Meeting the Behavioral Health Needs of Veterans Across the Intercepts

By: Ashley Krider, Terri Hay, Duane France

Human Toll of Jail Jail Populations Veterans November 10, 2022

Many veterans experience substance use disorders, mental health conditions including Post-Traumatic Stress Disorder (PTSD), and trauma, including traumatic brain injuries, all of which can lead to involvement with the criminal legal system. Fifty-five percent of veterans incarcerated in 2011–2012 reported having a mental health disorder, with mental illness diagnosis twice as high in veterans as in non-veterans. Approximately 65% to 71% of justice-involved Veterans had a reported substance use disorder before arrest.

In recognition of Veterans Day on November 11th, we would like to highlight several relevant resources and opportunities. A focus on specific populations, such as Veterans, aligns with the commitment Safety and Justice Challenge (SJC) communities have to diversion and deflection, as well as meeting the behavioral health needs of individuals who are or may become involved with the criminal legal system.

  • Many SJC cities and counties, which receive support from the John D. and Catherine T. MacArthur Foundation, operate Veterans Treatment Courts, including Harris County, TX, Cook County, IL, Ada County, ID, and Palm Beach County, FL. Unlike traditional criminal courts, the primary purpose of a Veterans Treatment Courts is not to determine whether an individual is guilty of an offense, but rather to ensure that they receive treatment to address unmet clinical needs. There are over 600 Veterans Treatment Courts across the U.S.
  • With the integration of the new three-digit National Suicide and Crisis Lifeline (988), people can now dial 988 and press 1 to access the Veterans Crisis Line. There are also options to chat online or text at 838255. Responders are trained in crisis intervention and military culture.
  • One program from the U.S. Department of Veterans Affairs (VA) that allow entities to identify whether an individual has prior military service is the Veterans Re-Entry Search Service. This web-based system allows prison, jail, and court staff to identify Veterans quickly and accurately among their populations. The VA makes this service available to facilitate its own direct outreach to these Veterans, and to inform the development of Veteran-specific programs in the criminal legal system.
  • Veterans Justice Outreach specialists provide a range of services to assist justice-involved Veterans, including outreach to Veterans across the possible span of their interactions with the criminal legal system, such as law enforcement encounters, courts, jails, and prisons. The aim of the Veteran Justice Outreach program is to avoid the unnecessary criminalization of mental illness and extended incarceration among Veterans by ensuring that eligible, justice-involved Veterans have timely access to Veterans Health Administration services. Each state has one or more Veteran Justice Outreach specialists who can provide additional information on the program.
  • The Peer Specialist Toolkit helps Veterans Health Administration medical centers hire and deploy peer specialists who help other Veterans get treatment for mental and substance use disorders.
  • The Rural Veteran Outreach Toolkitassists VA personnel in collaborating with community partners to reach rural Veterans through education and outreach.
  • The National Institute of Corrections’ Veterans Reentry Programming: Supporting Transition to Civilian Life Across the Sequential Intercept Model outlines Veteran-specific reentry approaches.

We also operate SAMHSA’s Service Members, Veterans, and their Families Technical Assistance (SMVF TA) Center, which serves as a national resource to support states, territories, and local communities in strengthening their capacity to address the behavioral health needs of military-connected individuals and families. The SMVF TA Center supports specific initiatives like the VA/SAMHSA Governor’s and Mayor’s Challenges to Prevent Suicide among SMVF as well as the public at large through a variety of technical assistance efforts including needs assessments, virtual and onsite consultation, Policy and Implementation Academies, interagency collaboration and support, and dissemination of educational resources including a monthly e-newsletter.

One offering from the SMVF TA Center is the Crisis Intercept Mapping (CIM) for SMVF Suicide Prevention. The Crisis Intercept Mapping is a tool that helps community stakeholders visualize how SMVF flow through the crisis care system. The Crisis Intercept Mapping has some parallels to our Sequential Intercept Model and is designed to help communities strengthen the delivery of evidence-based suicide prevention policies and practices for SMVF before, during, and after a time of crisis.

