Hawaii s HOPE Probation. Presented by: Angela Hawken, PhD July 31, 2012

Transcription

1 Hawaii s HOPE Probation Presented by: Angela Hawken, PhD July 31, 2012

2 Managing drug-involved offenders Probation and parole departments are on the front lines to reduce drug dependence Managing high caseloads with limited supervision and drug treatment resources A large number of violent offenders and property offenders are drug-involved More-serious offenders often have the least programming available because they are considered ineligible A large number of non-violent drug offenders will go on to commit non-drug crimes

3 Responding to violations: Too much or too little Most departments are limited to responding to drug use and other violations in one of two ways: Ignore violation and continue to cajole offender into cooperation (too little) Initiate proceedings to revoke probation (too much) The preferred response lies between these two extremes

4 The Move Towards Treatment Diversion Programs

5 Characteristics of diversion programs Mandates treatment for all; even those without a diagnosable substance abuse disorder. Treatment decisions based on selfreported behavior Limited use of sanctions

6 Treatment diversion Most important example is California s Proposition 36 Only 25% completed the treatment to which they were mandated Why? Little enforcement Poorly matched treatment The result? Poor compliance Increased arrests Perverse result those most in need received less

7 Percent Providers perceptions would jail sanctions for non-compliance improve treatment outcomes? % % 1% No Maybe Yes Notes: Data are from the 2007 Prop 36 Treatment Provider Survey. The results reflect responses from randomly selected Prop 36 Treatment Providers (n = 87).

8 What is the problem? Many violators Punishment is scarce and expensive Average risk of being punished violation is very small Low punishment risk more violations Unpunished strings of violations signals violating is OK (and sanctions, when delivered, are seen as arbitrary and unfair) We are trapped in a high-violation equilibrium Schelling s tipping models (can go the other way)

9 HOPE represents an alternative model that is aimed at tipping back to a low-violation equilibrium BEHAVIORAL TRIAGE

10 Behavioral Triage Model Not everyone is mandated to treatment Monitoring and treatment decisions based on observed behavior not self-report The idea is to allocate 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.

11 Example: Hawaii s HOPE Focus is on high-risk subjects Probation conditions are actually enforced Starts with a formal Warning Hearing Assigned a color for testing hotline Regular random drug testing (6x/month) Violations result in swift and certain but modest sanctions No one mandated to treatment if complying (but provided if asked) Three or more violations => TX mandate

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

13 Eligibility and randomization Probationers were indentified as: Drug-involved Demonstrated histories non-compliance Facing high risk of revocation We used third-party batch randomization to determine study groups

14 Assignment to study conditions RCT using an intent-to-treat design This had important implications for outcomes.

15 Description of study participants HOPE Control Demographics Age Average = 36.1(SD= 10.58) Average = 35.4 (SD = 10.06) Sex Male 75% 71% Female 25% 29% Race/ethnicity Black 5% 3% Caucasian 16% 14% Asian/Polynesian 65% 64% Portuguese 1% 2% Puerto Rican 1% 1% Other/Unknown 11% 14% Prior Criminal History Prior Arrests Average = 17.0 (SD = 14.2) Average = 16.4 (SD = 14.4) Most Serious Prior Charges Drug 35% 33% Property 30% 34% Violent 22% 22% Other 14% 11%

16 RCT Outcomes Outcome HOPE Control No-shows for probation appointments (average of appointments per probationer) 9% 23% Positive urine tests (average of tests per 13% 46% probationer) Revocation rate (probationers revoked) 7% * 15% Incarceration (days sentenced) 138 days 267 days

17 HOPE AS A BEHAVIORAL TRIAGE MODEL

18 Percentage Distribution of positive drug tests 60% 50% 51% 40% 30% 28% 20% 12% 10% 0% 5% 2% 1% 1% Number of positive drug tests

19 Percentage Probationers Perceptions (n=211) 80% 70% 60% 50% 40% 30% 20% 10% 0% In Treatment In Jail Specialised Unit General Unit Positive Neutral Negative

20 General observations from Hawaii Outcomes were consistent across probation offices, across probation officers, and across judges (no evidence of an operator effect within the system) Current study suggests outcome improvements are larger for higher-risk probationers Leniency kindness

21 Is HOPE for all? No. A minority of probationers (28%) did not respond well (accumulated three or more violations) In Hawaii, supervision is now a continuum The drug court has been reconfigured to accept high-risk subjects and HOPE failures are moved into the DC (but capacity is limited)

22 Important implications of our work Short jail stays are as good (better) than long jail stays Not everyone who uses drugs needs treatment (but those who do need more of it than they get now) Implementation is key (we know much more about this now than we did a year ago)

23 Ongoing studies will address many important unknowns Whether HOPE generalizes will soon be known. Replications: Alaska, Arizona, Arkansas, Massachusetts, Oregon, Texas, Washington Whether HOPE effects persist after probation is completed will be answered in the second wave of our study HOPE for juveniles? Two studies underway. About to launch a RCT.

24 The important unknowns Is the drug-offender population two subpopulations? Group 1: Bad drug habit Group 2: True dependency What are the essential elements and what is the optimal sanction? Planning an RCT magnitude of sanction is varied (includes non-incarcerating sanctions) Is judge essential? P(detection) randomizing testing frequency

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