Characteristics and Outcomes of an Innovative Ohio Juvenile Offender Reentry Program (ORP-J)

David Hussey & Rodney Thomas, Mandel School of Applied Social Sciences, Case Western Reserve UniversityKarl Cetina, Director of Cuyahoga County Juvenile TASC, Catholic Charities ServicesGina Mazzone, Catholic Charities ServicesMagistrate Terease Neff, Cuyahoga County Juvenile Court Ian Fraser, Regional Administrator, Ohio Department of Youth Services

Abstract

The purpose of this workshop is to describe and discuss the components of an innovative juvenile offender reentry program, and explore the relationship between client characteristics, program factors, and individual outcomes related to criminal offending, mental health, and substance abuse.

RECLAIM• Funds over 610 direct service programs throughout the State• Prevention, diversion, community based treatment, and residential

treatment• Touch nearly 110,000 youth who never reach our doors

ACCOMPLISHMENTS• Created a network of community-based alternatives to incarceration • Youth arrest and crime rates continue to fall • Reduced the county’s and state’s over-reliance on confinement

National Trends – Number of persons under age 21 detained, incarcerated, or placed in residential facilities (1997-2010)

1997 1999 2001 2003 2006 2007 201050,000

60,000

70,000

80,000

90,000

100,000

110,000

120,000

105,055107,493

104,219

96,53192,721

86,814

70,792

Num

ber o

f Pe

rson

Und

er 2

1

DYS Admissions 2004-2011(ODYS Deputy Director Dies, JDAI Inter-Site Conference, 4/26/12)

National Trends – Rate of persons under age 21 detained, incarcerated, or placed in residential facilities (1997-2010)

1997 1999 2001 2003 2006 2007 2010100

150

200

250

300

350

400

356 355335

306295

278

225

329344 344

316 320339

227

United StatesOhio

Num

ber i

n re

side

ntia

l pla

cem

ent p

er

100,

000

juve

nile

s

2012 Cuyahoga - Documented Weapon Use

Yes42%

No35%

Unk23%

2012 Cuyahoga - Need for Substance Abuse Services (JASAE)

None24%

Mild8%

Mod8%

Severe59%

Cuyahoga County DYS Youth Profile• Male: 95%• Immediate Family Member Incarcerated: 51%

– 25% unknown• Youth Confirmed as Parents: 12%• Special Education Status: 39%• Prior Mental Health Treatment: 76%• DYS Mental Health Caseload: 57%

– Males: 55%– Females: 100%– Currently on Psychotropics: 54%

Current Challenges (Columbus Dispatch, The Ohio

Model, 1/10/13)“Ohio now spends $38 million less than it did three years ago. One-year recidivism rates (kids who reoffended) dropped to under 23 percent. That’s the lowest in nine years. More-compassionate punishment isn’t signaling to kids that they can get away with delinquent behavior; instead, it’s redeeming them: Ohio led the nation with the largest drop — a 74 percent plunge — in violent juvenile crime between 1995 and 2010. The state has closed more than half of its youth prisons since 2007. The number of incarcerated youths has dropped from 2,000 to about 500. But this has left the state institutions with a core of truly incorrigible kids…Gangs are prevalent, teaching conditions are poor, and youth aren’t getting enough help for mental illnesses. Currently, 52 percent of all youths are on the mental-health caseload; 91% of the girls are. More than half require special-education services.”