As identified on the model below, within a community crisis system there are four key “intercept points” that provide opportunities for diverting at-risk SMVF to appropriate and effective prevention and support services:

  1. First Contact
  2. Acute Care
  3. Care Transitions
  4. Ongoing Treatment and Recovery Support

In 2022, the White House released a report, Reducing Military and Veteran Suicide: Advancing a Comprehensive, Cross-Sector, Evidence-Informed Public Health Strategy, directly calling for the “expansion of SAMHSA’s crisis mapping initiative to assist cities and counties in identifying gaps and incorporating best practices in suicide prevention for veterans interacting with community crisis systems” (Priority Goal 2 on page 13). Crisis Intercept Mapping is designed to bring together an interagency group of key stakeholders from the community to identify barriers and gaps in the community’s crisis system serving SMVF and discuss ways in which best practices and partnerships can be implemented to close those gaps and reduce service member and Veteran suicide through the development of integrated local strategic action plans.

A Q&A On Hispanic Heritage Month With 70 Million Creator Juleyka Lantigua

By: Juleyka Lantigua

Human Toll of Jail Jail Populations Racial Disparities September 27, 2022

Q: What does Hispanic Heritage Month mean to you?

A: It means that we’re trying to squeeze too much into a single month. As with any designated month or week to celebrate a huge swath of history and the contributions of a broad range of people, the notion falls absurdly short. But the month-long bookmark does have its utility inasmuch as it focuses the limelight on the rising-majority population of the country, thereby surfacing updated information, demographic trends, and political forecasts that, in the hands of people who want to shape the future of the US, can be very helpful

Q: 70 Million, LWC Studios’ podcast about criminal justice reform, was nominated for a Peabody Award and won several others. What prompted the idea? 

A: I created the show to bridge the gap between practitioners and the public, to provide an accessible tool for educators, supporters, and policymakers that could imbue their work with real-world stories about the disastrous consequences of the matrix of “criminal injustice” systems at work in the United States. It’s, at its core, a public service.

Q: Why is it so important to tell the story of the local impact of jail through the voices of people impacted by jail?

A: Jails are the gateway to life-long entanglements with the legal system; they are the progenitors of generational cycles of poverty and disenfranchisement; they are almost entirely useless given that 97% of defendants never go to trial to get their “day in court,” and they simply warehouse people who actually need help. They are the depositories of social ills (not people) we care very little about curing: mental health, domestic violence, drug addiction, homelessness, military PTSD, chronic poverty, and inhumane immigration policies. So they are ideal for unpacking how ignoring, miscategorizing and relegating our collective responsibility for our fellow citizens diminishes who we are and makes becoming who we pretend to be impossible.

Q: Which episode of the podcast has had the most impact on listeners, do you think? 

A: Based on listens, episode 10 in season four reached the most people.

When a State Treats Drug Addiction Like a Health Issue, Not a Crime

A year ago, Oregon became the first state to decriminalize drug possession. The goal is to reverse some of the negative impacts of the War on Drugs by approaching drug use from a health-centered basis. We visit an addiction and recovery center in Portland that’s gearing up for what they hope will be an influx of people seeking treatment. Reported by Cecilia Brown.

Q: Racial equity is a huge part of jail reform, isn’t it? 

A: Racial equity is the only axis on which true reform can be achieved. A system built on monetizing the capture of formerly enslaved people cannot be reformed without addressing the institutional DNA that created it.

Q: I understand that you’re Dominican, and that you’ve also traced your ancestry back to multiple parts of Africa. How does that play into your view of jail issues? 

A: I am an Afro-Descendent Latina woman raising two Black boys in the United States today. Every day I spend on this work extends my sons’ safety, further secures their well being, and contributes to the security of my family’s longevity. This work is vital to me.

Q: What are some of the major issues facing Latinx people in American jails?

A: The same issues that plague everyone else: unreasonable pre-trial detention periods, an exploitative bail system, lack of mental health services, overwhelmed public defenders, understaffed courts, physical hazards in dilapidated facilities, organized crime, etc. But increasingly, a subset of the country’s Latino population has been targeted and trapped by ICE and its private jail and prison contractors. The most revolting of these has been the children separated from their families and held in ice-cold warehouses for months as they sought asylum. So, in many ways, the local jail has become mobile and can pop up anywhere a dragnet needs to be formed for political theater.

Q: Why does it matter that stories about people of color in American jails are told by and for people of color?

A: Because we are the experts in our own experiences. 

