Clinical Assessment and Substance Abuse Treatment: The Target Cities Experience

10. Effectively Assessing and Preparing Inmates for Community Substance Abuse Treatment: The Portland Target Cities Project In-Jail Intervention by Michael W. Finigan, Nancy Barron, and Shannon Carey

C H A P T E R 10 Effectively Assessing and Preparing Inmates for Community Substance Abuse Treatment: The Portland Target Cities Project In-Jail Intervention Michael W. Finigan, Nancy Barron, and Shannon Carey A hallmark of the Target Cities Program, with its emphasis on system change, was the importance placed on the development of linkages between the substance abuse treatment system and the legal system. CSAT allowed limited Target Cities funds to support treatment and pretreatment enhancements for individuals in correctional settings. In some cities, these funds were used to expand centralized intake to include sites in the criminal justice system, with the provision of standardized, comprehensive assessments and referrals best suited to inmates (Jaffe & Scheckel, 1993). The Portland Target Cities Project (PTCP) recognized the opportunity to use treatment enhancement funds to develop an innovative pretreatment program that included a centralized intake unit located in the jail, called the InJail Intervention Program (IJIP). Evaluators in Portland were interested in assessing its effectiveness as measured by reduced criminal recidivism. A brief description of the implementation of this central intake model provides the background for the study. Prior Programs for Criminally Involved Substance Abusers The previous experience of correctional facilities in the implementation of these program models and the evaluations of such programming influenced the development of IJIP. Prior attempts to establish substance abuse programs within local jails were often 165 unsuccessful due to short stays and unpredictable release schedules of inmates, sometimes based simply on jail capacity relative to demand . Additionally, since jails are not designed with the delivery of substance abuse treatment in mind, they often fail to provide a conducive environment for these programs. These and other barriers have impeded the development of effective jail-based programs that address substance abuse problems among offenders (Peters, Kearns, Murrin, Dolente, & May, 1993; Tunis, 1994; Tunis, Austin, Morris, Hardyman, & Bolyard, 1996; Swartz, Lurigio, & Slomka, 1996). Beginning in 1987, the federal Bureau of Justice Assistance (BJA) funded preliminary jail-based drug treatment demonstration programs in three metropolitan jails (Bush, Hecht, LaBarbera, & Peters, 1991; Peters, 1993). All three programs served both sentenced and nonsentenced inmates, were voluntary, and included linkages to community -based treatment facilities (Bush et al., 1991). Lengths of stay in the three demonstration programs ranged from 30 days to 6 months. However, the linkages were not integral to the programs, and, in at least two cases, simply involved referrals to community agencies (Bush et al., 1991; Peters et al., 1993). In spite of these limitations , an evaluation of one of the programs concluded that, compared to untreated inmates, those who participated in treatment were less likely to be rearrested, remained in the community for longer periods of time before rearrest, and spent less time in jail during later arrests (Peters et al., 1993). Evaluations of other programs found that in-jail treatment that facilitated a continuum of service from jail into community-based treatment resulted in a reduction in recidivism (Swartz et al., 1996; Tunis et al., 1996). More recently, Wald, Pringle, Balavage, and Edmondston (1998) described a program in Allegheny County, Pennsylvania, that offered inmates an opportunity to participate in community-based residential substance abuse treatment in lieu of incarceration. In addition to long-term residential substance abuse treatment, this program provided vocational and educational training, job placement, life skills training, family counseling, short-term community aftercare, and gender-specific treatment. This gender-specific treatment enabled women to address personal issues in separate women’s groups. Women, older participants, and those who remained in the program longer were more apt to be successfully discharged than males, younger participants, and those who stayed only a short time. Participant outcomes, particularly recidivism, were significantly improved, but the differences between those who participated in the program and those who did not diminished over time (Wald et al., 1998). 166 Michael W. Finigan et al. The PTCP In-Jail Intervention Program The 1992 Drug Use Forecasting data ranked Portland fifth of 13 participating cities in drug use among male arrestees, and second (81%) in drug use of female arrestees (Office of Alcohol and Drug Abuse Programs, State of Oregon, 1993). In response to this finding, and under the auspices of the Portland Target Cities Project, a strategic planning committee along with the IJIP program director developed the Portland In-Jail Intervention Program (IJIP). The goal of IJIP was to identify substance-abusing individuals incarcerated within the jail and to provide them a...