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To gain additional planning information, the group should examine documents related to statewide and, if appropriate, countywide planning. These documents contain a wealth of information about many AOD problems. Data can be included from the Drug Abuse Warning Network (DAWN) hospital emergency room survey, the Monitoring the Future Survey, and the National Household Survey, published each year by the National Institute on Drug Abuse, and the Drug Use Forecasting (DUF) System, established by the National Institute of Justice. While most of this information will not be specific to offenders, it can be used to help lay the groundwork for an action agenda among criminal justice and AOD treatment system personnel. Using these data, the group can extrapolate the extent of local substance abuse problems. The group should analyze and discuss all data and plans to ensure that the work of integrating the systems does not conflict with AOD treatment activities in progress. In addition, plans for the expenditure of all State and local AOD treatment funds should be examined and compared with plans for AOD treatment programs. Several issues should be considered. Are AOD funds being focused consistently on the stated expenditure plans? How could AOD treatment plans be changed without decreasing their effectiveness? Where is the flexibility in the AOD treatment system that could permit the channeling of funds and resources to treatment in the criminal justice system? Where do data related to the needs for AOD abuse treatment coincide with needs for criminal justice treatment? What are the major problems in the AOD treatment system? What are the additional data needs in the AOD system? Exactly the same data collection process that is done for the AOD system must occur for the criminal justice system. All plans relating to drug-involved offenders, together with existing data, should be reviewed. These data may include DUF data and data on numbers of positive tests for various drugs. Data should be collected from all the probation, parole, jail, prison, and community corrections programs in the target area. Funds allocated to treatment of offenders should be specifically identified and cataloged. Data should be used for decisionmaking. Once data are collected, comparisons with data from other jurisdictions and States can be made for each of the nine system linkages. Areas of greatest need can be identified. For example, it may be found that one county administers drug tests to serious offenders significantly more often than another county does, and the group may decide to focus on that issue. Data and plans should be summarized for the policy group. Often, a systemwide analysis of plans and data will identify major areas of group agreement. Another way to identify goals is to do a "what's missing" analysis for each institutional unit within the criminal justice system. At the local level, this analysis might include forming focus groups with probation officers, jail personnel, parole officers, and community corrections personnel to find out what steps each group thinks should be taken. At the State level, focus groups could be conducted across the State for probation, parole, community corrections, and prison personnel. Feedback from focus groups, as well as the collected data and plans, can all contribute to the policy group's decisions about the size, seriousness, and locus of the problem. From this information, goals can be identified. Goals must be obvious and based on the data, plans must be studied, and the information must be gathered from the focus groups. System descriptions should always be made. Simply describing how the system actually operates at a specified time can often be a powerful tool in demonstrating linkage problems. This process can be accomplished with computer assistance and flow charts to illustrate systems and/or processes. The process of interviewing key players in a system and discussing the proposed system flow will often elicit important feedback. This feedback is essential for a properly operating system. Sensitive Areas Hindering System IntegrationSensitive points can hinder system integration by creating conflicts between systems and discouraging participants in the linkage process. Sensitive areas include
Collaboration Among StakeholdersThe hard work of planning AOD treatment for offenders in any part of the criminal justice system continuum will be carried out by the leaders in the criminal justice and AOD systems. Policy, procedures, relationships, and shared responsibilities will be developed to operationalize effective AOD treatment within the criminal justice system. Leaders in the criminal justice and AOD systems should not make the mistake, however, of being noninclusive. Many individuals and stakeholders will be affected in some way by the development of integrated criminal justice-AOD treatment programs. Stakeholders may include the citizen who depends on the local police department to keep the neighborhood safe, the professional in the social service agency who is concerned about the welfare of the offender's children, and the crime victims who want to see criminals punished. Organizations such as churches, youth programs, and businesses may view the criminal justice system from different perspectives. They too are stakeholders in the criminal justice system. Taxpayers are stakeholders who finance criminal justice system programs and often AOD abuse treatment programs. These and other stakeholders should be taken into consideration when an AOD abuse treatment program is being planned. Even the best planned program will not succeed if local citizens and taxpayers oppose it. In addition, public support and involvement can provide the momentum needed for programs to pass from the planning stage to implementation. It is important to obtain stakeholders' involvement early in planning for treatment capacity. Members of the affected groups can make major contributions to strengthen new programs. For example, AOD abuse treatment programs refer patients to human service agencies for necessary auxiliary services. If these agencies are represented in the planning group, they can assist in the design of referral policies and procedures that optimally benefit the AOD abuse treatment program, the criminal justice system, the offender, and the community. There are two broad categories of stakeholders: 1) those with an influence over the decisionmaking processes and 2) those who are affected by the decisions. The degree to which stakeholders have influence or control in the decisionmaking process varies, as does the extent to which a decision has an impact on each stakeholder. For example, the child of an offender has little influence over a decision but can be greatly affected by it. On the other hand, a prosecuting attorney may have great influence over the decisions made about an offender, but such decisions may have little impact on the prosecutor.
