Managing the Mentally Ill Offender in Washington, D.C.

“We Fix the Complexities of Life”

By Leonard A. Sipes, Jr. and Beverly Hill. Edited by Cedric Hendricks and Joyce McGinnis

See http://media.csosa.gov for “DC Public Safety” radio and television shows.

See www.csosa.gov for the web site of the federal Court Services and Offender Services Agency.

Walk down the streets of any major American city and you will likely encounter more than a few mentally ill individuals. Sometimes friendly, sometimes demanding and often scary, mentally ill people pose both a serious public health problem and a moral dilemma for our society. Both victimizer and victim, the mentally ill present especially unique challenges for those of us within the criminal justice system.

According to a Washington Post story filed by Rick Weiss on June 7, 2005, a recent National Institute of Mental Health study found that “One quarter of all Americans met the criteria for having a mental illness within the past year, and fully a quarter of those had a serious disorder that significantly disrupted their ability to function day to day.” Many criminologists suggest that rates of mental illness are even higher among the criminal offender population.

The vast majority of criminological concern for the mentally ill seems directed towards incarceration. Anyone working in our jails or prisons knows of the unique challenges mentally ill offenders offer to institutions attempting to balance security and treatment needs with the realities of budget. It’s difficult to operate within a purely medical model when a mentally ill offender becomes violent or disruptive and threatens the safety and security of the institution. Most correctional professionals have witnessed nurses and psychologists attempting to “talk down” an inmate after a verbal and near-physical encounter with staff or fellow inmates. Seething with emotion and ready to burst, the mentally ill inmate may sometimes stay in that agitated condition for hours at a time while the realities of prison continue to surround them.

Society justifiably calls for humane treatment. Correctional staff just try to keep the peace. But sooner or later, the mentally ill inmate is released back to the community, usually with the same mental health issues they went in with. What happens then?

In the Community

In the District of Columbia, they come to a unique federal, executive branch organization, the Court Services and Offender Supervision Agency (CSOSA). CSOSA supervises 15,500 offenders on parole, supervised release or probation every day. CSOSA assigns almost 50 percent of its caseload to its highest levels of supervision or to specialized caseloads, where each Community Supervision Officer (CSO – known elsewhere as a parole or probation officer) is responsible for only 25 or 30 offenders. Backed up by extensive drug testing, cooperative endeavors with police and prosecutors, a state-of-the-art information technology system, satellite tracking and 50 to 1 general supervision caseload ratios, CSOSA is well positioned to implement its community-based model of offender supervision. This research-based model combines the traditional elements of supervision with an equal emphasis on treatment, social services, and community involvement.

CSOSA’s specialized units offers counseling and special supervision techniques to offenders who are hard core substance abusers, involved in acts of violence, domestic violence, sex offenses and traffic-alcohol issues. Offenders with mental health issues may interact with any of these categories and are assigned to the Metal Health Unit. CSOSA currently supervises almost 800 offenders with confirmed mental health diagnoses Eighty-five percent are male. Some are assigned to mental health institutions and are monitored through regular correspondence with the facility.

CSOSA’s mental health teams have among the lowest caseload ratios in the country. At 30 offenders to each Community Supervision Officers, CSOs and their supervisors have contact with the offender an average of three to four times per week. All CSOs come to the job with a minimum of a bachelor’s degree and many hold master’s degrees as well. Most have a background in law or the criminological or social sciences. Most CSOs on the mental health teams volunteered for the assignment.

Thirty CSOs and supervisors staff the mental health teams. Mental health offenders are assigned to this specialized unit via a D.C. Superior Court or U.S. Parole Commission order; offenders assigned to another unit may also be referred by the CSO for evaluation. CSOSA contracts with psychologists who conduct an assessment of every referred offender. If the psychologist establishes a diagnosis of mental illness, retardation or a personality disorder, “gatekeepers” (licensed professional counselors with master’s degrees) then see the offender. It’s their job to represent the offender as he or she navigates through the District of Columbia’s mental health system to obtain counseling, therapy and medication services.

