A Parent in Prison Affects Children’s Health for Life: Study

A study published in Pediatrics found that young adults who had a parent incarcerated during their childhood are more likely to skip needed healthcare, smoke cigarettes, engage in risky sexual behaviors, and abuse alcohol and prescription and illicit drugs.

A parent’s incarceration has long-lasting effects on children’s health, according to researchers from Ann and Robert H. Lurie Children’s Hospital of Chicago.

A  study published in Pediatrics this month demonstrates that young adults who had a parent incarcerated during their childhood are more likely to skip needed healthcare, smoke cigarettes, engage in risky sexual behaviors, and abuse alcohol and prescription and illicit drugs.

Researchers observed different effects depending on the sex of the incarcerated parent. Children whose mothers were incarcerated were twice as likely to receive medical care from the emergency department rather than a primary care setting. A mother’s incarceration also doubled the likelihood that young adults would engage in prostitution.

Children whose fathers were incarcerated, meanwhile, were 2.5 times more likely to use intravenous drugs.

The Lurie Children’s study builds on previous research showing that individuals with a history of parental incarceration have higher rates of asthma, HIV/AIDS, learning delays, depression, anxiety, and post-traumatic stress disorder.

“It’s possible that because these young adults are more likely to forgo medical care and engage in unhealthy behaviors, they are at higher risk to develop these physical and mental health conditions,” says lead author Dr. Nia Heard-Garris, MSc, a pediatrician at Lurie Children’s Hospital and Instructor of Pediatrics at Northwestern University Feinberg School of Medicine, in a statement announcing the study’s findings.

The U.S. has the highest incarceration rate in the world, and more than five million children in this country have had a parent in jail or prison. In the study, 10 percent of the 13,000 young adults surveyed had a parent incarcerated during their childhood. Participants were 10 years old, on average, the first time their parent was incarcerated.

The study’s findings have particular implications for black children, who experience parental incarceration at a significantly higher rate than other populations. While less than 15 percent of the young adults surveyed were black, they accounted for roughly 34 percent of those with history of an incarcerated mother, and 23 percent of those with history of an incarcerated father.

“With the climbing number of parents, especially mothers, who are incarcerated, our study calls attention to the invisible victims – their children,” says Dr. Heard-Garris. “We shed light on how much the incarceration of a mother versus father influences the health behaviors of children into adulthood.”

This summary was prepared by TCR News Intern Elena Schwartz. Readers’ comments are welcome.

from https://thecrimereport.org

How Well Does the Justice System Track the Incarcerated?

Tracking the sheer number of incarcerated individuals is not enough to create a more fair, equitable criminal justice system, according to expert Adam Gelb.

Tracking the sheer number of incarcerated individuals is not enough to create a more fair, equitable criminal justice system, according to one expert.

While the national attitude about crime and punishment has shifted, and the public is now calling for more aggressive reforms to criminal penalties, the way data is collected in jails and prisons needs to change, argues Adam Gelb, the Director of the Public Safety Performance Project at The Pew Charitable Trusts.

Gelb, in a report produced for the Executive Session on Community Corrections at Harvard’s Kennedy School of Government, found that two new, nuanced ways to collect data were needed.

He suggests collecting the following information:

  1. Correctional Population Composition: This measure would track the profile, or composition, of the prison and supervision populations. It would shed light on the critical question of what percentage of these population consist of those who pose a threat to public safety, and how many are people who could safely pay their debt to society in less expensive and more effective ways.
  2.  Recidivism by Risk: A second metric would adjust recidivism rates to account for the changing composition of persons under correctional control. It would help gauge how well corrections agencies are succeeding with individuals across the risk spectrum, and guard against perceptions of failure if recidivism rates rise due to the higher-risk composition of caseloads rather than sagging performance.

If progress towards a better, more equitable justice system is to be achieved, we need to know more than “the raw number of people in prison”, Gelb said.

That gauge, in turn, will help illuminate whether institutional and community corrections agencies are succeeding in reducing the likelihood they will come back again, he concluded.

A full copy of the paper can be found here.

Megan Hadley is a reporter for The Crime Report. 

from https://thecrimereport.org

Prosecutor-Led Diversion Programs Lead to Reduced Incarceration, Re-Arrest

A study issued by the National Institute of Justice found that diversion programs benefit not only prosecutors, who save time, money and resources that could be spent on more serious cases, but also defendants, who avoid conviction and re-arrest.

Prosecutor-led diversion programs can lead to reduced conviction and incarceration, as well as reduced re-arrest rates, according to a study issued by the National Institute of Justice.

