Humane Exposures Blog

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Each year, up to 200,000 people are homeless in Canada — at an estimated cost of seven billion dollars. In 2008, the Government of Canada allocated $110 million to the Mental Health Commission of Canada (MHCC) for a research demonstration project on mental health and homelessness. The result, At Home/Chez Soi was a four-year project in five cities that aimed to provide practical, meaningful support to Canadians experiencing homelessness and mental health problems.

In doing so, the MHCC was demonstrating, evaluating and sharing knowledge about the effectiveness of the “housing first” (HF) approach, where people are provided with a place to live and then offered recovery-oriented services and supports that best meet their individual needs. Officially launched in 2009, At Home/Chez Soi sought to learn whether the housing first approach works—and, if so, for whom and at what cost. To gather the most comprehensive data, projects were established in five cities, each with a particular area of focus:

• Vancouver (people also experiencing problematic substance use)
• Winnipeg (urban Aboriginal population)
• Toronto (ethno-racialized populations, including new immigrants who do not speak English)
• Montréal (includes a vocational study)
• Moncton (services in smaller communities)

During the project, 1,158 Canadian from the streets and shelters received the housing first intervention.The National At Home/Chez Soi Final Report, released in 2014, demonstrated that housing first works to rapidly end homelessness for people experiencing mental illness, and can be effectively implemented in cities of different size and different cultural contexts. It also proved that HF is a sound investment, with every $10 invested in Housing First services resulting in an average savings of $9.60 for participants with high needs and $3.42 for participants with moderate needs.

The study demonstrated that housing first can be effectively adapted according to local needs, including rural and smaller city settings such as Moncton and communities with diverse mixes of people (e.g., Aboriginal or immigrant populations) like Winnipeg or Toronto.

The study also revealed more about the small group (about 13%) for whom housing first as currently delivered did not result in stable housing in the first year. This group tended to have longer histories of homelessness, lower educational levels, more connection to street-based social networks, more serious mental health conditions and some indication of greater cognitive impairment.

For some participants, involvement in the program likely resulted in the identification of unmet needs for more acute or rehabilitative levels of care in the short term.

The report stated:

Living in shelters and on the streets requires that enormous energy be put into basic survival. The circumstances are not conducive to participating in treatment and managing health issues. On average, participants had been homeless in their lifetime for just less than five years when they enrolled in the study, and many had a history of poverty and disadvantage reaching back to early childhood. For some, the road to recovery after housing can be rapid, but for most it is more gradual, and setbacks are to be expected.

Across all sites in the qualitative interviews, 61%  of the housing first participants described a positive life course since the study began, and in general, the study documented clear and immediate improvements, followed by more modest continuing ones for the remainder of the study period. The study revealed measurable improvements in participants’ mental health and substance-related problems.

Key findings included:
1) Housing first can be effectively implemented in Canadian cities of different
size and different ethno-racial and cultural composition. The HF approach was successfully adapted to serve Aboriginal, immigrant and other ethno-racial groups in a culturally sensitive manner.
2)  Housing first rapidly ends homelessness. Across all cities, HF participants in At Home/Chez Soi rapidly obtained housing and retained their housing at a much higher rate than the treatment-as-usual group.
3) Housing first is a sound investment. The economic analysis found some cost
savings and cost offsets.
4) It is Housing First, but not Housing Only. The support and treatment services
offered by the HF programs contributed to appropriate shifts away from many types of crisis, acute and institutional services towards more consistent community and outreach-based services. This shift supports and encourages more appropriate use of health and shelter services.
5) Having a place to live and the right supports can lead to other positive
outcomes above and beyond those provided by existing services. Housing first
participants also demonstrated somewhat better quality of life and community
functioning outcomes than those receiving existing housing and health services
in each city.
6 There are many ways in which Housing First can change lives. These groups,
on average, improved more and described fewer negative experiences than others. Understanding the reasons for differences of this kind will help to
tailor future approaches, including understanding the small group for whom housing first did not result in stable housing.
7 Getting Housing first right is essential to optimizing outcomes. Housing stability, quality of life and community functioning outcomes were all more positive for programs that operated most closely to the standards created initially by Pathways Housing First in the United States.

Over the last 20 years, Oklahoma

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has become the country’s capital of female incarceration with 127 of every 100,000 women behind bars, double the national rate of 63 per 100,000. It’s a situation so pronounced that even the Oklahoma Department of Corrections has had to acknowledge it: “Oklahoma has consistently ranked first in the rate of female incarceration nationally,” the department stated in both its 2013 and 2014 annual reports.

But Oklahoma’s prisons aren’t filled with women because they pose more of a threat than women elsewhere; the state simply penalizes women’s actions much more forcefully. At the same time, social safety nets have been cut away, limiting women’s options for other means of survival.

According to Susan Sharp, a professor at the University of Oklahoma and the author of Mean Lives, Mean Laws: Oklahoma Women Prisoners:

Drug possession and drug trafficking are the top two reasons for the ballooning women’s prison population. Of the 1,152 women entering Oklahoma’s prison system in 2013, 52.6% were arrested for a drug offense, with 26.2% ultimately sentenced for possession and 16.6% for distribution. Keep in mind that Oklahoma often ratchets up the charges by counting possessing, distributing, transporting or manufacturing a certain quantity of drugs as trafficking. Five grams of crack or twenty grams of meth can be charged as a trafficking act.

