Pennsylvania Veterans and the Criminal Justice System, Adjustment, Reentry and Associated Problems

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1 Pennsylvania Veterans and the Criminal Justice System, Adjustment, Reentry and Associated Problems Introduction: The Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) wars are now the longest in U.S. history. This war has yielded many Veterans that return with incidences of substance abuse, driving under the influence (DUI), domestic violence, Post Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), employment, depression, anxiety, suicidal ideations, redeployment and related problems. Like the Veterans of prior eras, many veterans encounter the Criminal Justice System (CJS) post-deployment or post-discharge and need a treatment alternative vs. incarceration, if deemed applicable. Veterans in this country appear to be overrepresented when it comes to psycho-social problems like, substance abuse, driving under the influence (DUI), higher rates of unemployment, assaults, intimate partner violence (IPV), family conflicts, homelessness episodes, suicides, PTSD and other problems. Tragically, some studies report that Veterans in general are twice as likely to commit suicide. Another study (Wortzel, 2009) also suggests that veterans in jail and prisons face an increased risk of suicide. Most Veterans have had more violent offenses, are usually first time offenders and honorably discharged (Noonan, 2007). A recent 2009 US Department of Labor (DOL) unemployment statistics revealed that veterans have nearly triple the unemployment rate than non-veterans. Astonishingly, even anecdotal reports of Veterans not wanting to highlight being a military status on their resumes due to stigma. Background: The most recent U.S. Department of Justice (DOJ) Bureau of Justice Statistics (BJS) Survey of Inmates in local jails (2002) data indicates that 9.3% of people incarcerated in jails are Veterans. The controlling offense for 70% of these Veterans was a non-violent crime, and 45% had served two or more state prison sentences. At minimum, 90,000 of the 9 million unique inmates annually released from U.S. jails are Veterans. A large majority, 82% are eligible for VA services, having been discharged either under honorable (65%) or general with honorable (17%) conditions. BJS reported in 2006 that 60% of all U.S. jail inmates had a mental health problem. As of 2005, only one in six jail inmates with a mental health diagnosis had received mental health treatment since incarceration. The 2002 BJS Jail Survey also found that 65 % had screened positive for either an alcohol or drug dependency problem. Twenty-nine % had been diagnosed with at least one of five psychiatric disorders (depressive, bipolar, psychotic, PTSD, or anxiety disorder). One in five (18%) Veterans were homeless in the year prior to the current incarceration. Statistics on the jail and prison inmate populations suggest significant health risk for Veterans released from jail.

2 Historically, reports of Vietnam and post-vietnam era Veterans with histories of civilian or military trauma suggested an association between trauma and subsequent contact with the CJS. PTSD symptoms can indirectly lead to criminal behavior (for example, domestic violence, substance abuse, prescription drug abuse, hyper-vigilance, road rage, etc.) or a traumatic incident to a specific crime. In 2008, a RAND Corporation study found that nearly 20% of military service members who have returned from OEF/OIF, reported symptoms of PTSD or major depression, with only about 50% seeking treatment. Also, anecdotal reports of OEF/OIF Veterans mental health have been reported with some frequency by the news media and involve law enforcement. Veterans Justice Outreach (VJO) Program: The VJO initiative started in 2009 and is authorized by VA Information Letter (IL) The VJO is new initiative targets homelessness among justice-involved Veterans in contact with law enforcement, jails, and the courts. The primary objective of this program is preventing homelessness among the Veteran population by connecting justice-involved Veterans with appropriate treatment and other resources and then encouraging adherence to treatment over time. Justice-involved Veterans are Veterans who have crisis encounters with law enforcement in the community, are jailed for relatively brief periods of time for offenses that do not result in prison time, and/or are adjudicated or monitored by either local criminal courts or specialty treatment courts, such as drug and mental health courts, usually for extended periods of time. VJO Specialists reach in to the criminal justice system to ensure that eligible justice-involved Veterans have timely access to Veteran Administration (VA) mental health and substance abuse services when clinically indicated, and other VA services and benefits as appropriate. For example, VJOs, such as Butler so far in 2010 have had over 300 referrals. Most are males, 5.7% females, 60% homeless episodes, 49% medical, 56% alcohol, 30% DUIs, 27% substance abuse, 17% domestic abuse, 33% psychiatric and a mix of Vietnam, post-vietnam, Persian Gulf War (PGW) and OEF/OIF era Veterans. These latter 2 eras represent a growing significant minority. In the fall 2009, the author was asked to wear this additional hat in September 2009 based upon his interest and expertise with this segment of the Veteran population. He had facilitated an Incarcerated Veterans Outreach Program (IVOP) in Cincinnati, Ohio and a Domestic Violence Program, approved by the Ohio Dept. of Corrections (DOC), from Case Example: The VJO social worker received a telephone call from a local city police officer. The officer reports that an OEF United States Marine Corps (USMC) combat Veteran has been arrested for forced entry into a local store. The officer elaborated that the Veteran is 24 years old, Hispanic male, neither intoxicated nor suicidal with no prior arrests. The Veteran has been handcuffed to a railing at the local police station and the officer would like assistance before he proceeds any further. The officer stated that he has not locked

