1. Ebony S. McDonald, MSW, LSW, MBA p VISN 4 HCRV Specialist Lebanon VA Medical Center

2. Goal: Promote successful community integration by engaging in Tx & rehab programs which assists in preventing homelessness & decreasing recidivism  Every VISN has a HCRV Specialist Many have at least 2 (39 nationally) Incorporating HCRV specialists into individual facilities

3.  Outreach into state & federal institutions 46 State, 13 Federal, & 49 CCC Pre-release services  Education on benefits & services  Assessment of needs (i.e. R-Form)  Eligibility (i.e.10-10EZ)  Collaboration with DOC, BOP, & Parole  Accessing healthcare upon release  Assisting with homelessness  Addressing mental health & substance abuse issues  Referrals VA Community

4.  ~1.2 million Veterans arrested in 2007  9 in 100 inmates in U.S. jails & prisons is a Veteran In mid 2007, 9.4% or 223,000 inmates in prisons & jails were Veterans Does not include those on community corrections or supervision  703,000 Veterans incarcerated or supervised in 2007  ~10-12% (5,124-6,149) of PA DOC inmates report military service Banks (2009); Bureau of Justice Assistance (n.d.); Gains Center (2008); Coleman (2009); PA DOC (2010)

5. BASIC CHARACTERISTICSPROBLEMS  Mean age: 48 years  98.2% Male  Race 52.3% White 40% Black 5.1% Hispanic  Marital Status 54% Divorced/Separated  79% Vietnam Era  16% Served in Combat  Medical & Psych Diagnosis 54.9% Medical 54.4% Alcohol 60.4% Drug 22.3% Dual Dx 28.6% Serious Psych Dx  Criminal Offenses 36.7% Violent 22.4% Property 25.1% Drug 14% Public Order (i.e. DWI, prostitution) NEPEC Draft Data for HCRV Report (2010)

6.  Trained to survive in combat which can change worldview The world isn’t safe Others want to harm me Must be ready for danger at all times No sense of purpose  Transition back to civilian life can be difficult  Hypervigilance  Aggressive driving  Carrying weapons at all times  Self-medication  Coming in contact with our criminal justice system

7.  As of May 2010, ~7,930 men & women from PA deployed in Iraq & Afghanistan  Post-deployment incidences  Substance abuse  Domestic violence  PTSD/TBI  Depression/Anxiety  Unemployment  Unmet mental health a growing concern for combat Vets Survey of 1,965 OEF/OIF Vets found  18.5% mental health condition  19.5% experienced a TBI during deployment  14% prevalence of current PTSD & depression 2008 RAND Corporation study found  1/5 or 300,000 of the 1.6M U.S. troops witnessed combat action & reported symptoms of PTSD & depression  Many did NOT seek treatment PA Dept of Military & Veterans Affairs (2009); Gains Center (2008)

9.  Small proportion of justice-involved Veterans  Actual number unknown nationally  ~4% in VISN 4 from 2007-2009(n=474 in state & fed prisons)* NEPEC Draft Data for HCRV Report (2010)

10.  More than 85% of people sent to prison are paroled back to the streets More than 650,000 people are released from state prisons in the U.S. each year Est. 9 million released from local jails each year  In 2007, Est. 56,000 Veterans released from prison each year  ~80% of incarcerated Veterans have an honorable or general discharge 82% are eligible for VA services Gains Center (2008); Noonan & Mumola (2007); Schaffer (2009)

11.  Many released from incarceration at-risk for homelessness Increases likelihood of recidivism More than 10% of those coming in & out of prison report homelessness in the months prior Mental illness increases this rate to about 20% 49% of homeless adults reportedly spend 5+ days in a city or county jail over their lifetime 18% has been incarcerated in state or federal prison Bureau of Justice Assistance (n.d.)

12.  States passing legislation to address increase in Veterans within justice system Preference towards treatment over incarceration  Veterans Courts  Veteran tracks within specialty courts  Veterans Justice Outreach into jails  Training police as first points of contact on how to appropriately respond & defuse situations  ReEntry Courts  Long-term housing solutions

13.  Continued identification to barriers for Veterans  Continued work with corrections & the community to establish solid relationships & supports  Treatment to address PTSD/TBI & trauma

14.  OEF/OIF Veterans increasing within justice system  Veterans have shorter criminal hx Committing more violent crimes  Military mind-set  Untreated PTSD/TBI & depression Serving longer sentences  Veterans are less likely in the first place to be incarcerated  Treatment needed post-deployment  Continued diversion & outreach needed

15. Ebony S. McDonald, MSW, LSW, MBA p VISN 4 HCRV Specialist 1700 S. Lincoln Ave (680) Lebanon, PA 17042 717-272-6621 ext 6215 ebony.mcdonald@va.gov