JUDGE INGRID GUSTAFSON

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JUDGE INGRID GUSTAFSON D R U G C O U R T S S A V E L I V ES D R U G C O U R T S S A V E M O N EY Presiding Judge 13th Judicial District Drug Court (13th JDDC) Billings, Yellowstone County, MT The

1 JUDGE INGRID GUSTAFSON D R U G C O U R T S S A V E L I V ES D R U G C O U R T S S A V E M O N EY Presiding Judge 13th Judicial District Drug Court (13th JDDC) Billings, Yellowstone County, MT The Mission of the 13th JDDC is to provide non-violent offenders with substance use disorders, court and treatment services to give them the tools and incentives necessary to conquer their substance abuse problems and become productive, law abiding citizens. Since taking the bench thirteen. years ago I have witnessed a steady increase of drug related crime and the negative impact drugs have on victims, offenders, their families and our community. Conventional criminal justice interventions of probation and incarceration, while at times necessary, have not shown to be the most effective means in addressing the unique issues addicted offenders face. It has been disheartening to me to watch the revolving door of addicted offenders in and out of prison, costing them their lives and placing a heavy burden on taxpayers. For most cases, there is a better way. Drug courts across the country have time and again shown that with the right court and treatment intervention, offenders with substance use disorders can conquer their substance abuse problems and become productive, law abiding citizens; all at a fraction of the cost of incarceration and corrections programs. In 2011, I started the 13th Judicial District Drug Court to become part of that solution. This year has brought exciting, but challenging changes to the drug court. I successfully secured SAMSHA grant funding which has, in turn, doubled the capacity of the drug court and allowed us to include participants with co-occurring mental health issues. Over the last 5 years, as the following Outcome Report shows, we have seen dramatic positive results and significant cost savings to taxpayers. Equally important, our graduates are getting jobs, going to college, raising children and contributing as productive members of our community. I am passionate about this work and the success we have had 1 P a g e

2 The court s value is reflected in the recent text received from one of its first graduates,... just wanted to say thank you and let you know I m celebrating 4 years of sobriety... can you tell Judge Gustafson I say Thank you for helping save my life and Thank you for having faith in me! I am extremely fortunate to work with a dedicated drug court team and I thank my team members for their dedication - and patience. I remain hopeful in the coming years we will have the support necessary to continue expanding the drug court to effectively work toward stopping the revolving door. 2 P a g e

3 Table of Contents Forward.. i Drug Courts: Models for Successful Diversion... 4 Summary of Findings... 6 Demographic Profile...8 Outcome Findings Basis 32 Findings Consumer Satisfaction... Program Evaluation P a g e

DRUG COURTS: MODELS FOR SUCCESSFUL DIVERSION For the last twenty years, the large increases in the number of offenders both nationwide and in Montana can be directly attributed to drug addiction 1.

4 DRUG COURTS: MODELS FOR SUCCESSFUL DIVERSION For the last twenty years, the large increases in the number of offenders both nationwide and in Montana can be directly attributed to drug addiction 1. Montana like many states, has invested heavily in incarceration at the jail, prison, and community correctional systems to attempt to stem these large increases. Still, our prisons are full and our jails are overcrowded. This policy has proven to be a very expensive policy; one that states can scarcely afford. The facts also suggest that this policy has failed to deter crime. Fortunately, over the past twenty years, drug courts have emerged as a highly successful alternative to the incarceration of drug-addicted non-violent offenders. Judge Ingrid Gustafson, of the Thirteenth Judicial District Court, initiated the first Felony Drug Court for the most heavily populated county in Montana, Yellowstone, in February, At Judge Gustafson's direction, this drug court initiated as part of its self-evaluation process, outcome evaluation. The purpose of this evaluation component is to demonstrate the efficacy of quality, intensive addiction treatment combined with community-based probation and judicial oversight utilizing the "Ten Key Components of Drug Treatment Courts". Outcome evaluation answers the question; "How well do our drug court participants do as a result of the drug court services we deliver"? This is the most important kind of evaluation a drug court can undertake and through which it can better understand what is working; what may need to be modified, and how to continue improving its' services. The measurement of quality and outcomes is essential to not only the optimum functioning of any endeavor such as drug courts, but because it also assures tax payers of accountability for funds expended. Outcome evaluation also permits us to evaluate the efficiency and effectiveness of the drug court model and makes it possible for us to determine whether it is cost-effective. In today's climate of scarce fiscal resources the search for outcome-reliable and cost effective management of drug addicted offenders is essential to making the needed paradigm shift; from incarceration to diversion. About the data in this report... The data reported in this manual as outcome findings have been collected in participant surveys. The raw data is entered into software programs and statistically tested by a third party. The statistical testing of the data includes ANOVA and other tests for differences using repeated measures t-tests and analysis of variance. The repeated measures tests answer the question; 1 Incarceration Rates by Crime, Blumstein and Beck, P a g e