Publication

Bail Community Engagement Crime Data Analysis Featured Jurisdictions Human Toll of Jail Jail Populations Pretrial and Bail Pretrial and Jails Pretrial Justice Pretrial Services Racial Disparities July 1, 2022

Expanding Supervised Release in New York City

Safety and Justice Challenge, Center for Court Innovation

In 2015, the John D. and Catherine T. MacArthur Foundation launched the Safety and Justice Challenge (SJC), a multi-year initiative to reduce populations and racial disparities in American jails. To advance knowledge development grounded in a research agenda that explores, evaluates, and documents site-specific strategies to safely and effectively reduce jail populations and address racial and ethnic disparities, the Foundation engaged the Institute for State & Local Governance (ISLG) at the City University of New York (CUNY) to establish and oversee an SJC Research Consortium. Consortium members are nationally renowned research, policy, and academic organizations collaborating with SJC sites to build an evidence base focused on pretrial reform efforts.

Under New York City’s Supervised Release Program (SRP) individuals awaiting trial are released under community supervision to ensure their return to court, instead of via bail or pretrial detention. Defendants are eligible for the citywide SRP if they meet specific criteria, including arrest charge type, estimated risk status, and community ties. Towards the goal of reducing the jail population, New York City expanded the City’s Supervised Release Program (SRP) several times by altering the eligibility criteria to include a wider range of individuals. The first large expansion of SRP since 2016 occurred at the beginning of June 2019. A subsequent program expansion occurred in December 2019 as New York State prepared for 2020 bail reform legislation to go into effect.

In an effort to better understand the impact of expansion of SRP as a jail-reduction strategy, ISLG and the SJC Research Consortium funded the Center for Court Innovation to examine the impact of the June 2019 expansion. The Center conducted a time series analysis to determine if observed post-expansion SRP enrollment and/or detention rates significantly differed from predicted rates. The study found that the expansion increased SRP rates across racial groups and reduced detention for non-violent felony offenses, though not for misdemeanor offenses. In addition, the findings show increased use of SRP for misdemeanor offenses, which may suggest net-widening.

Key takeaways:

  1. Increasing program participation does not always decrease detention. For small program expansions (like the 2019 expansion) to have a true impact on detention, these initiatives must target serious crimes that are likely to be detained.

  2. Large changes are needed for large impact. Larger expansions, especially those that are driven by legislative change (like the December 2019 expansion in preparation for bail reform), can have a greater impact on detention compared to smaller expansions.

  3. Targeted efforts to reduce racial disparities are necessary. Disparities are not automatically impacted by increasing program participation and decreasing detention across the board. To reduce racial disparities, targeted efforts must be made.

Together, the findings suggest that the SRP expansion reduced detention for some offenses and highlight the importance of measuring the impact of program implementation and expansion to inform future work and jail reduction efforts in New York City and other jurisdictions.

Linking Mass Incarceration to Black History in Los Angeles and Beyond

By: Matt Davis

Community Engagement Human Toll of Jail Racial Disparities April 6, 2022

Members of the Safety and Justice Challenge grappled with questions about how mass incarceration is linked to Black history at a recent fireside chat during the annual convening of SJC network members.

Bria L. Gillum, Senior Program Officer, Criminal Justice with the John D. and Catherine T. MacArthur Foundation hosted the conversation with Kelly Lytle Hernandez, a professor of History and African American Studies at University of California, Los Angeles. She is also a member of the SJC Advisory Council and a MacArthur Fellow.

Bria asked Kelly how she uses her journey as a historian and professor to think about mass incarceration. Kelly began by acknowledging that the land she was dialing in from in Los Angeles was historically colonized. She talked about the Tongva Basin in Los Angeles, home to the Chumash and Gabrielino peoples. Mass incarceration, Kelly said, is “the current chapter in a long book of inequity here in the United States and in the colonies that predated it.”

Academics like Angela Davis have also shown how mass incarceration emerged out of Jim Crow, which arose from enslavement, Kelly said. She recommended Imani Perry’s South to America: A Journey Below the Mason Dixon to Understand the Soul of a Nation. The book “helps us to understand how so much of our contemporary life, our institutions, our families, our culture is really anchored in the experience of Black enslavement,” she said. The United States was created through a particular form of colonization—the transfer of a European population to the North American continent, Kelly said. The intention was to “remove, erase, and replace the Indigenous population,” Kelly said. Scholars call it “native elimination.” Mass incarceration can be seen in that arc of elimination in   U.S history, Kelly said. It is about “removing unwanted populations” from the “white settler society.”

Bria asked Kelly how current conversations about criminal justice policy fit into that lens. For example, there are conversations happening today about reverting to policies from the 1980s and 1990s, like bringing back cash bail or arresting people for crimes of poverty. Bria asked: “What lessons can history teach us about criminal justice reform, and how can we use the history of this country to impact change?”

