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Understanding Racial and Ethnic Disproportionality in

Adult Drug CourtsFamily Dependency Treatment Courts

andElsewhere in the Criminal Justice System

Developed by:National Drug Court Institute

Dr. Anne Dannerbeck Janku – Research ManagerCourt Programs & Research – Office of State Court Administrators (Missouri)

Vanessa Price – Division DirectorNational Drug Court Institute

Session

• What are the areas of disproportionality and disparities?

• Why do they exist?

• What can be done to alleviate them?

Duty Bound

“White people always ask us [black activists] what they can do. We have enough to worry about with plain old survival. I say wholeheartedly to you with no malice: Figure out what you do well and get in the game. Why sit there and wait for us to figure it out? We didn’t create the problems.”

Damon Davis, producer of Whose Streets?, a 2017 documentary film about Ferguson, MO. Ouagadougou, Burkina Faso, 1981

WHEREAS, more than 2.3 million adults are now behind bars in the U.S., representing 1 out of every 100 adult Americans; and

WHEREAS, the burden of incarceration is borne disproportionately by racial and ethnic minority citizens, with 1 out of every 15 African-American men and 1 out of every 36 Hispanic men are presently incarcerated in this country; and

WHEREAS, Drug Courts have been credited with helping to alleviate unfair disparities in the incarceration of racial and ethnic minority citizens for drug-related offenses; and

WHEREAS, Drug Courts perform their duties without manifestation, by word or conduct, of bias or prejudice based on race, gender, national origin, ethnicity, disability, age, sexual orientation, language, or socioeconomic status; and

WHEREAS, Drug Courts are, first and foremost, courts, charged with safeguarding and advancing the constitutional right of all citizens to due process and equal protection under the law; and

WHEREAS, more than 20% of Drug Courts cannot report reliable information on the representation of racial and ethnic minority citizens in their programs; and

WHEREAS, evidence suggests that racial and ethnic minority participants may be experiencing relatively lower success rates than nonminorities in some Drug Courts; and

WHEREAS, the adoption of evidence-based, culturally proficient interventions in Drug Courts has been shown to significantly improve outcomes for minority participants..

RESOLUTION OF THE BOARD OF DIRECTORS ON THE EQUIVALENT TREATMENT OF RACIAL AND ETHNIC

MINORITY PARTICIPANTS IN DRUG COURTS

NOW, THEREFORE, BE IT RESOLVED THAT:

1. All Drug Courts have an affirmative obligation to examine, in an ongoing manner, whether there are potential racial or ethnic disparities in their programs.

At a minimum, the examination of potential racial and ethnic disparities should include the collection of reliable and valid data on:

• the percentage of racial and ethnic minority participants who are enrolled in the Drug Court;

• the degree to which these percentages reasonably reflect the respective arrestee population for Drug Court-eligible offenses in the jurisdiction;

• the factors that might account for any discrepancies in the representation of minorities;

• the percentage of racial and ethnic minority participants who successfully graduate from the Drug Court; and

• the factors that might account for any discrepancies in graduation rates.

2. All Drug Courts have an affirmative obligation to take reasonable actions to prevent or correct any racial or ethnic disparities that may be found to exist by:

• adopting evidence-based assessment tools, treatments, and other interventions that have been proven through scientific research to produce equivalent or superior effects for racial and ethnic minority individuals; and

RESOLUTION OF THE BOARD OF DIRECTORS ON THE EQUIVALENT TREATMENT OF RACIAL AND ETHNIC

MINORITY PARTICIPANTS IN DRUG COURTS

Understanding disproportionality

• Disproportionality- There is a difference in the total volume of activity for minority individuals compared to White non-Hispanic individuals or the majority population.

• Ex. of disproportionality: 50% of drug arrestees are black. 25% of drug court participants are black.

Race and Drug Court

• Disparity- outcomes or treatment differences are impacted by race.

• Study of factors associated with graduation in 10 Missouri ADCs found that being black reduced the odds of graduating, holding other factors constant (including age, gender, legal status, employment, marital status, community socioeconomic status). Dannerbeck, et al, 2006.

Substance abuse has touched every family and circle of friends in America and causes and aggravates the nation’s most wrenching social problems - violence and property crimes, soaring health care costs, family breakup, domestic violence and child abuse, the spread of AIDS, teen pregnancy, poverty, low productivity……….

Americans, comprising only 4% of the world’s population, consume 2/3’s of the worlds illegal drugs.

