River Region Wraparound
Presented By: Jeffrey Becraft Morrisa Tuck Michelle Walker May 5, 2010
Table of Contents
ABSTRACT: River Region Wraparound Program Despite their status as criminal offenders or innocent citizens, few medical practitioners and experts would refute the fact that individuals with mental illnesses need special medical treatment and social services in order to properly address such needs, particularly juvenile delinquents. Currently, within the state of Alabama, all juvenile offenders receive adequate medical attention, such as medication or psychological counseling, as offered by our state’s Department of Youth Services (DYS), if they have been diagnosed with a mental illness. However, upon their release from prison confinement, as well as upon their maturation of age 21, juvenile offenders are dropped completely as recipients of any such services. Upon such events, juveniles are left as free agents of their own medical problems, and are not even provided with the identification of the prescription medication(s) they were receiving during their confinement. They receive no medical referrals to particular physicians, nor are offered any systemic form of support and accountability as they reenter society as ex-offenders with mental illnesses. In the context of quantitative decision-making, this project and essay will address this dire need by presenting the creation of a comprehensive approach to managing the wellness of released juvenile delinquents. By offering ongoing medical and counseling services, the River Region Wraparound Program (RRWP) is our proposal to help to decrease recidivism rates in the River Region, and ultimately help juvenile delinquents make smooth transitions into adulthood. Inevitably, the success of this program would also have a positive impact on reducing the amount of dependency such offenders may hold onto federally funded or state sponsored services. We firmly believe that the implementation of such an initiative will also simultaneously address the following: a) select segments of the purpose(s) of Alabama’s Department of Youth Services (DYS) and b) the overall welfare of our state as desired by the governor of the state of Alabama. Truly, it embodies the essence of ensuring not only liberty, but also “justice for all”.
Executive Summary According to the Alabama Criminal Justice Information Center, in 2008, 14% of all Part I crimes were committed by persons under the age of 18. Part I crimes are comprised of the following: “Homicide, Rape, Robbery, Assault, Burglary, Larceny, Motor Vehicle Theft, and Arson.” 1 Among these juvenile offenders there is an alarming prevalence of mental illness. Both mental illness and substance abuse greatly contribute to the criminal behaviors and tendencies of these youths. “While estimates of the percentage of juvenile offenders who have mental health problems vary widely (e.g., between about 30-90%, depending upon what is included as a mental illness), most estimates are substantially higher than the roughly 20% prevalence rate found in the non-delinquent adolescent population. Indeed, many juvenile offenders have multiple mental health problems, and about 15-20% have a serious mental illness.” 2 Sadly, there is an alarming trend of the “school-to-prison” pipeline that occurs when juveniles enter the criminal justice system. Juvenile offenders are more likely to become adult offenders. The special needs of juvenile offenders in the River Region (Autauga, Elmore, and Montgomery Counties) are ones that this program seeks to address. The River Region Wraparound Program clearly aligns with the priorities that Governor Bob Riley has for the State of Alabama. One area of particular concern for Riley’s administration is to “reduce recidivism rates through an increased investment in community corrections and other alternative rehabilitation programs”, as listed on the Smart Governing Website. Governor Riley is committed to protecting Alabamians, and his strategy is to do so through “an aggressive focus on preparedness, enforcement, and rehabilitation." Our program centers on the rehabilitative component of his strategy. Juvenile offenders with mental illness will receive continued mental health treatment and services, post-release, in order to reduce recidivism in the River Region. The implementation of the proposed program will be successful if the number of juvenile offenders with mental illness that recidivate is reduced by 10% within a two year period of completion of the River Region Wraparound Program. Reducing the recidivism rate among juvenile offenders in this region will contribute to the overall security and strategic plan that Governor Riley has for this state. There are three options or alternatives for addressing juvenile recidivism rates. First, we can do nothing. While this option requires little effort upfront, over time it will greatly exhaust the resources of this state. A tremendous burden will be placed on the taxpayers of this state if nothing is done to combat the rate of recidivism plaguing our youths and the state criminal justice system. Second, we can provide mental health treatment and services without monitoring/tracking the progress of participants. While this option would provide vital services and treatment to participating juveniles, the results of the said services and treatment would be undermined by a lack of evaluation. And finally, we can create a program, the River Region Wraparound Program, which would aid in reducing recidivism rates by offering ongoing medical 1
