Tag Archives: Alternatives to Prison

Report-back from National Public Health and Criminal Justice Convening

On November 9, Human Impact Partners and the Vera Institute of Justice co-convened over 40 criminal justice advocates and public health practitioners from around the country at a groundbreaking, first of its kind convening. The event grew out of the idea that health and justice system leaders’ work in the pursuit of health equity, public safety, and social justice could be magnified by a powerful partnership across the fields of public health and criminal justice to advance these collective goals.

ConveningGroupPictureAn advisory committee – with leaders from JustLeadershipUSA, The Sentencing Project, Ford Foundation, WISDOM, and Drug Policy Alliance – helped HIP and Vera envision what the gathering could accomplish, and ultimately proposed a bold and audacious goal: to develop an alternative vision for a justice system that works to improve population health and wellbeing at every step and to develop an agenda for collaborative work to achieve that vision.

The convening was envisioned as a space to build relationships between people working at the intersection of public health and criminal justice and had an ambitious agenda. We began with participants recounting the modern history of mass incarceration and its disproportionate effects on communities of color. Participants spent time describing how they using a public health approach to issues such as drug policy and drug use, sentencing, over-incarceration, victims’ services, and reentry. Over and over, the group kept coming back to the significance of the current political moment and recognized that the progress we’re witnessing today was due to the committed efforts of community organizers – many of whom were formerly incarcerated and some of whom were in the room – who kept a constant spotlight on the injustices of the criminal justice system over many decades.

The group then turned to a discussion of their vision for an alternative justice system, and principles that should ground that vision. It was a robust dialogue, with participants highlighting the need to make a broad statement about our societal obligation for health and safety and that both the criminal justice and public health systems need to be transformed to focus on creating the social, economic, and political conditions necessary for all to thrive. This includes making the criminal justice system the choice of last resort for addressing social problems, and instead, upholding and supporting communities to overcome those challenges. The group agreed on the need to explicitly name race and racism as a root cause of poor health and over incarceration, and that the vision should be framed as a call to action. At the end, the group came to agreement on points of unity for the vision and clarity about who the vision was for. It was quite an accomplishment!!

Finally, the last part of the day focused on identifying a set of joint goals to move the vision forward. It was another rich conversation with many ideas of how the group could collaborate. The group was able to come to consensus on a set of research, communications, policy, and community building goals to advance together. Working groups are kicking off their efforts in the New Year, and we anticipate convening again in 2016.

We continue to be inspired by the energy and commitment of convening participants. A deep thanks to them for working hard and giving each other the benefit of the doubt as they explored what it means to be in relationship with one another. A special thanks to Mari Ryono – our fearless facilitator – as well as Ford Foundation for hosting the event and Open Philanthropy for funding it.

This work is part of HIP’s Health Instead of Punishment Program, which grew out of our recently adopted Strategic Plan. Contact us if you’re interested in learning more!

The Misuse of Jails

Most efforts to reform the criminal justice system have focused on state and federal prisons. But a recent report by the Vera Institute of Justice, Incarceration’s Front Door, examines a level of the justice system just as much in need of reform: Jails.

Unlike prisons, jails are locally controlled facilities and were initially designed to house people considered too dangerous to release or at risk of flight pending trial. But the Vera Institute’s research highlights some startling statistics illustrating that they no longer fulfill this mission.

  • Nearly 12 million people are admitted to jails each year. The number has doubled in the last 20 years, even though crime and arrest rates have fallen steeply.
  • About 75% of people in jail are being held for nonviolent traffic, property, drug, or other minor offenses.
  • Over 60% of people in jail are legally presumed innocent, but are too poor to post bail while their cases are processed.
  • People in jail are four to six times more likely than the general population to have serious mental illnesses such as schizophrenia.

The stark racial disparities that characterize the prison system are also seen in jails. Vera reports that African-Americans are jailed at more than four times the rate of whites. Among other factors, this is a reflection of aggressive policing in African-American neighborhoods, “zero tolerance” suspension policies in schools, and the intersections of race and class that mean African-American men are less likely to be able to post bail than their white counterparts.