Joseph A Califano, Jr., Former Secretary of Health, Education & Welfare “ HIGH SOCIETY:

How Substance abuse Ravages America and What to do About it” May 2007

How Substance Abuse Ravages America

The Impact

9

• School problems

• delinquency

• absenteeism

• Criminal behavior

• Homelessness

• Unemployment

• Poverty

• Addictions

Social and Emotional Consequences

10

• Isolation

• Feelings of guilt and shame

• Poor peer relations

• Poor anger management

• Chaotic lifestyle

• Attachment Disorders

Elsewhere in Criminal Justice

• DMC• Disproportionate Minority Contact

• High/over-representation of minority youth in JJS vs. white youth

• School to Prison Pipeline• Youth of color sanctioned more punitively than white you

• Same or similar crimes

• Same or similar criminal history

• Service Diversion vs. Supervision• Access to services within community

• Transportation

• Anti-gang policiesCoalition for Juvenile Justice, “Ensuring School Engagement and Success vs. Exclusion “ 2009 9 Hsia, Heidi, “A Disproportionate Minority Contact (DMC) Chronology: 1988 to Date,” OJJDP.

W. Haywood Burns Institute, “Disproportionate Minority Confinement/Contact (DMC) Fact Sheet.” 3National Juvenile Justice Network, “Policy Platform on Disproportionate Minority Contact (DMC),” May 2010.

Funding

Changed Approach

Historically Disadvantaged Groups

• Why the focus on racial and ethnic minorities? “constitutionally suspect classes”; most researched; observable

• Unintended discriminatory impact may not be constitutionally objectionable, yet is contrary to drug court best practice and this standard.

Intent Impact

Race and criminal history

✓ Blacks are overrepresented in correctional populations and underrepresented in drug court

✓ Criminal history patterns explain much of the disproportionality in correctional populations

✓ Criminal history patterns may be explained by following theories:

Theory 1

• Structural disadvantages of high poverty crime areas with predominantly minority inhabitants [more open drug sales, more police surveillance, more gun/violent crime]

(Blumstein, 1993) Implications for drug court

Theory 2

• Prejudice and poverty create conditions even in utero that can lead to offending:

• prenatal care,

• nutrition quality,

• exposure to toxic and infectious agents,

• Can lead to infant risk for nervous system problems that interfere with prosocial development.

• Cumulative disadvantage can continue due to stress, loose family bonds, poor quality schools, etc.

(Moffitt, 1994) Implications for drug court

Theory 3

• Differential offending- minorities have more severe levels of risk for criminogenic factors

• neighborhood disadvantage,

• compromised family situations,

• exposure to violence,

• limited educational attainment,

• and employment difficulties.(Thornberry, et al, 2004) Implications for drug court

Theory 4

• Street code- impoverished neighborhoods and limited opportunities to join mainstream society lead to alienation.

• Alternative culture developed governing behavior in inner city:

• respect from peers on the street,

• attitude of toughness, street smarts, violence, and retribution.

(Anderson, 1999; Miller, 1958) Implications for drug court

National Report Card:

A Review of the Scientific Literature

Page 46

How did we do?

Painting the Current Picture

•On average, Caucasians represented two-thirds (67%) of participants in respondents drug courts in 2014, African-Americans represented 17% of participants, and Hispanics represented 10%.

•In 2014, representation of African-American and Hispanic individuals in respondents drug courts was lower than the arrestee, probation, and incarcerated populations.


Based on available data from roughly one-half of U.S. states and territories, African-American and Hispanic participants

graduated from some drug courts at rates substantially below those of other drug court participants.


• Women represented approximately one-third (32%) of participants in

respondent drug courts in 2014, and appear to have received at least

proportionate access to drug courts.

• Based on available data from roughly one-half of U.S. states and

territories, female participants graduated from some drug courts at

rates substantially below those of male drug court participants.

Best Practice Standards

Duty to avoid disproportionate access and

impacts irrespective of intent

Affirmative obligation to know wherever

disparities exist

Take corrective actions unless doing so

would demonstrably threaten public safety

or effectiveness

Evaluate success of corrective actions until

disparities are eliminated

Equity and Inclusion

• Engage community

• Holistic approach – physical, emotional, spiritual elements

• Relevant Cognitive-behavioral approaches

• Motivational Interviewing

• Family Engagement

• Gender Specific Approaches

• Client Program Matching

Citizens who have historically experienced

sustained discrimination or reduced social

opportunities because of their race, ethnicity,

gender, sexual orientation, sexual identity,

physical or mental disability, religion, or

socioeconomic status receive the same

opportunities as other citizens to participate

and succeed in Drug Court.

