GEORGIA
GEORGIA
GEORGIA
Department
of Corrections
GEORGIA
GEORGIA
ON THE MOVE
Stopping the Revolving Door for
Mentally Ill Offenders in the
Criminal Justice System via
Diversion and Re-entry Programs
International Crisis Intervention Training Conference
Eleanor Brown, LPC
Georgia Department of Corrections
Georgia Department of Corrections
Statistics
 Nationally, 1 in 31 adults is under some form of correctional
supervision.
 Georgia ranks 1st in the nation with 1 in 13 under some form
of correctional control.
 Georgia ranks 4th in the nation with an adult incarceration rate
of 1 in 70.
 GDC currently has approximately 160,000 convicted felons
under probation supervision.
 Approximately 56,000 inmates in GDC prisons.
 Approximately 9,000 are classified as having a mental illness
(15.4%).
 27% of Day Reporting Centers Participants are classified as
mentally ill.
Justice Center Report “ A Guide to
Research-informed Policy Practice”
Increasing high numbers of people with mental illnesses are coming in
contact with law enforcement agencies, courts and correctional agencies.

Offenders
with mental illnesses have a greater chance of recidivating
than the general population offender.
People with mental illness are at an increased risk of developing
substance use disorders over the course of their life.

Nearly
a third of people who experience homelessness have a serious
mental illness and their homelessness makes them highly visible to law
enforcement.
People
with mental illnesses tend to stay in jail and prison longer and are
less likely approved for parole than others charged with similar offenses.
72%
of offenders with mental illness have a co-occurring substance
abuse disorder.
Justice Center Report “ A Guide to
Research-informed Policy Practice”
Best practices which are evidenced based in the delivery of mental health
services for the mentally ill under community corrections supervision:
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Assertive Community Treatment utilizing a multidisciplinary team of
professionals.
Illness Self management and recovery, in which people learn skills to
monitor and control their well-being.
Integrated mental health and substance abuse services.
Supported employment, in which people with mental illness are
employed in competitive, integrated work setting with follow-along
supports.
Psychopharmacology-medications are used to treat mental illness.
Family and consumer education, people with mental illness(es) and
their families learn about mental illness, symptom management
techniques and stress reduction.
The Revolving Door for the
Mentally Ill
Homeless
Prison
Hospital
Homeless
Jail
Probation
Inmate Cost for GDC
• It costs GDC $67 a day to house the mentally ill.
• It costs GDC $50.17 a day to house a general
population inmate.
• GDC spends approximately five million dollars a
year on Psychotropic medication.
• Psychotropic medication accounts for 18% of
GDC’s total pharmacy budget.
Georgia Department of
Corrections (GDC) Solutions
 Diversionary and Reentry Programs that involve
partnering with other State, Local, Law Enforcement,
Judicial Systems, and Faith Based Organizations in
order to provide wrap-around services to meet all of
the offenders’ needs and responsivity issues.
Diversion
 Day Reporting Centers
 13 Day Reporting Centers
 Non-residential Substance Abuse Programs that use
evidenced-based evaluations and programs to
address the underlying problem of the offender.
 Mentally ill probationers can be diverted from
expensive prison beds if the underlying root of their
problem is addressed: mental health compliance,
and substance abuse treatment.
Day Reporting Centers
What is a Day Reporting Center (DRC)?
 A community-based, highly structured, nonresidential sanction for probationers with a history
of non-compliant behavior related to substance
abuse. Day Reporting Centers provide intensive
supervision and behavioral interventions as an
alternative to incarceration for probationers who are
failing to adhere to standard supervision conditions.
What are some of the Components
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Substance abuse counseling and programming
Rigorous drug testing
Cognitive restructuring (changing criminal thinking)
Employment preparation, enhancement, and maintenance
Adult literacy and GED preparation
Intensive supervision (field contact, curfew compliance)
80 hours community service
Life skills classes
Anger management (some sites)
12 step attendance
Family Night participation
Six months Aftercare
Why Day Reporting Centers?
 Georgia has the fourth highest incarceration rate in
the country with one in thirteen Georgians being on
some form of correctional supervision. Nationally the
rate is one in thirty-one.
 Approximately 75% of incarcerated offenders are
drug or property offenders, and 72% of those
offenders report using drugs prior to their arrest.
 In Georgia, 250 – 300 new methamphetamine cases
enter the prison system every month.
 51% of inmates self-report never having a job
 75% without a high school education
 In CY2011, 21,055 offenders entered the prison
system and 21,390 were released. Of those released,
200 – 300 have mental health issues.
Why Day Reporting Centers?
 65% of felons commit additional crimes and return to
prison in their lifetime
 DRCs apply Evidence Based Principles that are part of the
“What Works” in correctional rehabilitation (cognitive
based programming, employment enhancement,
substance abuse treatment, and education
opportunities)
 2010 Study by University of Cincinnati indicated DRC
participants recidivated 24% less than non participants.