Even a short stay in jail increases the likelihood of a longer prison sentence, disrupts families and communities, diminishes economic opportunities, and worsens peoples’ health. In a textbook example of the feedback loops that perpetuate problems, the report says: “Time spent in jail exacerbates already difficult conditions and puts many on a cycle of incarceration from which it is extremely difficult to break free.”

But Incarceration’s Front Door also identifies turning points in a given criminal case where there are opportunities to divert people from jail and connect them to resources that support health and strengthen communities:

  • Partnerships between police and mental health providers so that people with mental illness can be routed to community services rather than subject to arrest.
  • In lieu of prosecution, referral to community courts based in restorative justice practices.
  • Ensuring that bail hearings occur within 24 hours of arrest. The authors cite recent research showing that “long-term outcomes are considerably worse for defendants held in jail longer than 24 hours, even if they are later released.”

The report paints a picture of a convoluted and destructive system, but the authors emphasize that the misuse of jails is neither inevitable nor irreversible. Crafting healthy and equitable policies will require identifying and then acting on the turning points that can fundamentally shift the workings of the system.

It’s Time for a Feminine Perspective

Last year I wrote a blog about the stress response, explaining how chronically stimulating the fight-or-flight response to stress can have a host of impacts on health.

But there’s another, less well known, response to stress. In the animal world, females are often responsible for caring for the young. When threatened, they may not be strong enough to fight off the aggressor, and fleeing would mean leaving their young vulnerable to attack. So the females will often group together to surround the young, creating power in numbers to overcome the threat. Researchers have labeled this strategy tend-and-befriend.

This concept should be considered when we assess the impacts of policies. Whether you respond with fight-or-flight, or with tend-and-befriend, each option is a response to what your brain perceives as a threat. If you think about it, many policies are created in response to what some groups consider to be threatening situations or conditions.

Consider school discipline. Disruptions in the classroom, fights between students, bullying and other threats of violence are considered threats by many students and teachers. “Zero tolerance” policies that mandate suspension or expulsion of students who engage in these activities might be considered a fight-or-flight response, by fighting back.

On the other hand, restorative justice policies, which focus on repairing the harm caused by misbehavior and getting students to take responsibility for their actions, might be considered a tend-and-befriend response. These policies suggest that the threat of a lack of discipline (and potential violence) should be addressed by tending to those who are perpetrating the violence, as well as those who have experienced it, encouraging them to befriend each other. Research shows that this approach, and other trauma-informed approaches to improving education outcomes, are more effective – both in reducing the threats and also in improving health and education outcomes.

Let’s look at another example. Human Impact Partners recently assessed the potential health impacts of California Proposition 47, which proposed reducing six low-level, non-serious offenses of drug possession and various forms of petty theft from felonies to misdemeanors and redirecting resources to services to treat the mental health and substance abuse problems underlying many of these offenses. Labeling these behaviors as felonies is often seen as “tough on crime” – fighting the threat of criminal activity.

But providing treatment instead of incarceration tends to the needs of those with mental health and substance abuse problems rather than harshly criminalizing them. Again, research shows that providing mental health and substance abuse services is more effective in reducing crime, as well as improving physical and mental health outcomes.

There are many other examples. For instance, it often costs less and is more effective to take care of people by providing paid sick days, protecting against wage theft, and keeping families intact – tending to their needs – than to deny access to resources or enforce harsh immigration policies and then deal with the domino effect of more expensive public resources required afterward.

Tend-and-befriend policies, reflecting a traditionally feminine perspective, can be equally, if not more, effective than the flight-or-fight approach. If we’re truly interested in improving health outcomes, we should look to them more often.

Treatment, Not Prison: Reforming Sentences for Low-Level Crimes Will Boost Health and Safety for All Californians

[Originally posted at The Pump Handle]

Reforming California’s sentences for low-level crimes would alleviate prison and jail overcrowding, make communities safer, strengthen families, and shift resources from imprisoning people to treating them for the addictions and mental health problems at the root of many crimes, according to a study by Human Impact Partners.