A. Equivalent Access

B. Equivalent Retention

C. Equivalent Treatment

D. Equivalent Incentives & Sanctions

E. Equivalent Dispositions

F. Team Training

II. Historically Disadvantaged Groups

• Concentrate on the high value cases

• Fidelity to the 10 Key Components

• Ongoing judicial authority

• Interagency team approach

• Get it right the first time

Recipe for Success

How to implement the standard

• Equivalent• Equal in effect

• May differ in appearance but has the same value to the recipient

Steps to Take

Specific strategies and examples

• Performance measures

• Evaluations

• Other quantitative studies

• Focus groups

• Interviews

• Literature reviews in other fields

Demographic Data

• Age

• Sex

• Race

• Ethnicity

Collect at 3 Processing Points

• Referral

• Admission

• Exit

Step #1: Collect Demographic Data

Missouri, Racial and gender distribution of drug offenses

Drug Possession

Drug Manufacture/Sale

Alcohol

White females 2105 (65%) 669(21%) 455(14%)

Black females 245(62%) 113(28%) 41(10%)

White males 3916(48%) 1799(22%) 2450(30%)

Black males 1648(57%) 949(33%) 279(10%)

Statewide Drug/Alcohol Offenders, fiscal 2012

Charges associated with drug court exits

Alcohol/ DWI

Manufacture/Sale

Possession Other

Exits 52/ 5% 135/ 12% 594/ 53% 340/ 30%

Recommendation: To estimate the number of offenders who could potentially be eligible for drug court, 1. Calculate the distribution of charges for current drug court participants.2. Calculate the distribution of charges for drug offense categoriesAnd add the relevant percent for other charges.

• Date of referral

• Source of referral

• Reason for referral

Provided by Dr. Fred Cheesman, National Center for State Courts

Step #2: Create a Referral Information Form

It is insightful to compare referral cohort demographics to the demographics of arrestees for drug court eligible offenses, or at a minimum, the demographics of the jurisdiction’s adult offender population to look for bias in the referral process.


Step #3: Compare Referral Cohort

Missouri, Racial and gender distribution of drug offenses

Drug Possession

Drug Manufacture/Sale

Alcohol

White females 2105 (65%) 669(21%) 455(14%)

Black females 245(62%) 113(28%) 41(10%)

White males 3916(48%) 1799(22%) 2450(30%)

Black males 1648(57%) 949(33%) 279(10%)

Statewide Drug/Alcohol Offenders, fiscal 2012

Do no harm…..Equivalent Dispositions

• If 35% of drug offenders are African American and 15% of drug court participants are African American, should you recruit more African American participants?

• It depends • On how well the program actually meets their needs,

• On their ability to successfully complete the program,

• And on who is best suited to participate in your program.

Begin with the end in mind

• Compare the exit status of your participants in gender/racial/ethnic groups.

✓Do similar proportions graduate?

• If yes, compare your rates to state and national rates.

• If the answer is still yes, your program is performing well.

Equivalent dispositions

43 43

5048

4346 47 46

40

3236

38

5956

5149

5357 58

5653

5557 56

0

10

20

30

40

50

60

70

Jan -June,2011

July -Dec,2011

Jan -June,2012

July -Dec,2012

Jan -June,2013

July -Dec,2013

Jan -June,2014

July -Dec,2014

Jan -June,2015

July -Dec,2015

Jan -June,2016

July -Dec,2106

Percent Graduating by Race

Black

White


Missouri Adult Drug Courts

Performance Indicator

• Performance Indicator: your graduation rates compared to state and national graduation rates

• State graduation rates for 2016: • 56% Caucasians• 38% African Americans

• National graduation rates among BJA recipients*:• Caucasians: 50%• African Americans 54%• Hispanics: 59%• Native Americans: 47%• Others: 66%

* West, Kenyon, & Pryce 2016Equivalent dispositions

Race, a proxy or indicator of bias?

• Race may be a proxy for other variables- including bias/prejudicial treatment.

• Dannerbeck et al, 2006, found that the effects of race (being black) on graduation probability decreased when one accounted for low community SES, unemployment and low social support.

• The more disadvantaged the neighborhood, the less likely an individual is to graduate (Howard 2016).

And speaking of

race……Mixed Race

• 3% of US population identifies as mixed race with the largest proportion identifying as White and Native American (US Census 2010)

• Not much research because of the tremendous diversity of individuals who could potentially be considered mixed race

• Implications of self-identification • Risk and needs indicator• Tends to fluctuate over the life course

• Implications of ‘observer’ identification• Monitor practices for potential discrimination

Is it of value to maintain cultural identity?

Is it ofvalue to maintainrelation-ships withothergroups?

