Re-entry Issues Take Center Stage with Release of Report, Legislation

Re-entry Issues Take Center Stage with Release of Report, Legislation

Mental Health Weekly February 7, 2005

A council of state, local and federal leaders and representatives of health, mental health and substance abuse treatment systems this month released a landmark report describing how to overhaul prisoner re-entry systems nationwide.

The 600-page document offers hundreds of recommendations to help make prisoners' transition from a correctional facility to the community safe and successful.

The Re-Entry Policy Council, spearheaded by The Council of State Governments (CSG), is a partnership among 10 national organizations, including the National Association of State Alcohol and Drug Abuse Directors (NASADAD) and the National Association of State Mental Health Program Directors (NASMHPD).

Officials say the report will bolster pending re-entry legislation, "The Second Chance Act of 2004," which is geared to reducing recidivism, increasing public safety and helping states and communities better address the growing population of ex-offenders returning to communities.

The legislation addresses mental health and substance abuse treatment, jobs, housing and strengthening families. Officials said lawmakers plan to reintroduce the legislation this year.

The Re-Entry Policy Council is comprised of 100 key leaders at the local, state and national levels, including Republicans and Democrats and representatives of law enforcement, corrections and health and social service systems.

According to the Report of the Re-entry Policy Council: Charting the Safe and Successful Return of Prisoners to the Community, two million Americans are serving time in prison. Ninety-seven percent of those people will be released at some point. About two out of every three people released from prison in the U.S. are re-arrested within three years of their release.

The report found that spending on corrections has been the fastest or second-fastest growing item in state budgets over the last 15 years, from $9 billion a year in 1982 to $60 billion in 2002. The recidivism rate has not improved over the past 30 years, according to the report.

According to CSG, legislators from across the country have noted that re-entry will be a hot topic in their states during the upcoming year. "We've got a broken corrections system," said Sam Brownback (R.-Kan.). "Recidivism rates are too high and create too much of a financial burden on states without protecting public safety."

Brownback added, "The Second Chance Act, which I will be reintroducing in 2005, acts on many of the recommendations in the Report of the Re-Entry Policy Council to transform not only individual lives but our nation as a whole."

The Re-Entry Report

"The council did an outstanding job in putting together this comprehensive report," NASADAD Executive Director Louis Gallant, told MHW. This is the first time a comprehensive report has been released on re-entry issues in this country, said Gallant.

The report helps to recognize ex-offenders released from prison who have significant substance abuse problems, said Gallant. "About 70 percent have some level of alcohol or other drug abuse problem that needs to be supported as they are reintegrated back into the community," said Gallant.

Some of the legislators sponsoring the Second Act legislation "have been intimately involved in the scope of the report," said Gallant. The legislation will hopefully support resources that returning military personnel from Afghanistan and Iraq can also access, said Gallant.

"We welcome the report," Ron Honberg, legal director of the National Alliance for the Mentally Ill (NAMI), told MHW. "It's very important. It highlights something we already know. The reason for the high rates of recidivism for so many people with mental illness is because when they get discharged from jails and prisons, they don't get the services they need."

The report recommends the development of policies and programs that provide the following:

o Substance abuse treatment

o Services for physical and mental illness

o Smart release and community supervision decisions

o Support for victims

o Safe places to live

o Meaningful relationships

o Training, education and jobs

Focus on mental health

The report contains recommendations specific to mental health and the challenges of maintaining services in the community. The challenges include:

o Inconsistent and ineffective screening and identification of prisoners for mental health disorders.

o Compartmentalized, uncoordinated treatment of co-occurring disorders.

o Inadequate communication and cooperation between correctional health officials and community service providers.

o Limited capacity of community-based services.

o Delivery of services and use of medications that do not reflect the most current evidence-based practices.

o Shortage of qualified health care professionals in prisons and jails, and the high cost of medications.