 Public demand for offenders to be punished, while they
expect offender rehabilitation
 Studies show for every dollar spent on treatment there is
upwards of a $7 return
 DRC offenders cost per day is $14.78 compared to prison
cost of $50.17
 DRCs provide a sentencing alternative that is community
based in lieu of incarceration
DRC Program Goals
 Protect the public through intensive supervision and behavioral
interventions
 Divert offenders from the warrant and revocation processes who
would otherwise be confined to jails, prisons, or other residential
facilities
 Provide an alternative sentencing option to divert offenders from
future criminality
 Replace criminal behaviors and attitudes with pro-social
alternatives that reduce recidivism
 Provide offender opportunity for Restitution, Rehabilitation, and
Restoration
 Develop a collaborative with law enforcement, state agencies,
non-profits and the faith based community to effect
accountability of the offender
How long is the Program?
 The program is six to nine months for Phase I and II,
and six months for Phase III
 Phase I is the first four to eight weeks of intense
programming
 Phase II is approximately 2 to 6 months and is
generally when the offender works and attends
classes in the evening
 Phase III is the aftercare phase and is six months in
length
 Participants return or transfer back to general
probation or parole supervision after Phase II to a 6
month Phase III aftercare program
Mental Health Counselors for DRC, CIP, &
Probation Offices
Legend
Northwest
DRC Sites
Location of the MH
Counselors
Gainesville
Rome
Athens
Cobb
Future DRC
Sites
Dekalb
Atlanta
Probation
Offices
CIP Sites
Clayton
Augusta
Griffin
Macon
Columbus
Savannah
Albany
Tifton
Waycross
Thomasville
DRC Female Diagnosis
38%
DRC Male Diagnosis
16%
18%
34%
11%
Mental Health Counselors in DRCs
• Four (4) Mental Health Counselors are certified
addiction counselors (Atlanta, Athens, Gainesville
and Griffin).
• Eight (8) Mental Health Counselors are in the
process of obtaining their certification in
addiction counseling.
• Three (3) Mental Health Counselors have
obtained their Licensed Associate Professional
Counselor (LAPC) (Atlanta, Augusta and Clayton),
and One (1) has obtained her LMSW (Northwest).
Mental Health Services in Each DRC
A mental health counselor has been placed in
each DRC.
The mental health counselor conducts a
Mental Health screening on all participants
during intake.
The mental health counselor completes a
Mental Health Evaluation on all participants
identified during intake as possibly needing
MH/MR services.
Mental Health Services (cont.)
If a participant is not currently receiving
mental health services, the counselor makes
an appointment with the local mental health
center.
The mental health counselor conducts a
minimum of one (1) supportive group per
week.
The mental health counselor monitors mental
health compliance and reports this to the
Probation Officer and/or Center Administrator.
Mental Health Services (cont.)
The mental health counselor elicits
community partnerships to address other
needs of the participants, such as housing,
food, clothing, child care, transportation, crisis
stabilization, referrals to vocational
rehabilitation programs, and/or assistance
with SSI/SSDI applications.
Some mental health counselors attend
treatment team meetings at the local mental
health center.
Collaborative agreements to meet
Offenders Needs
• Department of Behavioral Health and
Developmental Disabilities.
• NAMI
– Crisis Intervention Team (CIT).
• Georgia Mental Health Consumer Network
(GMHCN).
Department of Behavioral Health and
Developmental Disabilities
• There are ten (10) DRCs that have the local
Community Service Board coming on-site
providing initial mental health evaluations the
complete intake packet), referrals to the
psychiatrist, individual and group therapy
(Athens, Augusta, Columbus, Gainesville,
Griffin, Macon, Northwest/Dalton,
Thomasville, Tifton, and Waycross).
Mental Health Services (cont.)
One (1) more will begin on-site services in the
next month (Rome).
These clinicians also conduct mental health
groups such as co-occurring disorders, coping
skills, DBT, stress management, trauma
survivors, and Anger Management.
GMHCN and NAMI
• GMHCN conducts a Double Trouble group at
the Atlanta DRC.
• NAMI provides Peer Specialists to conduct
groups, provide support and act as a liaison
with the local CSB at the Columbus DRC.