Yes No

Yes Integration Assimilation

No SeparationMarginalization

And speaking of ethnicity……Latinos and Cultural Identity

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Women and Drug Court

• Gender specific issues: Trauma, domestic violence, child care, guilt

• Self-medicating for abuse and trauma

• 12-step programs designed for men

• Gender responsive programs lead to better drug court outcomes

“My child’s first sentence was: ‘Mommy with her PO.’ I cried.” female drug court participant, 2015

Artist, Patricia EricksonCosta Rica


Outcomes for Participants from a Health Perspective

• Reduction in stress

• Improvement in behavioral health issues (depression, substance use disorders)

• Increase in strength and resiliency

History

• Slavery. Did there ever exist a more annoying way to try to make a modern-day black man feel like his troubles were insignificant, that he should be satisfied with the sorry hand society dealt him? Cha-Cha, a character in Angela Flourney’s The Turner House, p 82

• Amazing how in the beginning of time we were the first people to have a great civilization and we were some of the most important people on this planet. Then 1000s of years of erasing our history and hundreds years of us being chained up and brought down. And now we are here. We see more of us than of them [in prison]. Focus group participant

Post traumatic slavery syndrome

State CapitalColumbia, SC, May 2015Confederate Memorial Day

Media Responsibility

• Images that misinform

• “Making a life on North Garth Avenue” “Their neighborhood flagged as a drug-infested haven for criminals, residents offer unique perspectives about living in the area.”

Source: Columbia Daily Tribune, Oct. 8, 2006

Reinforcing labels and bias thru exclusion

• Brochure promoting a Missouri town with a significant minority population

Where do your participants live? St. Louis, MO

Blue dot= white person; green dot= black personSource: http://demographics.coopercenter.org/DotMap/

http://demographics.coopercenter.org/DotMap/

Residential Segregation

• Neighborhood segregation may create differences in:

• employment opportunities,

• community resources,

• transportation access,

• treatment availability

• and other factors that impact drug court participant success.

1950s, Los Angeles, CA

Neighborhood Disadvantage• Biggest thing from Af Am standpoint, know white pp using drugs.

Don’t buy drugs in their neighborhood. They go somewhere or someone brings them the drugs.

• Coming from neighborhood where gangs and drugs are part of neighborhood environment, it is difficult to come in program like this where you are expected to follow the straight and narrow and be clean but you are back home to that.

• Growing up we had opportunities, had parks, community centers. Mom and pop stores. Resources in community allowing us to live effectively as a community. Had grocery stores, dental clinics, family practice health care. Stores selling fruits and vegetables.

• Today don’t have those resources.

• No resources for individual to come out and be productive.

So why don’t you just move?

• People are a product of their environment. People in my house were non-functional. It was hard to get out of that environment. After getting out of prison I had to go back and stay with family who did not support me in drug court. That happens to other people I know. Sometimes you can’t change where you live because you have no resources and no housing choices. Drug court participant

Culture of the Streets

• Many African-Americans relate to the culture of the streets. • You have people who grew up, their mama not there, daddy locked

up, no uncles or anybody to guide them so they feel like the streets is right here and the streets is their home and they are protected when they around the people in the streets because those people feed them, help them, do things for them, rob for them. The streets is their home, that’s why they fall right in, join a gang. Certified youth

• Didn’t want to be told what to do, when to do it and how to do it. I’m a man and I have been living on the street and I’ve been doing what I been doing to get by. So how dare somebody come and try to tell me how to live my life. Focus group

Wealth accumulation through respect and social relationships

Digre, Burkina Faso, 1981

A Deficit of Trust

Painting by Lynette Yaidom-BoakyeAs printed in Vogue April 2017

I have been disrespected by the system. Say I am tall, African American, and have short hair. I could be walking down the street and get stopped multiple times because I fit the description: tall, African American, short hair. Once I was walking from my house to a park and I got stopped three times. Why? I didn’t do nothing. (certified youth)

When you have been arrested and locked up you get used to a system. People enter drug court with the idea that its just like the rest of the system. There’s unconscious distrust of anybody in authority positions. Focus group

Coping Strategies

• “Relationship frequently trumps everything else.” (p. 28)

• “Greeting becomes a symbol which underscores the importance placed on the relationship.” (p. 31)

• Possible association between performance and perceptions of one’s relationship with those in charge.

• Hypersensitivity about matters of respect.

• Source: DeGruy 2005

Drug Court Responses: Procedural Justice

• Participants often mention their relationship with the judicial officer as a key element of their success. Research suggests that the principles of procedural fairness are strongly associated with success (Mackenzie 2016).

• Voice I knew they listened to me when they gave me a travel pass.