The recommendations include:

o Screen people for mental illness using standardized, validated instruments upon their admission to a correctional facility and determine which require further assessments and programming.

o Facilitate community-based mental health providers' access to prisons and jails.

o Prepare providers to receive individuals upon their release to ensure uninterrupted services and supports.

o Ensure that individualized, accessible, integrated and effective community-based mental health treatment services are available.

o Ensure that people who are eligible for public benefits receive them immediately upon their release.

Report findings

According to the council, nearly 650,000 people in the U.S. are released from prison each year, and over 7 million are released from jails. The report found that three out of four jail inmates have a substance abuse problem, but only 10 percent in state prisons and three percent in local jails receive formal treatment prior to release.

The report cites several examples of programs that demonstrate the positive impact of substance abuse treatment.

The Delaware-based KEY-Crest Substance Abuse Program is a multiphase, therapeutic-based program that seeks to treat and modify the behaviors of substance abusers in prison and in a work-release center.

Of the inmates who participated in the in-prison treatment and work release treatment program, 77 percent had not been arrested after 18 months, compared to the control group in which 46 percent had not been re-arrested within 18 months. Also, 47 percent of participants were drug-free at 18 months, compared to only 16 percent of the control group.

Improving re-entry efforts

According to the council, the first place to start for improving the re-entry process is the creation of a local or statewide version of the Re-Entry Policy Council, with a diverse collection of stakeholders represented.

The report provides 35 policy statements, each of which is a consensus-based principle that can serve as an underpinning of a re-entry initiative. Each policy statement is followed by a description of the problem it addresses and includes research highlights that summarize relevant statistics and studies.

Recommendations identify steps that should be taken to implement the corresponding policy. The report is divided into three parts. The first chapter: Planning a Re-Entry Initiative, offers key steps for engaging the relevant stakeholders in a re-entry initiative and developing the knowledge base that will leverage the project.

The second chapter: Review of the Re-Entry Process: From Admission to the Institution to Return to the Community, reviews strategies for overcoming major hurdles that will confront leaders planning a re-entry initiative: redefining missions; funding; integrating systems; measuring performance; and educating the public.

The third chapter: Elements of Effective Social Service Systems, addresses the systems that provide housing, workforce development, mental health services, substance abuse treatment, children and family supports, and health care and explains what improvements must occur within these systems.

Second Chance Act

In 2004, the U.S. House of Representatives and Senate introduced legislation consistent with many of the recommendations of the report. The Second Chance Act, introduced in June 2004, would authorize the U.S. Department of Justice to establish a task force on federal programs and activities relating to the re-entry of offenders into the community.

The legislation would provide grants to community-based organizations to provide mentoring and other transitional services essential to re-integrating ex-offenders.

"I like to think the Second Chance Act is the first modest initiative that is trying to recognize the importance of rehabilitation," said Honberg. "We hope it will pass. We hope it will be adequately funded. If it's passed, it could benefit a whole lot of people; it could benefit society."

The legislation would also establish or expand the use of re-entry courts to provide offenders returning to the community mental and medical health assessment and services, as well as with drug and alcohol testing and treatment when needed. The legislation would also provide continuity of services as offenders re-enter society.

The Report of the Re-Entry Policy Council is available at www.re-entrypolicy.org.

Mental Health and Re-entry, By the Numbers

The Report of the Re-Entry Policy Council: Charting the Safe and Successful Return of Prisoners to the Community, cites the following statistics related to mental health and re-entry:

o An estimated 8 to 16 percent of the prison population and 10 percent of the jail population has at least one identified serious mental disorder and is in need of treatment.

o The incidence of serious mental illness, such as schizophrenia, major depression, bipolar disorder and post-traumatic stress disorder (PTSD), is two-to-four times higher among prisoners than the general population.

o Among prisoners with serious mental disorders, over 70 percent also have a substance abuse problem.

o Sixty percent of state prisoners with mental illness have received some form of mental health treatment while in prison. Of these, half reported taking prescription medication and 44 percent reported receiving counseling services.

o A national survey of parole administrators found that less than a quarter of respondents indicated that they provide special programs for parolees with mental illness.

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