ORP & TASC: Challenges and Opportunities

• Treatment Accountability for Safer Communities (TASC)• Offender Reentry Project (ORP-J): Substance Abuse

Mental Health Services Administration (SAMHSA)– Pre-Release: Engagement, Evidence-Based

Assessment, Planning & Services– Post Release: Tx Dosage; Retention; MET/CBT5;

Comprehensive Case Management; Relapse Prevention; Dual Disorder Awareness and Intervention

– Reentry Court– Establish effective partnerships and coalitions

TASC Clinical Case Management Model

• Referral• Screening or Clinical Assessment• Recommendations & Service Planning• Service Referrals, Linkage, & Placement• Monitoring, Reporting (Service Plan

Adjustments)• Termination

TASC Advantages

• Timely assessments• Greater treatment retention• Improves client readiness• Provides additional services

Pre-Release: Evidence-Based Assessments

• Ohio Youth Assessment System (OYAS)• Global Appraisal of Individual Needs

(GAIN)

Pre-Release: Ohio Youth Risk Assessment System - OYAS

• Based on risk, need, responsivity principles

• Low, moderate, high risk categories• Multiple versions & domains

ORP-J Population Description

16

Global Appraisal of Individual Needs (GAIN)• GAIN Background• Assessment• Client Profiles

– Demographic– Criminal– Substance Abuse– Mental Health– Victimization

• N=139 (total number of client records)

– 100% male– 78% African American, 10% multiracial, 6% Caucasian,

2% any Hispanic, 1% other– Average age= 17 years (range=13-20)

• 139 administered GAIN at intake– 101 with 3-month GAIN– 77 with 6-month GAIN– 33 with 12-month GAIN

18

ORP-J Client Race (N=139)

African Amer-ican\Black

77%

Caucasian\White 6%

Hispanic 2%

Multiracial 14% Other 1%

ORP-J Client Age (N=139)

Less than 15 years2%

15-17 years55%

18+ years43%

21

Got Drunk or High Kept from Meeting Responsibilities

Used Alcohol Used Marijuana-10

10

30

50

70

90

35

138

36

Substance Use Past 90-Days in the Community (N=139)

Aver

age

Num

ber o

f Day

s

ORP Lifetime Substance Severity (N=139)

No Use Use Abuse Dependence Physiological Dependence

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

9%

25%20%

14%

31%

Perc

enta

ge

23

Given up activites b/c of AOD

Fights/Troubles b/c AOD

AOD caused prob-lems w/law

Hide AOD use Other complain about AOD use

Used AOD where unsafe

0

20

40

60

80

100

41% 44%35%

51% 54%

33%

Lifetime Substance Use Characteristics at Base-line (N=139)

Life

time

Per

cent

age

Past Year Internalizing Problems (N=139)

Any P

ast Y

ear In

terna

lizing

Diso

rder

Major D

epres

sion D

isorde

r

Genera

lized

Anx

iety D

isorde

r

Suicida

l Tho

ughts

or A

ction

s

Traumati

c Dist

ress D

isorde

r0%

10%20%30%40%50%60%70%80%90%

100%

17%11%

1% 5%9%

Perc

enta

ge

Past Year Externalizing Problems (N=139)

Any P

ast Y

ear E

xterna

lizing

Diso

rder

Condu

ct Diso

rder

Attenti

on D

eficit

-Hyp

eracti

vity D

isorde

r0%

10%20%30%40%50%60%70%80%90%

100%

55%

35%42%

Perc

enta

ge

Past Year Co-Occurring Internalizing and Externalizing Problems (N=139)

Neither Externalizing only Internalizing only Both0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

41% 42%

4%

12%

Perc

enta

ge

Lifetime Victimization (N=139)

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

54% 52%

22%

Perc

enta

ge

Violence and Illegal Activity (N=139)

Any V

iolen

ce or

Illeg

al Acti

vity

Acts of

Phy

sical

Violen

ce

Any Ill

egal

Activit

y

Propert

y crim

es

Interp

erson

al cri

mes

Drug re

lated

crim

es0%

10%20%30%40%50%60%70%80%90%

100%86%

78%

46%

31%25%

14%

Perc

enta

ge

ReCAPP Structure• Phase I: Begins Pre-Release – TASC worker meetings;

Forward Thinking Curriculum; Magistrate specifies 1-2 Phase 2 tasks.