Moreover, sentencing is more severe in Oklahoma than elsewhere. Compare the state’s mean sentence for “drug trafficking” to the country’s mean sentence for the same crime: In Oklahoma, the average penalty is 10.3 years, while the country’s is 6 years.

In addition, conditions in Oklahoma often push women down the path toward prison. Oklahoma ranks among the bottom 16 states for women’s mental health, meaning that Oklahoma experience poor mental-health conditions, including stress, depression and eating disorders, at a higher average than in many other states. In 2015, it ranked among the bottom 10 states for women’s economic security and access to health insurance and higher education.

The result of all these tangled, competing forces is a vicious cycle in which the women who have the least access to social and economic independence, health insurance and mental health treatment are the most at risk for imprisonment.

And, as in other parts of the country, women of color tend to suffer disproportionately: in a state where black people make up only 7.7%  of the entire population, nearly 20% of the women’s prison population are African-American. Native American women are 13% of the prison population, but Native people of all genders are only 9% of the state population.

Yet rather than address these disparities, Oklahoma continues to lock up the hundreds of women each year who are most vulnerable to them. Recently, however, the fastest-growing segment of Oklahoma’s drug-crime prisoners have been white women, convicted of illegal possession and/or sale of prescription pain medications and/or meth.

For Oklahoma’s thousand-plus female inmates, prison does not merely mean the loss of liberty; it also means a loss of their children, sometimes permanently. In 1997, Congress passed the federal Adoption and Safe Families Act, stipulating that the state begin proceedings to terminate parental rights if a child had spent 15 of the past 22 months in foster care. In 2014, Susan Sharp conducted a survey of incarcerated mothers for Oklahoma’s Commission on Children and Youth and found that nearly 10% of the women participating had children in foster care, placing them at greater risk for permanent separation from their parents.

Fortunately, to some degree Oklahoma recognizes that it has a problem. To combat the drastic increase in incarceration caused by the War on Drugs (as well as the accompanying costs), counties have turned to drug courts, which send women (and men) charged with a nonviolent drug crime to treatment programs, rather than prison.

However, failing to complete the stipulations of the drug court can lead to prison, sometimes for a lengthier sentence than if a person had initially pled guilty. Oklahoma has a 42% rate of drug-court failure, Sharp noted in her book. She has stated that the average sentence for failure is 74 months. Most of these failures are for flunking a urine test or not paying court-imposed fines. It’s an “alternative” that is also a pathway to prison.

Sentencing is another area in which state is beginning to recognize the need for change. Sharp has stated:

We definitely need to revisit lengthy sentences, especially for drug crimes and low-level property crimes.

In February 2015, state legislators introduced House Bill 1574, which allows for a 20-year sentence instead of requiring life without parole for a third drug offense (so long as the two prior convictions are not drug trafficking). And on May 6, 2015, Governor Mary Fallin signed it into law. But 55 people serving life without parole for drug offenses won’t be going home, because the bill is not retroactive.

So what could stem the flow of women to prison and end the state’s womb-to-prison pipeline? Oklahoma’s incarcerated women understand how their lives—and their lack of opportunities—helped snare them in the criminal-justice net. And they know what needs to change for women in the state. Reflecting on their experiences, they see the holes in the state’s social safety net that would have kept them from falling out of society and into prison. They also know the solutions that would help keep other lives from being destroyed. But these solutions are systemic changes that might take decades, if not generations, and they would refashion Oklahoma dramatically.

For the past three years, Dr. Jaime Burns, an assistant professor at the University of Central Oklahoma’s School of Criminal Justice, has taken about 15 university students to Mabel Bassett Correctional Center to meet with an equal number of incarcerated women as part of the Inside-Out Prison Exchange program. Each week, the group discusses different issues, including the idea of restorative justice. Restorative justice is a theory and practice by which people who have harmed others take steps to try to repair the damage. The process includes not only the person who has done the harm and the person(s) harmed, but also their families and communities.

In an era in which marijuana is legal in five states and legalization is pending in more than a dozen others, decriminalization of minor drug offenses is very important.

How many alcoholics are in prison for anything other than DUI? That’s because the cost of their drug of choice is not prohibitive. Nobody robs a liquor store so they can buy liquor.”

Girls serve longer sentences than boys in the

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Texas juvenile justice system and for less serious offenses, according to a new study from the University of Texas at Austin. Researchers studied 5,019 juveniles in three large urban Texas counties over two years, finding that a female’s likelihood of remaining in confinement was 12.5 percent greater than that of a male.

Females were held longer for less serious offenses, the study found. They were released at a much slower pace than their male counterparts for “status offenses,” such as running away from home or skipping school, and spent an average of five days longer in pretrial detention for less serious offenses than male counterparts.

Girls in the juvenile justice system are also more likely to have a mental health issue and to have experienced trauma prior to incarceration, the study said.

Lead researcher Erin Espinosa said trauma might influence the longer confinements:

Certain aspects of detention, such as a door slamming or footsteps coming down the hall, can trigger girls who have experienced sexual abuse or assault to act in self-defense, leading to new charges and a longer stay. In a fight or flight scenario, girls in detention don’t have an opportunity to flee, so they fight.

Advocates called for better trauma-informed therapies within detention facilities and more community-based programming outside them to reduce the time girls spend locked up.