The study examined 16 prosecutor-led diversion programs in 11 jurisdictions across the country and conducted impact evaluations of five programs and cost evaluations of four programs.

Authors found that conviction rates among diversion and comparison cases were nine percent vs. 74 percent in Milwaukee’s Diversion program; 16 percent vs. 64 percent in Chittenden County’s Rapid Intervention Community Court (RICC), and three percent vs. 61 percent among felony defendants in Cook County’s Drug School.

Notably, all five programs also achieved at least some reduction in the use of jail sentences.

In recent years, a growing number of prosecutors have established pretrial diversion programs, either pre-filing—before charges are filed with the court—or post-filing—after the court process begins but before a disposition.

Participating defendants must complete assigned treatment, services, or other diversion requirements. If they do, the charges are typically dismissed, relieving the defendant of jail time and the latter consequences of a criminal record.

Diversion programs are beneficial not only to defendants, but to prosecutors as well, who save time, money and resources that could be allocated towards more serious and complex crimes, said the authors.

Now, prosecutor-led diversion programs are one of several increasingly popular “front-end” interventions targeting cases early in case processing, often before a case reaches the court, they noted.

“Our study confirmed a broader trend towards diverting cases to treatment or services at an extremely early juncture in criminal case processing,” the authors concluded.

Here are some of the other main findings in the study:

  • Case Outcomes: All five programs participating in impact evaluations (two in Cook County, two in Milwaukee, and one in Chittenden County, VT) reduced the likelihood of conviction — often by a sizable magnitude.  All five programs also reduced the likelihood of a jail sentence (significant in four and approaching significance in the fifth program).
  • Re-Arrest: Four of five programs reduced the likelihood of re-arrest at two years from program enrollment (with at least one statistically significant finding for three programs and at least one finding approaching significance in the fourth).  The fifth site did not change re-arrest outcomes.
  • Cost: All four programs whose investment costs were examined (two in Cook County and one each in Chittenden and San Francisco) produced sizable cost and resource savings.  Not surprisingly, savings were greatest in the two pre-filing programs examined, which do not entail any court processing for program completers.  All three programs whose output costs were examined (i.e., omitting the San Francisco site) also produced output savings, mainly stemming from less use of probation and jail sentences.

This study was implemented as a collaboration among the Center for Court Innovation, the RAND Corporation, the Association of Prosecuting Attorneys, and the Police Foundation. A full copy of the report can be found here.

Megan Hadley is a staff writer with The Crime Report. She welcomes readers’ comments.

from https://thecrimereport.org

Homeless, Mentally Ill and Addicted: The Downward Spiral

An outbreak of hepatitis A in a number of states highlights the vulnerability of individuals suffering from both mental illness and substance abuse. Those most at risk —the homeless and formerly incarcerated—deserve “compassionate, evidence-based solutions,” says a TCR columnist.

Several states are in the midst of hepatitis A virus outbreaks. San Diego and the surrounding region are among the hardest hit, but southeast Michigan has more reported cases and more deaths. Utah, Colorado and Kentucky also have experienced outbreaks.

California had 683 cases as of Jan. 23, with 21 deaths. Michigan recorded 715 cases as of Jan. 24, with 24 deaths. Colorado has had 62 cases, and one reported death.

Understanding these outbreaks requires acknowledging the links between homelessness, addiction and mental illness—and it requires more than a single solution.

Hepatitis A is typically a disease spread by human contact with already-infected individuals or pieces of their stool that are too small to see. High-risk groups include the homeless, the incarcerated (and those released from prison) and drug users—all groups that have some overlap. The homeless and the incarcerated also suffer from mental illness and are drug users, a condition known as a dual diagnosis or co-occurring disorders, and the deficiencies of health care in many prison facilities make incarceration a key risk factor.

According to a 2009 National Coalition for the Homeless (NCH) fact sheet, the Substance Abuse and Mental Health Services Administration found that “20 to 25 percent of the homeless population in the United States suffers from some form of severe mental illness,” compared to only six percent of the population as a whole.

A one-year study of people with serious mental illnesses examined by California’s public mental health system found that 15 percent were homeless at least once in the previous 12 months.

In addition, the NCH fact sheet found that “some mentally ill people self-medicate using street drugs, which can lead not only to addictions, but also to disease transmission from injection drug use.”

The Los Angeles Times cites experts who say that 50 percent to 70 percent of homeless people with severe mental illness (SMI) also have problems with alcohol or drugs.

