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The Success of Drug Courts-The Urban Institute-DC Public Safety Radio

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Radio Program available at http://media.csosa.gov/podcast/audio/2012/08/the-success-of-drug-courts-the-urban-institute-dc-public-safety-radio/

[Audio Begins]

Len Sipes: From the nation’s capital, this is DC Public Safety; I’m your host Leonard Sipes. Today’s show is on drug courts and we have Urban Institute research addressing multiple outcomes from multiple places throughout the country, but it’s just not recidivism or return to crime, but it also measures drug use, socio-economics, status and outcomes, family functioning and mental health. It’s one of the most complete evaluations I’ve ever seen in terms of drug courts. Our guest today is Shelli B. Rossman, Senior Fellow, the Urban Institute, www.urban.org. www.urban.org. Shelli, welcome to DC Public Safety.

Shelli Rossman: Thank you Len.

Len Sipes: Shelli, before describing the research I want to state that it addresses 23 drug courts in 8 states. That’s a big evaluation.

Shelli Rossman: Yes, this is the largest drug court study every undertaken and it’s interesting because within those 23 drug courts, in very different demographic areas, we have both large and small courts represented. Rural, suburban and urban courts from major cities, and we selected them so that they represented different parts of the country, where different drug use patterns were represented.

Len Sipes: Now one of the things I did want to get straight from the very beginning is the fact that we’ve had lots of evaluations of drug courts, but this is sort of what we call a meta examination. This is something large, this is something comprehensive, because you know, and you’re talking about different drug courts. So this particular evaluation, I think, is almost the final word on drug courts, or the best assessment that we have in terms of drug courts considering its complexity and the fact that it’s from around the country?

Shelli Rossman: Well, it’s a very comprehensive study. It’s not truly a meta analysis, because it doesn’t do a secondary analysis of data collected by other organizations or researchers. This was really original research in which we selected 23 drug courts based upon a nationwide survey we had done earlier, so that we could find out what the patterns among different drug courts were, and make sure that they were in this study. And then we selected six comparison jurisdictions. So this impact evaluation looks at outcomes for individuals who participate in drug courts compared to similar substance abusers who are participating in whatever is business as usual within their local jurisdiction. So it’s not a comparison of drug court treatment to no treatment, it’s a comparison of drug court treatment to whatever is standard throughout the United States.

Len Sipes: Right, I mean it’s, its pretty close to being an apples and apples comparison.

Shelli Rossman: Yes, it is.

Len Sipes: The title, by the way, is the Multi Site Adult Drug Court Evaluation Executive Summary, again, by the Urban Institute, funded by the Office of Justice Programs of the US Department of Justice, I take it?

Shelli Rossman: That’s correct, and it’s actually the Executive Summary has behind it four very detailed volumes that look at the results of our process, impact, and cost/benefit analysis and all of those are available both on the National Institute of Justice’s Drug Court website, and Urban Institutes website.

Len Sipes: And one of the things that I do want to say, as, as I mentioned before we hit the record button, the fact that, you know, the Urban Institute writes good reports.

Shelli Rossman: Thank you.

Len Sipes: There aren’t too many criminological organizations out there that know how to write and provide clear cut findings and clear cut policy implications for those of us on the practitioner side. So, I wanted to thank the Urban Institute for knowing what very few people seem to know in this country: how to write. I mean, the findings are clear and the findings are pretty interesting. So give me a description of the outcomes.

Shelli Rossman: Okay. Well, first of all I’d like to tell you a little bit about the scope of the study itself –

Len Sipes: Please.

Shelli Rossman: Beyond the jurisdictions. In terms of individual outcomes, we had a sample that was almost 1,800 persons strong.

Len Sipes: That’s a lot of people.

Shelli Rossman: It is, it’s large. It was 1,156 drug court participants and 625 substance abusers who were not offered drug courts, but would have been eligible –

Len Sipes: A large sample size.

Shelli Rossman: So they were a match sample. And the sources, we used several different sources of information to generate our findings. One was a series, three waves of very detailed, one and a half to two hour interviews at baseline, when people were either enrolled in drug court or the alternative comparison condition, and then at six months and 18 months later. At the 18 month administration, for those who were eligible and consented, we did a field test, an oral swap, to actually confirm independently whether or not individuals were using.

Len Sipes: Didn’t take their word for it, you proved it.

Shelli Rossman: That’s correct.

Len Sipes: Okay.

Shelli Rossman: And then we also collected administrative, official Criminal Justice Records from the state systems of the eight states and from the FBI and CIC database.

Len Sipes: As to whether or not they’d been arrested?

