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Veterans Treatment Courts. American Judges Association 2012 Educational Conference-New Orleans Presented by Judge Robert Russell. Outline. Who is a Veteran? Who are they? Justice-involved Veterans What is a Drug Court? How is a Veterans Treatment Court different?
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Veterans Treatment Courts American Judges Association 2012 Educational Conference-New Orleans Presented by Judge Robert Russell
Outline • Who is a Veteran? • Who are they? • Justice-involved Veterans • What is a Drug Court? • How is a Veterans Treatment Court different? • Why have a Veterans Treatment Court?
Veterans: Who are they? 23.2 million Veterans in the United States 5.2 million have served from the Gulf War to present 2 Million members of the armed forces have served in Iraq and Afghanistan since October 2001 As of December 31, 2007, more than 800,000 veterans of these conflicts were eligible for VA healthcare
Reserve and National Guard 254,000 Reservists and 332,000 National Guard members have deployed to OEF/OIF Increased stress on families, employment, and housing
Women Veterans 1.8 million of today's Veterans are women (7.5%) 20% of all military personnel are represented by women 182,000 served in OEF/OIF 5% of the Veteran homeless population are women 4 times more likely to become homeless than male veterans
Homelessness • Over 67,000 Veterans will be homeless tonight • Veterans 50% more likely to become homeless than non-Veterans • 76% suffer from a substance abuse and/or mental health condition • Criminal involvement is single best predicator of future homelessness
Unemployment • As of Oct 2011, unemployment rate for Veterans was 11.5% who served since September 2001 • Rate for 18-24 yr old Veterans was 21.9% Bureau of Labor Statistics
Suicide • Veterans make-up 1% of the population, but 20% of suicides • Women Veterans are 2-3 times more likely to commit suicide than non-Veteran women • Suicides among active duty Army and Marines have increased following OEF/OIF • VA indicates 4 or 5 Veterans commit suicide each day
Traumatic Brain Injury (TBI) • Primary: Resulting from initial trauma • Secondary: Resulting from Intracranial Pressure (ICP), hypoxia, hypotension. • In 2010: 31,407 cases of TBI • 11,800 troops injured in IED attack • 28% of all military evacuated to Walter Reed AMC = TBI • Rapid evac + treatment = 96% survival rate • TBI is not only the result of combat
Post Traumatic Stress Disorder (PTSD) Exposure to traumatic event in which both of following present: (1) Person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. (2) Person’s response involved intense fear, helplessness, or horror.
How common is PTSD among Veterans? • Vietnam – 15% men/8% women (31%/27% est. lifetime prevalence) • Desert Storm – 10% • Operations Enduring Freedom & Iraqi Freedom (OEF/OIF) – 14% • Est. 300,000 suffering from PTSD or major depression (2010) • Repeated deployments increase the likelihood of PTSD
Combat Experience (OEF/OIF) • 78% Received incoming artillery, rocket or mortar fire • 72% Knew someone seriously injured or killed • 60% Saw dead bodies or human remains • 58% Received small arms fire • 56% Had a member of their unit become a casualty • 49% Saw dead or seriously injured Americans • 33% Handled or uncovered human remains
Military Sexual Trauma(MST) • Both sexual harassment and sexual assault that occurs in military settings • 60% of women with Military Sexual Trauma also suffered from PTSD VA Screening, 2002-2008
Substance Abuse Among active duty service members: • Heavy drinking (five or more drinks per occasion at least once a week) self-reported at 20%. • Heavy drinking is higher among 18 to 34 age group than civilians. • Prescription drug misuse doubled from 2005 to 2008 ( 5% in 2005 to 12% in 2008) Dept of Defense Behavioral Health Survey - 2008
Justice-involved Veterans • Less likely to be arrested or incarcerated • Average 10% of criminal justice population • Approx 80% with Honorable/General discharge • 57% violent offenders compared to 47% of non-Veterans • Reported longer sentences for all crime types. -On average, Veterans are expected to serve 22 months longer than non-veterans Bureau of Justice Statistics - 2004
Justice-involved Veterans • 61% of Veterans in State prison meet the criteria for substance dependence or abuse (57% of Federal prison veterans) • 54% of Veterans in State prison met one of two criteria for a recent mental health problem • Veterans in State prison (45%) and Federal prison (35%) reported symptoms of mental health disorders in the past 12 months • Veterans are more likely to report recent history of mental health services • Experienced physical abuse: 18% • Experienced sexual abuse: 7%
What is a Drug Court? Judicially-supervised docket that provides defendants/clients with intensive treatment and other services while holding them accountable to the court, society, their families and themselves
What is a Drug Court? • Judge, Prosecution, Defense, Probation, Law Enforcement, Treatment, using a non-adversarial, team approach • Regular court appearances • Frequent and random drug tests • Immediately rewards positive behavior, sanctions negative
Drug Courts • 1989 – 1st Drug Court formed in Miami, FL • 2011 – 2,569 Drug Courts in the United States • Drug Courts Work! • Reduce crime • Lower costs • Ensure compliance
Reduce Crime • 75% of Drug Court clients remain arrest-free at least 2 years after graduation. • Reductions in crime last at least 3 years and can endure for over 14 years. • Drug Courts reduce crime as much as 35% more than other sentencing options.
