Calgary Drug Treatment Court (CDTC)

Transcription

1 Calgary Drug Treatment Court (CDTC) Breaking the Cycle of Drug Use & Criminal Recidivism Diana Krecsy RN, BN, MEd. CEO, Calgary Drug Treatment Court Society Mount Royal University, Nov 21, 2012

2 Disclosures No Conflict of Interests to disclose Acknowledge CDTC Program funders: Crime Prevention Investment Plan o The City of Calgary Safe Communities & Strategic Policy o GOA, Minister of Justice & Attorney General (Funding secured to March 31, 2013)

3 Goals Enhance audience understanding of the following: Impact of Addiction Evolution of Drug Courts Brief overview of 12 Key Principles of successful DTCs Specifics of the CDTC Program o Who, What, Where, When, How and Why it Works 2012 CDTC Evaluation data

4 Impact of Addiction Crime & the Justice System

5 Addiction and Crime Canadian Impact: costs approx. $39.8 Billion annually Loss productivity, health care costs, law enforcement costs, etc. Drug Abuse & Crime are connected Approx. 70% of Federal offender pop in CAN has a substance abuse problem Most severe 90% of their criminal activity is related to substance use in some way (Juristat 2003) CDTC Participant: Steal, Deal or Prostitute to support their addiction A $200/day cocaine addiction can require 10 times that value in stolen goods to finance ( Calgary street value ) Need $2000/day in stolen goods to support $200 a day habit Shoplifting, car thefts, credit card theft, home B&Es; and/or other crimes Prostitution, drug-trafficking COMMUNITY IMPACT: $2000 a day = $730,000 a Year

6 Addiction and Human Cost Loss of family, friends, personal support system Homelessness (living on the street and/or in a shelter, cyclic- incarceration) Criminal Record Loss of employment Increased burden on others (family, community) Not paying child support Not paying taxes Increased cost to Police, Emergency Services, Healthcare Services

7 Addiction and Justice System Costs approximately $75,000/year to maintain ONE prisoner in a provincial jail Jail/Correctional facility does not and/or can not address the root causes of criminal activity Rehab or treatment programs: sporadic, generally not mandatory, limited options, insufficient quality/intensity for population, little incentive to participate Criminal recidivism for untreated addicts is very high on release

8 Cycle of Addiction & Crime Crime (Arrest) Drug Addict in the community (untreated)

9 Evolution of Drug Treatment Courts (DTCs) Why do we need them? What is a DTC?

10 International Awareness Every Country touched by impact of drug- addiction Social infrastructure burdened by costs of drug abuse Healthcare, Social Services, Corrections Human lives are being destroyed Valuable human & financial resources are being diverted away form essential activities Criminal Justice System: Murderers/ Organized crime.not on parole violations of a drug addict Untapped potential for Justice systems to better HELP Greater involvement in treatment and rehabilitation Problem-solving and preventive processes (United Nations, Office on Drugs and Crime (1999) Report: Expert Working Group on Drug Treatment Courts)

11 What is a Drug Court? An innovative justice alternative for high risk, high need drug addicted offenders Younger (20-45 years) Previously failed treatment (often numerous times) Unemployed and Homeless Chronic medical and/or mental health conditions Diagnosed with antisocial personality disorder Prior felony convictions (frequent fliers in the Justice System) A Court program that integrates Comprehensive judicial supervision A multidisciplinary team of professionals Openness to change traditional practices & procedures Treatment services Use of mandatory drug testing and sanctions & rewards

12 Drug Court: Where Accountability meets Compassion The intersection between Justice and Treatment Justice Judge Law Enforcement Legal Corrections Treatment Addictions Treatment Health Services Human Services

13 CDTC Pre Court Team Judges: J. Ogle, C. Skene, P. Barley Provincial Crown Prosecutor: J. Abbott Federal Crown Prosecutors: S. Tkatch, A. Webber, J. Schweitzer Defense Counsel: E. Washington, S. Jenuth Calgary Police Services: Sgt. D. Laduke Probation/Corrections: B. Zimmer Clinical Director: D. Dupuis Case Managers/Counselors: N. McKenna, P. Sheridan CEO: D. Krecsy Human Services/Employment: D. Carl-Hudgeon (Collaborative, Respectful, Inclusive; leave our EGOs at the office..)

14 Drug Courts Work! 20 year Evolution 1rst DTC in Florida, USA (1989): 3,000 DTCs in USA (2012) THE most researched & studied Justice program o 6 Meta-analyses since 2006 o criminal recidivism & overall costs associated with addiction Canadian Scene o 1rst DTC in Toronto (1989): 10 DTCs in Canada (2012) o 6 are Federally funded (Van, Edm, Regina, WPG, Toronto, Ottawa) o Calgary DTC began in 2007 (No Federal $) International Scale o 12 Key Principles of successful treatment and rehabilitation courts (UNODC, 1999: United Nations Office on Drugs Courts)

15 12 Key Principles Integrate addiction treatment services with justice system case processing (multi-disciplinary team) Non-adversarial approach between Judge, Prosecution and Defense Counsel; promote public safety while protecting participants Charter Rights Early identification and prompt placement of eligible offender in program Access to a continuum of treatment and rehabilitative services Objective monitoring of compliance by frequent & random drug testing A coordinated strategy to participants compliance and non-compliance

16 Key Principles cont d Swift, certain and consistent sanctions or rewards for noncompliance or compliance Monitoring and evaluation processes; achievement of program goals and gauge effectiveness Continuing inter-disciplinary education in DTCs Partnerships among courts, treatment and rehabilitation programs, public agencies and community-based organizations Ongoing and coordinated case management providing the social support necessary to achieve social reintegration Appropriate flexibility in adjusting program content to unique needs: Women, Indigenous people and Ethnic groups.

17 Calgary Drug Treatment Court (CDTC) Who do they serve? How do I access them?

18 Who IS eligible? Any Adult offender (age 18 +) Must be Pre-Sentence Currently IN custody or OUT of custody Resident of Calgary (or charges waived to Calgary) Criminal code offence (direct link to their addiction) Theft, prostitution, possession for purpose of trafficking, trafficking, B&Es, etc Drug addiction must be to a Schedule 1 substance Cocaine, Crack, Heroin, Methamphetamine, other Opiates Do not take marijuana if this is the only drug addiction Note: Co-existing addictions are typical (i.e. alcohol, gambling, sex) Treatment assessment supports enrollment in program Drug Addict, cognitive capacity, manageable in a social environment, absence of severe mental illness (Axis 1 diagnosis) and/or confirmed resources in place to manage their health needs

19 Who is NOT eligible? *Degree of Crown discretion ( * Individual/FULL context) Offence involves a person < 18 years of age Offender charged with selling drugs to a person under age of 18 Offence was committed PRIMARILY for commercial gain/profit Offence attracts a jail sentence >3 years OR < 1 year Applicant is facing deportation (*for criminality or other) History of serious violence or associated with organized crime Involved in Gang or Crime Family; Violence in Criminal record (i.e. assault); or NEG. historic pattern (i.e. stayed, withdrawn or diverted charges) Other NOs: Sexual offences, domestic violence, weapons charges Treatment assessment does not support enrollment Diminished cognitive ability; unable to function in a social setting; a risk to self or others; severe mental illness; and/or unable to access suitable resources aligned with applicants needs