It is helpful to divide stakeholders into five basic categories:
Community StakeholdersThe PublicThe public may influence what happens at every point along the criminal justice continuum. The importance of informing the community about AOD treatment and criminal justice issues cannot be overemphasized. Many individuals and groups, including the voting and nonvoting public, have different influences and needs. The electorate can be considered to have more clout than the nonvoting public and is therefore in a position to wield greater influence over decisionmaking. In addition to educating the public about needed changes, it is vital to let the public know what is working. For example, officials responsible for overseeing each stage of the criminal justice system might consider releasing a community annual report, similar to a corporate annual report, that includes facts such as the number of people who have successfully completed a treatment program. Such successes may allay some of the public's fears about offenders. It is important to help the public understand that providing treatment to offenders is not being "soft on crime" and that these programs do not overlook the primary justice system responsibility of protecting public safety. When members of the public participate in planning, this ongoing educative process is initiated. VictimsThose victimized by a crime include the crime victim and family members -- especially children -- and significant others. Several States have passed constitutional amendments to protect the rights of victims. These amendments usually provide an opportunity for the victim to take part in the criminal justice process. In a number of jurisdictions, community-based victims' rights groups have also been established. Some prosecutors' offices employ victim advocates, who should also be included as stakeholders in the planning process. Victims have a variety of interests, depending on the circumstances of their cases. Most victims want punishment, restitution, and protection. For their protection and the protection of other potential victims, they may want the offender removed from society and punished. They may also want to see the offender's AOD problem addressed. Many victimization circumstances are not direct, as in the case of persons who live across the street from a crack house and whose main goal is to close it down. Some victims may want every opportunity possible to represent their own interests, while others may prefer to have nothing to do with the criminal justice system.
MediaThe media play a major role in shaping public attitudes toward the criminal justice system, especially attitudes about how to handle AOD-involved offenders. Personnel in the criminal justice and AOD treatment systems should always be aware that the primary goal of those in the media is to get a good story. This objective often plays out in stories that expose weaknesses and failure in human systems. Few events make bigger headlines or splashier leads for the evening TV news than the violent crime committed by an offender who has been returned to the community. Television news, in particular, will often spend the first 10 minutes of a broadcast reporting stories of violent crime, without considering the impact of these stories or putting them within a balanced context. Such reporting may have the effect of creating an adversarial relationship between the media and the criminal justice and AOD treatment systems. Avenues of communication between the media and the criminal justice and AOD abuse treatment systems must be kept open. Continual efforts should be made to communicate a full picture of the multifaceted issues surrounding crime, substance use disorders, and AOD treatment. AOD and criminal justice system personnel should take a proactive approach and work with the media, rather than just reacting to negative stories about crime and drugs. When media representatives are involved in planning, they may begin to see the positive side of joint efforts of the criminal justice and AOD abuse treatment systems. LegislatorsLegislators should be consulted and educated about the addicted offender in the criminal justice system. It is important that they become aware of success stories, so that the overwhelming influence of failed cases does not dominate their policy decisions. The political stance of being "tough on crime" and "waging war on drugs" has resulted in legislation requiring mandatory sentences for drug offenses, which must be tempered with a well-informed view of positive treatment outcomes. Community OrganizationsCommunity groups include local boards, recreational programs, church groups, neighborhood watches, and other community associations that address either directly or indirectly the issues of AOD abuse and criminal behavior. These groups can play a role in prevention, treatment, and referral. Advocacy groups such as Mothers Against Drunk Driving (MADD) and other special interest groups also can work effectively at the community level to address prevention issues. Their agendas are often tied to those of other community groups that can be helped to understand the importance of reaching offenders with effective treatment. BusinessesLocal businesses and business groups, such as Kiwanis, Rotary, and downtown business associations, have a very strong interest in preventing crime, since they may be targets. They often take a strong and active role in their communities. Employers may also be interested in preventing AOD abuse by their employees. Vocational training is an important component of helping AOD-involved offenders reenter the community. Business leaders can provide invaluable assistance in planning training programs and providing opportunities for job placements. Businesses, as a vital component of the larger community, should be involved in planning for AOD treatment in the criminal justice system.