Rehabilitating Corrections in California, a Health Impact Assessment of reforms proposed by a state ballot initiative, predicts the changes would reduce crime, recidivism, and racial inequities in sentencing, while saving the state and its counties $600 million to $900 million a year – but only if treatment and rehabilitation programs are fully funded and implemented properly.

Read the full article at The Pump Handle.

Reforming California’s broken criminal justice system

If you haven’t seen John Oliver’s piece on the prison system in the United States, you should check it out. Oliver uses satire to make his point that the U.S. criminal justice system, and particularly the War on Drugs, fosters massive inequities.

“On the one hand, the War on Drugs has completely solved our nation’s drug problem, so that’s good. On the other hand, our drugs laws do seem to be a little draconian, and a lot of racist. Because while white people and African Americans use drugs about the same amount, a study has found that African Americans have been sent to prison for drug offenses at up to 10 times the rate, for some utterly known reason.”

What the U.S. prison system does to people and families, particularly communities of color, isn’t humorous at all, of course, and that was Oliver’s point. It’s depressing.

“Tough on crime” sentencing policies gained significant traction as the War on Drugs picked up in the 1980s. While appearing tough on crime was good for politicians’ reelection prospects, did anyone look down the road to anticipate the long-term impacts of criminalizing health problems like substance abuse and mental illness?

This summer as an intern at HIP, I’ve been working with a team of people to conduct a Health Impact Assessment to evaluate the impacts of tough sentencing policies. Proposition 47, the “Safe Neighborhoods and Schools Act” ballot initiative, would change six low-level non-violent felonies to misdemeanors, and channel savings to prevent crime, treat offenders and people victimized by crime, and keep kids in school. Our HIA found that the ballot initiative would improve the chances at healthier and happier lives for Californians and their families.

We heard directly from the people across the state who would be most impacted by a change in sentencing policies – people who had been incarcerated, their family members, and the service providers who help them. Some quotes from our focus groups:

It used to be you do the crime, you do the time, but it’s no longer like that. The felony conviction on your record lasts for a long time. You can’t get a job, you can’t get housing, and you recidivate.”

“People don’t understand that when you lock someone up, it makes their family go through that mental turmoil, that trauma, every day. Locking someone up tears families up. It makes them go crazy.”

“If I had help for mental illness, I wouldn’t have went to prison. If I had a job, I wouldn’t have gone to prison.”

It saves money to boot. Because charging people with misdemeanors instead of felonies for these low level crimes would mean that thousands of people would not go to prison, the state would save $200 million to $300 million a year. There would be fewer people sentenced to jail as well, so counties will save $400 million to $600 million. Proposition 47 requires that state savings go toward helping the root causes of people committing crime – up to $195 million for mental health and substance abuse treatment, up to $75 million for truancy and dropout prevention, and up to $30 million for victim of crime services.

An HIA about incarceration that HIP worked on in Wisconsin also showed that providing treatment alternatives to incarceration were resoundingly positive: it would reduce recidivism, keep families together, and save money. The evidence is so strong, as one of the Wisconsin HIA partners said, “The greatest challenge in presenting the HIA was to explain to journalists that we were not hiding the downside of the policy – the preponderance of evidence for alternatives was simply that overwhelming.”

Sometimes the best public health interventions are not, strictly speaking, health interventions. A policy change that reduces the criminalization of substance abuse and mental health issues would support Californians to have a better shot at living healthy lives.

Matthew Mellon is pursuing a dual master’s degree in Public Health and Public Policy at the University of Michigan.

Overcrowded Prisons, Immigration Reform and the Power of the Presidency

In his fifth State of the Union Address, President Obama declared that he would defy a do-nothing, obstructionist Congress and use his executive authority to address the ever-growing gap between the richest Americans and the rest of us. “America does not stand still,” the president said, “and neither will I. So wherever and whenever I can take steps without legislation to expand opportunity for more American families, that’s what I’m going to do.”

Raising the minimum wage for federal contract workers and other executive actions to fight inequality are important steps, and they are directly connected to improving public health. But there are other crises the president can tackle with the power of his office. Two of the most serious are, like inequality, strong determinants of public health.