5 how do individuals differ from one time [admission] to three times [six, twelve, and eighteen months] Statistical tests were considered significant at the p>.05 level. This is a level that allows for very little chance and permits us to have a high degree of confidence in the data. The tested data is collected and organized to address Quality Indicators which have been established from a number of sources; the National Outcome Measures [NOMS], developed by the Substance Abuse and Mental Health Services Administration [SAMSHA] and from research findings published by the National Association of Drug Court Professionals [NADCP]. The selected measures are: 1. Reduction in days of substance use 2. Reduce intravenous drug use 3. Engage offenders in self-help programs 4. Minimize relapse into substance use 5. Reduce Involvement in criminal justice system 6. Increase employment 7. Improve health status 8. Improve interpersonal relationships 9. Reduce homelessness 10. Reduce days of incarceration 11. Demonstrate improvement across domains of functioning as measured by the BASIS 32 Additionally, there are some measures of the satisfaction of drug court participants. Consumer satisfaction is an important quality variable because if offenders feel they are getting their needs met and staff are available and supportive, retention rates increase and outcomes are enhanced. 2 This outcome report consists of the survey data from the drug court's past five years. The data comprises the findings from over 76 drug court participants which is a robust sample of this population. The findings make it very clear that the Thirteenth Judicial Felony Drug Court team is meeting their quality standards and taxpayers are receiving a corresponding fiscal benefit and the community is realizing a social benefit from the work of this team. 2 McLellan AT., Alterman A.I, Metzger et al, Similarity of Outcome Predictors Across Treatments; Journal of Clinical Consulting and Psychology, 62 [1994]

6 SUMMARY OF FINDINGS This 2015 report represents the fifth full year of operation of the Thirteenth Judicial Adult Felony Drug Court. It contains some remarkable findings and trends in the population being served by this court under the direction of Judge Ingrid Gustafson. Demographic Profile The demographic profile in 2015 indicates more cultural diversity in this drug court. It is important that drug courts mirror the demographics of the community they serve and accordingly, this drug court is serving more Native Americans and Hispanics than in previous years. The age of the participants is trending upward and now averages 32.6 years. This is an increase of 3.2 years since The increasing age of participants also contributes to the acuity level of those being admitted since they have longer histories of addiction and criminal involvement. According to Douglas Marlowe, Ph.D. a principal researcher for the National Association of Drug Courts, our drug courts should be serving high risk individuals; meaning those who have the greatest likelihood of re-offending and who s addiction problems are severe. In his work on risk and needs assessment, Dr. Marlowe urges courts to carefully assess risk levels. Accordingly, the 13 th JDDC Drug Court uses both the RANT instrument developed by Dr. Marlowe as well as the IORNS [Inventory of Risk and Needs] to identify high risk, high need candidates for the drug court. The felony adult drug court treats a very high percentage of females. The three year average for female participants is 61.5% which is very high for drug courts. This also means drug free babies for the community! Acuity Factors Only 8% of participants are married while 91.5% are unattached and/or estranged from close familial relationship. 72.2% are homeless and 59.7% are unemployed at the time of admission. The research suggests that employment and safe, drug free housing are key variables to sustained recovery from addiction. The substance use disorders of this population also suggest very severe levels of addiction. The average age of first use of mood altering substances in this population was at age 14. We know the younger the age at which drug abuse is initiated, the earlier the age of onset of addiction and when this is the case, we see arrested adolescent development and under-education. Methamphetamine has increased by 20.7% as a major drug of choice of these participants. Over fifty percent are using this drug and 30% are using opiates. Fifty eight percent [58.3%] have injected these substances. 6 P a g e

These drugs are particularly destructive to the brain. Extraordinarily high rates of incarceration [96%] are also indigenous to this population.