Stakeholders Associated With the OffenderThe OffenderA review of the AOD-abusing offender's needs can highlight the difficulties associated with effectively treating and rehabilitating this population. Offenders usually want as little intervention in their lives as possible. They do not want to go to jail. In addition, offenders who are actively using drugs at the time of arrest may not be very interested in treatment. Many offenders want to continue using drugs and may deny their AOD problems. However, once the effects of AODs dissipate, remorse, depression, or anger may set in for some offenders, and they may be more open to treatment. Mandated AOD abuse treatment in a community setting with justice system supervision can be an alternative to incarceration for some offenders. Family MembersRelatives and significant others often want to change an offender's behavior. However, many offenders come from dysfunctional or marginally functional families, where their efforts to change may be undermined. A multigenerational approach can be used in an attempt to work with the family system. If there are treatment opportunities available for the offender in the criminal justice system, family members may believe that arrest is the best thing that could happen. Some family members may also believe they need protection from the offender, especially if domestic violence is an issue. The interests of female offenders with children should also be taken into account when a treatment decision is made. EmployersMany offenders lose their jobs when they enter the criminal justice system. However, some employers may be willing to support an offender by allowing the offender to keep his or her job during the presentencing stage and later if the offender is put on probation. Employers can participate in the pretrial investigation and support appropriate treatment for the offender. Some employers are becoming aware that they can play a strong role in the treatment process of their employees. Such employers may participate in probation or parole planning. Their support can make a significant difference in treatment outcomes for the offender.
Social Service ProvidersOffenders entering the criminal justice system are frequently known by a variety of social service providers through school programs, recreational activities, and public assistance programs. These providers have an interest in the disposition of an offender's case, and the presentence investigators can bring them into the process. Once an offender has been found guilty, specific social service systems may become involved. For example, child protective services may become involved when offenders have dependent children, or immigration services when offenders are illegal immigrants. It is often helpful if the offender's involvement in such programs is known before sentencing. Presentence investigation should uncover this information. Stakeholders Within the Criminal Justice SystemPoliceAs described in Chapter 5, community policing programs can be crucial components in preventing both crime and AOD abuse. Such programs should be holistic, providing services in many different areas. For example, police can work with the schools to reduce absences of children who are at risk of developing AOD problems, and they can visit the children's homes and connect mothers and other childcare providers with AOD abuse treatment programs. For example, police can alert outreach workers to individuals who need services. Some treatment programs and other service agencies have outreach workers who spend time in the community visiting schools, homes, and community groups to educate people about their services. It has been shown that individuals are more likely to stay in AOD treatment if they are provided with support services such as primary healthcare and transportation. Police can perform an important role in connecting people with social service agencies, where individuals and families can obtain needed services. Police can be mentors and role models for youth in the community. Some officers have had success with "homesteading" -- actually living in the community they serve and becoming an integral part of the community. It is usually the police who provide the entry point for an offender into the criminal justice system, and police will want to see that both systems support their actions. Police can also contribute valuable preliminary screening data, based on their assessment of the offender's condition at the time of arrest. Pretrial Service AgenciesOnce an offender has been arrested and charged, pretrial service agencies become stakeholders. Their charge is to gather information that will be used by the court in setting pretrial release conditions. In most States, the court is required to set the least restrictive conditions that will reasonably ensure the defendant's return to court and the protection of public safety. Pretrial agencies thus serve a supervisory function and are responsible for ensuring that the offender returns to court as ordered, that he or she does not commit another crime, and that AOD use is minimized. These responsibilities may include periodic reporting, curfew supervision, and drug testing.
