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Treating Ex-offenders: Barriers to Treatment.
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Tom Granucci, LCSWSupervisory U. S. Probation OfficerUnited States District CourtCentral District of California&Peter Getoff, LCSWSupervising Psychiatric Social WorkerCalifornia Department of Corrections and RehabilitationParole Outpatient Clinic
Today’s Workshop • Overview of USPO and CDCR POC • Current Data on: • The offender population • Mentally ill offenders • Substance Abuse in the offender population • COD in the offender population • Trends in community supervision of offenders
Today’s Workshop • Barriers to Treatment for Offenders: • Offender Characteristics • Lack of Motivated and Qualified Providers • Evidence-based practice in: • Mental Health, Substance Abuse, Co-occurring Disorders, and Correctional Treatment • Underfunded Public Mental Health System • Collaboration: Integrated Treatment and Community Corrections
U.S. Probation • Established by Congress in 1925 • 94 Federal Districts • Central District of California • 7 Counties: Los Angeles, Orange, Riverside, San Bernardino, Ventura, Santa Barbara, San Luis Obispo
CD-CA • 12 Field Offices, 120 Supervision Officers, 40 Pre-sentence Officers, 3 Federal Courthouses • Crimes: Bank Robbery, Drug Trafficking, Credit Card Fraud,White Collar Fraud, Cyber Crime, Sex Offenses • Diversity of Offenders
Caseload/workload • General Caseloads = 55-65 • Drug Specialists = 45 • MH Specialists = 35-40 • Sex Offender Specialists = 25
U.S. ProbationGoals • Provide objective, verified information and recommendations to assist the court in making fair decisions • Ensure offender compliance with court-ordered conditions through community-based supervision and partnerships • Protect the community through the use of controlling and correctional strategies designed to assess and manage risk • Facilitate long-term, positive changes in offenders through proactive interventions • Promote the fair, impartial, and just treatment of offenders
U.S. ProbationValues • Integrity • Effective stewards of public resources • Treat everyone with dignity and respect • Fairness in process and excellence in service • Work together to foster a collegial environment • Responsible and accountable
Parole abolished November 1, 1987 • Supervised Release (76%) • Probation (22%) • Parole (<2%) • Military Parole (<1%) • Conditional Release (<1%)
Reentry • in 2001, 1,600 state and federal prisoners released per day • Residential Reentry Centers (RRCs)
California Department of Corrections and Rehabilitation • State prison population is 174,000 felons • California: one of the highest recidivism rates in the country • 70% within 3 years • Average yearly cost: $35,587 per inmate; $4,338 per parolee • 33 state prisons
California Department of Corrections and Rehabilitation • Los Angeles County - 40,000 parolees • Largest population of all counties • 125,000 parolees statewide
Parole Outpatient ClinicPOC • 1954: Established by the California Department of Corrections • To assist parolees with mental health problems • To reduce recidivism
POC • Caseloads: 80-200
POC Outcomes • UCLA Integrated Substance Abuse Program contracted by CDCR to conduct program evaluation • The greater # of contacts a parolee has with clinic clinicians, the less likely to be returned to prison • 17.4% of parolees with at least 9 POC contacts recidivated within 12 months vs. 70.6% of parolees w/ no POC contact
Co-occurring Disorders at the POC • Estimated at 75-85% at Region III’s POC
Reentry • Dr. Joan Petersilia proponent of prisoner reentry programs but only where practitioners and researchers work together to create services, both clinically and administratively effective
The Offender PopulationThe Numbers • At midyear 2006: One in every 133 U.S. residents in prison or jail
Mentally Ill OffendersThe Numbers • “There are three kinds of lies: lies, damned lies, and statistics” (Benjamin Disraeli)
The Numbers • 7% of Federal Inmates • 16% in state prisons, local jails, and on probation Department of Justice, Bureau of Justice Statistics, 1999
More Numbers • DOJ, BJS 2006: 50% • Change in Methodology • Our current MH = 17%
Mental Illness in the Forensic Population • Psychotic Disorders and Major Depression 2-4x more common than in the general population
Personality Disorders in the Forensic Population • Anti-social personality disorder 10x more common than in the general population
Substance Abuse in the Forensic Population • Across studies: 55% - 72%
Co-occurring DisordersThe Numbers • General MH Population: 20-80% of severely mentally ill abusing substances • Substance abuse treatment: 30-70% of addicts have a mental disorder
Co-occurring DisordersForensic Numbers • Across studies: 56% - 75% (85% for alcohol)
TrendsOur Numbers • MH doubled from 2000 to 2004 • Drug cases = 57% • Co-Occurring = > 70%?
More Trends • More Sex Offenders: Internet Child Pornography and Lurers/Travelers
More Trends • More High Risk • Axis I: Clinical Disorders, especially Psychotic Disorders and Mood Disorders + • Axis I: Substance Abuse/Dependence + • Axis II: Personality Disorders, especially Borderline, Narcissistic, and Antisocial
My Forensic Formula • Axis I + Axis II + Substance Abuse = Trouble
Our Response:Specialized Caseloads • Mental Health and Sex Offenders in 2000 • Further Specialization of Sex Offenders in 2007
Specialized Caseloads • Council of State Governments, Criminal Justice/Mental Health Consensus Project in 2002 www.consensusproject.org
Specialty vs. Traditional Agencies • Specialized Caseloads • Reduced Caseloads • Sustained Officer Training • Integration of Internal and External Resources • Problem Solving vs. Traditional
Recidivism:Are they really “ex”? • From Inmate to Offender to Inmate? • Numbers are Frightening and Depressing: 50-70% Recidivism within 3 years; 70% in California
or • From Inmate to Offender to Ex-Offender: Law-abiding, drug free, productive, tax-paying citizen
Federal Supervision Numbers: 70% Succeeded, 30% Revoked • Why? Speculation, no data. • Low risk/rehabilitation of some offenders • Sophistication of other offenders
Outcomes • My Snapshot: January 2007 - September 2007 n=13 • 31% Successful without violations • 38% Revoked (1 for technical violations; 2 for drug use; 2 for new criminal conduct) • 31% Violations without revocation • 62% Overall success rate
Mental Illness and Supervision Failure • Research indicates mentally ill offenders are more likely to fail on supervision • In my experience, due to substance abuse and new criminal conduct; not due to mental illness or mental health noncompliance
Outcomes • My Officers’ Snapshot: October 1, 2007 - January 14, 2008 • n= 33 • 55% Successful without violations • 27% Revoked (1 for technical violations; 3 for drug use; 5 for new criminal conduct) • 18% Violations without revocation • 73% Overall success rate
Characteristics of the Forensic MH Population • Mandated/Involuntary = Unmotivated • Deceptive • Criminal Lifestyle • Dangerousness • Substance Abuse • Co-occurring Disorders PLUS Antisocial Personality Disorder and/or Psychopathy
Motivation: Stages of Change • Pre-contemplation • Contemplation • Determination • Action • Maintenance • Relapse