Elizabeth Henneke, policy attorney with the Texas Criminal Justice Coalition, said:

Girls end up languishing in these facilities that are meant to help treat their underlying issues … yet these facilities don’t have sufficient programming to support their recovery. There is a need for an investment in community programming specifically directed to girls and youth who are struggling with issues that can be best resolved in the community rather than in a facility.

Lisa Pilnik, deputy executive director of Coalition for Juvenile Justice, said locking girls up for status offenses is a misguided approach to protecting them:

I think the best solution is for most of these kids not to be in a facility in the first place — to be getting trauma-responsive services in their communities. Kids who do need to be detained need trauma-informed and gender-responsive programming.

A 2015 report from the Council of State Governments found that juveniles in community-based supervision programs were less likely to re-offend than those in confinement.

“If the system is designed to be rehabilitative in nature … then what are we really achieving by keeping them locked up just because they’re girls?” Espinosa said.

The study’s abstract: The study examined the influence of gender and history of trauma exposure on the length of time juvenile offenders served in post-adjudicatory placements. Data were drawn from a database that included information on all juvenile referrals from three large urban counties in Texas during a 2-year period. The study sample included 5,019 juveniles placed in local non-secure and county-operated secure facilities. Findings indicate that female juveniles served significantly longer periods of confinement in local facilities than boys, even when controlling for other influential variables such as offense severity, prior record, age at referral, and facility type. Findings also indicated that girls with histories of trauma served longer periods in confinement than boys for violating their court-ordered conditions of probation.

According to the United Way, it’s estimated that

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200,000 Canadians will be homeless this year. On any given night 30,000 people are without a place to call home. In the last five years 1,300,000 Canadians have experienced homelessness. Canada is in midst of a federal election. Anti-poverty and housing advocates are calling on all political parties to put poverty and homelessness on the campaign agenda.

Poverty and homelessness can affect a person’s health. The average life expectancy of a homeless person in Canada is 39 years. In addition, ending homelessness could save the Canadian economy $7 billion dollars, which includes not only the cost of emergency shelters, but social services, health care and corrections.

Winnipeg Mayor Brian Bowman has said:

It will take our entire community working together, including government, private sector and non-profit organizations to help end homelessness.

Winnipeg’s goal this year is to raise $200,000 to create employment opportunities for the city’s homeless and spur dialogue around the issue. The Canadian Medical Association has said that “the biggest barrier to good health is poverty.”

Many people believe that Canada can do a better job dealing with issues such as poverty, homelessness and food security. Past president of the CMA Anna Reid said:

There is no one sector responsible for making this happen. It has to be a joint effort, involving health care providers, governments, patients and Canadians from all backgrounds.

Canada is a wealthy country with the capacity to invest in the well-being its citizens and solve poverty. It has had dramatic success in reducing poverty among seniors over the past few decades. Everyone benefits from a Canada without poverty and homelessness.

Several of the federal candidates will be participating in this year’s Winnipeg CEO Sleepout, so it is possible that poverty and homelessness will start receiving more attention in the federal election. So far, however, these issues have been largely ignored during the campaign. Advocates will be watching party leaders closely to see if they have a social policy vision and platform.

Canadian disability/anti-poverty advocate Harry Wolbert says:

Ending homelessness isn’t rocket science! Medicine Hat, Alberta has become the first Canadian city to eliminate homelessness using the ‘Housing First’ approach. Nothing is preventing Winnipeg and other Canadian cities from doing the same.

We need, once and for all, to break the cycle of poverty in Canada and to finally lift its devastating burden. We owe it to the millions of Canadians who struggle day in day out with poverty. But we also owe it to Canada as a whole. The time for action is now!

Prison practices regarding pre-natal care, childbirth and mother-child relations vary widely and in many cases are quite restrictive and punitive.

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Pregnancy among inmates is a unique challenge. According to a 2008 report from the Bureau of Justice Statistics, 4% of state and 3% of federal inmates were pregnant at the time they began their incarceration. The needs of mothers during pregnancy and childbirth often conflict with the demands of the prison system.

The U.S. prison system was designed to accommodate male inmates, so the rising rate of female incarceration poses challenges on a variety of levels, including health care. It is estimated that 9% of women in prisons give birth while completing their sentence. In spite of a Supreme Court ruling which declared entitlement to basic health care for all people who are incarcerated, provision of adequate prenatal care in U.S. prisons has been inconsistent at best.

Women in jail or prison often have very high-risk pregnancies due to a higher prevalence of factors which can negatively influence both pregnancy and delivery. Among these are the mother’s own medical history and exposure to sexually transmitted infections, her level of education, mental health, substance use/abuse patterns, poor nutrition, inadequate prenatal care, socioeconomic status and environmental factors, such as violence and toxins.

Prenatal care in prisons is erratic. The Federal Bureau of Prisons, the National Commission on Correctional Health Care, the American Public Health Association, the American Congress of Obstetricians and Gynecologists and the American Bar Association have all outlined minimal standards for pregnancy-related health care in correctional settings, but only 34 states have established policies for provision of adequate prenatal care. However, the services can vary widely, and there is no reliable reporting measure to ensure services are delivered.

Prenatal care for incarcerated women is a shared responsibility between medical staff in the prison and community providers, but specific delineation of care is determined locally, depending on available resources and expertise. Women must often be transported for prenatal care and delivery, which can cause stress for the mother. In addition, some states continue to use shackles for security during transportation, labor, delivery and postpartum care. The use of shackles is highly controversial, and it is reported as both dangerous and inhumane.