7 These drugs are particularly destructive to the brain. Extraordinarily high rates of incarceration [96%] are also indigenous to this population. Their age of commission of first criminal offenses is correspondingly young; 68.8% committed their first offense by the age of 16. This low mean age indicates a span of over 15.3 years of substance abuse and criminal activity for large numbers of individuals. The high cost of incarceration of these participants prior to drug court and the reduction of days of incarceration through participation in drug court, make the felony adult drug court a hands down best buy for the community. Trauma In 2015, we added some additional indicators of trauma to the survey. This was done because the historical data indicates high levels of abuse in this population and we felt it was important to better identify the numbers of participants who need trauma-specific treatment if they are to be successful in an abstinence-based recovery process. Once again this year, the numbers of those experiencing abuse were up significantly. Additionally, 60.7% of the participants acknowledge experiencing a traumatic event and over half of these individuals would likely meet diagnostic criteria for Post-Traumatic Stress Disorder. Trauma can interfere with the ability of a person to fully engage in the treatment process out of fear of being re-traumatized through memories etc. Thus, this drug court team integrates treatment for trauma into its' continuum of services. And, finally, we are pleased to have in this fifth year, significant numbers of participants responding at eighteen months post discharge. We will likely add an additional survey interval so that we are surveying folks up to 24 months. We have also been able to establish three year averages which permit us to begin to compare our data and results against historical averages. Please take the time to carefully read this report if you do, we know you will become another advocate for drug courts in Montana. These courts are reducing incarceration levels and over-all involvement in the criminal justice system two critical objectives for our state! Most importantly, 100% of the participants would recommend the Drug Court to family or friends who might need help for their addiction and criminal activity. 7 P a g e

8 DEMOGRAPHIC PROFILE OF THE 13 TH JUDICIAL FELONY DRUG COURT Race Race % 3 Year Average % % Change Caucasian Hispanic African American Native American Admission Treatment Level Treatment Level (On Admission) % 3 Year Average % Program Use 2015 % Modality Change Intensive Outpatient Day Treatment Age Year Minimum Maximum Mean P a g e

Gender Gender % - 3 Year Average % in 2015 % Change Male 37.2 48.

1 2015 - Program Composition by Gender % of Participant by Gender -

9 Gender Gender % - 3 Year Average % in 2015 % Change Male Female Program Composition by Gender % of Participant by Gender Females 51.4% Males 47.4% Males Females 8.1% of the Females in Drug Court reported being pregnant 9 P a g e

10 Marital Status STATUS % - 3 Year Average % % Change Married Divorced Separated Never Married Unmarried Partners Drug Court participants are generally unattached making them less amenable to the treatment and supervision services of the Court. Employment Status Employment % - 3 Year Average % % Change Employed Unemployed Average income for those employed was $1, per month Living Arrangements at Time of Admission Living Status % - 3 Year Average % % Change Own Rent Homeless P a g e

3 Receives Medicaid 9.0 7.9-1.1 Public Assistance 0 0 0 SSDI 0 1.3 1.

11 Rates of Homeless continue to be high! Entitlements Type of Assistance % - 3 Year Average % % Change Receives Food Stamps Receives Medicaid Public Assistance SSDI Number of Children Number of Children % Three Year Average % in 2015 % Change or more The mean number of children per participant was 1.81 in P a g e

Education: Last completed Year of School Grade/Year % Three Year Average % in 2015 % Change 8

0 22.7 9.7 23.3 21.2-2.1 39.2 33.3-5.9 5.7 6.1.4 14 years + 5.1 3.0-2.1 16 years 1.9 1.5 -.4 52.

School Completed % Education Last Completed - 2015 % Years Completed 24.5 19.6 14.7 9.8 4.