The likelihood of homelessness also is increased when you have a mental illness, an addiction disorder and a disease such as hepatitis A. None of these conditions is going to go away if you are homeless and have no access to health, substance abuse or mental illness services.

If only one of the three gets treatment, the other two remain, and the third may return because they are all connected.

In 2016, Kevin Fischer, executive director of the National Alliance on Mental Illness (NAMI) of Michigan, suggested on Michigan Public Radio that closing all the state mental hospitals in the 1990s by then-Gov. John Engler resulted in an “explosion in homelessness.”

The mentally ill were supposed to be sent home, but many ended up on the streets because the private mental health system and the patients’ families were not prepared to handle them.

Joel John Roberts, CEO of People Assisting The Homeless (PATH) Partners, says many people in the mental health field put the blame on Ronald Reagan, then governor of California, who they say released more than 50 percent of the state’s mental hospital patients and abolished involuntary hospitalization of people with mental illness.

“This started a national trend of de-institutionalization,” Roberts wrote.

Then, as president, Reagan ended funding for federal community mental health centers. No one expected the mentally ill to wander the streets. The feds thought the states would take care of them. The states thought private insurance or family would take care of them.

Somewhere, somehow, they were wrong.

To get these outbreaks under control, and to prevent future outbreaks, we need more support for mental health and substance abuse treatment, and better harm reduction strategies (including clean needle exchanges and safe injection sites).

Some of that funding could come from Medicaid if the Trump administration eliminates the Institutions for Mental Diseases (IMD) Exclusion, which prohibits Medicaid funds going to mental health providers with more than 16 beds. There’s bipartisan agreement that this rule, which dates back to 1965, needs to go. The executive branch can, has, and does issue exemptions for this rule, and Trump has pledged to speed up the process.

But virtually no one thinks the rule needs to remain.

More than money is needed. Sometimes only one co-occurring disorder is apparent. First responders need to be trained to look for and recognize both.

In 2017, the Michigan Department of Health and Human Services (MDHHS) & Michigan Association of CMH Boards wrote, “Supports and services for persons with co-occurring mental health and substance use disorders must be the norm for all agencies across the network.”

The department added this was because “it is more prevalent than addiction-only or mental illness-only among the people served by MDHHS providers. Practitioners in every program at all levels of care must be competent to address comorbidity in mental health and substance abuse treatment.”

Effective treatment, according to the NAMI, requires not only that both be treated—but preferably at the same time. It’s called integrated intervention, and often involves detoxification, inpatient rehabilitation with psychotherapy, supportive housing, maybe medications (either to treat mental illness symptoms or to control addiction) and self-help/support groups.

The Michigan House of Representatives’ bipartisan House C.A.R.E.S. (Community, Access, Resources, Education, and Safety) Task Force’s final report recommended that crisis intervention training (CIT) for first responders should include “information on signs and symptoms of mental illnesses” and “co-occurring substance use disorders.”

It also recommended that trial and pre-trial practices “should assess defendants to determine whether the person has a serious mental illness, co-occurring substance use disorder” and so benefit from “mental health services.” Better and more consistent efforts must be made to screen for mental illness and co-occurring substance disorders during the booking process, the task force said.

But that’s if the individual ends up in the mental health or criminal justice system. There are harm reduction practices that can save lives even if the person with mental health and substance-use disorder remains out of the system.

One is providing maintenance drugs (medication-assisted treatment or MAT) such as buprenorphine (brand name Suboxone, also available as an implant, Probuphine, that only needs to be replaced every 90 days) or methadone to addicts to prevent withdrawal, and there are drugs for mental illnesses such as depression, bipolar disorder, schizophrenia, and psychosis.

Another—although hep A isn’t as likely to be spread this way—is providing intravenous drug users with a safe injection space. These spaces are also known as safe consumption sites, fix rooms, drug consumption room (DCR), supervised injecting facilities, and shooting galleries. But they share the following characteristics: a clean facility, with clean needles, the availability of testing supplies to make sure the drug is unadulterated, and a nurse to administer naloxone in case of an overdose.

They not only save lives—no deaths have been reported at any such site around the world, including Canada and Australia—they also save money.

Editor’s Note: San Francisco is set to become the first in the U.S. to introduce safe injection spaces, with two sites scheduled to open in July.

A recent study estimated that such strategies could save an average US city $3.5 million per year and that some could save more (Baltimore: $6 million). The American Medical Association likes the idea, as do the Clinton Foundation and the Johns Hopkins Bloomberg School of Public Health.

Some in the anti-drug camp oppose harm reduction in particular, and substance abuse treatment in general. They prefer incarceration to rehab. Their position on the mentally ill is less clear, but maybe they feel that, too, is the result of a poor personal choice.

