Diverting Women Offenders from Prison

Nena Messina, PhD, UCLA Integrated Substance Abuse ProgramsNancy Chand Esq., Los Angeles County Public Defender’s Office

Association of Criminal Justice Research October 22, 2010

Changing AOD Treatment Populations and Policies

Changing Criminal Justice Policies: Dramatic increases in the number of women under CJ

supervision over past 2 decades (8% increase in women in prison vs. 6% increase in men)

Zero tolerance policies surrounding drug crimes

Result: An Influx of Women into Prison & Community Programs

Women Pose Complex Issues for Treatment Practitioners

Compared with men, women:1. Have patterns of drug abuse that are more socially

embedded – revolving around their relationshipsa. Drug use is often initiated by sexual partnersb. Continue to use drugs to cope with abusive relationships

2. Have more severe histories of sexual/physical abuse

3. Have a higher prevalence of psychological and physical health problems

4. Have limited education/employment histories5. Are typically primary caregivers for minor children

Messina, Burdon, & Prendergast (2003).

Theoretical Developments:The Relational Model

Recognizes the different ways in which women and men develop psychologically.

Suggests that healthy connections with other people are fundamental to women’s psychological well-being. Incarcerated women continue to maintain a

relational context in their lives (develop closeness with other inmates, create pseudo-families)

Theory provides a conceptual basis for planning treatment services for women.

Miller (1976) & Covington (1997; 1998).

Women-Focused Programs: Women are more likely to discuss certain issues in

a growth-fostering environment (prostitution and abuse);

Have gender-specific role models. Include curricula and philosophy that attends to

women’s specific needs.Traditional Therapeutic Community Programs: Were designed initially for men; May hinder growth and recovery among women.

The Relational Model: Guide for Treatment

Treatment Components Associated with Better Outcomes for Women

Review of 38 studies with randomized and non-randomized comparison group designs:– child care– prenatal care– women-only admissions– supplemental services & workshops on

women’s focused topics– mental health services– comprehensive programming

Source: Ashley, Marsden, & Brady , 2003. Slide provided by Christine Grella, Ph.D.

Treatment Retention in Residential Programs by Program Characteristics

97

33

83

22

0

20

40

60

80

100

w/childcare

w/o childcare

women-only

mixed-gender

Days

Source: Brady & Ashley, 2005, SAMHSA Office of Applied Studies. Slide provided by Christine Grella, Ph.D.

Randomized Study of Women in G-R Prison Treatment Decreased Reincarceration

31.0

45.0

0

10

20

30

40

50

60

70

80

90

100

TOTAL TIME TO RETURN TO CUSTODY

GRT TAU (p<.05)

Source: Messina, Grella, Cartier & Torres, 2010

The 2nd Chance Women’s Re-Entry Court Program

• Drug Court ModelWomen are on paroleCharged with new felonyNo option but prison

A Unique Collaborative Effort

• Prototypes Centers for Change• CA Department of Corrections & Rehabilitation • CA Endowment • Los Angeles County Government & Community

Agencies • UCLA ISAP

Treatment Curriculum• Gender Responsive

– Helping Women Recover• Trauma Informed

– Seeking Safety

Two minor children allowed Children receive specialized treatment

Current EvaluationProcess evaluation:

Barriers to implementation & multi-agency collaborations

Perceptions of success/failure of program from staff and clients

Records based follow-up to assess:Program attendance & completion statusSanctions, court records, and incarcerationControlling for participant demographics

CA Endowment Funded EvaluationMatched comparison outcome evaluation:

1 to 1 matched comparison group from VSPW In depth interviews

Program entry for Prototypes 6 months to parole for VSPW women 6 month follow up interview

Outcomes Program completion/retention Health status and access to health care Psychological status and Self-Efficacy Employment and/or continued education Parental attitudes/parental reunification Drug use (urinalysis results and self-report) Recidivism (CDCR)

Subject Characteristics (N=145):

White (30%), Black (43%) or Latina (23%) Never married (59%) or previously married (30%) Mean age 37 (9.6) Mean education 11 years (1.9) Primary drug –cocaine/crack (38%),

methamphetamine (29% ), heroin (17%) Post Traumatic Stress Disorder (51%) Hepatitis (25%) HIV Positive (6%)

Criminal History and Current Sentence

Range Mean (SD)

Average number of arrests 2 – 85 18 (16.4)Felony convictions 0 – 14 4 (4.2)Misdemeanor convictions 0 – 42 7 (8.6)Prison commitments 1 – 10 3 (1.9)

Maximum exposure in years 2 – 24 8 (4.9)Estimated Offer in years -- 4 (4.0)Projected actual time served -- 3 (3.0)

Pregnancy & Children in Program

• 78% Have children (N=145) with 20% CPS involvement

• Average number of children = 3 (1.9)

• 11% Currently pregnant

• 47% came into program with no prenatal care

• To date, 12 babies born during treatment

• To date, 21 children in residence

Program Status for Clients

Program Status (N=145)

Graduated 36 25%Currently in Residential 35 24%Currently in Outpatient 20 14%Transferred 8 06%Bench Warrant 18 13%Returned to State Prison 25 17%Deceased 2 01%

Time in Treatment

N RangeMean (SD)

Months in Residential 118 1 – 19 8 (4.5)

Months in Outpatient 43 1 – 13 8 (2.9)

Graduate’s Months in Residential 36 2 – 16 9 (3.5)

Graduate’s Months in Outpatient 36 4 – 13 8 (2.1)

Total Months in Treatment for Graduates 36 11 – 24 15 (3.2)

Predictors of Program SuccessCharacteristic Prison/BW (n=43) Grad/Outpatient (n=56) Race/Ethnicity

Caucasian 33%33%

African American 38%29%

Hispanic/Latina 24%29%Other 5%

9%Criminal Justice Supervision

Parole 70%59%Probation 30%

41%Primary Drug

Heroin 23%11%Methamphetamine 23%43%Cocaine/Crack 35%33%Other 20%

13%Any Mental Health Diagnosis* 94%

75%Childhood Sexual Abuse 40%

34%Adult Rape Victim 40%

36%Age* 35 (9.2)

37 (9.5)Months in Residential Treatment** 6.2 (4.3)

10 (4.1)

Re-Entry Court Successes!• Improved & ongoing collaborations

– Benefit of over 5 years of multiagency collaborations

• Reduced costs for CDCR– If not for re-entry program, CDCR would have all 145

women in prison

• Prevention & health care for children– If not for re-entry program, CDCR would have 12

babies born in prison with more children in CPS

• Enormous State & County Savings

This study is funded by the

California Department of Corrections and Rehabilitation

& The California Endowment

Thank you!