12 Education: Last completed Year of School Grade/Year % Three Year Average % in 2015 % Change 8 th Grade 9 th Grade 10 th Grade 11 th Grade 12 th Grade 13 years years years % of participants have their GED and 32% have a High School Diploma Education: Last Year of School Completed % Education Last Completed % Years Completed Years Years Years Years Years Years Years % P a g e

High School Status Education: Graduation Status - 2015 % Education Status

You have given me a chance to live and a reason to live.

13 High School Status Education: Graduation Status % Education Status 60.0% 52.2% 50.0% 40.0% 36.2% 30.0% 20.0% 10.0% 4.8% 0.0% GED Diploma Neither Series1 52.2% 36.2% 4.8% I am thankful for all the drug court staff. You have given me a chance to live and a reason to live. Survey Intervals - % of Drug Court Participants Responding % Participants Responses % 46.1% 63.2% 6 Month Survey 12 Month Survey 18 Month Survey 13 P a g e

14 Trauma Profile: Drug Court Participants Trauma Identified 3 Year Average % 2015 % Change % Childhood Physical Abuse Childhood Emotional Abuse Childhood Sexual Abuse Partner/Family Member Assault Incest Victim Child Neglect Adulthood Physical Abuse Adult Sexual Abuse Drug court participants with a history of trauma attend Seeking Safety, which is a best practice cognitive behavioral modality for victims of trauma! With the exception of incest, all other types of abuse have increased in 2015 Trauma Indicators 14 P a g e

7% Yes No Type of Traumatic Event Traumatic Event % Experiencing Community/School Violence 1.

15 % -Experiencing an Event Resulting in Feeling Physically or Emotionally Harmed Events of Feeling Physical/Emotional Harm Not Feeling Harmed 39.3% Feeling Harmed 60.7% Yes No Type of Traumatic Event Traumatic Event % Experiencing Community/School Violence 1.3 Interpersonal Violence 9.2 Domestic / Family Violence 13.2 Death or Illness of a Loved One Witnessed another being hurt / assaulted Results of Traumatic Events 15 P a g e

16 Results of Traumatic Events % Experiencing Disturbing Memories, Thoughts, Dreams Go Out of my Way to avoid anything that reminds me of the event Constantly on Guard, Easily startled Felt numb, detached from others, easily startled It Still Has Negative Effects on me Of the 60.7% of Drug Court Participants who admit to a Traumatic Event or experience, well over half would likely meet diagnostic criteria for Post Traumatic Stress Disorder and need Treatment for this disorder It is because others cared enough that I started to care. Today I love my life. 16 P a g e

QUALITY OUTCOME INDICATOR: SUBSTANCE USE Primary Drug

Opiates Methamphetamine preference is rising at an

Drug of Choice 4.70% 4.7% 6.3% 21.1% Alcohol 9.

17 QUALITY OUTCOME INDICATOR: SUBSTANCE USE Primary Drug of Choice: Primary Drug Preferred % Cannabis 50.7% Methamphetamine 21.9% Cannabis Opiates, Narcotics Methamphetamines Opiates Methamphetamine preference is rising at an alarming rate: over 20% increase since 2014 Secondary Drug of Choice 4.70% 4.7% 6.3% 21.1% Alcohol 9.4% Cannabis Opiates/Narcotics 26.6% 21.9% Stimulants Methamphetamine Cocaine Heroin 17 P a g e

18 For the First Reporting Year Heroin is reported as a favorite drug Age: Time of First Drug Use (Years 9 16) Age 1 st Drug Use 3 Year Average % % Change / / Mean Age: At Time of First Drug Use Minimum Maximum Mean I just want to thank this program for all the growth both mentally and spiritually. My maturity level is a direct result of this program. I still have a long way to go but I know without the treatment and accountability I ve received in this past year, I would be no where near the person I am today. Thank you and God Bless! I wouldn t have been able to stay sober with anything less than what drug court has taught and given me. 18 P a g e

DESCRIPTION OF FOLLOW-UP SAMPLE AT INTAKE SECTION TWO

SECTION TWO DESCRIPTION OF FOLLOW-UP SAMPLE AT INTAKE 7 2.1 DEMOGRAPHIC CHARACTERISTICS Table 2.1 presents demographic descriptive data at intake for those who were included in the follow-up study. Data