Professional Documents
Culture Documents
in North Carolina
Behavioral Health
Analysis
November 16 , 2010
What Works
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Current Efforts In North Carolina
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Alcohol and Drug Use Disorders:
Household v. Jail v. State Prison
Percent of Population
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Serious Mental Illnesses:
General Population vs. Jail vs. State Prison
Percentage of Population
Source: General Population (Kessler et al. 1996), Jail (Steadman et al, 2009), Prison (Ditton 1999)
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N a tio n a l E stim a te s : Behavioral Health
Disorders are Prevalent in Justice-Involved
Population
ith substance use and co - occurring mental health disorder
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Mental Illnesses are Brain Disorders as Well
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Principles of Treatment for Justice Involved
Persons with Behavioral Health Disorders
Low High
Risk of
Recidivism
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Supervise high-risk offenders closely
and mandate treatment.
Impact on Recidivism Rates
Intensive
Drug Treatment in Drug Treatment in
Supervision +
Jail Settings the Community
Treatment
0%
- 6%
- 8%
- 18%
Elizabeth Drake, Steve Aos, and Marna Miller (2009). Evidence-Based Public Policy Options to Reduce Crime and Criminal
Justice Costs: Implications in Washington State. Olympia: Washington State Institute for Public Policy. Victims and
Offenders, 4:170–196.
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What Works as Effective Interventions?
Specialized
ice - Based Responses
Integrated
Specialty Courts
Treatment
Integrated
and Supervision
Treatment: Probation
and Superv
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W h a t W o rk s S u m m a ry
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Overview
What Works
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Current Efforts In North Carolina
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Behavioral Health Stakeholders
Specialized
ice - Based Responses
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Drug Courts are Focus of Court-based
Interventions
Specialty Courts
Community Prison&
Arrest & Jail Court Corrections Supervision
ult DTCs in district and superior court with some emphasis on high risk and need
tal Health Courts
21 Sentencing Services programs operate in 57 counties
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Current Practices: Probation Behavioral
Health
gement Model (OMM) jointly developed by DOC and HHS to guide supervision practice
rry and Black Mountain provide some opportunity for integrating treatment and s
ed to link courts, community corrections and treatment
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Current Practices: Prison Behavioral Health
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Current Practice: Staff and Programs
Probation
1 , 400 Probation Officers ; $120 Million
110 , 000 Probationers
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NC Still Spends More than $200 Million
Incarcerating Probationers with BH
Treatment Needs
FY09 Probation Revocations to Prison
MH SASSI Score Total
Score 1 2 3 4 5
1 2,153 3,327 4,343 2,407 1,401 13,631
2 65 117 161 157 169 669
3 126 273 445 402 323 1,568
4 0 2 1 0 6 10
5 5 17 29 35 30 115
Total 2,348 3,736 4,979 3,000 1,928 15,992
Arrest & Jail 151 law enforcement agencies with 2,135 CIT-
trained officers
18 counties have jail diversion programs
Jails statewide screening for individuals with
mental illness
27 Adult DTCs in district and superior court
Court 3 Mental Health Courts
services
CJPP funding for treatment + supervision
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Overview
What Works
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Current Efforts In North Carolina
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S u m m a ry : F in d in g s & R e co m m e n d a tio n s
Finding Recommendation
Treatment resources are Increase effectiveness of
spread across misdemeanor current treatment resources
1. and felony probation by shifting them to high
populations without regard risk felony probationers .
to
Somerisk .
components of treatment Increase funding for
programs funded by the state programs that work , and
have been shown to reduce reduce funding for those
2. recidivism , others have not . that do not .
Program data currently Monitor treatment program
collected does not allow the effectiveness through data
state to hold programs collection and hold programs
accountable for outcomes . accountable for performance .
3.
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Current Practice : Criminal Justice
Partnership Act Program
• Criteria:
– Probationers must be court ordered and assessed for
need by TASC
– Post-Release Supervision and Parole Commission can
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also order participation
1. Treatment resources are spread across
probation populations without regard to
risk
Receiving Services
Need Treatment
18 , 292 10 , 727 7 , 337 3 , 813 52 %
Felony Probationers High/Mod. Risk High/Med. Risk High/Med. Risk
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Recommendation: Increase effectiveness of
treatment by shifting resources to high risk
felony probationers
Receiving Services
Need Treatment
18 , 292 10 , 727 7 , 337 7 , 337 100 %
Felony Probationers High/Mod. Risk High/Med. Risk High/Med. Risk
7 , 565 4 , 206 0%
Low/Min. Risk Low Risk
20 , 847 9 , 881 0%
Low/Mod. Risk
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2 . Some components of treatment programs
funded by the state have been shown to
reduce recidivism , others have not
Type of CJPP Services Provided to Probationers Terminated in FY
2009
Service Type All CJPP SSA DRC RC
# % of # % of # % of # % of RC
Outpatient SA 2,569 CJPP
22.5% 1,072 SSA
34.9% 744 DRC
14.3% 753 24.0%
Counseling 2,136 18.7% 786 25.6% 638 12.3% 712 22.7%
Intensive Outpatient 1,601 14.0% 647 21.1% 525 10.1% 429 13.7%
SA
CBI - Anger Mgt. 1,099 9.6% 150 4.9% 752 14.5% 197 6.3%
Drug Classes 881 7.7% 184 6.0% 522 10.0% 175 5.6%
TASC 295 2.6% 87 2.8% 112 2.2% 96 3.1%
Other 2,824 24.8% 143 4.7% 1,910 36.7% 771 24.6%
Total 11,405 3,069 5,203 3,133
ment Only Comprises About Half of CJPP Services and Cognitive-Based Inte
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Recommendation : Increase funding for
programs that work , and reduce funding for
those that do not
Impact of Ohio Residential Correctional
Programs on Recidivism (Annual State Funding: $104m)
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R e co m m e n d a tio n : M o n ito r tre a tm e n t
p ro g ra m e ffe ctiv e n e ss th ro u g h d a ta
co lle ctio n a n d h o ld p ro g ra m s a cco u n ta b le
fo r p e rfo rm a n ce
• Better define data on service type and
utilization
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• Collect data on recidivism
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• Provide programs with data to allow for
quality improvement process
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• Develop performance incentive approach
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S u m m a ry : F in d in g s & R e co m m e n d a tio n s
Finding Recommendation
Treatment resources are Increase effectiveness of
spread across misdemeanor current treatment resources
1. and felony probation by shifting them to high
populations without regard risk felony probationers .
to
Somerisk .
components of treatment Increase funding for
programs funded by the state programs that work , and
have been shown to reduce reduce funding for those
2. recidivism , others have not . that do not .
Program data currently Monitor treatment program
collected does not allow the effectiveness through data
state to hold programs collection and hold programs
accountable for outcomes . accountable for performance .
3.
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Thank
You
Fred Osher , M . D ., Director of
Health Systems and Services
Policy
For questions , please contact :
Alexa Eggleston , JD
Substance Abuse and Addiction Project
Director
aeggleston@csg . org
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