• Phase 2: Focus on Basic Reentry Goals; Magistrate specifies 1-2 tasks & issues rewards or sanctions; promote to level 3 (or team if not successful in 60 days).

• Phase 3: Begins when basic reentry goals attained; maintain Phase 2 progress; Magistrate specifies 1-2 tasks & issues rewards or sanctions.– 6 month parole period = early discharge at 4 months– 9 month parole period = early discharge at 6-7 months

Forward Thinking

Pre-Release: ORP Flow

Youth receives OYAS Risk Assessment at CCJC prior to commitment. Youth identified at Reception as ORP-J candidate and given further screen/assessment. Youth agrees to be involved in ORP-J and transferred to CHJCF or IRJCF

ODYS site Social Worker (SW) primary liaison with Juvenile TASC ORP-J Case Manager, Reentry Coordinator, PO from Cleveland Region. Formal Staffing meeting with youth/family may lead to referral to TASC and Reentry Court (REC); 16-week Cognitive-Behavioral Forward Thinking Curriculum

Final Staffing (30 days prior to release) for reentry plan (Unified Case Plan – UCP) and Reentry Court (REC) start date; GAIN-I Assessment & OYAS completed

Post Release: ORP Flow

Phase one of Re-Entry Court (REC) begins on the 2nd or 4th Monday of the month. ORP-J Youth, Parent(s), JPO, TASC Case Manager, and other relevant stakeholders collaborate in order to administer appropriate incentives and necessary sanctions. Weekly drug screens begin.

TASC Case Manager assists youth with engaging and following through with a minimum of 5 weekly MET/CBT-5 individual treatment sessions in non-intensive outpatient at Catholic Charities Services, and providing family sessions as needed.

Within 24 hours of the youth’s release to the community, the youth reports to the Juvenile Parole Officer (JPO). At this face-to-face meeting, all community stakeholders participate. TASC continues with weekly case management services back in the community for six months post-release.

The Juvenile Parole Officer maintains weekly contact with ORP-J Youth and monitors collateral services with TASC case manager and family. The GAIN Assessment, completed in the pre-release phase, helps to determine appropriate level of care.

Post Release Components• Parole supervision & monitoring• Drug screening• Reentry Court• Case management• Level of care services• MET/CBT-5

Case Study #1

35

Results

36

General Crime

Property Crime

Interpersonal Crime

Drug Crime012345

1.6

0.6 0.5 0.20.5

0.2 0.1 0.1

Changes in Criminal Activity 3-Month Follow-Up (n=101)

Intake3-Month

Aver

age

Num

ber o

f Crim

es P

ast 9

0 Da

ys

37

General Crime

Property Crime

Interpersonal Crime

Drug Crime012345

1.7

0.6 0.5 0.20.3 0.2 0.1 0.0

Changes in Criminal Activity 6-Month Follow-Up (n=77)

Intake6-Month

Aver

age

Num

ber o

f Crim

es P

ast 9

0 Da

ys

38

General Crime

Property Crime

Interpersonal Crime

Drug Crime012345

1.9

0.7 0.70.20.1 0.1 0.0 0.0

Changes in Criminal Activity 12-Month Follow-Up (n=33)

Intake12-Month

Aver

age

Num

ber o

f Crim

es P

ast 9

0 Da

ys

39

Average days got drunk Average days smoked marijuana

0102030405060

4.1

37.9

0.77.9

Changes in Substance Use 3-Month Follow-Up (n=94)

Intake3-Month

Ave

rage

Num

ber o

f Tim

es P

ast 9

0 D

ays

40

Average days got drunk Average days smoked marijuana

0102030405060

3.2

34.9

0.48.4

Changes in Substance Use 6-Month Follow-Up (n=54)

Intake6-Month

Ave

rage

Num

ber o

f Tim

es P

ast 9

0 D

ays

41

Average days got drunk Average days smoked marijuana

0102030405060

4.0

34.8

0.6 5.5

Changes in Substance Use 12-Month Follow-Up (n=25)

