People with Intellectual & Developmental Disabilities within the Criminal Justice System

1. Presenter – Alexandra Andrews, MA Health Care Advocacy Program Coordinator at Advocacy Denver People with Intellectual & Developmental Disabilities within the Criminal Justice System

2. Advocacy Denver Profile • Formerly the Arc of Denver; still an Arc Chapter. • Non-profit, civil rights, advocacy organization serving people with I/DD of all ages. • Assistance/Guidance provided in many areas: • Housing, transportation, financial stability, legal services for special education, employment, and health care. • Initiate public policy change in order to promote positive solutions.

3. Health Care Advocacy Program Profile • Guide adults with I/DD through the health care system. • Serve both English and Spanish speaking individuals. • Provide health and wellness education. • Track gaps in the health care system. • Collaborate with other individuals and organizations to educate and assist in legislative and system changes.

4. Defining I/DD Intellectual disability – is a below average cognitive ability with 3 characteristics: • I.Q. is between 70-75 or below • Significant limitations in adaptive behaviors (the ability to adapt and carry on everyday life activities such as self-care, socializing, communicating, etc.) • The onset of the disability occurs before age 18.  Developmental Disability – includes people who have an ID, autism, cerebral palsy, severe seizure disorder, or a severe head injury. Under federal law, DD means a severe, chronic disability of an individual that: • is attributable to a mental or physical impairment or both. • is manifested before 22 yo. • is likely to continue indefinitely • results in substantial functional limitations in 3 or more major life areas.

5. Focus on perpetrators with I/DD • I/DD comprise 2% to 3% of the general population. • They represent 4% to 10% of the prison population, with an even greater number of those in juvenile facilities and in jails • (Petersilia, 2000).

6. Prepetrators with I/DD, cont. As suspects, individuals may: • Not want their disability to be recognized and try to cover it up. • Not understand their rights • Not understand commands, instructions, etc. • Be overwhelmed by police presence • Act upset at being detained and/or try to run away • Say what they think officers want to hear • Have difficulty describing facts or details of offense • Be the first to leave the scene of the crime, and the first to get caught • Be confused about who is responsible for the crime and “confess” even though innocent • (Leigh Ann Davis, 2009)

7. Perpetrators' Characteristics • Typically, the perpetrators with I/DD are: • Male • Older than other offenders • Exhibit long-standing and continuing serious behavioral disturbance (independent of their psychiatric diagnosis or level of involvement with the criminal justice system) • Require supported or custodial accommodation, despite only mild or borderline levels of ID. • Although only one-third have a diagnosable major psychiatric disorder, three-quarters have had prior or current contact with psychiatric services and two-thirds suffer chronic medical illness. • (W. Glaser & D. Florio, 2004).

8. Mental Health of Perpetrators with I/DD • “Despite increased prevalence of psychiatric disorder amongst offenders with an intellectual disability (ID), there is very little known about the characteristics and needs of those with dual disability” • “The multiple services provided to this group have been ad hoc, poorly coordinated and sometimes dangerously inappropriate. A service provision model is required which must be integrative and consistent.” • (W. Glaser & D. Florio, 2004).

9. Mental Health of Perpetrators with I/DD, Continued • Mental health services are provided in prison and jail, but infrequently meet the needs of people with I/DD. • Follow-up after incarceration is limited. • Police and mental health providers have limited training dealing with people who are dually diagnosed.

10. ACA and Medicaid Expansion • Improvements have been achieved in other states for people with I/DD and MI. • Better utilization of Home and Community-Based Medicaid Waivers • Increased state funding for crisis services and increased access to mental health services. • 1915(k) Community First Choice personal care plans • Money Follows the Person • Balancing Incentives Payments programs • The Health Home, optional Medicaid state plan Further Recommendations in: “Including Individuals with I/DD and Co-Occuring Mental Illness”, NADD, 2011.

11. Contact • Alexandra Andrews, MA • 303.974.2520 (office) • aandrews@advocacydenver.org • Advocacy Referral Line – 303.974.2530 • Website – www.advocacydenver.org