Shackles can also interfere with labor and delivery, prohibiting positions and range of motion for the mother, doctors and nurses. Following delivery, shackles interfere with a mother’s ability to hold and nurse her infant child. In addition, women feel ashamed and discriminated against when they are shackled in a community hospital. Eighteen states in the U.S. currently have laws either prohibiting or restricting shackling pregnant prisoners, and only 10 states prohibit use of shackles by law.

The structure of U.S. justice systems makes development of maternal attachment to children nearly impossible. After the birth of their child, many women are returned to the jail or prison, and their infant immediately enters foster or kinship care. However, within many state policies, relatives are given less financial support, which can leave foster care to be more viable than kinship placement.

In 2009, A.N. Chambers wrote in Nursing Practice magazine:

For 50% of all incarcerated mothers, this separation becomes a lifelong sentence of permanent separation between mothers and their children.

Some prisons have nurseries for the mother and child, but women are only eligible to participate in a prison nursery if they are convicted of non-violent crimes and do not have a history of child abuse or neglect. Prison nurseries vary widely, but they provide an opportunity to breast-feed during a sensitive stage in development. They also provide time for a maternal attachment to be formed. Rates of recidivism are less for women who participated in prison nursery programs. However, prison nurseries still leave many gaps in care.

A 2010 report from the The Rebecca Project for Human Rights & The National Women’s Law Center said:

Reports from mothers with children in prison nurseries indicate that their babies’ close proximity allows prison staff to coerce and manipulate a mother by threatening to deny her access to her baby.

Some advocacy groups argue for alternative sentencing, such as family-based treatment centers, where mothers convicted of non-violent crimes can learn parenting skills while receiving services and support to foster positive child development and build a foundation to re-enter society following her term, with decreased risk for future incarceration.

In some cases imprisonment means the loss of choice over abortion or sterilization. Imprisoned women have undergone forced sterilization which prohibited them from having children later in life. Other women in prison have not been given the option of having an abortion, although they may have desired one. These situations force women to have unwanted children, and then they must find someone to keep their child until they are no longer incarcerated.

One major effect of prison includes the assault on relationships between prisoners and their children. About 2.4 million American children have a parent behind bars today. Seven million, or 1 in 10 children, have a parent under criminal justice supervision—in jail or prison, on probation or on parole. Many of the women incarcerated are single mothers who are subsequently characterized as inadequate, incompetent and unable to provide for their children during and after imprisonment. At the same time, separation from and concern about the well-being of their children are among the most damaging aspects of prison for women, and the problem is exacerbated by a lack of contact. Obstacles that inhibit contact between mothers and their children include geographical distance, lack of transportation, lack of privacy, inability to cover travel expenses and the inappropriate environments of correctional facilities.

The intellectual development of the kids of incarcerated mothers is often compromised. A majority of parents in state and federal prisons are held over 100 miles from their prior residence, while in federal prison 43% of parents are held 500 miles away from their last home, and over half of female prisoners have never had a visit from their children. Very few mothers speak with their children by phone while incarcerated.

Recent legislation has further impeded incarcerated mothers. The Adoption and Safe Families Act of 1997 authorizes the termination of parental rights once a child has been in foster care for 15 or more months of a 22-month period. Incarcerated women serve an average of 18 months in prison, therefore, the average female prisoner whose children are placed in foster care could lose the right to reunite with her children upon release.

There are limited employment opportunities after incarceration, and so their children cannot access those resources denied to their parents, such as food stamps or employment. Single mothers with low income go into the “underground economies” because of their inability to find a job that is stable and provides a good earning. Many mothers end up trapped on drugs, prostitution and theft. In most cases incarcerated women who committed acts of violence did so for self-defense against abusive partners.

Children are at risk of following their parents footsteps where they might become criminals by learning antisocial and criminal behavior. Caregivers and teachers see the child of inmates fighting more and becoming aggressive leading them to have a higher risk of conviction.

Most prisons do not have public transport but do have restrictive policies governing visits and phone calls. Prisons have policies such as the removal of infants born to women in prison, speedy termination of child custody for incarcerated women and restrictive welfare policies that make it difficult for families to be reunited.

Activists are trying to make a change and pass reforms that are going to help children and mothers deal with these consequences that are affecting them. One guideline that would help is a family-connections policy framework to support and strengthen the relationship between incarcerated women and their children. If women are able to see their children, it gives them motivation to try to get their lives back on track.

A central question for policymakers and professionals

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in the juvenile justice system—and for society as a whole—is what makes a young person step away from past offending and opt for another path in life? Is it the threat of sanctions, treatment of substance abuse or mental health issues, or is it a slicing away from antisocial peers? Is it a warm and supporting parent or adult or increasing maturity? Is it the treatment the youth receives while in the juvenile justice system?

In one of the most rigorous studies of adolescent offenders to date, the MacArthur Foundation Adolescent Development and Juvenile Justice Research Network, in partnership with numerous federal and state agencies as well as other foundations, has been seeking answers to these and related questions. The Pathways to Desistance study has followed more than 1,300 serious offenders for seven years between ages 16 and 23 (on average). The length of the study and its focus on serious offenders provide those who work with young offenders the most comprehensive and reliable insight into the paths that these adolescents take out of or into future crime.

This brief reports on four key findings:
• The majority of young, serious offenders do not make a career of crime, and the original crime is not a good predictor of future patterns of offending;
• Substance abuse treatment plays an important role in desistance;
• Many juvenile offenders are placed in the most restrictive (and expensive) setting—institutional care—even though it has little effect on subsequent re-arrest;
• The threat of arrest is a deterrent for the most serious adolescent offenders.