Shelli Rossman: Correct, correct and their lifetime criminal history –

Len Sipes: Right.

Shelli Rossman: So that we could compare over time. We also did a process evaluation that had us surveying the drug courts nationwide and using those, that information for the eight, for the specific 23 courts that participated, and we went and spoke with all the stakeholders, the drug court team, the judges. We also used a systematic rating protocol to observe each of the drug courts and to rate them and rank them on various characteristics of the court operations. So that’s the source of our information. What did we find?

Len Sipes: Yeah, what did you find? I mean everybody’s there going, okay, it’s Urban, it’s Department of Justice, we understand that you do good research, what did you find, Shelli?

Shelli Rossman: So the study, there are a number of drug court studies out there but most have focused on whether or not drug courts have an impact on reducing crime for their participants.

Len Sipes: Right, recidivism.

Shelli Rossman: And we certainly looked at that.

Len Sipes: Right.

Shelli Rossman: But as you mentioned earlier, we were also interested in knowing, do they reduce drug use and do they contribute to other positive psycho-social changes?

Len Sipes: Right.

Shelli Rossman: So in terms of drug use, we measured self reported, whether individuals reported the use of marijuana, alcohol, and heavy alcohol, which we defined as more than four drinks per day for women and more than five per day for men, whether they reported use of cocaine, heroin, amphetamines, and hallucinogens and then whether they misused, that is, illegally used prescription drugs, or illegally used methadone.

Len Sipes: All right, so you did the whole gambit, what did you find?

Shelli Rossman: Yes, we did. We found that at the 18 month follow up; looking at their use in the period from six months to 18 months, there was a statistically significant difference between the drug court participants and the comparison group on all drugs.

Len Sipes: All right, statistically significant means it wasn’t by chance, it was the result of the program?

Shelli Rossman: Correct. 56% of drug court participants reported using any of those substances within months six to 18, as compared to 76% of the comparison group.

Len Sipes: Okay, so that’s a 20% difference?

Shelli Rossman: Yes, it is, and that’s quite large.

Len Sipes: That’s a very large difference.

Shelli Rossman: Right, and when you, when you remove the two least harmful substances, that is, light alcohol use and marijuana, that difference still stands. 41% of drug court participants report use of the more serious drugs, as compared to 58% of the comparison group. Now –

Len Sipes: So a significant decrease in drug use?

Shelli Rossman: Very.

Len Sipes: And, and we know that drug use is heavily, heavily correlated with criminal activity.

Shelli Rossman: We do, and but we also measured crime independently. But I do want to point out something that’s very important about this. When I’m talking about measuring it through the 18 months, that captures a period of at least several months, post enrollment in the drug courts. So that means that these people have already finished their drug court participation by and large.

Len Sipes: And nobody was watching them.

Shelli Rossman: Exactly.

Len Sipes: And there were no consequences, there were no legal consequences for imbibing?

Shelli Rossman: Correct. Now most drug courts nationwide, and this holds true for most of the drug courts in our sample as well, offer the program for a one year period.

Len Sipes: Right.

Shelli Rossman: But people typically have a number of relapses that extends their stay in drug court.

Len Sipes: And that’s, and that’s a natural part of the whole drug treatment process, something that most people don’t realize.

Shelli Rossman: It’s one of the reasons why the courts use graduated sanctions rather than simply failing people out at the first time that they do not remain sober.

Len Sipes: Right, right. It’s not unusual for a person who even if he or she is committed to drug treatment, committed to kicking drugs, to pull a variety of positives.

Shelli Rossman: That’s correct.

Len Sipes: Okay.

Shelli Rossman: And the practical ramification for operating a drug court is it means that a 12 month program typically takes people maybe around 15 months to complete. And so when we’re doing a measure at 18 months, for most of these people, they’ve been out of drug court for several months and they are still sustaining the gains.

Len Sipes: Before getting into the other variables, I do want to talk about criminal activity, because you know, there is one particular finding that I find astounding. Of those reporting criminal activity at the 18 month follow up, drug court participants reported about half as many criminal acts – 43, versus 88 on average in the prior year. Half as many criminal acts. Now I don’t know of many studies, I’m used to seeing 15%. I’m used to seeing good studies being, I mean, very successful studies being 20%. You’ve cut it by half.

Shelli Rossman: Well we cut it, well, that’s not percentage though, that’s the number of criminal acts they reported.

Len Sipes: Right.

Shelli Rossman: So there are, there’s a difference. There are two different kinds of measurements. So we measured whether or not they reported engaging in crime.

