.usdoj.gov/bjs/pub/pdf/dudsfp04.pdf.
Olson, Rapp, Powers, and Karr. (2006). Sheridan Program Outcomes. Sheridan Correctional Center Therapeutic Community: Year 2. Program Evaluation Summary. Vol. 4, No. 2. Illinois Criminal Justice Information Authority.
Sabol, W. J., Couture, H., and Harrison, P. M. (2007). Prisoners in 2006. U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Bulletin. December 2007, NCJ 219416. Retrieved April 30, 2008, from http://www.ojp.usdoj.gov/bjs/abstract/p06.htm.
Sabol, W. J. & Harrison, P. M. (2007). Prison and Jail Inmates at Midyear 2006. U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Bulletin. June 2007, NCJ 217675. Retrieved November 12, 2007, from http://www.ojp.usdoj.gov/bjs/pub/pdf/pjim06.pdf.
Substance Abuse and Mental Health Services Administration. (2007). Results from the 2006 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA 07-4293). Rockville, MD.
White, W. (2005). Recovery Management: What if We Really Believed Addiction was a Chronic Disorder? GLATTC Bulletin. Retrieved November 12, 2007, from http://www.glattc.org/RecoveryManagement.pdf.