In an op-ed in The New York Times, Bill Keller points to “the famously shocking numbers of Americans behind bars.” With 2.3 million prisoners, the incarceration rate in the United States is by far the highest in the world – with only 5 percent of the world’s population, we have locked up nearly one-fourth of the prisoners on earth.

Much of the increase in incarceration has come from harsh mandatory sentences for non-violent drug offenders and people with mental health issues – people who need treatment, not punishment. HIP’s Health Impact Assessment on reducing the prison population in Wisconsin found that sending non-violent offenders to treatment rather than prison would mean healthier lives, stronger families and safer communities. Treatment is much more likely to help people recover from substance abuse, reduce the need for future psychiatric care, and improve the health of children by keeping their parents at home, not behind bars.

And yet, writes Keller, Obama – a former community organizer in inner-city Chicago – “has had surprisingly little to say about the shadow cast by prisons on the families left behind, about the way incarceration became the default therapy for drug addicts and the mentally ill, about the abject failure of rehabilitation.” Although Attorney General Eric Holder has recently been more bold about urging states to rethink the cruel consequences of incarceration, the Administration has done little to reduce drug prosecutions or provide more money for treatment programs. Of the 8,000 people in federal prison because of outdated crack cocaine laws, which affect young black men disproportionately, last year Obama pardoned only three.

In the same issue, the Times reported on the annual congress of United We Dream, a national network of immigrant youth, many of whom were once undocumented themselves and whose parents are undocumented. Many Dreamers live in daily fear that their families will be torn apart by the arrest and deportation of their parents.

During his presidency, Obama has deported almost 2 million undocumented immigrants, more than any other president. HIP’s recent HIA on immigration reform found that if deportations continue at the present rate, each year more than 150,000 children will have a parent taken away, pushing more than 80,000 households into poverty and triggering poorer health or behavioral problems for approximately 100,000 children.

The Dreamers called on the president “to cut back programs that have greatly expanded the reach of federal immigration authorities” and grant deportation deferrals to parents of the more than 520,000 youth who have also received deferrals. In words that echo our HIA, United We Dream’s Cristina Jimeniz said: “These deportations are ripping our families apart; this has to stop. And we know the president has the power to do it.”

Making Mass Incarceration a Memory

“We cannot simply prosecute or incarcerate our way to becoming a safer nation. To be effective, federal efforts must also focus on prevention and reentry.”– U.S. Attorney General Eric Holder, 8/12/13

Last week, Attorney General Holder announced a plan for three key reforms to federal drug policy. If implemented, gone will be mandatory minimum sentences for many non-violent offenders. Non-violent, elderly inmates who have served substantial parts of their sentences will be considered for early release. And by encouraging the sharing of best practices, the Justice Department will support greater use of alternatives to prison.

The shift in federal policy was spurred by skyrocketing prison costs. As The Guardian reports, states like Texas and Arkansas were ahead of the federal government in looking at ways to reduce costs through more humane sentencing.

But saving money is not the only benefit. There’s another win here.  Expanding alternatives to prison will make communities safer, strengthen families and improve public health.

These were the findings from a 2012 HIA on the impacts of increased investment by the State of Wisconsin in problem-solving courts and other programs to keep low-risk non-violent offenders out of prison. For the study, Human Impact Partners partnered with WISDOM, a statewide network of faith-based congregations working to slash the number of people in prison.

We found that expanding alternatives to incarceration could keep thousands from prison – and rather than putting them behind bars, it could provide the help they need to get their lives back on track. Investment in alternatives could keep more than 24,000 people out of prison or jail, instead of sending them to drug courts, mental health courts and other diversion programs.

More than half of prisoners in Wisconsin are parents. Prison tears families apart, but diversion programs keep them together, enabling parents to continue caring for their children. These programs also are proven to reduce the risk of returning to prison, so they actually reduce crime and improve chances of recovery from substance abuse and to finding jobs.

Most compelling for legislators, the Wisconsin study found that state funding for alternatives would provide a return on investment of almost 2 to 1. By investing $75 million in alternative programs, the state would save $150 million in criminal justice costs.