CSOSA’s gatekeepers have expert knowledge of the public and private resources available. In addition to the standard D.C. agencies, CSOSA explores alternative strategies, such as accessing services through Medicaid or the Department of Veterans’ Affairs. The focus is on developing a precise diagnosis and an appropriate intervention plan, so that psychologists and social workers can act as advocates to get each offender the best possible treatment.

Once the offender’s mental health condition is controlled, he or she can benefit from other CSOSA services, such as job training, drug treatment, anger management or a faith-based mentor.

Community Supervision Officers

But CSOSA contends that a vital ingredient in the success of the program is the dedication of the Community Supervision Officers who see the offenders on a regular basis. “We care about the public’s safety and the offender’s progress,” states 30-year veteran and supervisor Verna Young. “We are determined to achieve both.”

Ms. Young suggests that the CSOs who volunteer for the mental health team are some of the best in CSOSA, if not some of the best in the nation. “Think about it for a moment,” she urges. “These are highly educated individuals who deal with the toughest clients possible. These offenders bring an immense array of problems that would challenge the most dedicated professional. We are the lifeline between the mental health profession, their families and friends, their employers and everyone who interacts with them. We talk them down from negative encounters. We act as intermediaries with frustrated family members. They grow to depend on us for structure and guidance in a world that offers fear and resistance. We help them survive on their own without returning to the criminal justice or social services system. More importantly, we help them exist without doing harm to anyone else.”

DeAndro Baker, Verna’s supervisor and another seasoned veteran of the criminal justice system, explains that offenders with mental health, retardation issues and personality disorders offer an amazing array of problems.

Research for all criminal offenders (examples: Bureau of Justice Statistics-Prior Abuse Reported by Inmates and Probationers and the National Institute of Justice-Early Childhood Victimization Among Incarcerated Adult Male Felons) indicates that substantial social problems result from child abuse and neglect, sexual and physical violence, early age onset of alcohol and drug use and criminal activity. Couple all of this with poor school performance and limited employment histories and involvement in the criminal justice system, and the challenges seem insurmountable. To state that the average offender is a trial is an understatement. Add mental health or retardation or personality disorders, and the challenges are immense.

“But we do not shy from the task at hand,” states Mr. Baker. “The bottom line is protecting the public. We will not hesitate to go back to the courts or the U.S. Parole Commission and state that the individual cannot be safely supervised in the community. We will reincarcerate. But we do everything in our power, including day reporting, to make sure that offenders live a productive life without harm to themselves or others. We are the front line in the effort to serve the offender’s needs and protect society, and we do it every day.”

“The New Asylums”

All of this takes on greater importance as society grapples with the need for safety, balanced with a desire for humane treatment. This dilemma was explored in a “Frontline” episode entitled “The New Asylums” (www.pbs.org/wbgh/frontline) produced by WGBH in Boston and co-produced by Mead Street Films. The episode aired on PBS stations on May 10, 2005. The implications of the program are profound. There are no easy answers.

The New York Times reported on the episode: “An enormously disturbing Frontline report profiles the enormously disturbed.” Times reporter Ned Martin wrote that the documentary …. “explains that the mentally ill, in the decade after a mass release from mental hospitals, have often wound up in less forgiving confines.”

“The New Asylums asserts that 500,000 mentally ill patients, who in earlier decades would’ve been treated in hospitals, are now mistreated in prisons. The mental hospitals now house only a tenth of that number, the narrator says.”

Ultimately, after they leave the hospitals, or the prisons, the mentally ill return to the community.

