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Veterans Treatment Courts. American Judges Association 2012 Educational Conference-New Orleans Presented by Judge Robert Russell. Outline. Who is a Veteran? Who are they? Justice-involved Veterans What is a Drug Court? How is a Veterans Treatment Court different?

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Veterans treatment courts

Veterans Treatment Courts

American Judges Association

2012 Educational Conference-New Orleans

Presented by Judge Robert Russell


Outline
Outline

  • Who is a Veteran?

  • Who are they?

  • Justice-involved Veterans

  • What is a Drug Court?

  • How is a Veterans Treatment Court different?

  • Why have a Veterans Treatment Court?


Veterans who are they
Veterans: Who are they?

23.2 million Veterans in the United States

5.2 million have served from the Gulf War to present

2 Million members of the armed forces have served in Iraq and Afghanistan since October 2001

As of December 31, 2007, more than 800,000 veterans of these conflicts were eligible for VA healthcare


Reserve and national guard
Reserve and National Guard

254,000 Reservists and 332,000 National Guard members have deployed to OEF/OIF

Increased stress on families, employment, and housing


Women veterans
Women Veterans

1.8 million of today's Veterans are women (7.5%)

20% of all military personnel are represented by women

182,000 served in OEF/OIF

5% of the Veteran homeless population are women

4 times more likely to become homeless than male veterans


Homelessness
Homelessness

  • Over 67,000 Veterans will be homeless tonight

  • Veterans 50% more likely to become homeless than non-Veterans

  • 76% suffer from a substance abuse and/or mental health condition

  • Criminal involvement is single best predicator of future homelessness


Unemployment
Unemployment

  • As of Oct 2011, unemployment rate for Veterans was 11.5% who served since September 2001

  • Rate for 18-24 yr old Veterans was 21.9%

Bureau of Labor Statistics


Suicide
Suicide

  • Veterans make-up 1% of the population, but 20% of suicides

  • Women Veterans are 2-3 times more likely to commit suicide than non-Veteran women

  • Suicides among active duty Army and Marines have increased following OEF/OIF

  • VA indicates 4 or 5 Veterans commit suicide each day


Traumatic brain injury tbi
Traumatic Brain Injury (TBI)

  • Primary: Resulting from initial trauma

  • Secondary: Resulting from Intracranial Pressure (ICP), hypoxia, hypotension.

  • In 2010: 31,407 cases of TBI

  • 11,800 troops injured in IED attack

  • 28% of all military evacuated to Walter Reed AMC = TBI

  • Rapid evac + treatment = 96% survival rate

  • TBI is not only the result of combat


Post traumatic stress disorder ptsd
Post Traumatic Stress Disorder (PTSD)

Exposure to traumatic event in which both of following present:

(1) Person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.

(2) Person’s response involved intense fear, helplessness, or horror.


How common is ptsd among veterans
How common is PTSD among Veterans?

  • Vietnam – 15% men/8% women (31%/27% est. lifetime prevalence)

  • Desert Storm – 10%

  • Operations Enduring Freedom & Iraqi Freedom (OEF/OIF) – 14%

    • Est. 300,000 suffering from PTSD or major depression (2010)

  • Repeated deployments increase the likelihood of PTSD


Combat experience oef oif
Combat Experience (OEF/OIF)

  • 78% Received incoming artillery, rocket or mortar fire

  • 72% Knew someone seriously injured or killed

  • 60% Saw dead bodies or human remains

  • 58% Received small arms fire

  • 56% Had a member of their unit become a casualty

  • 49% Saw dead or seriously injured Americans

  • 33% Handled or uncovered human remains


Military sexual trauma mst
Military Sexual Trauma(MST)

  • Both sexual harassment and sexual assault that occurs in military settings

  • 60% of women with Military Sexual Trauma also suffered from PTSD

VA Screening, 2002-2008


Substance abuse
Substance Abuse

Among active duty service members:

  • Heavy drinking (five or more drinks per occasion at least once a week) self-reported at 20%.