• Neutrality There are rewards for those who do well and punishments for those who do bad. That’s just the way it is in this program.

• Respect Showed disrespect in the way they talk to us sometimes.

• Trustworthiness Drug court peoples you can see the hand they offer to you. Give you chance to help yourself.

Performance Indicators

• Interview Participants• What makes it hard for you to successfully complete the Drug Court Program

(e.g., lifestyle, family influences, time commitment, neighborhood)?

• What triggers make it hard to stay clean and sober?

• Do family and friends know you are in drug court? And support you?

• Among program staff, who do you talk to when you’re having a tough time? What helps you feel comfortable talking to him/her?

Equivalent TreatmentRecognize that equivalent does not mean treating people the same.

• Equivalent• Equal in effect

• May differ in appearance but has the same value to the recipient

• The trauma of racism and discrimination and the role of drugs and drug trafficking in coping with such discrimination may need to be addressed in treatment.

Cultural

Competence

in Drug Court

Treatment

How culture can matter• Individuals respond more positively to interventions

that respect and respond to their specific values, traditions, and needs (Bettancourt, et al, 2003)

• Latinos may vary by country, region, immigrant generation and degree of acculturation.

• Sources of stress- bias, environmental noise, violence

• Coping mechanisms • alternative healing

• belief systems

• exercise

• music

Equivalent TreatmentSome factors to consider

• African Americans may cope with stress through: smoking, alcohol, drugs, comfort foods (Mezuk et al. 2011).

• African Americans have a lower incidence of mental health problems than similarly situated whites (Kressler, et al. 1994) but more physical health problems over the life course.

• African Americans are treated differently in health care settings.

• They are less likely to have their pain acknowledged and treated than are similarly situated Caucasians. False stereotypes may be factors driving this trend. (Meghani, Byun, & Gallagher, 2012).

• Minorities report lower levels of satisfaction with treatment (Wells et al. 2001). They underutilize treatment because of potential stigma (Menke & Flynn 2008), distrust of providers (Freimuth, Quinn, & Thomas 2001) and lack of financial resources (Hines-Martin, et al. 2003).

• Lower levels of education and income in the community may impact participants’ self-efficacy and their perceptions of the benefits of staying in treatment (Saloner & Cook 2013).

• To engage minority participants in treatment, providers need to have staff who understand the participants and are knowledgeable about their daily lives (Guerro, et al. 2013.)

CopingSmoking patterns

• Smoking at age 50 accounts for 20% to 48% of the black-white gap in male life expectancy.

• Black men are more likely to be ever smokers.

• Black men have lower cessation rates.

• Smoking serves as a self-medicating mechanism and form of relaxation among low income individuals facing high levels of stress. (Ho & Elo 2013)

• Blacks tend to smoke fewer cigarettes but are more likely to smoke menthol cigarettes (which numb throat and allow for deeper inhalations) and those with higher tar yields experience higher indices of smoke exposure and may be at risk for greater physical dependence. (Sellers 1998)

Coping: The Alcohol Paradox

• African Americans are more likely to abstain from drinking than are whites yet they are more likely to be problem drinkers. (Keyes, et al. 2015).

• Problem drinking among African Americans is linked to discrimination. (Borrell et al. 2013)

• Having religious beliefs and engaging in religious behaviors protect against problem drinking.

• Having such beliefs without a religious practice actually increases the risk of alcohol abuse. (Brechting et al. 2010)

Coping: Religion and Faith-Based Institutions

• African Americans may utilize religious and spiritual coping mechanisms. (Neblett, et al. 2010)

• For those under financial stress, ‘the collection basket’ can be another stressor (Hudson et. al. 2016).

• Potential stigma among church attendees about associating with justice-involved individuals and their families. (DeGruy 2005)

• Younger generation don’t have same feelings about church. Seen as European, from slavery. Focus group

Being color blind is not helpful

• “We treat everyone the same in our drug court program.”

• Research indicates that practicing an ideology of color blindness is ineffective, provokes interracial tension, and promotes inequality. (Neville, et al. 2013).

• What to do instead?• Discourage color blind attitudes among staff.

• Engage in hard discussions about how race may matter in your program.

• Include community partners and participants in these discussions.

Drugs may not be the ‘problem’

• Not just focus on drug treatment because that is not an addict’s whole downfall. Drugs is not the problem. Addicts have more than one problem. All you focus on is drug problem, then you aren’t going to get down to the serious problems. Education might be a much bigger problem than drugs. Job problem might also be bigger. I don’t want to play the race card but being African American it really does make a big difference, especially when you are a felon.

Equivalent treatment

What type of services?