and counseling services to juvenile delinquents with diagnosed mental illness, post release their incarceration from an institution as well as monitor all participants and track their progress for a period of not less than two years after they complete the program. This will ensure that participants in this program achieve success and are able to positively contribute to society. The alternative we have chosen is the implementation of the River Region Wraparound Program. This alternative is the appropriate selection for many reasons, as it will 1) Reduce recidivism among juvenile offenders with mental illness in this region, 2) Align with the organizational goals and strategies set forth by the Chief Executive of this state, 3) Provide the greatest benefit at the least cost (in comparison to other identified alternatives), and 4) Maximize the resources allocated for this purpose. Introduction States throughout the country are constantly struggling to reduce recidivism rates amongst offenders. Recent investigations by the US Department of Justice of juvenile correctional and detention facilities have documented the failure of facilities to respond to the mental health needs of youths while incarcerated in the system. 3 Research indicates that inadequate mental health services has led to an increase in recidivism rates because these juvenile offenders continue to cycle in and out of the system as a result of their crimes associated with their untreated illness. These findings suggest that although the juveniles are receiving treatment while incarcerated, albeit insufficient, post release treatment will be necessary to reduce recidivism. In 2006, the National Center for Mental Health and Juvenile Justice declared that over 2.3 million youths are arrested each year and approximately 600,000 of these youths are processed through juvenile detention centers with more than 100,000 placed in secure juvenile correctional facilities.4 Existing research suggest that â€œ70 percent of these youths suffer from mental health disorders, with 25 percent experiencing disorders so severe that their ability to function is significantly impaired.5 According to the Department of Youth Services (DYS) for the State of Alabama, 94.8% of juveniles admitted into DYS were between the ages of 13-17. Our program targets this specific age group, as records indicate that juveniles from this age group comprise the majority of all persons under the age of 18 that are admitted into DYS. There is not only evidence of the presence of mental illness among the juvenile population, but an obvious link also exists between these mentally ill youths and the number of crimes committed among this demographic. Some of the youths diagnosed with mental illness demonstrate poor judgment in society, particularly at school. After exercising poor judgment and committing offenses on school premises, these youths are detained in juvenile facilities and become part of the criminal justice system. Local non-profit/advocacy group Voices for
www.ncmjj.com Ibid. 5 Ibid. 4
Alabama’s Children has conducted research that “shows that placing youthful offenders in juvenile prisons has been proven to be the least effective method in reducing future offenses.”6 Once these juveniles become part of the system, evidence indicates that upon release, these juveniles are highly likely to recidivate and remain in the justice system. A comprehensive study completed by the National Center for Mental Health and Juvenile Justice, after careful examination, “found that 70 percent of all youthful offenders released from DYS during 2001 and 2002 experienced one or more instances of recidivism, with recidivism rates higher for youth incarcerated for longer periods of time.”7 Individuals experiencing mental illness have special needs that incarceration cannot meet. However, great strides have been made in Alabama over the years regarding reducing recidivism rates among this state’s youth. Within the last several years state legislators and child advocates have come together to address this pressing need. A sign of promise came to fruition in May 2008, when Governor Bob Riley “signed into law the Alabama Juvenile Justice Act of 2008 which will reduce reliance on juvenile incarceration and expand community-based alternatives”. 8 Our program would further extend and expand on the work that is being done to reduce recidivism among our mentally ill youth population.