One example of a comprehensive pretrial services agency is in the District of Columbia, where an average of 100 new cases are processed every day, and 72 percent of defendants are released on their own recognizance or on supervised release. (Seventy percent of arrestees are released at first appearance. Another 10 percent are released at a later time.) Urinalysis of all defendants in this system is conducted, and over half show evidence of recent drug use. These defendants are either placed in a regular urine-testing program on an order to refrain from drug use or are sent for an AOD assessment. This agency also serves as a bridge between the court system and the AOD treatment system. Treatment Alternatives to Street Crime (TASC)TASC programs can be a bridge between the AOD treatment system and the criminal justice system. In some jurisdictions, TASC functions as a bridge between prosecution, probation, parole, and the AOD abuse treatment program. ProsecutorsProsecutors want to ensure that laws are enforced and that order is maintained within their community. Their goal is usually to obtain a guilty plea or conviction as quickly as possible. In many jurisdictions, the prosecutor's office faces a backlog of criminal cases, and prosecutors are pressed to move cases through quickly and to avoid wasting resources. Plea bargaining is frequently used to accomplish this goal. Defense AttorneysDefense attorneys play a critical role in the criminal justice system and may link the client to the AOD treatment system. In representing their clients, defense attorneys may face the ethical dilemma of deciding whether to do what their client demands or what they feel is in their client's best interests. Such a dilemma occurs when a client refuses to acknowledge an AOD problem. To provide a client with the best defense, attorneys may choose to ignore the client's potentially destructive AOD abuse in order to obtain the mildest sentence possible. If an offender is not being held in a detention facility, the defense attorney may feel it is in the client's best interests to get the case postponed for as long as possible. Despite the necessary emphasis on defending their clients, defense attorneys may also see a need to facilitate change for some clients. Some defense attorneys are becoming concerned because they see the same clients repeatedly. They may encourage treatment to break the criminal cycle. Although clients may be opposed to entering treatment, defense attorneys realize that treatment participation can be a valuable asset in arguing for a reduced sanction. Many defendants may be in denial not only about their AOD abuse but also about their criminal charge. JudgesJudges are key figures in any linkages between the criminal justice and AOD treatment systems. Judges work to see justice served, helping the offender whenever possible and moving the offender to trial quickly. As the interrelated needs of the criminal justice and AOD treatment systems have become apparent, some judges have recognized the necessity of taking time to apply graduated and intermediate sanctions to change behavior, rather than relying on all-or-nothing sentences. To make their decisions, judges want information that is usable, relevant, and as concise as possible. They need information about the offender, available treatment resources, and the success rate of offenders and others in such programs. Judges are also interested in managing court caseloads and disposing cases. AOD treatment interventions may conflict with these goals by prolonging the time necessary to manage a case. Like others in the justice system, judges may need time to see the evidence that shows that treatment interventions will reduce recidivism and will thus dispose of cases more effectively over the long term.
Presentence InvestigatorsPresentence investigators gather information about the offender and provide the court with information about resources available to treat the offender. They also make a sentencing recommendation. In some cases, the probation officer writes the presentence report and may have a role in supervising the case. Probation officers who supervise cases want to see a particular outcome for an offender and will recommend specific approaches such as urine testing or supervised curfew. Their goal is to set up a community control-and-treatment plan for the offender. Probation OfficersProbation officers supervise offenders who are found guilty and placed on probation. They ensure that offenders comply with conditions imposed by the court at the time of sentencing. Probation should not be viewed as an alternative to incarceration, but rather as a sentence in its own right; (incarceration should be reserved for the most dangerous or serious offenders). The probation sentence allows offenders to remain in the community under the supervision and guidance of a trained probation officer or case manager. During probation, offenders are helped to deal with issues, such as substance abuse, that contribute to criminality. Parole OfficersParole officers are involved in supervising offenders who are released from prison before completing their full sentence. Stipulations and prohibitions on certain activities are made. Parole is supervised by a Board of Parole. Various approaches, such as intensive parole, have been used to supervise specialized drug caseloads. Correctional Facility Administrators and StaffCorrectional administrators, officers, and other prison staff can play an important role in AOD treatment. Every opportunity should be provided for offenders to initiate and complete effective treatment within correctional facilities. Correctional staff should have an appreciation of treatment goals and how treatment programs can be designed so that security requirements and other correctional institution needs are met. Stakeholders Within the Public Health and AOD Treatment SystemsTreatment providers and support staff have a stake in treatment outcomes. They want individual offenders whom they treat to succeed in achieving recovery. AOD treatment service providers perform different roles, depending on whether services are community based or based within a correctional facility. Treatment providers from a range of modalities and settings should be included in the planning process. Examples include inpatient and outpatient detoxification programs, residential programs, day hospitals, methadone clinics, and therapeutic communities. Both program administrators and front-line direct-service providers have much to contribute to the planning process. Professionals and paraprofessionals from a variety of disciplines are involved in AOD treatment, and these disciplines should be well represented in the planning process. Healthcare OrganizationsHealthcare organizations can be partners in the comprehensive treatment of AOD-abusing offenders. Given the high incidence and risk of human immunodeficiency virus (HIV) infection, tuberculosis (TB), and sexually transmitted diseases (STDs) in the offender population, public health departments have an increasing interest in working with the AOD treatment and criminal justice agencies serving these populations. Healthcare providers in a community see daily evidence of the damage caused by AOD abuse and violent crime. Examples of such providers include primary care physicians, emergency department personnel, emergency medical services (EMS) teams, visiting nurses, and home healthcare workers. HIV disease service organizations often provide critical healthcare services. All these provider groups should be represented in planning AOD treatment for offenders. Mental Health OrganizationsMental health practitioners can help identify and treat offenders who need psychiatric care in order to comply with AOD abuse treatment. Mental health organizations can play a role in keeping offenders in the community and out of hospitals or psychiatric institutions.