Len Sipes: Right.

Shelli Rossman: And if we, if we used the same measure as we used, the same temporal measurement that we use for drug use, so at 18 months we looked at whether they self reported crime from months six to month 18, and there was a significant difference: 40% of the drug court group reported having engaged in crime as compared to 53% of the comparison group.

Len Sipes: Now that’s not based upon criminal record – that’s based upon surveys?

Shelli Rossman: Self reports.

Len Sipes: Self reports. But you know the interesting part is that there are increasing numbers of research reports based upon self report, and in a lot of cases, self report is not used. When self report is used, a lot of these programs show their full impact or their full potential to have an impact based upon self report. So sometimes I’m wondering why we’re not doing more self reporting and that’s one of the reasons I brought this up.

Shelli Rossman: We did both. And I want to make a couple points –

Len Sipes: Okay, go ahead.

Shelli Rossman: If you’ll let me?

Len Sipes: Oh, of course.

Shelli Rossman: So that, that looked at a one year period prior to the 18 month mark. We shaved that period and said, “Well, what about the last six months?” Because it might be that they were committing their crimes earlier in their program affiliation.

Len Sipes: Right.

Shelli Rossman: And so if we look at only the last six months, 31% of the drug court group, as compared to 43% of the other substance abusing offenders engaged in any kind of crime.

Len Sipes: Okay, that’s 31 to what?

Shelli Rossman: 31 to 43%.

Len Sipes: And that’s based upon official records or interviews?

Shelli Rossman: That’s also self report.

Len Sipes: Self reports, okay.

Shelli Rossman: But, but when we look at the official records, we get similar findings.

Len Sipes: Right.

Shelli Rossman: So we find for instance, that the rearrests, based upon administrative records and that’s at 24 months, 52% of the drug court participants had a rearrest at any point during the 24 months, as compared to 62% of the comparison group.

Len Sipes: Yeah, a significant, a significant difference.

Shelli Rossman: Ten percentage points, right?

Len Sipes: Okay.

[Audio Ends]

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Pretrial Supervision and Treatment-DC Public Safety Radio

See http://media.csosa.gov for our television shows, blog and transcripts.

Radio Program available at http://media.csosa.gov/podcast/audio/2011/12/pretrial-supervision-and-treatment-dc-public-safety-radio/

We welcome your comments or suggestions at leonard.sipes@csosa.gov or at Twitter at http://twitter.com/lensipes.

[Audio Begins]

Len Sipes:  From the nation’s capital, this is DC Public Safety.  I’m your host, Leonard Sipes.  Ladies and gentlemen, today’s topic is pretrial and treatment in pretrial and one of the main points that I want to make from the very beginning is the fact that where we have two million people in the present system throughout this country, we have  many millions more who are involved in the pretrial process.  They are arrested, they go through the pretrial process and this whole concept of treatment within pretrial, actually from a sheer numerical point of view, takes on much greater importance than those—than the discussion of treatment within the correctional setting.  There are literally millions of people going through the arrest process, going through the pretrial process, all throughout the United States and my guess is that the vast majority of them do not receive treatment of any kind by their pretrial agency.  To talk about this issue, we have two principals.  One is Terrence Walton, he is the Director of Treatment; and two, is Michael McGinnis, he is the Deputy Director of Treatment.  Both represent the Pretrial Services Agency for the District of Columbia and they’re my sister agency for the court services and a federal supervision agency.  Pretrial Services is a federal agency like we are at CSOSA.  And to Terrence and to Michael, welcome to DC Public Safety.

Michael McGinnis:  Well, thank you, Len, good to be here.

Terrence Walton:  Thank you.

Len Sipes:  All right, gentlemen, first of all, Michael, let’s go and set some basics up.  The Pretrial Services Agency for the District of Columbia does what?

Terrence Walton:  Why don’t I take that one if I could?

Michael McGinnis:  Yeah, go ahead.

Terrence Walton:  I’ll take it, all right.  Listen, the agency does a lot and it’s hard to capture it but essentially we’re responsible for two big tasks. The biggest task is and the first task is to assist the court in making release decisions. So when a defendant is arrested and is being considered for release, Pretrial Services conducts an interview, reviews criminal history, talks with the defendant directly, talks sometimes with collaterals to get a sense of who we have, and then recommends to the court either release or detention.  And if they’re going to be released, the many of them we recommend they be released with certain conditions that they must comply with.

Len Sipes:  Right.

Terrence Walton:  That’s our first big task, helping the court make good release decisions.

Len Sipes:  And a good release decision is based principally upon two things:  A) risk to public safety and B) whether or not the defendant will return for trial, do I have that right?