According to the “Frontline” web site, “In 2004, some 630,000 prisoners were released back into their communities, many with mental illnesses and co-occurring disorders such as substance abuse. Studies have shown that 60 percent of released offenders are likely to be rearrested within 18 months, and that mentally ill offenders are likely to be rearrested at an even higher rate. Experts claim that a major cause for recidivism among the mentally ill is the “epidemic” shortfall in community-based mental health services (emphasis added). While offenders have a constitutional right to receive mental health treatment when they are incarcerated, they do not enjoy a similar right to treatment in the community…”

I do not understand how everything began to unravel,” said a 52-year-old woman from northwest DC. She is on probation for drug distribution. Her years of cocaine abuse produced severe depression and an array of medical problems. She just got out of drug treatment, but recently tested positive for marijuana. She understands that CSOSA will mandate twice a week drug testing as a sanction for drug use. She believes that this level of scrutiny (and the possibility of returning to jail) will keep her from doing drugs.

“I need structure in my life, and my CSO provides that structure. My CSO comes to my home to check on me. It’s nice that I can talk to people who insist that I take care of myself.”

A 48-year-old parolee from southeast DC presents similar problems. He was incarcerated for assault and gun charges. He is a diagnosed paranoid schizophrenic. His drug use (cocaine) was a social event with friends until it became a demon that made his illness much worse. Structure is an essential element in his rehabilitation, and the requirements of supervision help him cope with life’s problems. “As long as I keep my job, I can stay away from drugs and take care of my family. CSOSA helps me cope with problems and keeps me on track.” He admits that drug testing is an essential element. “It’s nice that they care,” he states, “but I know that they will put me back in prison if I do not improve, so I know that I must stay on my medication and do what they want me to do.”

“Public safety is combined with a sincere desire to assist…”

It was because of concern for the community that CSOSA started its innovative mental health caseload. “Public safety is combined with a sincere desire to assist these offenders in meaningful ways,” states CSOSA’s director, Paul A Quander, Jr. “We can manage this caseload in a way that services both goals.”

Thomas H. Williams, CSOSA’s Associate Director of Community Supervision Services, states, “The Frontline report only confirms our experience with mentally ill offenders. Many of the recommendations of the report are already in place within the District of Columbia. The challenges are immense, but we are attempting to meet them with vigor and dedication.”

Tiffany Robinson is ready. “We fix the complexities of life,” she states. A CSO on the Mental Health Unit, she is ready to bring her education and enthusiasm to the challenges offered by this population. Ms. Robinson understands her caseload. “They often say, “˜Please help me,” she reflects. “They do not understand the world they inhabit. It’s my job to help them cope, to reassure, to make the world a less frightening place. That requires structure, and that’s what we and the mental health professionals offer. If that need for structure leads to incarceration or commitment to a mental health facility, then so be it. We will protect society.”

Ms. Robinson understands that CSOSA embraces both sides of the challenges posed by the mentally ill offender. “But we will also offer a humane and compassionate hand to those who need it,” she says. “Thousands have become productive citizens because of it.”

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Domestic Violence Prevention in Washington, DC

The Domestic Violence Branch of the Court Services and Offender Supervision Agency

By Leonard A. Sipes, Jr. Edited by Cedric Hendricks and Joyce McGinnis

See http://media.csosa.gov for “DC Public Safety” radio and television shows.

See www.csosa.gov for the web site of the federal Court Services and Offender Services Agency.

“To experience domestic violence is to walk into hell over and over again,”she said. She was a victim of constant beatings by her former husband. She decided to bring charges. I was a young police officer, assigned to check on her (and her children’s) safety while she navigated the criminal justice system. She explained that the beatings were severe and frequent. Her self-esteem had reached rock bottom. Her children, ages five and nine, wanted their father. She had hinted at suicide.

To many, the phrase “domestic violence” does not do justice to the far-reaching impact of this crime on the lives of the perpetrator, victim, children, extended family, friends and larger society. One victim said that anything less than the phrase “vicious beatings by someone who knows you” does an injustice to the issue. Another suggested that “constant assaults that screw up the lives of everybody” comes closer to reality. The trauma of domestic violence is almost endless: mental health issues, school dropouts, workplace problems, drug and alcohol abuse and the general deterioration of families all correlate to the presence of violence in the home. There are criminologists who believe that solving the domestic violence crisis in America is central to reducing crime and restoring neighborhoods.