Coordinating ActivitiesTo effectively conduct collaborative efforts with stakeholders, leaders in the criminal justice and AOD treatment systems are well advised to create two types of groups:
These committees should have a dual focus on the complex individual needs of the offender and the need of the community for accountability, security, and sanctions. Program DevelopmentGenerally, the most specific client-focused coordination occurs locally; but since States legislate, oversee, and fund many local programs, State-level policy coordination and planning are essential. At the policy level, representatives from the following groups can be included:
Coordination should take place from the top policymaking levels to the direct service staff. Agreements should be worked out at upper levels to determine how collaboration will begin. These agreements should address negative attitudes and turf issues. Using the two-tiered committee structure mentioned above, communication and information exchange, interagency cooperation, and cross-training can be targeted on multiple levels. An ongoing interagency group should meet regularly to solve problems as they surface. An oversight committee can provide a forum for presenting issues. Although information sharing is desirable, it is often problem driven. Collaboration should be institutionalized. "Forced networking" through State and county laws and ordinances can determine when and how often a coordinating group should meet. Interagency coordination can also be enhanced by including local service providers and providing a forum to handle issues that surface when dealing with clients who have multiple problems. An integrated management information system can greatly enhance linkages between the criminal justice and AOD treatment systems. In addition, the data gathered can be used to monitor treatment outcomes and assess the effectiveness of the integrated systems. Several jurisdictions have established coordinating groups. They include
Ongoing IssuesSome would argue that coerced treatment, even of offenders, conflicts with American values of freedom of choice and noninterference by government in personal lives. However, even when coerced, AOD abuse treatment is effective. The criminal justice system imposes sanctions for a certain period of time, while the AOD treatment system works with a client for an indeterminate length of time until he or she can achieve and maintain sobriety. The challenge is to look for creative ways to apply sanctions and provide incentives for offenders to continue treatment after their involvement with the criminal justice system. Treatment AvailabilityDespite the obvious need for a wide range and large number of AOD treatment programs, both in the community and in correctional facilities, appropriate treatment programs are not always available. Availability varies by community and by setting. For example, one jurisdiction may have insufficient AOD treatment in the community but may have excellent AOD treatment programs in both jail and prison. Another jurisdiction may not provide any treatment in its jails but have a range of services available in the community. Not enough treatment slots are available at any given time for those needing treatment. In addition, the available AOD treatment programs in the community may lack appropriate and necessary controls for the criminal justice client. Offenders who are screened, assessed, and recommended for treatment need services until a treatment slot becomes available. Day reporting centers, where clients attend every day and take advantage of a variety of programs, are a short-term solution for those awaiting treatment. Undue InfluenceJudges should discourage "lobbying" by representatives of specific programs. It is not a judge's role to assess programs or the suitability of an offender for a particular program. But judges should understand the value of different types of treatment in order to be able to fully understand available placement alternatives. Judges should advocate for outcomes-based program evaluations to better inform decisionmaking processes. Efficacy of Mandated TreatmentResearch has shown that mandated treatment works. (Chapter 1 of this TIP provides a review of research in this area.) However, some treatment providers are not accustomed to working with offenders. Criminal justice personnel may feel that some providers are too quick to conclude that an offender is not going to benefit from treatment. This particular problem is common and not insoluble, although the existing system was not established to provide a solution. Pretreatment readiness programs can work for some offenders. Implications of Urine TestingAn issue that must be addressed by both systems is how to respond to positive urine tests. Both systems must agree on the goals of testing and outline specific responses to positive tests. RecommendationsSpecific suggestions for State action plans include
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