The prevalence and severity of crime drop off over time, and the original crime is not a good predictor of future patterns of offending. Most current law and policy assume that in the case of juvenile crime, the worst offenders are likely on a path to continued crime. Yet both in number of arrests (based on FBI data) and self-reported antisocial activities, ranging from very serious acts such as murder to less serious property crime, a majority of serious offenders are loosening their ties to criminal careers over time.

This brief reports the findings from both self-reported antisocial activity and official re-arrest reports because these two lenses offer a fuller picture of criminal activity over time.

The good news is that even after accounting for time incarcerated, the general trend is one of declining antisocial activities over time. Not all the offenders follow the same path, however. There are five identifiable subgroups in the sample, based on a composite score of the youths’ self-reported offenses at various time points over seven years.

Among this group of serious offenders, only about 10% report continued high levels of antisocial acts. About one in five shift from high levels of offending at the outset to very low levels of offending over the intervening years. Slightly more than one-half start off committing relatively fewer offenses and change little over time. In contrast, 12% start off committing relatively few offenses but increase their antisocial activities slightly over time.

The overall trend of loosening ties to crime over time holds when examining official records of re-arrest. Although a majority of the adolescents were re-arrested over the seven-year period, the prevalence and rate of arrest as well as the severity of the charges decreased over time. In about four in ten re-arrests, the most serious charge was a misdemeanor. Although it is difficult to determine an individual’s future on the basis of the initial crime, other factors do shed light on offending, including substance use.

Youth who become involved in the juvenile justice system often share some common risk factors, including mental health problems, developmental immaturity (a lack of self-control, for example), antisocial peers, harsh or lax parenting and growing up in neighborhoods characterized by poverty, crime and social disorder. Substance abuse, however, stands out among the risk factors.

Substance use problems exert a strong influence on continued offending. The study finds that youth with a substance use disorder were more likely to continue offending over the seven years and less likely to spend time working or in school than those with no substance use issues. In addition, having a substance use disorder magnified the impact of other risk factors related to continued offending. Having a substance use disorder made things significantly worse. Level of substance use also contributes to offending in this group. Heavier users are more likely to be arrested than are less frequent users, and this pattern does not change over time. So greater substance use goes hand in hand with increased offending at each time point.

There is also some encouraging news. Treating substance use disorder, albeit difficult, can help reduce later re-offending among serious juvenile offenders. However, interventions that curbed re-offending were those that involved family members in the treatment process and that lasted more than three months. Unfortunately, only one-fourth of treatments included family members.

The study reveals that there is no clear advantage of institutional care over other types of intervention and rehabilitation. Institutional placement seems to have no effect—positive or negative— on the subsequent rate of rearrest, and longer lengths of stay (exceeding three to six months) in a juvenile facility do not appear to reduce the rate of re-arrest. The rate of re-arrest after a stay in an institution is the same for stays between three and twelve months in length. If longer stays in institutional facilities are not reducing future offending, then it seems questionable whether this use of resources is either justified or politically attractive as a means of achieving public safety benefits.

It is also important to consider what services the youth are provided during their time in the facility and how well the services provided match their needs. Currently, services are not well matched to identified need. Depending on the setting, nearly two-thirds of youth with a mood or anxiety disorder, for example, did not report receiving mental health services. Likewise, more than half of youth with substance use disorders did not report getting drug or alcohol treatment.

Improved screening could help target services to need. In general, state-run facilities do a better job in matching services to particular needs. Youth in state-run facilities with an identified substance use problem were five times more likely to report receiving substance use treatment than those without a substance problem. Likewise, those with a mental health problem were four times more likely to report receiving mental health treatment than those without a mental health problem. In contrast, in private-sector contracted residential settings there were no differences in service receipt between those with and without substance use or mental health problems. In these settings, the tendency was to provide a similar package of services to everyone.

In a study of youth perceptions of their experiences in institutional settings, those who reported the settings as well-structured, with clear rules and routines, with limited exposure to antisocial peers and a generally more positive atmosphere reported less antisocial activity in the year after discharge. Youth making the transition from residential placement back to the community need a variety of supportive services, and community-based aftercare programs are becoming more widely available for these youth. Early evidence from this study shows that more planning for these aftercare services and contact with aftercare services before release from an institutional setting significantly reduce the odds of re-arrest or return to an institutional setting.

However, more needs to be done in connecting these adolescents with community services. During the seven years of the study, only 43% of youth participated in a range of community-based services, and they did so very infrequently. These results suggest that both more community-based care and improved institutional care could help reduce the chance of re-arrest.

This study finds that among serious offenders the certainty of arrest is a greater deterrent than the severity of punishment. While it is important that adolescents believe that if they do something wrong they’ll be arrested, the findings suggest that bringing the full force of the justice system to bear on them is not cost-effective. More targeted enforcement for those offenders who are unsure about their chances of getting caught will reduce the chances of re-arrest the most.

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“Housing First,” supported by the United States Department of Housing and Urban Development and nonprofit agencies throughout America, not only provides permanent homes for the homeless but also provides wraparound case management services to the tenants. This case management provides stability for homeless individuals, which increases their success. It allows for accountability and promotes self-sufficiency.