3 the Veteran in the holding cell due to his sensitivity to Veterans issues. This Marine had received 2 purple hearts for combat injuries sustained in battle in Afghanistan and suffers from Traumatic Brain Injury (TBI) The VJO informed the officer their role is to identify, assess, divert, refer and advocate for Veterans in contact with law enforcement from the point of arrest through release (Munetz and Griffin, 2006). The officer verbalized that he does not want to take this Veteran to the local county jail, but would like treatment at the VA or a community hospital. The Veteran was deemed by the officer to not be a threat to himself or others. The officer is made aware that the Veteran could be coordinated a voluntary admission to a local psychiatric unit. The officer requested that the VJO contact the local hospital to secure the process for a voluntary admission to the inpatient psychiatric unit. Thus, the hospital admission coordinator and even the local county mental health delegate were made aware of the situation. Both supported the plan to have the Veteran evaluated for voluntary admission. However, during this process the officer s superior insisted that the Veteran be arraigned by the local Magistrate within 6 hours versus the usual hours. Typically, when an individual is arrested for a crime, the person will be taken to a local law enforcement station for booking, prior to incarceration in the County Jail or Police station lock-up. The Magistrate allowed the Veteran to return home with his mother under a non-monetary bond. The Veteran was released on his own recognizance (ROR) with the understanding that the mother contact the mental health delegate in case of emergency and that the Veteran be seen and evaluated at the VA. The Veteran had the option of obtaining a public defender or an attorney. Obtaining legal counsel is a financial-based decision. This decision was entirely that of the Veteran. The Veteran obtained the services of a private attorney. He was subsequently treated at a VA for his PTSD and TBI problems. The outcome is that the Veteran successfully completed treatment and received 1-year probation. Veterans Treatment Courts: In 2008, the first Veterans Treatment Court (VTC) was started in Buffalo, NY by Judge Robert Russell. Since this court started, Veterans Courts have opened in Orange and Santa Clara counties in CA; Tulsa, OK; Rochester, NY; Anchorage, Alaska. The larger metropolitan jurisdictions are encountering Veterans per month. Veteran s Courts are a growing therapeutic jurisprudent approach within the PA County Court system as well as across the United States. This new judicial approach are challenging the traditional roles of Judges, Attorneys, Courts, Jail Corrections Counselor, Warden s, County Sheriff s, State Police, Probation Officers, Police Chief s and Police Officers and VA staff affording unique collaborations, alternatives and sanctions. These Courts are a special docket within the Court system and target Veterans charged with non-violent felony offenses. They are similar to Mental Health, Drug and DUI Courts. All parties are

