Essential Elements and Growing Trends in Veterans ...

©JFV, January 2020

The following presentation may not be copied in whole or in part without the written permission of the author of Justice For Vets. Written permission will generally be given upon request.

Essential Elements and Growing Trends in Veterans Treatment Court

Current Statistics

• Approx. 6,000 currently served by Veterans Treatment Courts in 2020

• 3,500 volunteer veteran mentors in VTCs (2020)

• 475+ approximate number of recognized VTCs/VT dockets

• 460,000 approx. veterans w/ trauma or MDD

• 345,000 approx. veterans with substance use disorders

• 181,500 veterans currently incarcerated

Essential Elements (2020-2022)

• There must be a treatment need.

• Court comprised entirely of veterans from the U.S. Military.

• There is structure and it is memorialized.

• There is Department of Veterans Affairs involvement

• There is a veteran mentoring component.

• There is community investment.

• Data collection and evaluation are prioritized and ongoing.

THERE MUST BE A TREATMENT NEED

➢ Current and former service members that become justice involved have needs and risk that require clinical and criminogenic interventions which are culturally sensitive to them.

➢ At the same time, recognizing that these tailored interventions are most effective when balanced with an adherence to evidence-based practices and standards that are implemented in the treatment court model.

Suggested Read: Military Service and Crime: New Evidence (Snowden, Oh et al., 2017). doi:10.1007/s00127-017-1342-8

Photo by Wesley Tingey on Unsplash

Potential Treatment Needs of JIVs

Multiple medical issues

Posttraumatic Stress

Substance misuse/moderate and severve

Depression

Trauma (and related disorders)

Traumatic Brain Injury

Criminogenic

Suggested Read: Posttraumatic Stress Disorder Increases Risk of Criminal Recidivism among Justice Involved-Persons With Mental Disorders (Sadeh & McNeil, 2015) Criminal Justice and Behavior. doi:10.1177/0093854814556880

Focus on:

Traumatic Brain Injury (TBI)

❑ TBI is an injury to the brain from an external force.

❑ The external force could be from a rapid acceleration and deceleration, impact and blast waves.

❑ TBIs are classified as Mild, Moderate and Severe

❑ TBI can cause temporary or permanent impairment to cognitive, physical and social functioning.

Suggested Read: Traumatic Brain Injury in Iraq and Afghanistan Veterans: New Results from a National Random Sample Study J Neuropsychiatry Clin Neuroscience. 2017 ; 29(3): 254–259. doi:10.1176/appi.neuropsych.16050100

Treatment Need (examples)

Focus on:

Military Sexual Trauma (MST)

❑ MST is sexual harassment and/or sexual assault that occurs in military settings.

❑ 60% of women with Military Sexual Trauma also suffered from PTSD.

❑ MST is not a diagnosis, but a type of trauma.

❑ 1 in 5 women and 1 in 100 men report experiencing MST.

Suggested Read: A Specialized Treatment Court for Veterans with Trauma Exposure: Implications for the Field (Knudsen & Wingenfeld) Community Mental Health Field. 2014. doi:10.117/s10597-015-9845-9

Treatment Need (examples)

Focus on:

Alcohol Use

Alcohol is the primary substance of abuse/dependence for those that are serving or have served in the military.

❑ Heavy drinking (five or more drinks per occasion at least once a week) self-reported at 20%, 27% among those with high combat exposure.

❑ Those deployed to imminent danger areas were 1.36 times more likely to develop an alcohol use disorder than non-deployed service members.

❑ Veterans are twice as likely to die from an accidental opioid overdose compared to the general population.

The correlation: Trauma Substance Use Criminal Justice Involvement

Treatment Need (examples)

❑ Veterans are twice as likely to become homeless as non-Veterans

❑ Criminal involvement is the single best predicator of future homelessness.

❑ Fact: Veteran homelessness increased from 2019-2020.

❑ States w/largest increase include California, Delaware and Nevada (California accounted for 31% of all veterans that are homeless.

❑ Black veterans accounted for one-third of homeless veterans, despitecomprising 12% of the overall veteran population

❑ Promising news: The new law entitled, the American Rescue Plan provides increased resources for veterans presently receiving housing support through the VA; includes forgiveness of VA medical debt and repaid retraining for those that lost their jobs

Treatment Need: If I have no place to sleep…

Court comprised entirely of veterans from the U.S. Military.

The publication that defined the drug court model and remains a blueprint for implementing successful programs including Veterans Treatment Courts.

Structure = The Ten Key Components

The Ten Key Components of VTCs

Key Component #1: Veterans Treatment Court integrate alcohol, drug treatment, and mental health services with justice system case processing.

Key Component #2: Using a nonadversarial approach, prosecution and defense counsel promote public safety while protecting participants' due process rights.

Key Component #3: Eligible participants are identified early and promptly placed in the Veterans Treatment Court program.