The housing provided through government-supported Housing First programs is permanent and “affordable,” meaning that tenants pay 30% of their income towards rent. Housing First initially targeted individuals with disabilities. This housing is supported through two HUD programs: the Supportive Housing Program and the Shelter Plus Care Program. The Housing First model has been recognized by the Substance Abuse and Mental Health Services Administration as an Evidence-based practice.
Principles of Housing First are: 1) Move people into housing directly from streets and shelters without preconditions of treatment acceptance or compliance; 2) The provider is obligated to bring robust support services to the housing. These services are predicated on assertive engagement, not coercion; 3) Continued tenancy is not dependent on participation in services; 4) Units targeted to most disabled and vulnerable homeless members of the community; 5) Embraces harm-reduction approach to addictions rather than mandating abstinence. At the same time, the provider must be prepared to support resident commitment to recovery; 6) Residents must have leases and tenant protections under the law; 7) Can be implemented as either a project-based or scattered-site model.[6]
Housing First is currently endorsed by the United States Interagency Council on Homelessness  as a “best practice” for governments and service-agencies to use in their fight to end chronic homelessness in America.
Housing First programs currently operate throughout the United States in cities such as New Orleans, LA; Plattsburgh, NY; Anchorage, AK; Minneapolis, MN; New York City; District of Columbia; Denver, CO; San Francisco, CA; Atlanta, GA; Chicago, IL; Quincy, MA; Philadelphia, PA; Salt Lake City, UT; Seattle, WA; Los Angeles; Austin, TX and Cleveland, OH, among many others, and are intended to be crucial aspects of communities’ so-called 10-Year Plans To End Chronic Homelessness.

On June 11, 2014 the “100,000 Homes Campaign” in the United States, launched in 2010 to “help communities around the country place 100,000 chronically homeless people into permanent supportive housing,” announced that it reached its four-year goal of housing 100,000 homeless people nearly two months before its July 29 deadline.

Here are some “Housing First” results:

In Massachusetts, the Home & Healthy for Good program reported some significant outcomes that were favorable especially in the area of cost savings.

The Denver Housing First Collaborative, operated by the Colorado Coalition for the Homeless, provides housing through a Housing First approach to more than 200 chronically homeless individuals. A 2006 cost study documented a significant reduction in the use and cost of emergency services by program participants as well as increased health status. Emergency room visits and costs were reduced by an average of 34.3% . Hospital inpatient costs were reduced by 66%. Detox visits were reduced by 82%. Incarceration days and costs were reduced by 76%, and 77% of those entering the program continued to be housed in the program after two years.

Researchers in Seattle, partnering with the Downtown Emergency Service Center, found that providing housing and support services for homeless alcoholics costs taxpayers less than leaving them on the street, where taxpayer money goes towards police and emergency health care. Results of the study funded by the Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation appeared in the Journal of the American Medical Association April, 2009. This first US controlled assessment of the effectiveness of Housing First specifically targeting chronically homeless alcoholics showed that the program saved taxpayers more than $4 million over the first year of operation. During the first six months, even after considering the cost of administering the housing, 95 residents in a Housing First program in downtown Seattle, the study reported an average cost-savings of 53%—nearly US $2,500 per month per person in health and social services, compared to the per month costs of a wait-list control group of 39 homeless people. Further, stable housing also results in reduced drinking among homeless alcoholics.

In Utah, there has been a 72% homelessness decrease overall since enacting the plan in 2005, according to the Utah Division of Housing and Community Development.

In August 2007, HUD reported that the number of chronically homeless individuals living on the streets or in shelters dropped by an unprecedented 30%, from 175,914 people in 2005 to 123,833 in 2007. This was credited in part to the “housing first” approach; Congress in 1999 directed that HUD spend 30% of its funding on the method.

In September 2010, it was reported that the Housing First Initiative had significantly reduced the chronic homeless single person population in Boston, although homeless families were still increasing in number. Some shelters were reducing the number of beds due to lowered numbers of homeless, and some emergency shelter facilities were closing, especially the emergency Boston Night Center. By 2015, Boston Mayor Marty Walsh had announced a 3-year plan to end chronic homelessness, focusing on coordinating efforts among public agencies and nonprofit organizations providing services to homeless men and women.

In South Australia, the State Government of Premier Mike Rann (2002 to 2011) committed substantial funding to a series of initiatives designed to combat homelessness. The Rann Government established Common Ground Adelaide, building high-quality inner city apartments (combined with intensive support) for “rough sleeping” homeless people. The government also funded the Street-to-Home program and a hospital liaison service designed to assist homeless people who are admitted to the emergency departments of Adelaide’s major public hospitals. Rather than being released back into homelessness, patients identified as rough sleepers are found accommodation backed by professional support. Common Ground and Street-to-Home now operate across Australia in other states.

In its Economic Action Plan 2013, the Federal Government of Canada proposed $119 million annually from March 2014 until March 2019—with $600 million in new funding—to renew its Homelessness Partnering Strategy (HPS). In dealing with homelessness in Canada, the focus is on the Housing First model. Thus, private or public organizations across Canada are eligible to receive HPS subsidies to implement Housing First programs. In 2008, the Federal Government of Canada funded a five-year demonstration program, the At Home/Chez Soi project, aimed at providing evidence about what services and systems best help people experiencing serious mental illness and homelessness. Launched in November 2009 and ending in March 2013, the At Home/Chez Soi project was actively addressing the housing need by offering Housing First programs to people with mental illness who were experiencing homelessness in Vancouver, Winnipeg, Toronto, Montréal and Moncton. In total, At Home/Chez Soi has provided more than 1,000 Canadians with housing.