4 collaborating in this effort to address the needs of military Veterans who turn to various crimes in the aftermath of military service. VTCs are hybrid Drug and Mental Health Courts that use the Drug Court model to serve Veterans struggling with addiction, serious mental illness and/or co-occurring disorders. They promote sobriety, recovery and stability through a coordinated response that involves cooperation and collaboration with the traditional partners found in Drug and Mental Health Courts, with the addition of the VA, volunteers Veteran mentors and Veterans and Veterans' family support and service organizations. These Courts address the needs of all Veterans ready, willing and able to abide by the Court sanctions and make the necessary changes in their lives. The need for intervention, services and treatment related to their military service has drastically increased in the last several years, especially with the impact of the OIF/OEF wars amid a turbulent economy. The rationale is based on the combat PTSD, non-combat PTSD (military sexual trauma), economic hardships, substance abuse, domestic violence and readjustment. Most of these Veterans are generally law-abiding, but their problems contribute to criminal behavior among a substantial number of Veterans. For Pennsylvania, VTCs are underway in Pittsburgh, Philadelphia, Scranton, Montgomery and Chester counties; with data gathering and discussions starting in Beaver and Mercer counties. The PA statewide task force on Veterans and the Criminal Justice System in Pennsylvania is co-chaired by Justice Seamus McCaffery, Supreme Court of Pennsylvania and Michael Moreland, Director, Veterans Integrated Service Network (VISN) 4. Case Example: The county jail corrections counselor referred a 40 year old, female, African American, PGW non-combat Veteran for interview and assessment. She had originally been seen in VTC, but failed to follow through with treatment. She is an active crack addict and relapsed. She is remanded for check forgery, probation violation positive urinalysis. During the assessment she reports that her forgery was done to support her cocaine habit which she has been struggling with for years. She verbalizes that her habit started as a result of sexual abuse prior to her entry into the military in addition to being a domestic violence victim during active service. She has never received treatment for the sexual and domestic violence traumas. Both of these traumas can lead to PTSD. She also reports episodes of prostitution to support her habit. She reports having been first arrested at age 25 for prostitution to support her drug habit. She was arrested 10 times total in her life for a combination of prostitution, drug possession and forgeries. She says she will probably be homeless when released. She had been attending a community college prior to this incarceration. She is serving on probation in two counties in Pennsylvania. Upon release she would agree to enter a rehabilitation program for substance abuse and counseling for PTSD. She agrees to treatment at a

5 VA that provides these services for female Veterans. She verbalizes plans to use her GI bill and return to college. The outcome was that the Veteran received the required VA treatment and continued serving probation. The transition from military to civilian life is challenging and Veterans cope in many different ways whether exposed to combat or not. However, not all Veterans get into trouble with the law, but for those do, VJO and VTC is available. Many systems seem overburdened, lack sufficient resources to meet the needs of those suffering from PTSD, readjustment and other psychological problems, which overall may place Veterans at-risk for a host of problems. Like prior wars, current Veterans are also facing the growing stigma of war. Collectively, we should all care about all Veterans. Pennsylvania men and women alike have served their country honorably, whether during peace time or war, in need of services, need our help. Both VJO professionals and those involved in VTCs are assisting these Veterans in nearly every county in the State. As citizens, taxpayers and Veterans, we then have an obligation to respond by addressing their CJS needs. The aggregate of their problems and statistics profile the timeliness and the urgency of VJO, VTCs, and diversion programs, as we face epidemic proportions. VJO Contacts: Sites Contacts Phone Numbers s Altoona, PA Dr. Todd Negola x7522 Todd.Negola@va.gov Butler, PA Bradley Schaffer Brad.Schaffer@va.gov Clarksburg, WV Dr. Jennifer Myers Jennifer.Myers4@va.gov Coatesville, PA Torrie Osterholm x5687 Torrie.Osterholm@va.gov Erie, PA Terrence W. Yeager Terrence.Yeager@va.gov Lebanon, PA Julie Bergstresser x5162 Julie.Bergstresser@va.gov Philadelphia, PA Rebecca Hicks x6594 Rebecca.Hicks@va.gov Pittsburgh, PA Beverly Vanderhorst Beverly.Vanderhorst@va.gov Wilkes-Barre, PA Kimberly Sapolis x4574 Kimberly.sapolis@va.gpv Wilmington, DE Sarmite Tyus x4810 Sarmite.tyus@va.gov For supplemental information, please visit the: Veterans Treatment Court Clearinghouse at: and/or the Pre-Trial Justice Institute at:

6 References: Hal S. Wortzel, MD, Ingrid A. Binswanger, MD, MPH, C. Alan Anderson, MD, and Lawrence E. Adler, MD: Suicide Among Incarcerated Veterans, J Am Acad Psychiatry Law 37:82 91, 2009 Munetz, Mark R., and Patricia A. Griffin. April, Use of the Sequential Intercept Model as an Approach to Decriminalization of People with Serious Mental Illness. Psychiatric Services, 57, ME Noonan: Veterans in state and federal prison, Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics Special Report, About the author: Bradley Schaffer is the Coordinator, Veterans Justice Outreach (VJO) at the Butler VA Medical Center. He has over 24 year s federal service and is a USMC Veteran. He has developed particular expertise with incarcerated veterans & reentry, diversion, domestic violence prevention and fatherhood programs for Veterans. He is a Licensed Master Social Worker (LMSW) and Board Certified Diplomat (BCD) in Clinical Social Work. For more information, contact him at (724) and/or Brad.schaffer@va.gov