• Focus on Habilitation- life skills training

• The evidence points to a need to focus on habilitation (being able to function independently in an adult world) especially for poor urban men, 50% of whom are black or Hispanic. (Institute on Research on Poverty 2016)

• 2/3 are fathers with children raised in female headed households.

• 60% have not worked in past 12 months.

• Employment rates for urban black men have decreased from 73.4% in 1970 to 44.7% in 2010 vs. from 85% to 77% for white men.

• 50% of black and Hispanic men have been arrested by age 35.

• Employment status at drug court entry is a significant predictor of exit status. Providing an equivalent experience may entail offering additional resources for employment supports.

Equivalent treatment

Gender-Specific Treatment

Substantial evidence shows that

women, particularly those with

histories of trauma, perform

significantly better in gender-specific

substance abuse treatment groups

(see, e.g., Liang and Long, 2012)

Contains information on interventions that

have been evaluated among substantial

numbers of racial and ethnic minorities

participants, women, and members of other

historically disadvantaged groups

http://www.nrepp.samhsa.gov/

SAMHSA’s National Registry of Programs and Practices (NREPP)

http://www.nrepp.samhsa.gov/

Should client and counselor be matched?

• [recall heterogeneity within groups. Also relevant for counselor/client pairing]

• Study results are inconsistent. SES and other cultural factors may impact pairings.

Equivalent Retention


• Most difficult group across types of interventions: young black males, 17-25

• Typical comment: “I’m not an addict. I just choose to smoke weed. Its part of my lifestyle.”

• Emerging adult characteristics- brain not mature, weak connections to social control mechanisms, establishing a lifestyle

• High prevalence of gateway drugs-alcohol and marijuana –related to experimentation, instability and stress, peer influence (Dannerbeck, 2010)

Performance Indicators

• Break down participants by age group: • 17-25 emerging adults• 26-35 young adults• 36-60 middle adults• 60+ older adults

• Look at length of time in program, risks, needs• Look for patterns of absconding, early termination• Interview participants

• What do you like least about the Drug Court Program?• What has been the most helpful thing about the Drug Court Program?• What did you hear about drug court before you entered?• Why did you decide to participate in drug court?


I don’t have none of that addiction stuff. I don’t even see why I am in drug court. I guess because I had drugs but I don’t know what. They should have a different program to talk about how to get money. They should put me in a different room to talk about why I want fast money. . . I don’t have an addiction it is more of a lifestyle. You know how you grow up seeing your older cousins and brothers doing this. You like what you see. They have good clothes, shoes, game systems. Just trying to live the good life. Without having to do nothing for real for it just somebody put it in your hand real quick and easy like that. None of that ‘oh my feet hurt’ coming home from work type stuff. Reintegration evaluation

Retention

To help with retention, assess for risk and needsMO Drug Court Exits by Race & RANT Score

Risk/Need Hi/Hi Hi/Low Low/Hi Low/Low

White 666

81%

75

9%

51

6%

30

4%

Black 183

64%

74

26%

14

5%

13

5%

HEAT, A promising intervention

• Habilitation, Empowerment and Accountability Therapy

• created by Guy Wheeler and Darryl Turpin

• Manualized cognitive behavioral therapy designed for those who identify with the culture of black males between the ages of 17 and 29

• Focuses on spirituality, community, family and self.

• Geared to reduce recidivism, reduce drug use, address trauma, ambivalence and resistance

Consider ways to connect your program to the participants to improve retention• A recent Pew Research Center study (2015) found that young adults, those

with low incomes and minority status were the groups most likely to be smart-phone dependent. How can you use this device to enhance access to your program?

• Send text reminders about appearance dates.• Clinicians and probation officers can do quick check-ins on mental state,

cravings, or activities to see how participants are doing.• Drug testing reminders can be sent via text. • Some clinical interventions may be conducted over smart-phones.• On-line reviews of NA/AA groups can help individuals find a good match. • Create an app for stress reduction.• Link participants to health literacy information. • Community members can form a virtual network to offer support to

participants. (Anderson & Olson, 2016)Equivalent Retention

Drug Court Responses: Family Engagement

For participant support: After 3 jail sanctions, What helped me to stop the B.S. was a call from my daughter, ‘Daddy, me and Granny was talkin’ and we concluded you ain’t doin’ what you’re supposed to be doin’. ADC focus group participant

My brother was there to support me but a lot of people don’t have that.

To help family members:Adverse Childhood Experiences study found parent substance use to be a risk factor for other ACEs, including child maltreatment.Children with a large number of ACEs are likely to use substances andBe justice involved. A good time to identify and treat at-risk children are while their parents areIn treatment using a family centered approach in ADC.