Kelly said that white supremacy is resilient and adaptable, cautioning against supposed reform efforts if they end up harming colonized and marginalized groups. For example, Kelly referenced Indian Boarding Schools as a so-called reform effort against genocide. She referenced Jim Crow laws as supposed reform efforts against the white backlash against Black emancipation from slavery. We need to monitor the outcomes of reform efforts across time to see if historically marginalized communities are not harmed, Kelly said.

Bria also asked Kelly to reflect on what era the United States is in, now, in 2022. We are transitioning out of an era of mass incarceration, Kelly said. But what comes next is still being defined. We need to listen to the voices and leadership of Black and Indigenous communities “to ensure we have the capacity to build a new society rather than a new regime,” Kelly said. She also called this a “very dangerous moment.”

Kelly spoke about using data to inform those conversations.

“One of the things that we noticed here in Los Angeles – and I’m sure you all were noticing this in other localities across the country – is that data was being used against our communities. We were being told that we always needed a bigger jail or more jails to keep us safe,” she said.

Instead, at UCLA, Kelly worked with community-based organizations in Los Angeles to acquire arrest and jail data. She worked together with those communities to clean up the data, categorize it, give it definitions, and analyze it. Together, they founded the Million Dollar Hoods project, which maps the cost of mass incarceration, documenting that local authorities are spending more than a million dollars annually to incarcerate people in some neighborhoods. The leading charges and causes of arrest in those neighborhoods were narcotics possession and driving under the influence, according to the data. “Both are substance related issues and the community wanted to see a community health response – not incarceration — to those substance related issues,” Kelly said.

The project has also sued the Los Angeles Police Department for data, including 200 boxes of records from the 1980s and 1990s. “We can use these records to document happened during the era of mass incarceration, and how the rise of policing and incarceration extracted much-needed resources from Black communities” Kelly said. Million Dollar Hoods is also collecting oral histories with residents. It’s important to collect people’s stories, Kelly said, to assess the past, understand the present, and imagine a new way forward. “Today, at the end of the age of mass incarceration, we refuse to have our stories overlooked, hidden, or ignored. We are saving our stories, on our terms, to assert a voice in the future to come.”

Bria closed the conversation by asking Kelly to reflect on the work of the Safety and Justice Challenge. The SJC is a diverse network including public defenders, prosecutors, policymakers, city and county leaders, and judges, Bria said. We are entering the third year of a pandemic, and we are continuing to deal with the death of Black, Indigenous, and People of Color people by law enforcement. Bria asked Kelly: “Do you have any recommendations about what we can collectively do to move forward on our criminal justice reform efforts? Taking history as our example, what should we be grappling with?”

Kelly encouraged SJC members to read history, especially to understand the history of criminalization, policing, and incarceration. It documents the many turning points and is a way of opening up the collective imagination about what is next, she said.

Kelly also recommended another book, called Covered with Night—A Story of Murder and Indigenous Justice in Early America by Nicole Eustace. It is a story about the murder of an Indigenous man by a White colonist. The White colonists were eager to be seen as doing justice and proposed killing the White murderer. But Indigenous people halted the process to avoid “greater harm and greater damage.” Instead, they demanded that the murderer pay emotional and financial reparations and that the neighboring white and Indigenous communities use the crisis to build stronger bonds.

“I encourage people to look at that book for an early alternative to punishment,” Kelly said. “I know everyone’s so busy, but maybe on weekends, pick up a chapter here and there to find the alternative histories that ground our radical perspectives and possibilities for what’s to come.”

We Can Do Much for Women in Jails

By: Wanda Bertram

Data Analysis Human Toll of Jail Women in Jail March 22, 2022

March is Women’s History Month, and the picture for women in America’s jails remains troubling. Focusing on women in jails is an important part of the work of the Safety and Justice Challenge as it seeks to reduce jail populations across the country. Here are just a few examples of the challenges women face in jail.

We Lock Up More Women Than Any Other Country

Only 4% of the world’s female population lives in the U.S., but the U.S. accounts for 30% of the world’s incarcerated women. Such an alarming disparity should prompt us to consider how our policies and practices are contributing to it. Nearly half of the 231,000 women and girls locked up in the U.S. each day are in local jails. Compared to other countries, the U.S. locks women up at the highest rate on the planet.

