Managing drug- involved offenders with HOPE Presented by: Angela Hawken, PhD October 22, 2010 ACJRCA

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) New drug arrestNew property arrestNew violent arrest Percent of offenders Referred but untreated Comparison Group Entered but did not complete treatment Completed treatment

Treatment provider perceptions of why Prop 36 clients did not complete their planned treatment. 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? 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 served  Prosecutor discretion  Concern 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 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 efficiently  Many 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-involved  Demonstrated non-compliance  High risk of revocation

FINDINGS

Summary of RCT outcomes OutcomeHOPEControl 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

Process integrity Tenets of HOPE are research based  Sanctions are certain.  Sanctions are swift.  Sanctions are consistent.  Sanctions are modest.

Probationers’ Perceptions (n=211)

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)

Contact information Please address questions or comments to Angela Hawken at: