Presented by: Angela Hawken, PhD October 22, 2010 ACJRCA
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Transcript of Presented by: Angela Hawken, PhD October 22, 2010 ACJRCA
Managing drug-involved offenders
with HOPE
Presented by:Angela Hawken, PhD
October 22, 2010ACJRCA
Managing drug offenders Probation departments are on the front lines to
reduce drug dependence Managing high caseloads with limited supervision and
drug treatment resources A large number of non-violent drug offenders will go on to
commit non-drug crimes
Important approaches
Treatment diversion (e.g., Proposition 36) Drug courts
Managing Drug-involved Offenders:
Diversion Programs
Characteristics of diversion programs
Mandates treatment for all; even those without a diagnosable substance abuse disorder.
Treatment decisions based on self-reported behavior
Limited use of sanctions
Treatment diversion – example California’s Proposition 36
Only 25% completed the treatment to which they were mandated.
Why? Little enforcement Poorly matched treatment
The result?
Increase in Arrests (30 Month follow-up)
56
17
6
61
17
5
43
10 4
0
20
40
60
80
100
New drug arrest New property arrest New violent arrest
Perc
ent o
f off
ende
rs
Referred but untreated Comparison GroupEntered but did not complete treatmentCompleted treatment
40
11 4
Treatment provider perceptions of why Prop 36 clients did not complete their planned treatment.
63%
74%
18%
30%
17%19%
0
10
20
30
40
50
60
70
80
Transportation Work schedule Housing Familyresponsibilities
Unwilling tocomply
Motivation
Perc
ent
Notes: Data are from the 2007 Proposition 36 Treatment Provider Survey. The results reflect responses from randomly selected Proposition 36 Treatment Providers (n = 87).
Providers’ perceptions – would jail sanctions for non-compliance improve treatment outcomes?
19%
1%
80%
0
20
40
60
80
100
No Maybe Yes
Perc
ent
Notes: Data are from the 2007 Prop 36 Treatment Provider Survey. The results reflect responses from randomly selected Prop 36 Treatment Providers (n = 87).
Managing drug-involved offenders:
The Drug Court approach
Drug courts The drug court movement has been very
successful and has demonstrated good outcomes
Resource intensive =>problems with scale In many jurisdictions – the wrong clients are
being servedProsecutor discretionConcern with evaluation outcomes
Why Drug Courts face problems with scale Role of the judge: regularly scheduled
meetings Role of treatment: all clients are mandated
to treatment Typical caseload is 50-100 probationers
$$$
A new alternative model BEHAVIORAL TRIAGE
Behavioral Triage Model Not everyone is mandated to treatment Monitoring and treatment decisions based
on probationers’ observed behavior not self-report
Allocates treatment resources more efficientlyMany drug-involved probationers do not have
a diagnosable substance abuse disorder, wasting scare treatment resources and displacing self-referrals in greater need of care.
Example: Hawaii’s HOPE
Probation conditions are actually enforced Regular random drug testing Violations result in swift and certain but
modest sanctions No one mandated to treatment if
complying (but provided if asked) Three or more violations => treatment
mandate
HOPE Two Studies
Integrated Community Sanctions Unit (Specialized Probation Unit)
Outcomes compared for HOPE probationers and a comparison group of probationers (TAU).
Smaller caseloads (~90:1)Adult Client Services (General Probation Unit)
Intent-to-treat randomized controlled trial Larger caseloads (~180:1)
Eligibility
Probationers were indentified as:Drug-involvedDemonstrated non-complianceHigh risk of revocation
FINDINGS
Summary of RCT outcomes
Outcome HOPE Control
No-shows for probation appointments (average
of appointments per probationer)
9% 23%
Positive urine tests (average of tests per
probationer)
13% 46%
New arrest rate (probationers rearrested) 21% 47%
Revocation rate (probationers revoked) 7%* 15%
Incarceration (days sentenced) 138 days* 267 days
HOPE AS A BEHAVIORAL TRIAGE MODEL
Distribution of positive drug tests
0 1 or more 2 or more 3 or more 4 or more 5 or more0%
10%
20%
30%
40%
50%
60%
51%49%
21%
9%
5%1%
Perc
enta
ge
Process integrity
Tenets of HOPE are research basedSanctions are certain.Sanctions are swift.Sanctions are consistent.Sanctions are modest.
Probationers’ Perceptions (n=211)
In Treatment In Jail Specialised Unit General Unit0%
10%
20%
30%
40%
50%
60%
70%
80%
Positive Neutral Negative
Perc
enta
ge
Remaining questions
HOPE for all?A minority of probationers do not comply even
when faced with repeat sanctions. 30 HOPE probationers were transferred to drug court.
Whether HOPE generalizes is an unanswered question
Whether HOPE effects persist after probation is complete is an unanswered question (only 1 year follow-up)