Possible Retention Strategies

• Discuss culture/cultural themes

• Use motivational interviewing to engage clients in

treatment at onset

• Engage family in treatment

• Solicit feedback on cultural sensitivity from participants

and community members.

84

Incentives and sanctionsPerformance indicators

• Interview participants• Were sanctions used as a punishment or a form of help?

• A jail sanction doesn’t help if you are used to being locked up. You are used to that. Its comfortable. Give people the opportunity to step outside themselves, go talk at a youth center. Drug court participant

• Nurturing self efficacy- helping participants vs. giving them what they need to do thigs themselves

Equivalent Opportunity in Drug Court

✓If your rates didn’t measure up to state and national benchmarks, you examined your program.

✓Are you accepting the appropriate people based on their risks and needs?

• Especially regarding addiction vs. abuse and mental health status, trauma/racism?

✓Are you providing the appropriate services to meet those risks and needs?

✓And providing the services in a culturally appropriate manner?

✓Then it is time to consider program access.

Equivalent Access

Nationwide/

Statewide

Jurisdiction

Drug Court

Pool

Drug Court

Equivalent Access

1. Review criteria to ensure it does not restrict access,

unless doing so threatens public safety or program

effectiveness.

89

EligibilityCriteria

Eligibility criteria-what kinds of factors may be exclusionary?

• Prostitution

• English only

• Plea of guilty

• Criminal history (certain offenses, violence)

• Housing stability

• Geography

• Have community partners review eligibility criteria and program requirements for potential impacts on specific populations

Equivalent Access

2. Assessment tools must be validated with historically

disadvantaged groups within your potential drug court

pool.

92

The Risk and Needs Triage (RANT®) is a screening tool designed to match the prognostic-risk and

criminogenic needs of defendants with substance use disorders with dispositional outcomes that

support recovery and promote law-abiding behavior (Marlowe, D. et al, 2011).

To evaluate the extent to which the RANT® system is fulfilling its intended purpose with Missouri

treatment court participants, a state-level field validation study was completed.

Three questions guided the study:

Are participants being assigned to dispositions recommended by the RANT® results?

Do the RANT® results accurately predict the likelihood of re-offending?

And, are these predictions neutral with regard to race and gender?

Actual Assignment Level

Black White

RANT® Classification

Level 1

HH

Level 2

LH

Level 3

HL

Level 4

LL

Level 1

HH

Level 2

LH

Level 3

HL

Level 4

LL

Level 1 HH

437

(100%)

0

(0.0%)

0

(0.0%)

0

(0.0%)

1866

(99.9%

)

0

(0.0%)

0

(0.0%)

4

(0.0%)

Level 2 LH

3

(8.8%)

31

(91.2%)

0

(0.0%)

0

(0.0%)

14

(9.7%)

129

(89.0%

)

1

(0.7%)

0

(0.0%)

Level 3 HL

4

(3.7%)

0

(0.0%)

105

(96.3%

)

0

(0.0%)

16

(9.0%)

1

(0.6%)

157

(88.2%)

4

(2.2%)

Level 4 LL

1

(1.8%)

0

(0.0%)

0

(0.0%)

56

(98.2%)

4

(5.6%)

0

(0.0%)

1

(1.4%)

67

(93.1%)

Total 445 31 105 56 1900 130 160 72

Are participants being assigned to dispositions recommended by the RANT® results?

High degree of congruence between the RANT® classification and the actual dispositional assignment

• Reasons participants were assigned to more intensive dispositions:• treatment court team decision (81.2%), • unavailability of interventions associated with the participant’s

recommended RANT® classification level (18.8%). • Treatment court team decision was the only reason cited for assigning

participants to a less intensive disposition.

• Congruence between the RANT® classification and dispositional assignment was high• regardless of race. • regardless of gender.

Do the RANT® results accurately predict the likelihood of re-offending?

• Findings showed the RANT® factors had an acceptable level of reliability measured as internal consistency and statistically significant accuracy in predicting reoffending as evidenced through logistic regression modeling and ROC/AUC analytics.

Are these predictions neutral with regard to race and gender?

• Findings showed no evidence of racial or gender bias in the prediction of recidivism by the RANT®. o No significant interaction between race and risk level on the rate of recidivism ([OR] =

2.883, p = 0.189)

o No significant interaction between race and need level on the rate of recidivism ([OR = 1.438, p = 0.469).

o No significant three-way interaction of race by risk by need on the rate of recidivism ([OR] = 1.298, p = 0.561).

o No significant interaction between gender and risk level on the rate of recidivism ([OR] = 1.12, p = 0.862).

o No significant interaction between gender and need level observed ([OR] = 1.226, p = 0.710).

o No significant three-way interaction of gender by risk by need on recidivism ([OR] = 1.226, p = 0.813).