For example, studies suggest that 3-10 million children witness some form of domestic violence annually. A 1998 study by found that slightly more than half of female victims of intimate violence live in households with children under age 12. Children who witness domestic violence are more likely to exhibit health and behavioral problems including depression, anxiety and violence toward peers. They are also more likely to attempt suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution and commit sexual assault crimes.

In the nation’s capital, the Court Services and Offender Supervision Agency (CSOSA) is addressing domestic violence in an aggressive and comprehensive way. “Domestic violence is a pervasive problem with far-reaching consequences. Solving the problem requires a comprehensive approach that holds people strictly accountable for their actions while providing them the tools to avoid the behavior in the future,” states Paul A. Quander, Jr., CSOSA’s Director. ” Domestic violence is a community problem that cannot be ignored.”

Legislative Remedies

The mission of CSOSA’s Domestic Violence Branch is to increase public safety and prevent future victimization by providing close supervision and treatment for individuals convicted of domestic violence offenses. CSOSA also provides a range of services for victims. The Domestic Violence Branch also partners with stakeholders to facilitate awareness of domestic violence in the community. The US Attorney’s Office, the Metropolitan Police Department (MPD), DC Superior Court, the DC Coalition Against Domestic Violence, victim advocates and others are intimately involved in the process.

Domestic violence has been a high-profile issue in the nation’s capitol for more than a decade. In 1991, the D.C. Council enacted the Prevention of Domestic Violence Amendment Act. In 1992, the D.C. Superior Court established the Domestic Violence Intervention Program to address the increase in domestic violence arrests and the number of offenders sentenced to probation for those crimes. The initial thrust of the program was to provide batterers with counseling in an effort to reduce repeat offenses.

When the U.S. Congress created CSOSA in 1997, through the National Capital Revitalization and Self-Government Improvement Act, the new agency assumed responsibility for the community supervision of domestic violence offenders. The transition to a federally-funded probation and parole agency has dramatically improved domestic violence supervision. Since its inception, CSOSA has established four specialized supervision teams focusing exclusively on domestic violence offenders and two domestic violence treatment teams to provide needed counseling and treatment services and referrals. Reduced caseloads on these specialized supervision teams has allowed for increased monitoring of these offenders and improved support services.

Ground Zero: The Community Supervision Officer

CSOSA’s Community Supervision Officers (CSO) are at “Ground Zero” in the agency’s efforts to provide effective supervision of domestic violence cases. The agency ratio of CSOs to offenders is approximately 52 to 1. In specialized units, such as the Domestic Violence Unit, the ratio is 33 to 1. CSOSA’s four supervision and two treatment teams manage 1,300 domestic violence offenders. Domestic violence offenders are subject to the same drug testing regimen, periodic police contacts through joint patrols (Accountability Tours) and strict accountability requirements of other offenders. They have the same opportunities for drug treatment, vocational and educational placement and training, and faith-based mentoring offered to any other offender. Domestic Violence offenders can be on both probation and parole.

CSO Rodney Carter, a five-year CSOSA veteran, is a member of Team 40, which is devoted exclusively to domestic violence supervision work. Rodney was a treatment provider during his first year, and has been a supervision officer for the other four. He holds a masters degree in social work from Howard University and moved to the District of Columbia from Charlottesville, VA to pursue his goal of being a probation officer. “This is where the need is,” he explains. Working with disadvantaged populations and providing a positive role model is important to me. It’s important to provide an example and keep the community safe.”

“When I ran treatment groups for domestic violence, the focus was on offenders accepting responsibility for their actions and challenging their belief systems. Many offenders believe that violence is okay. They think it is an appropriate way to treat a person, whether they were strangers or intimate others,” he states.