For a state corrections system whose costs had topped $1.3 billion, the economic argument was certainly compelling. But the human story may have trumped it.

As one drug court participant said, “Drug court saved my life.”  Another told of how recovery from drug addiction enabled him to give back to his community and his family. Almost every former prisoner we spoke to had a story of a breakdown in their relationship with their children and partners. They reported stress, poor mental health and low self-esteem, and described neglect suffered in overcrowded prisons.

In an era of sharp partisan division, it’s refreshing to hear that progressives and conservatives both support the actions announced by the Attorney General – even if for different reasons.  As TIME reports, some see primarily the cost savings, while others are encouraged by the reforms’ potential to stem the so-called cradle-to-prison pipeline.

Alternatives to prison save money, but it’s important that the savings be funneled back into improving and expanding diversion and treatment programs. The initiatives outlined by Holder are a good first step; a next task is to ensure adequate funding both for alternatives to prison that avert re-entry, and for mental health and substance abuse treatment programs that prevent people from entering the criminal justice system in the first place.

Funding Treatment Instead of Prison

By David Liners, state director of WISDOM.

Almost a year ago, WISDOM, a Wisconsin network of congregation-based community organizations, launched an audacious campaign we call 11×15, calling on the state to reduce its prison population by half (to 11,000) by the end of 2015. Hundreds of volunteers were trained to make presentations in churches, synagogues and mosques as well as to Rotary, Kiwanis and Optimist clubs. By November, nearly 4,000 people had been at a presentation and had signed a sheet saying they wanted to be counted among the supporters of 11×15. Volunteers met with lawmakers, academics, law enforcement, judges and the formerly incarcerated.

State decision-makers were intrigued, but cautious. They got the message that Wisconsin had far too many people incarcerated (more than twice the rate of neighboring Minnesota), and that the state was spending far too much money on prisons (in 2012, the state’s contribution to prisons became greater than its contribution to the university system). But wait, they said. You can’t just let a lot of dangerous criminals back out on the street!

Enter Human Impact Partners.

Human Impact Partners spent more than a year working on an HIA to study the effects of a greater investment by Wisconsin in alternatives to incarceration. More specifically, they asked what would be the impact of a $75 million per year commitment to the existing Treatment Alternatives and Diversions (TAD) program. TAD is a $1 million-per-year grant program through which the state funds evidence-based jail and prison diversion programs run by several counties.

HIP, led by project director Kim Gilhuly, conducted an exhaustive literature review. They studied comparative data from existing Wisconsin alternative programs and compared it to data for those who went to jail or prison. They studied the literature related to Drug Treatment Courts and similar innovative alternatives around the country. They did focus group interviews with formerly incarcerated people, with drug court participants, judges and treatment providers.

On November 27, 2012, the HIA – Healthier Lives, Stronger Families, Safer Communities:  How increasing funding for alternatives to prison will save lives and money in Wisconsin – was released. HIP and WISDOM reached out to the news media, and held five major in-person events in cities around the state over the next several days to introduce the HIA. The results were overwhelming. Extremely positive articles were written; several major newspapers editorialized that the HIA was showing the way; many new partners joined the effort.

The HIA helped to demonstrate that WISDOM’s 11×15 goals were not just the lofty hopes of church folk; they are eminently achievable if the state follows its own best practices. The report projects that a $75 million investment in TAD would result in more than 3,000 fewer annual admissions to state prisons, and 22,000 fewer admissions to county jails. If that were not reason enough to make the change, the HIA shows that crime would be reduced (since people in alternative programs have a lower rate of recidivism), families would be kept together, health (especially addiction recovery and mental health management) would be improved, and more people would be employed. The greatest challenge in presenting the HIA was to explain to journalists that we were not hiding the downside of the policy – the preponderance of evidence for alternatives was simply that overwhelming.

With the HIA at its back, WISDOM volunteers are moving full speed ahead with efforts to see the recommendations included in the 2013-15 state budget which will be crafted in the first half of the coming year. It is our belief that faith, science, fiscal prudence, and organizing have all converged on the same important policy.

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