Housing First has grown in popularity in Canada and used in many Canadian ten-year plans to end homelessness, such as those in Edmonton and Calgary. Housing First: A Canadian Perspective is spearheaded by Pathways to Housing Calgary and director Sue Fortune. Canadian adaptations to Housing First have demonstrated positive outcomes as documented on the website: www.thealex.ca (Housing Programs; Pathways to Housing). Canadian implementations of Housing First must be tailored to Canadian homelessness, resources, politics and philosophy.

In Calgary, Alberta, the Alex Pathways to Housing Calgary which opened in 2007, had 150 individuals in scatter-site homes in 2013. Clients pay 30% of their income towards their rent: 85 percent of Pathways to Housing clients receive Assured Income for the Severely Handicapped benefits and 15% receive Alberta Works. The Alex Pathways to Housing uses a Housing First model, but it also uses Assertive Community Treatment (ACT), an integrated approach to healthcare where clients access a team of “nurses, mental health specialists, justice specialists and substance abuse specialists.”

Director Sue Fortune is committed to the 10 Year Plan To End Homelessless in the Calgary Region. Fortune reported that the Housing First approach resulted in a 66% decline in days hospitalized (from one year prior to intake compared to one year in the program), a 38% decline in times in emergency room, a 41% decline in EMS events, a 79% decline in days in jail and a 30% decline in police interactions.She reported that fewer than 1% of existing clients return to shelters or rough sleeping; clients spend 76% fewer days in jail and clients have a 35% decline in police interactions.

In 2007 the centre-right government of Matti Vanhanen began a special program of four wise men to eliminate homelessness in Finland by 2015. The program to reduce long-term homelessness targets hard-core homeless people,assessed on the basis of social, health and financial circumstances. The program to reduce long-term homelessness focuses on the 10 biggest urban growth centers, where also most of the homeless are to be found. The main priority, however, is the Helsinki Metropolitan Area, and especially Helsinki itself, where long-term homelessness is concentrated.

The program is structured around the housing first principle. Solutions to social and health problems cannot be a condition for organising accommodation: on the contrary, accommodation is a requirement which also allows other problems of people who have been homeless to be solved. Having somewhere to live makes it possible to strengthen life management skills and is conducive to purposeful activity.

Because of all the reasons there are for long-term homelessness, if it is to be cut there need to be simultaneous measures at different levels, i.e. universal housing and social policy measures, the prevention of homelessness and targeted action to reduce long-term homelessness.
The program’s objectives are to eliminate homelessness entirely by 2015 and to take more effective measures to prevent homelessness.

In France the government launched a Housing First-like program in 2010 in 4 majors cities: Toulouse, Marseille, Lille and Paris called “Un chez-Soi d’abord”. It follows the same principles as the Canadian and US programs, focusing on the homeless people with mental illness or addicted to drugs or alcohol. The plan is on a 3-year basis for each individual, sheltered in an apartment lent by a non-government organization. Several NGOs are involved in this experiment, they are assuring the rental management as well as the social support for the housed people.

Those NGOs are linked with scientists investigating the results of the experiment and serve as a relay for informations and status reports on the targeted public. The lead team of “Un chez-soi d’abord” is expecting results to be published around 2017.

According to the U.S. Department of Justice, Oklahoma has had the highest rate of female incarceration every year since 1993.

Photo by Susan Madden Lankford

In 2014, Oklahoma incarcerated women at a rate of 136 per 100,000; but the national average was only 65 per 100,000. In a recent op-ed piece in the Tulsa World, insurance and financial services company CEO Ed Martinez Jr. sought to answer the question ” Why is Oklahoma’s rate so high?”

He concluded:

Many compounding factors lead women to prison, starting early in life: outdated policing strategies, underfunded mental health systems, and draconian sentencing practices and laws.

Recently, we have witnessed overbearing law enforcement in the minority communities of Ferguson, MO and Baltimore. I have begun to think that women are being mistreated in the same manner.
My daughters and the daughters of friends who have come into contact with local law enforcement report common themes. Their cell phones are seized, which feels like a personal violation. If they try to prevent this violation, they are threatened with obstruction of justice charges. Women stopped for suspected traffic violations are immediately ask for permission to search their car without probable cause. If they decline, they are threatened with arrest.

From their experiences, I began to understand that Tulsa law enforcement, and maybe the rest of the country, is mistreating women and contributing to the high rate of arrest and incarceration of women.

Martinez believes this is only a small part of the problem. Most women involved in the criminal justice system are suffering from untreated trauma, mental illness and or drug addiction. They are homeless, unemployed and oftentimes victims of domestic violence. They have on average two to three children. Once they enter the criminal justice system, they are assessed with multiple fines and fees, most of which support the criminal justice system itself. If they are arrested, jailed or sent to prison, they rarely receive services to address any of the issues that entangled them in the first place. The state of Oklahoma also enforces sentencing enhancements, mandatory minimums, and harsh drug laws that result in unnecessary felony convictions and long prison sentences for non-violent women.
The system perpetuates itself in peculiar and unjust ways, he believes. For example, once a woman is charged, it becomes extremely difficult to secure a job, even if she is never convicted. She becomes unemployable. Even in cases where charges are dropped or deferred, women still face huge employment hurdles. This cycle pulls women into poverty and drags their children down with them. Entire families and communities become lost in a vicious cycle of poverty and incarceration.
Martinez reached out to Mimi Tarrasch, executive senior program director of the Women in Recovery Program at Family & Children’s Services, to better understand the issues. Women in Recovery helps about 100 women at a time break the cycle of incarceration. The program is an intensive outpatient alternative to incarceration for women who are not eligible for other diversion programs. It ensures women receive substance abuse and mental health treatment, trauma intervention, education, workforce readiness training, family reunification services, comprehensive case management, supervision, and safe housing. Families and children are integrated into the program. In short, it focuses on structure, safety and accountability.
The return on investment in this program has been significant. Today, there are close to 7,000 children with mothers in Oklahoma prisons. Those children are four to seven times more likely to be incarcerated themselves. He cautions:

If you remember only one thing, understand that incarceration has devastating impacts on children. It affects their education, health and life’s outcomes.
Women in Recovery provides its clients and their families stable housing and treatment to ease the transition to a “normal” life. But more important, they are trained to rejoin the work force. The program provides training for sustainable careers that will allow women to support themselves and their families.
Women in Recovery and similar programs need Tulsa’s good corporate citizens to commit to partnering with service organizations to provide employment and in some instances on-the-job training. A number of prominent Tulsa businesses already have committed to improving the lives of justice-involved women, but we need more. You do not have to be a big business to make a big impact.
Don’t let our women continue to be victims of reckless law enforcement and punitive criminal justice policies. Let’s commit to helping the ones that have been unjustly caught in this trap by helping them learn to live a positive life.

Governor Christie’s recent signature of S2003/A4299

Photo by Susan Madden Lankford

will implement significant and much-needed reforms to New Jersey’s juvenile justice system. The new law:

1) Raises the minimum age at which a child may be prosecuted as an adult from 14 to 15, narrows the list of offenses that can lead to prosecution as an adult, and amends the standard governing such decisions to reflect the continuing maturation of young people through their mid-twenties; 2) requires due process, including representation by counsel, before a young person who is confined in a juvenile facility can be transferred to an adult prison and 3) eliminates the use of solitary confinement as a disciplinary measure in juvenile facilities and detention centers, and places time limits on the use of solitary confinement for reasons other than punishment, such as safety concerns.

The New Jersey Juvenile Justice Reform Coalition is pursuing system-wide reforms of New Jersey’s juvenile justice system, including promoting alternatives to incarceration for youth and improving conditions of confinement for those who are incarcerated. Members of the Coalition’s Steering Committee include Advocates for Children of New Jersey, the American Civil Liberties Union of New Jersey, the Lowenstein Center for the Public Interest at Lowenstein Sandler, the New Jersey Institute for Social Justice, and Rutgers Law School Children’s Justice Clinic in Camden and Criminal and Youth Justice Clinic in Newark.

Through legislative advocacy on this bill, as well as executive advocacy and litigation, the Coalition has sought to reform the process and circumstances under which youth may be placed in an adult prison and to eliminate the practice of solitary confinement of juveniles. The Coalition applauds the extraordinary leadership of Senator Nellie Pou, who more than two years ago, began bringing together advocates (including members of the Coalition), retired judges, county prosecutors, the Attorney General’s Office and other stakeholders to discuss New Jersey’s juvenile justice system and how to improve it through these substantial reforms.

Alexander Shalom, Senior Staff Attorney at the ACLU of New Jersey, said:

The historic reforms to New Jersey’s juvenile justice system just signed into law will make us fairer, smarter, and safer. While there remains more work to do, these changes are a significant step towards making the ‘justice’ in our juvenile justice system a reality.

 

Natalie Kraner, Pro Bono Counsel at Lowenstein Sandler, explained:

New Jersey will become the twenty-first state to prohibit the use of punitive solitary confinement by either law or practice, in line with a growing national trend. This is a first and significant step towards reducing the risk of serious harm to juveniles in secure facilities, but we still have a long way to go.

The new law’s data collection requirement is critical because it will afford transparency to the Juvenile Justice Commission’s continued use of solitary confinement and protect against an over-broad and prolonged use of non-punitive solitary confinement.

Laura Cohen, Director, Criminal and Youth Justice Clinic at Rutgers School of Law, remarked, “Serving time in an adult facility has enormous and lifelong consequences.”

In another important change, youth who have been waived for adult prosecution presumptively will be held in local juvenile detention centers, rather than county jails, while awaiting trial. Similarly, any young person who is sentenced to a term of incarceration will be committed to the state’s Juvenile Justice Commission until the age of 21 and may remain there beyond that time at the discretion of the Commission. “These reforms to the waiver laws are consistent with the substantial body of research establishing that adolescents’ developmental immaturity renders them less culpable than adults,” explained Cohen.

Mary Cogan, Assistant Director, Advocates for Children of NJ., said:

While we agree that juveniles should be held accountable for their actions, we must treat juveniles who commit crimes differently than adults. These youth will return to their communities, and we must equip them with the skills they need to stay out of trouble and mature into productive adults.

LaShawn Warren, Vice President and General Counsel of the New Jersey Institute for Social Justice,  concluded:

This legislation represents a much-needed paradigm shift in how New Jersey addresses juvenile delinquency issues. It moves the state closer to a rehabilitative model that appropriately factors in developmental considerations of youth and ensures progress toward racial fairness in the state juvenile justice system.