Carter explains how domestic violence treatment works. “In treatment, we challenge the notion that violence is acceptable. Many offenders witnessed the abuse of their mothers or other women. The popular culture promotes violence-it suggests that violence is OK. Substance abuse is often connected to, but not necessarily caused by, domestic violence. It removes inhabitations. Offenders would say that it happened because “˜I was drunk.'”

“My job to break through these myths. In a group setting, members of the group would challenge and learn from each other. Not everyone can be helped. But I’ve learned that I can affect people and help them change. I can provide a safer environment for the participants and their children. The vast majority of those involved in domestic violence have children, so the implications are considerable for all involved. I provide offenders with the skills they can apply during difficult situations.”

Carter says that this work has changed him, too. “The experience has taught me to be a better person,” he says. “It’s taught me that domestic violence is an ongoing challenge that must be dealt with to create a better society. I love this work, and I love the challenge.”

Domestic violence CSOs meet regularly with offenders to monitor compliance with all supervision conditions. They are required to establish and maintain communication with victims to verify compliance with all “Stay Away” orders. CSOs are responsible for consultation with others associated with the offender (known as collateral contacts). These include family members and friends, employers, counselors and others to determine the offender’s overall adjustment to supervision.

Meeting with collateral contacts allows the CSO to determine if offenders are complying with their supervision obligations and to verify information provided by the offenders. The supervision level and frequency of contacts by the CSO is based on a risk and needs assessment conducted at the beginning of supervision and at regular intervals during the term of supervision. Poor adjustment and non-compliance automatically results in increased contacts and sanctions imposed by the CSO in an effort to correct negative behavior.

Field visits are a critical component of the supervision process. They provide insight into the offender’s environment, associations, belief systems, and other factors. Incorporated into the field visits are accountability tours conducted with District of Columbia Metropolitan Police officers. These joint home visits provide police officers with critical information about offenders residing within the Police Service Area the officer patrols. Information sharing between the CSO and MPD officer is a vital component of supervision, especially if there is police contact with the offender in the absence of the CSO.

“We provide them with the chance to save their lives.”

Mark Collins is one of eight CSOs on Team 38. Mark has a BS in communications from Bowie State University. He began his career with CSOSA in 2001, serving as a drug-testing technician for 10 months until a CSO position opened up. He’s been a CSO for two years.

“I love it,” he states. “Every offender is different; every set of circumstances is a challenge. We take threats to victims very seriously. We act on their information immediately. Domestic violence is a real problem in DC. We try to work with the offenders; we try to help them, provide them with domestic violence and drug treatment, and we do whatever it takes to keep them from engaging in further acts of violence. But if offenders violate the terms of their court orders, and do it constantly, then they go back to the judge or the Parole Commission, and often jail.”

“We are in constant contact with the victims to protect them, and to learn from them. Many offenders feel that violence was justified because they claim that they were assaulted first. It’s the role of the 22-week treatment program to help offenders understand the dynamics of interactions with others. In many instances, offenders feel that aggression directed to them justifies violence in return. Counselors and supervision officers get them to understand violence and alternatives, or how to deal with a situation without busting a window or slashing a tire. We help them change the way they deal with anger. We help them see the world differently. We provide them with the chance to save their lives.”

“It’s very important for folks to succeed, and to get on with their lives. We will take an offender to treatment, we will take an offender to a job, and we will do whatever it takes.

It’s my goal to keep the community safe.”

Intervention

The DC court and community supervision system has used the Duluth Model since the early 1990s, which focuses on how the concept of power and control adversely affects intimate relationships. As mandated by court order and based on the offense, offenders are placed in either an 18-week Family Violence Intervention Program or a 22-week Domestic Violence Intervention Program.

The Duluth Model views power and control as the primary factors in battering behavior within intimate relationships. It advances the idea that males have internalized a set of socialization values that predisposes them, in intimate relationships, to be the dominant violence initiators and perpetrators of domestic violence, which the model considers a learned behavior that can be changed through counseling.