    • Heavy drinking is higher among 18 to 34 age group than civilians.

  • Prescription drug misuse doubled from 2005 to 2008 ( 5% in 2005 to 12% in 2008)

Dept of Defense Behavioral Health Survey - 2008


Justice involved veterans
Justice-involved Veterans

  • Less likely to be arrested or incarcerated

  • Average 10% of criminal justice population

  • Approx 80% with Honorable/General discharge

  • 57% violent offenders compared to 47% of non-Veterans

  • Reported longer sentences for all crime types. -On average, Veterans are expected to serve 22 months longer than non-veterans

Bureau of Justice Statistics - 2004


Justice involved veterans1
Justice-involved Veterans

  • 61% of Veterans in State prison meet the criteria for substance dependence or abuse (57% of Federal prison veterans)

  • 54% of Veterans in State prison met one of two criteria for a recent mental health problem

  • Veterans in State prison (45%) and Federal prison (35%) reported symptoms of mental health disorders in the past 12 months

  • Veterans are more likely to report recent history of mental health services

  • Experienced physical abuse: 18%

  • Experienced sexual abuse: 7%


What is a drug court
What is a Drug Court?

Judicially-supervised docket that provides defendants/clients with intensive treatment and other services while holding them accountable to the court, society, their families and themselves


What is a drug court1
What is a Drug Court?

  • Judge, Prosecution, Defense, Probation, Law Enforcement, Treatment, using a non-adversarial, team approach

  • Regular court appearances

  • Frequent and random drug tests

  • Immediately rewards positive behavior, sanctions negative


Drug courts
Drug Courts

  • 1989 – 1st Drug Court formed in Miami, FL

  • 2011 – 2,569 Drug Courts in the United States

  • Drug Courts Work!

    • Reduce crime

    • Lower costs

    • Ensure compliance


Reduce crime
Reduce Crime

  • 75% of Drug Court clients remain arrest-free at least 2 years after graduation.

  • Reductions in crime last at least 3 years and can endure for over 14 years.

  • Drug Courts reduce crime as much as 35% more than other sentencing options.


Save money
Save Money

  • Up to $3.36 in criminal justice costs for every $1.00 invested.

  • Up to $12 for every $1 invested, when including other cost offsets (i.e., reduced victimization and healthcare service utilization.

  • Between $4,000 to $12,000 in Annual costs per participant.


Ensure compliance
Ensure Compliance

  • Provide more comprehensive and closer supervision than other community-based supervision programs.

  • 6 times more likely to keep offenders in treatment long enough for them to get better.



Veterans treatment courts1
Veterans Treatment Courts court for them?

  • Hybrid Drug and Mental Health Treatment Courts using the Drug Court Model. Principals of both Drug & Mental Health Courts

  • Addition of U.S. Dept of Veterans Affairs representatives, state and local agencies, and volunteer Veteran mentors.

  • Target those who have served in the U.S. Armed Forces.

  • Jan 08 – First opened in Buffalo, NY.

  • May 11 – Approx 100 VTCs, many are being planned.


Veteran specific benefits and services
Veteran-specific court for them?Benefits and Services

  • U.S. Department of Veterans Affairs (VA)

    • Veterans Health Administration (VHA)

    • Veterans Benefits Administration (VBA)

  • Department of Housing and Urban Development (HUD)

  • Department of Labor (DOL)

  • State/County agencies

  • Veteran Service Organizations

  • Pro Bono Legal Assistance


  • Veterans affairs va
    Veterans Affairs (VA) court for them?

    • Medical

      • Substance Abuse

      • Mental Health (to include PTSD)

    • Homeless Services

    • Employment and Vocational Training

    • Education

    • Pension and Disability Payments


    Veterans justice outreach vjo program
    Veterans Justice court for them?Outreach (VJO) Program

    • Outreach, assessment, case management for justice-involved Veterans in local courts and jails

      • Veteran identification

      • Assistance in eligibility and enrollment

      • Continued monitoring and consultation

      • Hand-off to VA and community service providers


    Vtc mentor peer programs
    VTC Mentor/Peer Programs court for them?