Terrence Walton:  That’s exactly right, that’s exactly right.  There’s lots of ways to say it, but those are the two big things. We don’t want them to jump bail, we don’t want them to disappear and we also don’t want a subsequent arrest if we can help prevent that.

Len Sipes:  And you’re talking about conditions of supervision.  There are many conditions of supervision.  You could put the person under GPS surveillance; have the person constantly being tracked.  There’s a lot of reporting requirements for that person and the treatment component, the very reason why we’re doing the program today, could be a component of pretrial release, it could be a condition of pretrial release.

Terrence Walton:  That is exactly right and in fact, because a significant number of defendants who are arrested in DC are testing positive for drugs or report drug use—in fact it’s about 33% of the adult population test positive for some drug other than marijuana.

Len Sipes:  Right.

Terrence Walton:  We don’t test for marijuana at lockup, so if we did, it would be twice that number.

Len Sipes:  Right.

Terrence Walton:  But we’ve talked about cocaine, heroin, PCP, amphetamines.

Len Sipes:  The drugs with the largest correlation to serious crime.

Terrence Walton:  That’s right, 33% of our population will test positive for that coming in the door and that’s 60% of the juveniles will test positive for some drug, and in that case it’s almost always marijuana.  So the size of those populations and for many of those adults, we’re recommending release conditions that include requirements that they drug test and that’s done by our agency and processed in our own lab, as well as other release conditions.  And that’s really the second big task.  The first big task is recommending release conditions.  And the second big task is supervising those conditions and keeping the court aware of how the defendant’s doing.  But I think Michael will agree with this, that it’s not simply just us overseeing and reporting what happens.  Pretrial Services is involved in trying to help motivate defendants, help them do the right thing, figure out their obstacles that will keep them from being able to comply and help them solve those problems.  So we see—we respond to the court, we have a law enforcement responsibility but we’re very much centered on the needs of the defendant and how best we can meet those needs in a way that helps them to do the right thing.

Len Sipes:  Well, Michael, the question goes over to you now.  For many people involved in the criminal justice system, they have mental health issues.

Michael McGinnis:  Um-hm.

Len Sipes:  How do we expect that individual to do well under pretrial or do well under any sort of supervision, whether they come over to us after they’re found guilty—how are they going to do well unless they get the treatment they need to stabilize themselves and to deal with their mental health issues, correct?  I mean, it does come down to that level of basics.

Michael McGinnis:  It definitely does and one of the things that we have here at the Pretrial Services, our Specialized Supervision Unit, and this is a unit that after a defendant is assessed and would be found perhaps with a current issue and they would meet the requirements of this unit, this is a unit that would—specializes in working with that population.

Len Sipes:  Um-hm.

Michael McGinnis:   So they could either be—they would get them immediately connected into a mental health program and a substance abuse program if needed.  If they were going to move them on to a mental health community court, you know, for diversion, that would be part of their job.  But all the PSOs that work in there have a background in working with this population.

Len Sipes:  And PSOs are?

Michael McGinnis:  Pretrial Service Officers.

Len Sipes:  Okay, fine, thanks.

Michael McGinnis:  Right, have a background on this unit and a great interest in working with this current population.  Which has, since I’ve been in this field and it’s been over 20 years working in this field, is this population is probably our most increasing population.

Len Sipes:  Um-hm, yeah, no doubt about it.

Michael McGinnis:  We had, when I started with pretrial, we had one unit, an SSU unit, that’s a Special Supervision Unit, and now, because of need, we have two.  So we have almost 18 Pretrial Services offices serving over 661 people in the program.

Len Sipes:  That’s amazing.  Terrence, give me a sense as to all the other treatment programs that you guys put on the table for people.

Terrence Walton:  Yeah, Michael mentioned the mental health component.

Len Sipes:  Right.

Terrence Walton:  We also have a unit that does nothing but assesses. We have a social services assessment center that assesses men and women who are released and even those who are being considered for release, we conduct both addiction assessments as well as mental health assessments from that shop.  Once we identify individuals who need treatment, there are really three big options for them, drug treatment.  One is the drug court program, which is the Superior Court Drug Intervention Program, a pretrial program that has been around since 1993.

Len Sipes:  A successful program that’s been noted nationally.

Terrence Walton:  Absolutely and one of the first ever to show up on the scene.  That’s the program of choice.  It has a complete regimen of incentives and sanctions, a single calendar, lots of contact with the judge

Len Sipes:  Right.

Terrence Walton:  Lots of opportunities for people to get the help that they need.