Intake3-Month

Ave

rage

Num

ber o

f Tim

es P

ast 9

0 D

ays

42

Conduct Disorder Symptoms0

5

10

15

2.7 1.5

Changes in Conduct Disorder3-Month Follow-Up (n=101)

Intake3-Month

Cond

uct D

isor

der S

cale

Sco

re

43

Conduct Disorder Symptoms0

5

10

15

2.7 1.3

Changes in Conduct Disorder6-Month Follow-Up (n=77)

Intake6-Month

Cond

uct D

isor

der S

cale

Sco

re

44

Conduct Disorder Symptoms0

5

10

15

3.31.0

Changes in Conduct Disorder12-Month Follow-Up (n=33)

Intake3-Month

Cond

uct D

isor

der S

cale

Sco

re

45

Traumatic Stress Levels0

5

10

15

1.2 0.9

Changes in Traumatic Stress Levels3-Month Follow-Up (n=100)

Intake3-Month

Trau

mat

ic S

tress

Sca

le S

core

46

Traumatic Stress Levels0

5

10

15

1.5 0.5

Changes in Traumatic Stress Levels6-Month Follow-Up (n=76)

Intake6-Month

Trau

mat

ic S

tress

Sca

le S

core

47

Traumatic Stress Levels0

5

10

15

1.90.2

Changes in Traumatic Stress Levels12-Month Follow-Up (n=33)

Intake12-Month

Trau

mat

ic S

tress

Sca

le S

core

48

Behavior Complexity Levels0

5

10

15

9.96.5

Changes in Behavior Complexity3-Month Follow-Up (n=101)

Intake3-Month

Beha

vior

Com

plex

ity S

cale

Sco

re

49

Behavior Complexity Levels0

5

10

15

9.96.8

Changes in Behavior Complexity6-Month Follow-Up (n=77)

Intake6-Month

Beha

vior

Com

plex

ity S

cale

Sco

re

50

Behavior Complexity Levels0

5

10

1511.7

5.5

Changes in Behavior Complexity12-Month Follow-Up (n=33)

Intake12-Month

Beha

vior

Com

plex

ity S

cale

Sco

re

Conclusions, 112-month Outcomes

(For the subset of 33 individuals with 12-month GAIN data)

• Significant decreases in alcohol and marijuana use.

• Significant deceases in criminal activity, including property, interpersonal, and drug crime.

• Significant decreases in conduct disorders.

• Significant decreases in behavior complexity.

• Significant decreases in traumatic stress levels.

51

Implications & Limitations

• Effective reentry program designs (e.g., best practices/EBPs; behavioral criminogenic focus; etc.) must integrate an implementation science focus

• Particularly salient program features:– Early Engagement: Motivation; therapeutic relationship; retention &

dosage– Continuity, Coordination, & Comprehensiveness of Care: Structure;

evidence-based programming; consistency of staff, monitoring, communication (messaging); and coordination

• Limitations: Attrition; lack of control/comparison group

Thank you…Karl M. Cetina MPA, LICDC-CSPresident of the Ohio TASC AssociationDirector of Juvenile TASC for Cuyahoga CountyCatholic Charities, Diocese of Cleveland 3135 Euclid Avenue- Cleveland, Ohio 44115Phone: 216-391-2064 ext. 13kmcetina@clevelandcatholiccharities.org

Gina Mazzone LSW, MSW, LCDC IIICatholic Charities3135 Euclid AveCleveland, OH 44115gmazzone@clevelandcatholiccharities.org

53

David Hussey, PhD.Rodney Thomas, M.A.The Begun Center for Violence Prevention Research & EducationMandel School of Applied Social SciencesCase Western Reserve University11402 Bellflower RoadCleveland, Ohio 44106Ph: 216-368-3162David.Hussey@case.eduRodney.thomas@case.edu