Key Component #4: Veterans Treatment Court provide access to a continuum of alcohol, drug, mental health and other related treatment and rehabilitation services.

Key Component #5: Abstinence is monitored by frequent alcohol and other drug testing.

Key Component #6: A coordinated strategy governs Veterans Treatment Court responses to participants' compliance.

Key Component #7: Ongoing judicial interaction with each Veteran is essential.

Key Component #8: Monitoring and evaluation measure the achievement of program goals and gauge effectiveness

Key Component #9: Continuing interdisciplinary education promotes effective Veterans Treatment Court planning, implementation, and operations.

Key Component #10: Forging partnerships among Veterans Treatment Court, Veterans Administration, public agencies, and community-based organizations generates local support and enhances Veteran Treatment Court effectiveness.

The Ten Key Components of VTCs (continued)

Structure = Best Practice Standards as a Guide for VTCs

I. Target Population

II. Equity and Inclusion

III. Roles and Responsibilities of the Judge

IV. Incentives, Sanctions, and Therapeutic Adjustments

V. Substance Use Disorder treatment

VI. Complementary Treatment and Social Services

VII. Drug and Alcohol Testing

VIII. Multidisciplinary Team

IX. Census and Caseloads

X. Monitoring and Evaluation

Where do you want

to intercept?

Is everyone in agreement?

▪ Pre-plea diversion

▪ Diversion with stipulated facts

▪ Post-plea, pre-adjudication

▪ Post-adjudication probation

▪ Probation revocation

▪ Mixed models

The Model is clear to all parties

https://www.ndci.org/resources/the-drug-court-judicial-benchbook-updated/

U.S. Department of Veterans Affairs

• Veterans Justice Outreach (VJO) Specialist• Obtaining VA Releases of Information• Facilitating VA linkages for services• Coordinating and providing VA status report

regarding Tx, tox screens, appointments, etc.• Case management & crisis management• VBA Referral and linkage• Facilitate processing or review of Pension

Disability Benefits • Process review of potential errors or corrections

on veterans DD214• Peer Support Specialist – NOTE!!• Housing, Education, Vocation, Employment

Veterans Treatment Courts: Historical Context

18

2004 – 2008 Increased influx into our legal system

The need concomitantly surfaced in multiple areas of our country.

Something was different. Responsivity would be tailored to meet the needs of the population.

Veteran Mentors“Leave no one behind”

The backbone of Veterans Treatment Courts...

Veteran Mentors’ Role

❑ Coach

❑ Facilitator

❑ Advisor

❑ Sponsor

❑ Support

The Role of a Mentor Coordinator (MC)

❑ The importance of a Mentor Coordinator.

❑ Duties of a Mentor Coordinator include:

- Recruiting

- Role modeling

- Structure

- Training

21

…and juggling many other challenges!

The MC is the leader; reinforcing a system that is structured

• Establishes a Hierarchy of Communication.

• Role Models the Veteran Centered Approach and encourages others to do the same.

• Oversees all aspects of mentor engagement.

• Co-develops the mentor handbook.

• Maintaining, Recruiting and Innovating

CHECK OUT OUR E-Learning !

https://www.nadcp.org/e-learning-center/

Growing Trends

Growing Trends in VTCsPost 2020/2021 – “Buddy checks” are here to stay!

✓ “Buddy checks” are becoming standard practice in several VTCs

✓ Primarily conducted by the mentoring component on a weekly basis.

✓National VSOs - The American Legion, are providing direction/guidance for effective vet to vet interactions.

https://www.legion.org/buddycheck

Growing Trends in VTCsOutreach to rural communities

www.ruralcommunitytoolbox.org/treatment-services

www.ruralcommunitytoolbox.org/action-guide

Growing Trends in VTCs : Family support and involvement A critical component of recovery

Growing TrendsThe “Nexus” - You are dismissed.

A greater number of veterans treatment courts across the nation do not use the concept of “nexus” as a qualifier for acceptance into a VTC.

Participant virtual check-ins are an adjunct to face to face check-ins.

Virtual team meetings are an adjunct to face to face meetings and are an alternative to the traditional conference call.

Growing TrendsPost 2020/2021 – Lasting virtual changes

Growing TrendsData collection and evaluation is the norm

A greater number of veterans treatment courts across the country routinely collect data and share data with the community to benefit programmatic needs.

✓ Training and Technical Assistance✓ Evidence-Based Research✓ Mentoring Specific Assistance✓ Videos with Resource Library✓ Subject Matter Expert (SME) Webinars✓ VTC Academy✓ SME Office Hours✓ SME Speakers for conferences/on-

demand✓ e-Learning

https://justiceforvets.org/resources/

JUSTICE FOR VETS is here for you!

A hand - up!

You have work to do!

©JFV, January 2020

The following presentation may not be copied in whole or in part without the written permission of the author of Justice For Vets. Written permission will generally be given upon request.

Questions