Len Sipes:  Right.

Terrence Walton:  For those—for folks that don’t qualify for drug court because of criminal history or some other disqualifier, we have another program called New Directions, which they can get the same treatment as a drug court defendant. The court supervision isn’t as close because these defendants are on various different calendars and they are incentives and sanctions, but while in drug court, there are both judicial sanctions, sanctions that come from the bench, from the judge as well as administrative sanctions, the ones that come from the supervision officer.  In New Directions, all sanctions are administrative, all administered by the supervising officer.

Len Sipes:  Right.

Terrence Walton:  Those are the two main programs.  There’s one other option.  Sometimes individuals are not eligible for New Directions either because they’re about to go to sentencing perhaps or some other reason.  We have another track for those, where we’ll put them in treatment somewhere, temporarily, under a sanction contract, primarily to prepare for a transition to CSOSA probation, to probation here in the city.

Len Sipes:  Right.

Terrence Walton:  So those are the three big options and they are all based on treatment needs.

Len Sipes:  So in essence it is a combination of either substance abuse or mental health, and Michael, these are all, I’m assuming, cognitive-based programs where we help the decision-making process of the individuals involved in the criminal justice system.  I mean, a lot of people don’t quite understand cognitive treatment but we really can, and the research is pretty clear on this, we really can intervene in the lives of other human beings and help them rethink their decision-making process.

Michael McGinnis:  Right, that’s the key word.  I mean, helping someone rethink what they’re doing.  You know, a lot of people that come in when they’re in the throes of an addition or they’re in this mode of what I call concrete-type thinking, that they’re repeating something over and over and getting the same result.  You know, especially in our treatment program, which is our PSA STARS program, most all of our interventions are of the cognitive, behavioral kind.

Len Sipes:  Right.

Michael McGinnis:   But what’s also important, I just wanted to speak to a point that Terrence was talking about.  In two of our programs, in the New Directions programs and in the drug court programs, the Pretrial Service offices that involved in those programs, they’re not only Pretrial Service offices, they’re also licensed clinicians and licensed substance abuse counselors.

Len Sipes:  Right.

Michael McGinnis:   So they’re providing not only the supervision but they’re also providing the clinical services, and that’s very unique to that program because they have a key perspective in working with the offender.

Len Sipes:  Well, that’s one of the points that I wanted to make.  Gentlemen, let’s cut to the chase. We are not just talking about pretrial in the District of Columbia; we’re talking about pretrial throughout the United States.

Michael McGinnis:  Yes.

Len Sipes:  Well, for that matter, we’re talking about pretrial in the western industrialized world.  Same situations for Canada, same situations for England, same situations for Australia, New Zealand, France.  These are all the same issues that everybody is wrestling with throughout the country.  We, in the District of Columbia, because we’re a federal agency, we have resources that the overwhelming majority of pretrial agencies do not have.  To my knowledge, the overwhelming majority of pretrial agencies don’t have a dime for treatment.  They have to put this person into a waiting list someplace and that person could wait quite some time before they get involved in treatment and for the love of heavens, they could have their trial before every get involved in treatment.  So there is that difference, we have to admit that right up front, correct?

Terrence Walton:  That’s correct.

Len Sipes:  Okay, the second thing is that you can tell within the stats.  I mean, we have one of the best return to trial rates in the United States.  Our stats are quite good.  And probably one of the reasons why they’re good is that we do have people involved in treatment programs because the research is abundantly clear it can’t just be a matter of supervision.  As I said to Michael at the very beginning, if you have somebody with a mental health problem, they need treatment.

Terrence Walton:  That’s right.

Len Sipes:  So if you combine treatment with supervision, you get better results.

Terrence Walton:  I think that’s right.  And Len, I want to add one other I think difference between what we have here in DC and what exists elsewhere in the country that doesn’t cost any money and that is, we have a Bail Act.  We have a statute that really supports Pretrial Services.  Most folks don’t know this but there are very few bail bondsmen in the District of Columbia.

Len Sipes:  Are there any?

Terrence Walton:  Very few.  There may be one or two but there are very few.  Because Pretrial Services as an industry, as a field I should say, has a belief in pretrial justice, essentially saying that if an individual needs to be detained, if they’re dangerous, they should be detained regardless of ability to pay.

Len Sipes:  Right.

Terrence Walton:  And if they don’t need to be detained, if they’re not a danger to society, then it’s fundamentally unfair for them to be held merely because they can’t afford to post bond.  So instead, we have a Bail Act, which heavily encourages the court to consider release of those who are safe to release with conditions, that pretrial supervises, that helps to assure public safety and return to court.  And that doesn’t cost money, that takes political will and it takes advocacy and it takes being able to battle the interest groups that wouldn’t like that.