The Domestic Violence Intervention Program also offers a special counseling component dedicated to treating the Latino offender, under the counseling guidance of a Latino CSO.

The program has about a 60 percent completion rate. In the groups, counselors focus on persuading the offender to see the futility of violence in relationships, to accept responsibility for his/her role in the incident and to explore alternative ways to avoid violence using a safety plan. The program CSOs are specially trained, certified and licensed in the area of domestic violence counseling.

The program receives about 2,000 domestic violence referrals each year from the DC Superior Court. These referrals are usually the result of Civil Protection Orders, Deferred Sentence Agreements, Adult Probation, Parole or Supervised Release. Occasionally, pre-trial defendants are referred to the program by the Pretrial Services Agency.

The Domestic Violence Intervention Program also has a vendor component, which employs well-qualified private treatment providers to provide domestic violence counseling to employed offenders or offenders who have income, as opposed to unemployed offenders who receive the counseling at no cost from CSOSA domestic violence CSOs. The vendor and the non-fee programs are mutually complementary; offenders can transfer from one to the other if their employment status changes. The program currently has 14 vendors and 8 CSOSA CSOs providing treatment to domestic violence offenders.

The CSOSA domestic violence initiative, although very young, has achieved some positive results. Within two years of release from CSOSA supervision, 29.3 percent of all offenders are rearrested (for all crimes), versus 26.2 percent of those offenders going through the domestic violence program.

With an emphasis on public safety, examples of CSOSA’s efforts to improve offender lifestyles and modify behavior include:

  • An individual on probation for assault was being uncooperative with the supervision officer, evasive in providing information on employment, residence, and activities and was on occasion missing appointments without notice. Information was presented to the CSO that the offender was communicating with and intimidating the victim, in violation of the court order. It was also reported that the individual had come to the attention of local law enforcement authorities for possible involvement in other illegal activity in a designated police “hot-spot.” Based on this information and the officer’s contact with individuals familiar with the offender, the officer requested a court hearing to address the offender’s overall non-compliance. The court ordered the offender placed on intensive surveillance through the use of our Global Positioning System (GPS)-based electronic monitoring. The offender’s daily activity and location are now constantly monitored and community safety has been greatly enhanced. Restrictive areas have been imposed and we are now able to verify where the offender has been at all times.
  • A probationer on supervision for destruction of personal property within a domestic abuse setting, reported for supervision with numerous problems beyond her need for domestic violence treatment. A mother of two young children and a regular user of PCP, she displayed a negative attitude and unwillingness to comply with her conditions of supervision. The offender was returned to Court to address these issues and the Court’s intent was to revoke her probation. However, the supervision officer recognized redeeming qualities in the offender and presented options to the Court including residential treatment that would accommodate the offender’s two young children. The court agreed with the CSO and the offender was immediately placed in a residential treatment facility that allowed her to keep her children with her. She worked closely with the program staff and the CSO and successfully completed program. During her stay in the program, she was diagnosed with mental health problems. After participating in a transitional housing program, the offender and her two young children are now living in their own apartment. She continues to address her addiction issues with no evidence of relapse, and is participating in mental health counseling on a regular basis. The Court has extended her supervision period to allow continued monitoring of the offender’s progress.

CSOSA’s domestic violence initiatives will continue to include aggressive supervision and appropriate treatment for offenders. In an effort to promote community awareness and offer additional assistance to victims, Domestic Violence staff is conducting an ongoing cell phone collection drive to in collaboration with non-profit agencies that assist domestic violence victims. In 2004, CSOSA conducted its first annual conference on domestic violence. The conference focused on prevention and intervention techniques from government, advocates and nonprofit organizations and drew participants throughout the city and metropolitan area.

“Programs to deal with domestic violence can make our communities safer,” said Thomas Williams, CSOSA’s Associate Director for Community Supervision Services. “These efforts mean justice for victims and their children, which is essential to any caring society.”

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