Save Money • Up to $3.36 in criminal justice costs for every $1.00 invested. • Up to $12 for every $1 invested, when including other cost offsets (i.e., reduced victimization and healthcare service utilization. • Between $4,000 to $12,000 in Annual costs per participant.
Ensure Compliance • Provide more comprehensive and closer supervision than other community-based supervision programs. • 6 times more likely to keep offenders in treatment long enough for them to get better.
Veterans have challenges, but why have a separate treatment court for them?
Veterans Treatment Courts • Hybrid Drug and Mental Health Treatment Courts using the Drug Court Model. Principals of both Drug & Mental Health Courts • Addition of U.S. Dept of Veterans Affairs representatives, state and local agencies, and volunteer Veteran mentors. • Target those who have served in the U.S. Armed Forces. • Jan 08 – First opened in Buffalo, NY. • May 11 – Approx 100 VTCs, many are being planned.
Veteran-specificBenefits and Services • U.S. Department of Veterans Affairs (VA) • Veterans Health Administration (VHA) • Veterans Benefits Administration (VBA) • Department of Housing and Urban Development (HUD) • Department of Labor (DOL) • State/County agencies • Veteran Service Organizations • Pro Bono Legal Assistance
Veterans Affairs (VA) • Medical • Substance Abuse • Mental Health (to include PTSD) • Homeless Services • Employment and Vocational Training • Education • Pension and Disability Payments
Veterans JusticeOutreach (VJO) Program • Outreach, assessment, case management for justice-involved Veterans in local courts and jails • Veteran identification • Assistance in eligibility and enrollment • Continued monitoring and consultation • Hand-off to VA and community service providers
VTC Mentor/Peer Programs • Volunteers with prior or current military service • Help Veterans navigate the Court, VA, and treatment systems • Assess “other needs” and help adjust to civilian life • Help the Veteran and Veteran’s family receive the services they need to be productive members of society
Military Cultural Veterans are used to: • Structure • Leadership • Loyalty • Patriotism • Camaraderie • Teamwork & Self-reliance
Veterans Treatment Courts have adopted with slight modifications the essential tenements of the Ten Key Components as described in the U.S. Department of Justice Publication entitled “Defining Drug Courts: The Ten Key Components”, (Jan. 1997).
Key Component # 1 Integrates alcohol, drug treatment, mental health treatment, medical services with justice system case processing
Key Component # 2 Using a non-adversarial approach, prosecution and defense promote public safety while protecting participants' due process rights
To facilitate the veterans’ progress in treatment, the prosecutor and defense counsel shed their traditional adversarial courtroom relationship and work together as a team.
Key Component # 3 Eligible participants are identified early and promptly placed
Early identification of veterans entering the criminal justice system is an integral part of the process for placement in the Veterans Treatment Court program. The trauma of arrest can be an opportunity for the veteran to address denial issues.
Key Component # 4 Access to a continuum of alcohol, drug, mental health and rehabilitation services
Participants in Veterans Treatment Court may have different levels of need in a wide variety of service domains. Issues such as PTSD, TBI, Domestic Violence and homelessness may need to be assessed and addressed. Mentors
Key Component # 5 Abstinence is monitored by frequent alcohol and drug testing
Drug Testing Court ordered drug testing Frequent Random Use of results
Key Component # 6 Coordinated strategy governs Court’s responses to participants' compliance
Incentives and Sanctions Coordinated strategy establishes protocols for rewarding progress as well as sanctioning non-compliance.
Key Component # 7 Ongoing judicial interaction with each Veteran is essential
Judge as leader of the team. Continuity of relationship between judge and veteran Relationship from acceptance in program throughout treatment and commencement and aftercare The message is “Someone in authority cares”
Key Component # 8 Monitoring and evaluation measure the achievement of program goals and gauge effectiveness
Program Monitoring Measures progress against goals Results are used to monitor progress Results are used to improve operations
Key Component # 9 Continuing interdisciplinary education promotes effective Court planning, implementation, and operations
All Veterans Treatment Court staff should be involved in interdisciplinary education and training. Shared interdisciplinary training creates common knowledge and understanding.
Key Component # 10 Forging partnerships among the Veterans Administration, public agencies, and community-based organizations generates local support and enhances Court effectiveness