Len Sipes:  Well, it does take come money because I would imagine judges sitting on the Superior Court for the District of Columbia know that there are treatment options, know that there are GPS options for following that person 24 hours a day if necessary, know that our staffing levels are probably lower than most pretrial agencies throughout the country.  My guess would be that the judge within the Superior Court here in the District of Columbia, they would be more apt to release a person on pretrial because they know they’re going into a top-rated organization that generally speaking does an excellent job of returning that person to trial

Michael McGinnis:  And I agree with you 100% and they also know that when a substance abuse problem is identified or a mental health issue is identified and is treated, the failure to appear and the re-arrest rates go down with the population that we’re working with.

Len Sipes:  Right, so they have –

Michael McGinnis:  And that is very big.

Len Sipes:  Yeah, and if a judge in Milwaukee wants to put the person on pretrial, I would imagine he or she is going to say, well, you know, well, they were handling cases of 200 to 1, 200 defendants to 1 Pretrial Services officer, they have on room for treatment, gee, I’d better stick this person in jail.  So I would imagine that you save the system money as well as have a higher rate of success.

Terrence Walton:  Well that’s exactly right.  I mean, some of us are motivated by the fact that it seems fundamentally fairer to do it this way, but others, the reality is, is it saves money. That if we can allow a person to stay in their community and at the meantime address their pro-social needs, we save in jail costs.  That’s another important point.

Len Sipes:  Ladies and gentlemen, our guests today are Terrence Walton, he’s the Director of Treatment; and Michael McGinnis, the Deputy Director of Treatment for the Pretrial Services Agency for the District of Columbia, a federal agency.  The website is: www.psa.gov.  As I move throughout the country and as I talk to my counterparts throughout the country, they ask about Pretrial Services Agency for the District of Columbia.  It’s one of the best-known pretrial agencies in the country and having one of the best reputations.  Principally I think, because we have a level of funding that so many other agencies simply do not have and the level of training and a level—you’re just a good agency and I think people recognize that within the criminal justice system throughout the country.  Alright, where do we go to from here?  So the average person in the District of Columbia, the average person in Milwaukee—why am I bringing up Milwaukee so many times today?  The average person in Honolulu, the average person in Anchorage, Alaska says to themselves, the police finally got this idiot who’s been bothering the community and three hours later, he’s back on the street.  Where is the justice in that?  So you guys face that issue all the time.  I mean, we have to hit that square, that nail squarely on the head and what people don’t understand is that they are defendants, they are not offenders and within our system, you are not guilty until you’re proven guilty, correct?

Michael McGinnis:  That’s correct.

Terrence Walton:  No, that’s right, and you know, there’s a balance here, that there’s a constitutional presumption of innocence and that means that unlike convicted offenders, the individuals who have not yet actually been convicted of their offense, have certain rights, and that we go to great effort to be sure that we’re using the least restrictive means possible to assure community safety.  Now I want to put a caveat there because we respect the presumption of innocence, but recognize the possibility of guilt.  And so because of that second piece, that’s the reason why we also assess criminal history, we assess the seriousness of the charge so that in the event this person is guilty, how serious is this, and that is factored into our recommendations.

Len Sipes:  And you’re not talking about a short assessment, you’re talking about a rather lengthy, well thought-out assessment in terms of trying to get at that person’s risk to the community and that person’s treatment needs and that person’s past criminal history.  I mean, it’s a pretty complete overview that you do with that individual.  When you make those recommendations to the court, you probably know more about that person than his kid brother.

Terrence Walton:  Well, that may be true and it happens in a couple of stages.  There was the initial stage, pre-release, where we do a comprehensive interview and review the records that we have to make initial decisions.  But also other factors are considered there, that there are sometimes prosecutors who have positions and defense attorneys who have information, that’s all presented to the court as they’re making a release decision.  Once the defendant is released, if he or she is released to our supervision, then if we have any reason to think they need one, we do an additional assessment, a clinical needs assessment that’s designed to look at both treatment needs, at mental health needs as well as social service needs.

Len Sipes:  And many people caught up in the criminal justice system do have needs.  I mean, there was a piece of research out a little while ago and now—I remarked on Milwaukee or kept bringing Milwaukee up a little while ago, now I’m bringing mental health back up—that 55%, according to a Department of Justice document, 55% of people called up in the criminal justice system self-assess or assess themselves.  It was not a political designation but they did a self-assessment as having mental health issues.  So this issue of mental health is something that is really driving much of our service component within the criminal justice system, assuming we have the programs there to service them to begin with.