Description of the opportunity: Comprehensive, long term medical treatment and services can reduce recidivism among the mentally ill youth population within this region. The proposed River Region Wraparound Program (RRW) would be implemented to: • • • • • • •
Target juveniles ages 13-17 that have been diagnosed with mental illness. Serve juveniles in the River Region (Autauga, Elmore, and Montgomery Counties). Provide comprehensive medical treatment and services, post-release, for these juveniles until they reach the age of 18. Monitor and track participant progress for a period of no less than two (2) years after they complete the RRW Program. Provide measurable cost savings to the criminal justice system, and ultimately the taxpayers, of the State of Alabama. Reduce recidivism rates among the targeted population by 10% over a five (5) year period. Create a program that, once successfully implemented, can be replicated in other regions across this state and nation.
Project’s measurable organizational value (MOV):
MIJP (Mentally Ill Juvenile Population)
Provide Comprehensive Medical Treatment & Services
Time Frame Year One (1) of RRW Program, and each year thereafter
10% Reduction of the Recidivism Rate for the Region (among targeted population)
MIJP (Mentally Ill Juvenile Population)
Reduce Recidivism Rate in the Region among the targeted population
Alabama State Criminal Justice System
Reduce monetary burden of state juvenile prison system
Year Five (5) of RRW Program
Reduce tax burden of juvenile prison system
Year Five (5) of RRW Program
Year Five (5) of RRW Program
River Region Wraparound Program The objective of writing this business case is to demonstrate, both qualitatively and quantitatively, the benefits of offering mental health treatment to juvenile delinquents, post release, with mental illness. We will also exhibit the risks, benefits and costs associated with the implementation of this program. Analysis of Project Alternatives: Alternative #1-Do Nothing- While this option requires little effort upfront, over time it will greatly exhaust the resources of this state. A tremendous burden will be placed on the taxpayers of this state if nothing is done to combat the rate of recidivism plaguing our youths and the state criminal justice system. Alternative #2-Provide Mental Health Treatment & Services without Monitoring/Tracking Progress of Participants- While this option would provide vital services and treatment to participating juveniles, the results of the said services and treatment would be undermined by a lack of evaluation. Alternative #3-River Region Wraparound Program- The alternative we have chosen is the implementation of the River Region Wraparound Program. This alternative is the appropriate selection for many reasons, as it will 1) Reduce recidivism among juvenile offenders with mental illness in this region, 2) Align with the organizational goals and strategies set forth by the Chief Executive of this state, 3) Provide the greatest benefit at the least cost (in comparison to other identified alternatives), and 4) Maximize the resources allocated for this purpose 8
River Region Wraparound Program Risk Assessment of Alternative 3: 1. Pilot program may go over budget
2. Tax payers may not support program
Reduce recidivism rates among juvenile delinquents in the River Region Area by implementing RRWP
3. Lack of participants
4. Juveniles may continue to recidivate
Mitigation Strategies 1. Budget for an emergency fund in the overall budget 2. Create in communities through public service announcements or a public relations campaign. 3. Seek partnerships with collaborate agencies that would refer participants based on that agencies information. 4. Create awareness of the possible reduction of recidivism, not the elimination.
River Region Wraparound Program 10
Regression Analysis Methodology & Conclusions H=In comparing youths with diagnosed mental health disorders in the River Region, ages 13-17, those who received a greater number of mental health sessions had fewer arrests than similar youth who did not receive treatment. This hypothesis is based primarily from the data gathered through our pilot program. In developing our hypothesis, we considered several alternate independent variables that also may affect the recidivism rate (See Appendix A). As well as evaluating these alternate variables, we created a causal model depicting their relationship(s) to reducing the recidivism rate in the River Region (See Appendix B). Based on our research and observations, our program is the best choice for reducing recidivism amongst juveniles in the River Region. In evaluating the programâ€™s success, we utilized auditing processes, surveys, evaluation data and other reported outcomes to monitor the quality of care provided to the youth that participated in the RRWP.