Stephen Bitsoli

Stephen Bitsoli

Maybe paying for these sinners to go to dual diagnosis treatment centers seems like rewarding bad behavior. The result: we have a homeless problem, an opioid epidemic, and hepatitis A outbreaks,

Punishment isn’t working, and science and public opinion now believe addiction is like a disease. It’s time to look for compassionate, evidence-based solutions.

Stephen Bitsoli, a Michigan-based freelancer, writes about addiction, politics and related matters for several blogs. He welcomes readers’ comments.

from https://thecrimereport.org

Offender Recidivism: What Works-What’s Hogwash

Subtitle We may be making progress as to reducing recidivism in the United States. Author Leonard Adam Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Former Senior Specialist for Crime Prevention for the Department of Justice’s clearinghouse. Former Director of Information Services, National Crime Prevention Council. Post-Masters’ Certificate of Advanced […]

Subtitle We may be making progress as to reducing recidivism in the United States. Author Leonard Adam Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Former Senior Specialist for Crime Prevention for the Department of Justice’s clearinghouse. Former Director of Information Services, National Crime Prevention Council. Post-Masters’ Certificate of Advanced […]

from http://www.crimeinamerica.net

Parole Caseloads Longer, More Violent, More Challenging Since 2005

Subtitles The use of discretionary parole increased dramatically. The parole population from 2005 to 2015 included the same percentage of active cases (83 percent) when they were supposed to decline. Caseloads grew more challenging with more violent offenders. The increased use of parole rather than mandatory release means that offenders will be on parole and […]

Subtitles The use of discretionary parole increased dramatically. The parole population from 2005 to 2015 included the same percentage of active cases (83 percent) when they were supposed to decline. Caseloads grew more challenging with more violent offenders. The increased use of parole rather than mandatory release means that offenders will be on parole and […]

from http://www.crimeinamerica.net

Despite Reform Efforts, Probation Hasn’t Changed Much Since 2005

Observations  The probation population from 2005 to 2015 included more active cases when they were supposed to decline due to diversions. Treatment doesn’t exist beyond 1 percent. Caseloads grew more challenging with more felonies and more violent offenders. Author Leonard Adam Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Former […]

Observations  The probation population from 2005 to 2015 included more active cases when they were supposed to decline due to diversions. Treatment doesn’t exist beyond 1 percent. Caseloads grew more challenging with more felonies and more violent offenders. Author Leonard Adam Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Former […]

from http://www.crimeinamerica.net

Top Ten Releases from Prison by State-State Releases Over Time

Subtitle 641,000 Offenders Released From Prison in 2015 Author Leonard Adam Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Former Senior Specialist for Crime Prevention for the Department of Justice’s clearinghouse. Former Director of Information Services, National Crime Prevention Council. Post-Masters’ Certificate of Advanced Study-Johns Hopkins University. Article There were […]

Subtitle 641,000 Offenders Released From Prison in 2015 Author Leonard Adam Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Former Senior Specialist for Crime Prevention for the Department of Justice’s clearinghouse. Former Director of Information Services, National Crime Prevention Council. Post-Masters’ Certificate of Advanced Study-Johns Hopkins University. Article There were […]

from http://www.crimeinamerica.net

Top Ten States for Imprisonment- State Incarceration Rates Over Time

Observations The District of Columbia and Louisiana have the highest rates of incarceration. Main has the lowest rate of incarceration. Author Leonard A. Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Former Senior Specialist for Crime Prevention for the Department of Justice’s clearinghouse. Former Director of Information Services, National Crime […]

Observations The District of Columbia and Louisiana have the highest rates of incarceration. Main has the lowest rate of incarceration. Author Leonard A. Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Former Senior Specialist for Crime Prevention for the Department of Justice’s clearinghouse. Former Director of Information Services, National Crime […]

from http://www.crimeinamerica.net

Do Prison Inmates Deserve Incarceration?

More Titles The American Prison Vote Project Are American prisons incarcerating the right people? Do violent or repeat offenders deserve prison? Article There are endless groups advocating for lessening or ending (at least by 50 percent) America’s reliance on prisons. “They are costly and inefficient,” many will say. “Americans have the shame of having the […]

More Titles The American Prison Vote Project Are American prisons incarcerating the right people? Do violent or repeat offenders deserve prison? Article There are endless groups advocating for lessening or ending (at least by 50 percent) America’s reliance on prisons. “They are costly and inefficient,” many will say. “Americans have the shame of having the […]

from http://www.crimeinamerica.net