20 Overview : Application & Decision Making Process Criteria Screening: Must meet Crown Prosecutor Eligibility CDTC Application form / Current charges & past criminal history Crown will consult with Calgary Police Services Waivers (sharing of information & abide by program conditions) Agree to postpone Bail Application while in application Agree to plead Guilty to criminal charges (accept accountability) Attend and observe 1 full day of CDTC Criteria Screening: Must meet Treatment Eligibility TX Assessment: medical & mental health history; addiction treatment attempts; holistic & wellness approach (employment, housing, other) Multidisciplinary Pre-Court Team Informed Discussion Expertise shared and leveraged (synergy): Non adversarial approach Reviews & makes a Recommendation to Crown (consensus model) Final Crown decision on acceptance or non-acceptance into CDTC program

21 Application Process: How? Numerous routes (all lead to Prosecutors office) Offender self-identifies (from community or from inside jail) Offender s personal Lawyer Legal Aid Lawyer Community resources person Application form CDTC Application form submitted to CROWN prosecutors office (Federal or Provincial) o Forms Accessible: Calgary Remand; Courthouse clerk s desk in 505 & 305; Prosecutors office; Legal Aid Society o Applicant should complete the application form with legal assistance

22 Calgary Drug Treatment Court (CDTC) How does it work?

23 Stage 1: Treatment 3 5 months of Addiction Treatment Participants are triaged to appropriate TX path (needs/best fit) Residential Recovery House Program CDTC Day Program (New 2012 in response to capacity & access issues) Continuum of services Medical Detox; Dental, Vision, HIV & Hepatitis; Counseling (Group and Individual); Life skills;12-16 Step Recovery programs (AA, NA, GA etc.); Support groups (Aboriginal Elders, Sweats etc. ) Weekly team conferencing & Participant Progress Report to Judge Frequent & Random drug testing (min. 2-3 times a week)

24 Stage 2: Community Transition 8 18 months; Unique to individual Move back into community (stable housing) Abstain from using drugs or alcohol Obtain employment Educational upgrading and/or Employment training Recovery support network (i.e. NA, AA, Church ) Ongoing counseling & linkages to community resources Mandatory 10 week Criminal & Addictive Thinking course Weekly attendance in Court; conversation with Judge Weekly meeting with CDTC Case Manager & Probation Frequent & random drug testing Rewards & Sanctions in courtroom aligned with behaviors & progress

25 Rewards In general, Rewards are more effective than sanctions Use of the Bucket in courtroom for compliant week Coffee card, movie pass, recreation pass, chocolate, etc Acknowledgement is the key (esp. from the Judge) Keep it Simple: Verbal approval, applause, public recognition Look for positive behavioral changes (i.e. did not yell when receiving constructive feedback; on time this week; shared; volunteered, etc.) Catch them doing it RIGHT! Celebrate Milestones 1 year clean & sober; Happy Birthday; Community Accountability/Reintegration (i.e. regained drivers license; filed income tax; paid child support; paid parking tickets; applied for GED etc.) Progress earns Privileges: Cell phone; weekend pass; extended curfew Graduation ceremony & Celebration (i.e. CDTC Medallion)

26 Sanctions Used with high degree of caution; not a first line strategy DO NOT sanction a drug-relapse Chronic disease: Relapse is to be expected Sanction behavior around the relapse: Breached bail terms, dishonesty Pre-court team discusses incident & recommends sanction (consensus) Must have a hearing in court Participant has opportunity to discuss with Judge in court Judge is final arbiter of sanctions Must be swift, certain and consistent Scale sanction to the non-compliant behavior: Removal of a privilege; insight letter; letter of apology; community service hours; revoke bail for a defined period of time etc.. May progress to discharge from program. Expectations on participant increase with amount of time/stage in program

27 Stage 3: Graduation and Sentencing Graduation Range: 12 months (min) 24 months in program Drug & Alcohol free for 6 months; including 3 months immediately prior to graduation Successfully completed Treatment Phase and Criminal & Addictive Thinking course Completed Stage 2 Community Transition to highest Capacity (i.e. stable housing & employment; or, volunteer/ education) Solid recovery plan and network of support in place Sentencing Agreement at start of program: Crown will not seek a custodial sentence if participant graduates from program Can expect a non-custodial sentence (i.e. term of Probation)