    • Volunteers with prior or current military service

    • Help Veterans navigate the Court, VA, and treatment systems

    • Assess “other needs” and help adjust to civilian life

    • Help the Veteran and Veteran’s family receive the services they need to be productive members of society


    Military cultural
    Military Cultural court for them?

    Veterans are used to:

    • Structure

    • Leadership

    • Loyalty

    • Patriotism

    • Camaraderie

    • Teamwork & Self-reliance



    Veterans Treatment Courts have adopted with slight modifications the essential tenements of the Ten Key Components as described in the U.S. Department of Justice Publication entitled “Defining Drug Courts: The Ten Key Components”, (Jan. 1997).


    Key component 1
    Key Component # 1 modifications the essential tenements of the Ten Key Components as described in the U.S. Department of Justice Publication entitled “Defining Drug Courts: The Ten Key Components”, (Jan. 1997).

    Integrates alcohol, drug treatment, mental health treatment, medical services with justice system case processing


    Key component 2
    Key Component # 2 modifications the essential tenements of the Ten Key Components as described in the U.S. Department of Justice Publication entitled “Defining Drug Courts: The Ten Key Components”, (Jan. 1997).

    Using a non-adversarial approach, prosecution and defense promote public safety while protecting participants' due process rights


    To facilitate the veterans’ progress in treatment, the prosecutor and defense counsel shed their traditional adversarial courtroom relationship and work together as a team.


    Key component 3
    Key Component # 3 prosecutor and defense counsel shed their traditional adversarial courtroom relationship and work together as a team.

    Eligible participants are identified early and promptly placed


    Early identification of veterans entering the criminal justice system is an integral part of the process for placement in the Veterans Treatment Court program.

    The trauma of arrest can be an opportunity for the veteran to address denial issues.


    Key component 4
    Key Component # 4 justice system is an integral part of the process for placement in the Veterans Treatment Court program.

    Access to a continuum of alcohol, drug, mental health and rehabilitation services


    Participants in Veterans Treatment Court may have different levels of need in a wide variety of service domains.

    Issues such as PTSD, TBI, Domestic Violence and homelessness may need to be assessed and addressed.

    Mentors


    Key component 5
    Key Component # 5 levels of need in a wide variety of service domains.

    Abstinence is monitored by frequent alcohol and drug testing


    Drug Testing levels of need in a wide variety of service domains.

    Court ordered drug testing

    Frequent

    Random

    Use of results


    Key component 6
    Key Component # 6 levels of need in a wide variety of service domains.

    Coordinated strategy governs Court’s responses to participants' compliance


    Incentives and sanctions
    Incentives and Sanctions levels of need in a wide variety of service domains.

    Coordinated strategy establishes protocols for rewarding progress as well as sanctioning non-compliance.


    Key component 7
    Key Component # 7 levels of need in a wide variety of service domains.

    Ongoing judicial interaction with each Veteran is essential


    Judge as leader of the team. levels of need in a wide variety of service domains.

    Continuity of relationship between judge and veteran

    Relationship from acceptance in program throughout treatment and commencement and aftercare

    The message is “Someone in authority cares”


    Key component 8
    Key Component # 8 levels of need in a wide variety of service domains.

    Monitoring and evaluation measure the achievement of program goals and gauge effectiveness


    Program monitoring
    Program Monitoring levels of need in a wide variety of service domains.

    Measures progress against goals

    Results are used to monitor progress

    Results are used to improve operations


    Key component 9
    Key Component # 9 levels of need in a wide variety of service domains.

    Continuing interdisciplinary education promotes effective Court planning, implementation, and operations


    All Veterans Treatment Court staff should be involved in interdisciplinary education and training.

    Shared interdisciplinary training creates common knowledge and understanding.


    Key component 10
    Key Component # 10 interdisciplinary education and training.

    Forging partnerships among the Veterans Administration, public agencies, and community-based organizations generates local support and enhances Court effectiveness


    Questions

    Questions interdisciplinary education and training.?


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