Racial Disparities

White women are incarcerated at a rate of 108 people per 100,000, less than half the incarceration rate of Black women. Native women are incarcerated at a rate of 349 people per 100,000. Black women are incarcerated at a rate of 285 people per 100,000.

Unsupportive Environments for Pregnant Women

58,000 pregnant women go to jail annually. But recently published findings from the groundbreaking Pregnancy in Prison Statistics (PIPS) Project and other datasets shed light on a common but rarely discussed experience: being pregnant, postpartum or giving birth while incarcerated. In total, 22 state prison systems, all federal prisons, 6 jails, and 3 youth confinement systems participated in the PIPS Project, a systematic study of pregnancy and its outcomes among incarcerated women. The project shows that being pregnant in jail or prison, or youth confinement, is characterized by a lack of supportive policies and practices. For example, only one-third of prisons and jails had any policy about breastfeeding and lactation. Even where policies supporting lactation did exist, relatively few women were breastfeeding or pumping.

Absence of Reproductive Choice

Two articles recently published in medical journals analyzed incarcerated people’s access to abortion and to permanent and reversible contraception. The studies reveal that abortion and contraception access varies greatly between states — and that abortion access for incarcerated people is related to broader state policies. Even in states that officially allow abortion, many people may be effectively blocked from obtaining the care they need, thanks to insurmountable barriers like self-payment requirements and physical distance from abortion caregivers. The studies make clear that people behind bars often have very few, if any, choices and autonomy when it comes to their reproductive health and decisions.

Rise in Jail Deaths Troubling as Jail Populations Become More Rural and Female

New data show record high deaths of people locked up in jail, as jail populations have shifted toward smaller, rural jails and growing numbers of women. A lack of accountability and acknowledgement of women’s unique disadvantages all but ensures more deaths to come. Women’s jail populations and rural jails are growing together. Between 2004 and 2014, the number of women in jail increased 43 percent in rural counties, while declining 6 percent in urban counties. For decades, jails in non-urban jurisdictions have quietly proliferated, fueled by increases in pretrial detention. Additionally, researchers have found that women entering rural jails are significantly more likely to have co-occurring serious mental illness and substance use disorder, despite being severely under-identified by their jails as having such needs.

Prisons and Jails Separate Millions of Mothers from Their Children

2 million women are jailed in the U.S. each year, and 80% are mothers. Every Mother’s Day, nearly 150,000 incarcerated mothers will spend the day apart from their children. Most of these women are incarcerated for non-violent offenses. Most are also the primary caretakers of their children, meaning that punishing them with incarceration tears their children away from a vital source of support. Women incarcerated in the U.S. are disproportionately in jails rather than prisons. Having to leave their children in someone else’s care, these women will be impacted by the brutal side effects of going to jail: Aggravation of mental health problems, a greater risk of suicide, and a much higher likelihood of ending up homeless or deprived of essential financial benefits. Most women who are incarcerated would be better served though alternatives in their communities.

Drug Law Enforcement Appears to Have Driven Women’s Incarceration

After skyrocketing for decades, overall incarceration rates have finally been on a slow decline since 2008. But a closer look at the data reveals a major exception: women. From 2009 to 2018, the number of women in city and county jails increased by 23% — a rise that effectively cancelled out more than 40% of the simultaneous 7.5% decrease in the men’s jail population. Meanwhile, reductions in state and federal prison populations have mostly affected men. Over the past 35 years, total arrests have risen 25% for women, while decreasing 33% for men. The increase among women is largely driven by drugs: During that period, drug related arrests increased nearly 216% for women, compared to 48% for men. Knowing that drug arrests are on the rise, we looked to see if addiction is increasing among women, particularly opioid abuse. We found that although women and men are equally likely to develop a substance use disorder, 57% of those misusing opioids are women. The health toll is enormous: Women entered emergency rooms due to painkiller misuse an average of once every three minutes in 2010. Women’s rising opioid use is also reflected in an almost 600% increase in opioid overdose deaths from 1999 to 2016, compared to a 312% increase for men over the same time frame.

Challenges on Release

1.9 million women are released from prisons and jails every year. Formerly incarcerated women (especially women of color) have higher rates of unemployment and homelessness; and are less likely to have a high school education, compared to formerly incarcerated men.

More on Women in Jail

As strategic allies of the Safety and Justice Challenge, I encourage readers to check out the Prison Policy Initiative’s Women and Gender page, for more of our original research and visualizations, and our research library for work done by other organizations looking at the incarceration of women.