28 CDTC 2012 Evaluation Date What are the demographics? How does the program benefit society?

29 Participants: Physical Health Conditions 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Acute conditions Chronic conditions Dental problems Vision problems ADHD/FASD 80% Acute: Injuries, Migraines 60%Chronic: HIV positive, Hepatitis C, Heart conditions, chronic pain over 70% Serious Dental issues * 70% of participants had health needs addressed before they exited the program

30 Participants: Drugs of Choice Presciption Opiates Heroin Methamphetamine Alcohol Marijuana Crack/Cocaine Number of Participants 93% with Marijuana addictions; 90% with Alcohol addictions; 70% with Cocaine addictions; & 42% with Methamphetamine addictions ; started using at 18 years of age or younger.

31 Participants: Length of Clean Time over a year 29% between 6 months and 1 year 26% less than 3 months 10% 3 to 6 months 35% Notably, in the year prior to their admission to the program all of these clients had much shorter periods of sobriety; consisting of only a few days at a time.

32 Participants: Housing, Employment, Education (on admission to CDTC program) 100% 90% Yes, 7% Yes, 12% 80% 70% Yes, 52% 60% 50% 40% No, 93% No, 88% 30% 20% No, 48% 10% 0% Stable Housing Employment High School Graduation 93% unstable housing/living on the street; 88% unemployed; 48% did not complete high school

33 Participant Graduates: Employment Status Unemployed 14% Not employable 7% Student 14% Employed 65% Majority of participants were chronically unemployed at the time of their arrest and acceptance into the program. *86% supported by program to reach their highest potential

34 Social Return on Investment The social return on investment (SROI) methodology is a principles-based approach that values change for people and the environment that would otherwise not be valued. It assigns monetary value to traditionally nonvalued things such as the environment and social value (The City of Calgary, 2011). For every $1.00 dollar spent: $2.25 is created in savings to the community in the first year of program; and $6.50 is created in the second year. Program Benefit Reduction in Costs across Multiple Systems Jail costs; cost of property stolen to support addiction; time required for police investigation; costs related to treatment of mental and behavioral disorders resulting from addictions; Child Services costs; in hospital and related costs; community services costs; shelter costs; and employmentrelated benefits, such as taxes, turn-over, use of income support.

35 Final WORDS from our CDTC Graduates, Escape I had lost touch with reality and there were so many dark days where I would sit there like a zombie hoping the next time I used it would take me out. Criminal and addictive thinking & behavior I never thought about consequences. I had a one-set criminal mind and worked up any scam to get my next fix. CDTC structure and accountability When I first started drug court, like mostly everyone else, I just wanted to get out of jail. I did not want to have to do the work that came with it. I was not even sure if I was going to stay. [Structure] was definitely hard for me. I struggled a lot. After about a month, the novelty wore off and the realization [set in] that to change my life around was going to require a lot of patience and extremely hard work.

36 Final WORDS from our CDTC Graduates, CDTC team: Support and Hope It really helps tremendously knowing that there is a whole team of people behind you, who believe in you, who believe that you are worth it, who believe that you can be someone. Personal Recovery and A New beginning. I d like to sum up my experience with a word acronym I invented (A.I.R): I need A.I.R. to breathe and I need to breathe to live. A = Accountability, I = Individuality, R = Responsibility. Accountable When I am accountable I m kept in line because relapsing doesn t happen overnight. It is when little thoughts, ideas, behaviors are allowed into my life that cause me to gradually deviate from the path of recovery. Individuality When I am treated like an individual, I no longer feel like a prisoner or robot. As an individual, I can express myself and share my feelings in a safe environment. I have choices to make as well, by either accepting or rejecting suggestions. Responsibility When I am responsible I no longer have to be told what I can and cannot do.

37 Thank You Starting Dec 01, 2012 For more information on the CDTC program, visit our NEW