• Track each referral cohort to the point of admission and

then compare demographics at admission

(admitted/not admitted) with those of the referral

cohort to look for signs of bias.

• Track reasons for rejection in the case of referrals not

granted admission to drug court.


Step #4: Track

Recognize when Equivalent Access is not being Achieved

2008 2009 2010 2011 2012 2013 2014 2015 2016

American Indian/Alaskan Native 0% 0% 0% 0% 0% 0% 0% 0% 0%

Asian or Pacific Islander 0% 0% 0% 0% 0% 0% 0% 0% 0%

Black 28% 22% 23% 18% 18% 19% 19% 20% 17%

Hispanic 1% 1% 0% 1% 1% 1% 1% 0% 1%

White 70% 77% 76% 81% 81% 79% 80% 79% 82%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Adult Drug Court Admissions by Race and Ethnicity

American Indian/Alaskan Native

Asian or Pacific Islander

Black

Hispanic

White

Performance Indicator

Understand reasons for non-admittanceReason for Non-Admittance Black

FemalesBlack Males

White Females

White Males

Defendant Opt-Out 12/33% 78 /37% 123/37% 134/27%

Medical 1 0 6 8

Mental Health 0 2 5 10

Admit to Other Treat Pgm 0 0 6 5

Dismissed 0 1 8 13

Judicial Override 0 3 13 39

PA Decision 18/ 50% 262/ 68% 81/ 24% 145/29%

Not Eligible 5/ 14% 39/ 10% 91/ 27% 138/28%

TOTAL 36 385 333 492Cases that received a RANT but were not admitted to Treatment Court, Jan 1, 2014 through December 31, 2015

2016 Statewide Statistics related to Adult Treatment Court

Black Females Black Males White Females White Males

Proportion of all Felony Drug Charges Filed

2% 15% 29% 52%

Proportion of all Admissions

4% 12% 33% 49%

Proportion of in group exits graduating

34% 36% 57% 56%

Recruitment considerations

• Why are certain groups underrepresented in your program?• Prosecutorial decisions or judicial considerations?

• Word on the street – “Drug court is a trap.”

• Other access issues: affordability, transportation, scheduling, neighborhood

• Eligibility criteria-are any unnecessarily exclusionary? Language, housing stability, geography,

• Perceptions of program requirements- a help or a burden?

• At orientation they throw a lot of rules at you. ‘Do this.’ ‘Don’t do that.’ There was no focus on how the program can help you. A lot of guys decided they didn’t want to go through it. Focus group

Equivalent Access

• If minorities are under-represented in your drug court

(verified with statistical evidence), how can you increase

their participation?

• Educate key stakeholders

• Interview current participants from target group and

people in jail.

Developed by Anne Janku, Ph.D. for NADCP Conference 2016

Step #6: Recruitment

Market your program

Poverty and Access to Drug Court

• “Participants who are employed at program entry and who can pay their fees are more likely to graduate. “ program staff

• Ask the following at program entry:

• To what extent do you think your income is enough for you to live on?

• Not at all adequate

• Can meet basic necessities only

• Can afford some of the things I want

• Can afford about everything I want

• Can afford everything I want and still save money

Key Component #10 Community partnerships

• In 2015 NPC Research completed a best practices assessment of Missouri drug courts.

• Just 16% had a community partnership.

• Who should be included in such a partnership?

• Related agencies like mental health, prosecutors

• Reps from community organizations (including faith based) serving neighborhoods where target population resides, key employers, and the informal go-to people from neighborhoods and schools.

Community partners can….

• Review eligibility criteria and program requirements for potential impacts on specific populations

• Help find staff who are knowledgeable about the world view of the population

• Help identify ancillary services of benefit to DC participants

• Identify barriers to accessing drug court services and possible ways to overcome barriers

• Share the word on the street about drug court

Create an atmosphere of social accountability

• Plays into our desire to look good to our peers. Knowing that we may have to explain our decisions leads us to change our behavior (Dobbin & Kalev 2016)

• Discourage color blind attitudes among staff.

• Provide training on implicit bias and

• Use performance indicators, both statistics and interview materials to engage in continuous improvements.

• Have staff review them regularly

• Have a stakeholder group review them periodically and ask questions.

A review of the jurisdiction's charges filed population vs. the treatment court population was conducted and is outlined in the tables below.

Distribute Status Reports including:

Equivalent Access

Opportunistic Time Use

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