SUMMARY OUTPUT Regression Statistics Multiple R 0.813369654 R Square 0.661570194 Adjusted R Square 0.646855855 Standard Error 1.278233252 Observations 25 ANOVA df Regression Residual Total
1 23 24
SS 73.46075433 37.57924567 111.04
Coefficients Standard Error 5.372046623 0.470943487 -0.023427974 0.003493954
MS F Significance F 73.46075433 44.96092 7.7E-07 1.633880246
t Stat P-value Lower 95% Upper 95% Lower 95.0% Upper 95.0% 11.40698782 6.04E-11 4.397826 6.346267446 4.3978258 6.34626745 -6.705290233 7.7E-07 -0.03066 -0.01620018 -0.03065577 -0.01620018
River Region Wraparound Program The r2 of 66.15 demonstrates a significant decrease of 66% in recidivism rates among juvenile offenders in the River Region which is attributable to the RRWP. The number of times a participant recidivates clearly decreases based upon their participation in the RRWP. The maximum number of hours of treatment a RRWP participant can receive is 192 hours over a two year period. In our pilot program we enrolled a total of 25 participants; however 24 participants completed the program. Our regression analysis of the subject matter exhibits a strong correlation between the participantâ€™s hours of treatment received and the number of times that individual recidivated.
Times Participants Recidivated According to Hours of Treatment
River Region Wraparound Program Cost-Benefit Analysis: According to the RRWP financial figures, it will cost $1786.00 each youth per month to be in the program for the first year and $1856.00 for year two. These two amounts reflect inflation It costs approximately $7100.00 per month to keep a youth incarcerated in the state of Alabama. The primary investments include facilities, implementation costs, ongoing support, training and personnel (See Appendix C & Appendix D). The implementation of the RRWP will assist the state of Alabama in saving nearly $130,000.00 a month and the social value is not measurable. The River Region will benefit by treating their youths of mental illness and keeping them off the streets and out of institutions.
PROGRAM River Region Wraparound Program Group Homes Corrections Psychiatric Inpatient Hospital
AVERAGE COST PER MONTH/PER YOUTH $1786
Recommendations: Since there is no data indicating the existence of a program in the State of Alabama (River Region) that services juveniles, post release, the implementation of the River Region Wraparound Program will greatly reduce the rate of recidivism among participants that complete the program. The pilot program far exceeds expectations and predictions. Our RRWP is committed to providing quality care to the youths and the families we serve, and we believe that this proposed program will be an effective one. The sources of funding that have been allocated to the implementation of this proposed program are varied and widespread, demonstrating community support and general public interest. Furthermore, the benefits of the RRWP far outweigh the expected costs and risks, thus affirming the overall sustainability and longevity of our program for future generations.
Works Cited About Juvenile Delinquency, “Statistics and References on Juvenile Delinquency.” http://www.aboutjuveniledelinquents.com/references.html (accessed Jan 18, 2010). Alabama Criminal Justice Information Center, http://www.acjic.alabama.gov/cia/2008_cia.pdf (accessed Jan 18, 2010). Alabama Department of Youth Services, http://dys.alabama.gov/ (accessed Jan 22, 2010). Coordination Aftercare Recovery Educational Services, http://www.caresllc.com (accessed Feb 5, 2010). National Center for Mental Health and Juvenile Justice, http://www.ncmhjj.com/Blueprint/programs/AlabamaJuv.shtml (accessed Feb 7, 2010). Positive Outcomes for Youth: A Time for Change, “Juvenile Justice News.” http://www.arkdisabilityrights.org/newvision/index.html (accessed Feb 5, 2010). Voices For Alabama’s Children, “Juvenile Justice.” http://www.alavoices.org/childrens_issues.aspx?pid=105 (accessed Jan 22, 2010). Wraparound Milwaukee: Program Overview, http://www.milwaukeecounty.org/router.asp?docid=7890 (accessed Feb 7, 2010).
APPENDIX A Variables
Recidivism (fewer arrests)
RRWP (Mental Health Sessions)
Low Family Income
APPENDIX B Causal Model
APPENDIX C Benefit-Costs
APPENDIX D Tasks
Rough draft of our project. I have to figure out how to attach the appendices to the rest of the paper because we each have to turn in ONE...