DRC Graduates FY 2012
100
90
80
70
60
50
40
30
20
10
0
94
62
46
20
9
5
52
34
31
20
13
10
66
48
41
MH
Non-MH
8
14
20
25
15
11
18
25
7
23
9
At
he
n
At s
la
n
Au ta
gu
st
Cl a
ay
Co ton
lu
m
Ga bu
s
in
es
vil
le
Gr
iff
i
M n
No aco
rth n
w
es
Ro
t
us
R
e/ om
W
ay e
cr
os
s
T
Th ift
om on
as
vi
lle
DRC MH Graduates by Gender
FY 2012
16
14
12
10
8
6
4
2
0
15
12
10 10 10
55
6
1
6
3
2
3
2
77
5
10
10
8
6
5
5
6
2
3
Male
Female
DRC Graduates by Diagnosis
FY 2012
70
60
50
40
30
20
10
0
62
46
21
25
1
9
Total Graduates: 164
DRC Female Graduates
by Diagnosis FY 2012
35
30
25
20
15
10
5
0
29
28
10
8
3
0
Total Graduates: 78
DRC Male Graduates by
Diagnosis FY 2012
33
35
30
25
20
15
15
10
5
17
13
7
1
0
Total Graduates: 86
DRC Mental Health
Phase I Completions
Number of participants
Length of Time to Complete Program
45
40
35
30
25
20
15
10
5
0
42
33
22
19
5
9
9
9
2
Time in Weeks
3
4
3
1
4
DRC Mental Health
Phase II Completions
Number of participants
Length of Time to Complete Program
90
80
70
60
50
40
30
20
10
0
79
27
14
15
16
Time in Months
10
2
1
DRC Unsuccessful Completions FY 2012
MH
Non-MH
128
75
53
40
At
la
nt
Au a
gu
st
a
Cl
ay
t
Co on
lu
m
Ga bus
in
es
vil
le
Gr
iff
in
M
a
No con
rth
w
es
t
Ro
Ro
us
e/
m
W
e
ay
Th cros
om s
as
vil
le
Ti
fto
n
20
ns
At
he
Number of Participants
139
140
121
107
120
85
100 78
81
70
70
80
58 58
4958 48 48
46
60
37
33
31
40
19
12
20
0
MH Discharges: 463
51
DRC MH Participant
Unsuccessful Completions FY 2012
Sentence Modified/Prob. Ended
Medical
Other
Technical Violation
Probation Sentence Expires
Misdemeanor Charge (new)
MH Services Terminated
Failure to Comply w/MH Services
Felony Charge (new)
Death
PDC/RSAT Treatment Program
Absconded
3
2
20
88
2
17
14
2
12
1
5
73
0
20
80
60
40
Number of Participants
100
DRC Overall Mental Health
Unsuccessful Completions
40
36
35
30
27
25
24
25
20
17
17
14
15
9
10
9
4
3
5
1
Time in Weeks
to
10
8
36
37
33
to
32
29
to
28
25
to
24
21
to
20
17
to
16
to
13
9
to
12
8
5
to
4
3
2
0
1
Number of Participants
35
Total = 221 Discharges
DRC MH Phase I Unsuccessful
Completions
35
29
29
25
18
20
17
16
15
14
15
10
10
7
6
3
1
Time in Weeks
10
8
to
36
37
33
to
32
to
28
29
to
24
25
21
to
20
17
to
16
13
to
12
to
9
5
to
3
2
0
8
0
4
5
1
Number of Participants
30
Total = 165
10
9
8
7
6
5
4
3
2
1
0
9
8
8
7
7
6
3
2
2
2
10
8
to
36
37
to
32
33
to
28
29
to
24
25
21
to
20
17
to
16
13
to
12
to
9
5
to
4
8
1
3
2
1
1
Number of Participants
DRC MH Phase II
Unsuccessful Completions
Time in Weeks
Total = 56
DRC MH Unsuccessful
Completions by Diagnosis
DRC MH Unsuccessful
Completions by Gender
180
154
Number of Participants
160
140
120
100
80
67
60
40
20
0
Females
Males
DRC Study
• Morehouse School of Medicine began the
outcome study April 17, 2012.
• Dr. Brian McGregor and three (3) interns.
Program Success of Dually Diagnosed
Clients in Georgia’s Day Reporting Centers
Core Research Questions
1. Do dually diagnosed participants in the DRC experience
program success relative to a matched comparison group of
DRC participants with substance abuse only?
2. Are indicators of program success in the DRC such as
maintaining sobriety, completing treatment programs, and
obtaining employment, different depending on mental
health status?
Methodology
Research Design – Observational study, prospective cohort
Participants
•
•
Total n = 150
Dually Diagnosed group (n = 25 per site)
–
•
Substance Abuse Only group (n = 25 per site)
–
•
Mental health diagnosis (DSM-IV)
No mental health diagnosis
Matched on demographics
Study Sites
•
•
•
Athens, GA DRC
Griffin, GA DRC
Metro Atlanta DRC
Measurement & Outcomes
•
•
•
•
•
•
•
•
•
•
Phase completion
Pass/fail on scheduled and random sobriety tests
Substance abuse & mental health counseling
Employment (obtaining a job, length of employment)
Medication management
Number of absconders
Program restarts
Self-efficacy & life satisfaction
Recidivism (i.e., re-arrest [probation/parole violation], re-conviction,
re-incarceration)
Self-report Surveys
–
Program satisfaction, readiness to change, self-efficacy, interpersonal
supports
Summary
•
Program features associated with positive outcomes may
need to be strengthened
•
May reduce stigma of treatment difficulties with justiceinvolved individuals with dual diagnoses
•
Create impetus for broader evaluation of Georgia DRCs
•
Seek collaboration & partnership with other states
interested in and successful with justice re-investment
DRC Study Participants By Center
35
30
25
20
15
10
5
0
Co-occurring
SA only
Atlanta
Athens
Griffin
16
29
12
13
15
32
Substance Abuse Only Group
30
25
20
15
10
5
0
Male
Female
Atlanta
26
3
Athens
12
0
Griffin
24
8
Co-Occurring Group
10
8
6
4
2
0
Male
Female
Athens
9
4
Atlanta
9
7
Griffin
6
9
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(DRC)? - CIT International Conference