Michael McGinnis:   I think unfortunately, our prisons have been used as our mental health treatment centers in this country and as you’re saying, most people, when they—  To go back, I just want to go back to what you were talking about—

Len Sipes:  Please, please, Michael.

Michael McGinnis: -our funding here.  It’s not only that we have the funding to provide these services.  Our Director, Susan Shaffer, is also a real believer in the treatment of the offender that comes in and she puts a lot of her energies and times into this.  And it really is a big piece of our agency because before I came to pretrial, I’d been running programs for alternatives to incarcerations, therapeutic communities.

Len Sipes:  Right.

Michael McGinnis:  Taking programs behind the wall.  And people are just cycling in and out of these, of our prisons without having these issues identified.

Len Sipes:  But that’s the fundamental problem because I’ve talked to my peers throughout the country and they’re going to go, Leonard, I hear you on your daggone radio programs and you focus on public safety first, but you say that you have to have these treatment components because the research is clear that supervision doesn’t work unless you have a treatment component, and I got news for you, Leonard, I don’t have a dime for treatment.  You know, but I want that person to get mental health treatment, substance abuse treatment, if I want to find some assistance in terms of that person getting work or getting occupational training, I’ve go to put him in a long line, where that person basically waits for months, unless I get a court order to move that person to the head of the line.  There’s a lot of frustration out there, we all believe in treatment, we all believe in that component being necessary, but most of us don’t have the money for it.

Terrence Walton:  Well, there’s no easy answer to that.  What many communities have done is done the best they can to leverage the resources that exist.  There is professional treatment, there are faith-based organizations, there are peer support groups, which isn’t formal treatment, but it can sometimes do the same job.  There are lots of options in most communities, especially around alcohol and drug issues, for people who need help to get some of that.  You know, I also encourage—there continues to be federal monies and state monies and grants available for organizations who have a will to go after it.  It’s just worth doing it.

Michael McGinnis:   I think it’s—but it’s a great point, Terrence, because you and I were just kind of talking about this earlier this morning, is the whole field is moving more towards this recovery-orientated system of care, where we’re kind of looking at some—that treatment, that line for treatment is different for everyone and there are many options, like faith-based options, there are community options, I think a lot of these other pretrial service organizations that might not have the funding, you know, to have their own treatment centers or put people in treatment—they need to look to these community organizations, to start partnering with these community organizations in hopes of linking their offenders up to services.

Len Sipes:  Well, and everybody’s got to come together and make this a priority.  I mean, there is limited treatment monies available, but as you all have said, I mean, there’s the Salvation Army, there’s the faith-based community, there are private individuals, there are people who will do this on a pro bono basis.  You’ve got to have the will to go out there and make those connections and that becomes extraordinarily important.  But I do believe that again, one of the reasons why we do as well as we do is because look at the two of you—I mean, we have the Director and Assistant Director of Treatment for a pretrial agency.  I mean, there are people, organizations out there that would kill to have a Terrence Walton and a Michael McGinnis sitting before their microphones.

Terrence Walton:  Well, Len, you know, it starts with the will though.  I mean, it starts with the desire, recognition that it’s important, that it’s necessary. And I want to take a minute to share something with our listeners that I think is important, that helps to underscore why it’s so important that we address the underlying issues of men and women who come through our systems.  The American Society of Addiction Medicine is a really collection of physicians who practice addiction medicine and who sort of govern the field and give us guidance and space on research and medicine to help us understand addiction and addition recovery.  And they’ve recently come out with a new policy statement that we don’t have time to go over—I hope people will go to asam.org to see more details.  But they’ve given for the first time a policy statement defining addiction.  And let me give you the most interesting piece of that to me, that they have defined addition primarily as a brain disease, a disease that affects a couple of major systems in the brain.  One is the reward system, as well as the command center, the logic and reason system of the brain.  And here’s what important.  They have through PET scans and SPECT images and MRTs, they have been able to look at brain activity and identify deficits in those areas of active addicts. But here’s what’s interesting.  We’ve known that for a long time and we’ve assumed that it’s the drug use that has caused those problems.

Len Sipes:  Right.

Terrence Walton:  What ASAM and other researchers have discovered is that for many, probably most current addicts, those brain deficiencies existed before they ever picked up a drug.

Len Sipes:  That’s interesting.

Terrence Walton:  It might have been genetic or as a result of traumatic life experiences growing up that changed the –

Len Sipes:  A biological predisposition.

