An Assessment of Substance Abuse Treatment in New York State Prisons: From Screening to Discharge

1. An Assessment of Substance Abuse Treatment in New York State Prisons: From Screening to Discharge Cindy Eigler, LMSW Prison Visiting Project, The Correctional Association of New York

2. The Correctional Association of New York (CA) • An independent, non-profit organization founded by concerned citizens in 1844 and granted unique authority by the New York State Legislature to inspect prisons and to report its findings and recommendations to the legislature, the public and the press. Through monitoring, research, public education and policy recommendations, the Correctional Association strives to make the administration of justice in New York State more fair, efficient and humane.

3. CA’s Projects • Prison Visiting Project • Women in Prison Project • Juvenile Justice Project • Public Policy Project

4. Treatment Behind Bars: Substance Abuse Treatment in New York Prisons 2007-2010 • First ever, in-depth assessment of substance abuse treatment services offered in New York State prisons • Includes information from visits to 23 correctional facilities and their substance abuse treatment programs, interviews with treatment and prison staff, review of system-wide data provided by the Department of Correctional Services (DOCS), and analysis of more than 2,300 surveys from inmates

5. Findings • Treatment Programs: • Effective to Ineffective • Didactic to Interactive • Treatment Staff: • Committed to Apathetic • Skilled to Inexperienced Tremendous Variability!

6. Findings • Screening and Assessment • Programs • Staffing • Discipline and Removals • Supervision and Oversight • Aftercare and Reentry

7. Screening and Assessment WHEN IS TREATMENT OFFERED? • “I am an alcoholic…my desires for treatment are very high and wanted. I am not in a program due to the amount of time I have yet to complete. They only take inmates that are closest to a release date, leaving hundreds of inmates who need and want treatment on a very long waiting list.” • “I’ve been upstate for over 7 years and I need help with my drug problem. I used drugs a few times while I’ve been in prison and have been trying to get into a program for years, but I never get close on any list. If I don’t get help I’ll end up stressing then I’ll smoke weed and catch another ticket and lose more good time. I don’t feel it is fair I’ll have to be stuck in prison longer because I was not allowed the help prison is suppose to offer me.”

8. Screening and Assessment WHO IS TREATMENT OFFERED TO? • “I’ve been incarcerated for over 15 years, and during that time I have not had a positive urine screening, nor have I had a misbehavior report for possession of illegal drugs of any kind. Yet, because it says on the probation report that I tried drugs/alcohol once before my arrest, now I’m being subjected to take a substance abuse program for which I have basically no need and which I believe, aside from being a waste of my time, is a waste of taxpayer money to have individuals like myself take a program for which I have no need for.”

9. Screening and Assessment • Broad and vague standards for what constitutes need • Lack of comprehensive assessment • Back-ended treatment

10. Programs • “One of the main reasons for this lack of enthusiasm is because the structure of the program is outdated. The material from which we study from is outdated. The movies we watch are all outdated. There’s nothing about this program that’s attractive or motivational.”

11. Programs • One-size fits all programming • Lack of consistency among programs • Limited adherence to any treatment modality • Large group sizes • Minimal individual counseling • Role of inmate participants

12. Staffing • “The counselors are very disrespectful. They call you stupid, loser, dumb, ignorant words that break a persons character. If I am an addict, I need to be built up, not broken down. Counselors want to exercise authority like a Corrections Officer (CO). Any little discrepancy and they want to threaten to kick you out of the program. Comply or goodbye.”

13. Staffing • Treatment staff with varying skills, experience and commitment • High staff to participant ratio • Staff vacancies

14. Discipline and Removal Drug Use Removals Process • “I’ve been incarcerated since 1998 and I’ve been dealing with a marijuana addiction for the duration of my incarceration. Just recently I was given 12 months SHU (solitary confinement), 24 months loss of good times and a host of other penalties for testing positive for marijuana use. This is my 11th such drug conviction. I’ve done almost my entire prison sentence in SHU and keeplock due to my struggle with this addiction. After being told that the SHU sentence might help me kick the habit, I wrote that if the last 10 disciplinary sanctions didn’t help me to kick the habit, then I obviously need some type of treatment and should be give such treatment.” • “You can’t file grievances while in the program, that’s the first thing I’ve learned while being here. If you do, the counselors will start nitpicking till they get you kicked out. I can’t afford to get kicked out cause there goes my conditional release (CR).’

15. Discipline and Removal • Drug use on the inside • Lack of formal removal policy • High removal rates • Minimal therapeutic training for security officers

16. Supervision and Oversight • Documentation • Clinical supervision • Outside oversight

17. Aftercare and Reentry • “Much of the information that they have is outdated, and what resources they do have are under-funded and under-staffed, many of them having moved away a long time ago. I never found these services helpful at all simply because most of them only exist on paper, and are not actual contacts with people who are in positions to really offer a helping hand.”

18. Aftercare and Reentry • No input from treatment staff to field parole officers • Absence of discharge paperwork • Minimal discharge planning • Limited support available in general population housing

19. Challenges Confidentiality Coercion • “Would you sit in a group of 45 criminals in a prison and talk about your personal life, feelings, beliefs, failures, pain, etc. Maybe YOU would. I have to live here, and there’s another 1,600-1,700 criminals around me everytime I go out the door. Word gets around quick. That guy this, that guy that.” • “The reality about prison programming is that you are going to take whatever they tell you to take, and if you don’t, don’t even try to consider parole or good time. To say to countless of inmates that you’re going to take what we tell you to take or you can kiss your conditional release date goodbye is not conducive to effective therapy and treatment, not at all.”

20. Recommendations • Comprehensive Assessment • Levels of Care and Treatment Matching • Clinical Supervision and Oversight • Training/Best Practice Centers • Coordinated Discharge Planning

21. Contact Information for the Correctional Association of New York • Cindy Eigler, Associate Director of Special Projects, Prison Visiting Project 212-254-5700 ceigler@correctionalassociation.org www.correctionalassociation.org