treatment alternatives to prison a health impact assessment scope of research february 2012

Treatment Alternatives to Prison A Health Impact Assessment

Scope of researchFebruary 2012

Health Impact Assessment – a structured yet flexible research and engagement tool used to elevate the consideration of health outcomes in decision-making.

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Incarceration

Drug & alcohol courts

Mental health courts

Job Placement Programs

Community Based SATS

Community Based MH Services

∆ Recovery rates

∆ Crime & Violence

∆ Economic impact

∆ infectious disease (HIV, Hep C, STI)

∆ premature mortality

∆ injuries

∆ mental health

∆ stress

∆ unemployment

∆ Quality of Life in Communities

∆ in Family life

∆ homelessness

ALTERNATIVES

General

Bail diversion Day Report programs

∆ chronic disease

∆ ability to manage mental

health

∆ addiction to substances

General Research Questions

How would Treatment Instead of Prison (TIP) change:

1 Number of slots for each intervention?

2 The proportion of the general population incarcerated vs. in each alternative intervention?

3 Number of people employed after each intervention?

4 Number of people able to find housing after each intervention?

5 Educational attainment for those in each intervention?

6 Racial equity in each intervention?

7 Rates of infectious disease (STIs, hepatitis), chronic disease (hypertension, heart disease, respiratory disease), mental health issues (stress, depression, anxiety) among the targeted population and among the general population?

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∆ Access to drugs and drug

tx services

∆ Case management

∆ Access to medical ins/ tx

for co-occurring issues

Recovery from substance addiction

∆ risk of infectious

disease (HIV, Hep C, STI)

∆ heart disease

∆ neurological damage

∆ respiratory harm

∆ mental health

∆ stress

∆ ability to manage mental

health

∆ access to a living situation

∆ Access to prescription tx &

MH services∆

homelessness

∆ physical health

conditions

Recovery

Incarceration






ALTERNATIVES


Recovery

Main question:

How would TIP impact SA recovery and MH management?

Questions address each intervention, with statewide and per county counts

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Recovery: Research Questions

How would Treatment Instead of Prison change:

1. Rates of substance abuse recovery and ability to manage mental health issues?

2. Access to: substance abuse and mental health treatment services; affordable medical insurance; prescriptions; and active case management?

3. Number of people who from each intervention who are homeless or otherwise do not have access to affordable housing?

4. The number of people who overdose and commit suicide?

5. The number of neurological disorders, STIs, and infectious disease in the targeted population?

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Crime and Safety∆ property/ violent crime (for those in drug courts or job training programs)

∆ Injury

∆ Death

∆ levels of crime in the community

∆ RecidivismAccess to Case

management and rehab programming

Access to prescription tx &

drug/MH tx services

Access to SATS

∆ Educational opportunities

∆ Access to a living situation

∆ Access to jobs

∆ Legal Income

∆ Stress

∆ Chronic disease

∆ Mental health

Solitary confinement/

punitive tx

Reentry

∆ Parole services

Incarceration






ALTERNATIVES


Crime and Safety

Main question:

How would TIP impact crime and safety levels?


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Crime and Safety: Research Questions


1 Number of violent & property crimes committed? Injury/fatality from these crimes?

2 Recidivism?

3 How many people receive parole, per intervention, and what is the rate of recidivism in these population groups?

4 The average time out of circulation to commit crimes in public, per type of crime?

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∆ educational outcomes for

children

∆ exposure to crime & violence

∆ extended family to care

for dependents

∆ Individual living with

family

∆ Children to foster care

∆ ability for custodial caregiver

to hold job

∆ child mental health

∆ financial effects of caring for

others’ dependents

∆ dependent abuse/ neglect

∆ ability to afford food, medicine,

clothes

∆ Behavioral issues for children

∆ parent mental health

∆ bonding w/ parent

∆ youth involvement in justice system

∆ child injuries

∆ peer bonding

∆ Immune system∆ Single parent

families

Family

Incarceration






ALTERNATIVES


Family

Main question:

How would TIP impact children/dependents of individuals involved in these programs?

Questions address each intervention, with statewide and per county counts.

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Family: Research Questions


1 Number of children in foster care or living w/ a non-parent family member?

2 Exposure to violence for children/dependents of individuals in each intervention?

3 Educational attainment of children in these families

4 Abuse/neglect of children/dependents for parents in each intervention

5 Number of single parent families

6 Cost of caring for child/dependent for alternate caretaker and unemployment for alternate caretakers

7 Children/youth in these families involved in youth justice system

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∆ Premature Mortality∆ persons who

commit crimes residing in community

∆ violent and property crime

∆ income levels (same as

poverty?)

∆ rates of unemployment

∆ infectious disease

∆ injury

∆ homelessness

∆ Chronic disease (obesity, nutrition,

cardiovascular, asthma, other)

∆ community-wide poverty

∆ social cohesion & support

∆ exposure to weather

∆ wealth)

∆ parolees living in

community

∆ Mental health

Community

Incarceration






ALTERNATIVES


Community

Main question:

How would TIP impact the quality of life in communities where many are involved in the criminal justice system?

Questions address each intervention, with statewide and per county counts.

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Community: Research Questions

In communities with high rates of incarceration, how would Treatment Instead of Prison change:

1 Community-level poverty, average household income, unemployment, and homelessness?

2 The number of those under supervision?

3 Community-level crime, fear of crime, and participation in the underground economy?

4 Levels of social cohesion and/or social support in each of these communities?

5 Level of substance abuse in each of these communities?

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Economic

∆ Government spending

∆ Personal income

∆Criminal Justice system

employment

∆ Health Care costs

∆ Stress & Mental Health

∆ HH income

∆ Occupational Injuries

∆ Medical costs

∆ Employment

∆ Premature mortality

∆ Chronic disease

∆ cost of interventions

∆ cost benefits

∆ parole costs

∆ homeless costs

∆ ED use

∆ case mgmt

∆ MH costs

∆ Poverty

∆ income tax revenue

∆ use of education system

Incarceration






ALTERNATIVES


Economy

Main question:

What is the economic impact of TIP?


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Economy: Research QuestionsHow would Treatment Instead of Prison change:

1 The annual costs of incarceration and alternate treatments?

2 Amount funded publicly and funded from other means for each intervention?

3 Health care costs for prison health care, health care provided to target population outside of prison, substance abuse treatment services and mental health services costs for each intervention?

4 Median household income and employment prospects for those participating in these interventions? Stress levels, mental health outcomes, and chronic disease associated with employment and low-income?

5 The number of people employed in each intervention, their average salary & benefits?

6 Income tax revenue from employees in each intervention?

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Economy: (con’t)


7 Case management and supervision costs of each intervention?

8 Annual costs of construction vs. start-up for alternate treatments)? Cost of operations/maintenance?

9 Emergency room use and costs for people in each intervention?

10 Costs of post-incarceration homelessness?

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treatment alternatives to prison a health impact assessment scope of research february 2012

Documents

mental health access

mental health addiction

mental health issues

respiratory disease

chronic disease hypertension

mh management

alternative intervention

living situation access