Terrence Walton:  Absolutely.

Len Sipes:  That biological predisposition, by the way, is clearly there established for alcoholism as well.

Terrence Walton:  Absolutely.

Len Sipes:  So why wouldn’t that biological predisposition be there for substance abuse.

Terrence Walton:  That’s right.  So there’s the biological piece as well as the environmental that they have done studies on monkeys and others that—and I wish I had time to tell you about one—but where they demonstrated that by changing the environmental situation, by depriving organisms of nurturing and affiliation, that they change their brains.

Len Sipes:  Give the public a sense of hope here because I’ve said that the research is abundantly clear.  They do better with a combination of supervision.  And we’re not leaving out the supervision component.  Whether that person’s in treatment or not, we still supervise that person to the best of our availability and that could include, again GPS supervision where we track them 24 hours a day, 365 days a year.  We’re not leaving out the supervision component.  And sometimes supervision is an integral part of treatment.  Sometimes that supervision officer, their first question is, are you taking your medication, are you going to treatment?  Well, we know whether they’re going to treatment regardless.  So sometimes that supervision component is an integral part of the treatment component but the bottom line is, to the public who, you know, say to themselves, you know, look, I’ve got schools underfunded, I’ve got the elderly to take care of, you’re talking about treatment for criminals for the love of heavens—defendants, I understand.  You know, we have to give them a sense of hope that what we do is successful and not only in the life of that individual, but we are protecting them by doing this and we’re doing that correct?

Michael McGinnis:  Well, of course we are.  I mean, I think as we all know here, there’s not enough jail cells across this country to put people in and treating people is a lot less expensive than putting people behind—

Len Sipes:  So it’s going to save them their taxpaying dollars.

Michael McGinnis:  There’s studies out for every dollar that’s invested in treatment.  There’s a savings of $4 on that individual.

Len Sipes:  And years ago, Rand said it was 7 to 1.

Michael McGinnis:  Yeah.

Len Sipes:  We’re also protecting public safety though.

Michael McGinnis:  Right.

Len Sipes:  I mean, that is a message that needs to be put on the table that their life is going to be safer if we provide substance abuse treatment or mental health treatment.

Terrence Walton:  If you don’t treat an addict, if you simply incarcerate an addict, when they come out eventually, and the vast majority of men and women who are incarcerated are eventually released.

Len Sipes:  Right.

Terrence Walton:  They will still be an addict.

Len Sipes:  Right.

Terrence Walton:  And so all of the problems that causes to our property and our lives and well-being will just continue.  It is a smart investment to see if we can address those issues and the justice system is helpful because it gives—holds people accountable and it gives them a little external motivation to stick with it, to go to the groups, to take the medicine until it kicks in naturally.  It’s an essential component.

Len Sipes:  But get back to the public safety point again because I do want to keep hammering this point home.  If the person doesn’t do well, the person doesn’t go to treatment, doesn’t take their medication, is not enthusi—well, not enthusiastically involved—is not meaningfully involved in the treatment process, we go back to the court and they could choose to incarcerate that person until trial.

Terrence Walton:  Well, that’s right, there’s some whose releases are revoked based on a decision that they are a danger to society if they aren’t treated successfully.  And there’s also in the drug court, there’s a number of other possible sanctions short of incarceration that’s designed to punish the behavior quickly and briefly and encourage them to get back on track.

Len Sipes:  And motivate them all at the same time.

Terrence Walton:  That’s right.

Len Sipes:  To get back on the track.  Okay, final minute of the program.  We save the public, the research states that we save the public a ton of money through the treatment and supervision process, number two that we enhance public safety, their odds of being victimized by this individual are greatly decreased, so we do that.  What am I missing, what is the final word on what the public needs to hear?

Terrence Walton:  Oh, I guess the final word would be that this matters to each and every one of us, that most of us have been affected by addiction and crime, one way or the other and this is a good, wise investment for anyone who cares about this.  And I encourage communities out there to do the best they can to make it happen.

Len Sipes:  Terrence, you’ve got the final word.  Ladies and gentlemen, our guests today, Terrence Walton, Director of Treatment and Michael McGinnis, the Deputy Director of Treatment of the Pretrial Services Agency for the District of Columbia.  It’s a federal agency, www.psa.gov.  The program that Terrence mentioned in terms of drug standards, substance abuse standards, asam.org.  Ladies and gentlemen again, this is DC Public Safety.  We appreciate your calls, we appreciate your letters, we appreciate your emails and we appreciate your guidance and please have yourselves a very, very pleasant day.

[Audio Ends]

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