Tuesday, October 28, 2014

Problem Solving Courts Are Effective But Limited Due To Underfunded Treatment Resources. 

In the Sayra and Neil Meyerhoff Center for Families, Children, and the Courts Student Fellows Program class, we have learned about a variety of problem solving courts in Maryland.  One recent creation are drug treatment courts, which in Maryland began under former Chief Judge Robert M. Bell’s administration.  The court was created from the perspective that a collaborative, problem solving effort between departments, with oversight for accountability, would help reduce addiction-driven crime and drug use.  Drug treatment courts throughout Maryland now assist criminal defendants charged with non-violent crimes through rehabilitative methods instead of punishment.  
One of the many experiential learning opportunities offered through the Student Fellows Program class was ability to  observe the collaboration in a drug treatment court.  As a clinical social worker, my prior professional experience fostered preconceived notions of drug treatment courts that were relatively accurate.  I believed courts were not likely to order evaluations without a defendant’s prior consent to treatment, as this would be deemed expending unnecessary resources without commitment to follow through.  Yet, defendants who are entangled in the disease of addiction and the reality of current criminal charges can feel pressure to commit to treatment without specifics on type, duration, location, or treatment expectations, only later to decide the punitive option is more suitable for them.  Further, treatment resources are limited, resulting in treatment history and funding being a priority over an individual’s needs.  This can be very frustrating for case workers, individuals, and families attempting to deal with the disease of addiction, where the potential for relapse is known to be part of managing treatment expectations.  At the same time, courts do not have the authority to order private treatment facilities to contractually accept an individual, and state funded residential treatment resources are extremely limited.  Thus, individuals desperate for help frequently find themselves in limbo.  It often takes time to find a drug treatment program that will accept an individual who has a long history of treatment, limited personal funding, and a negative outlook or attitude toward treatment. This leaves courts to constantly balance complex individual needs with resource demands, availability, and policies. 
Specifically noteworthy to me during my observation of a Baltimore City drug treatment court were two defendants.  One who was sitting in front of me had made remarkable progress but with great struggles.  He appeared to be invested in the drug treatment court model and concerned with other defendants who were currently facing adversity in their treatment progress.  It was obvious the drug treatment court model had paid dividends in his life.  Then, more specifically, I vividly recall a defendant who appeared before the court with a “recommendation” “requiring” residential treatment, yet the planning quickly shifted to an outpatient treatment plan when a lack of funding for inpatient treatment was revealed.  What were the court’s options for this defendant?  Should he remain detained awaiting necessary, available, residential treatment, or for should he be released to an outpatient program and try to manage this option?  Neither plan seemed viable, but the court ultimately discharged this defendant to outpatient treatment. 

These complicating factors can easily turn a collaborative effort into finger pointing, especially if the plan in place results in individual or community harm.  In reality courts, departments, agencies, and staff generally are doing the best they can with resources available.  Accordingly, my drug treatment court observation confirmed for me the immediate need for legislative action to significantly increase funding for mental health treatment, encompassing substance abuse, as a top priority.  Underfunding results in insufficient treatment resources and often leads to increased recidivism, resulting in a higher cost to society.  Funding for preventive measures has always been more cost-effective in the long term than reactive measures.  Yet, as a nation, we still let crises trigger change.  Why?  When sufficient funding is available to advances more effective resources for individuals in need, such as drug treatment courts and other problems solving court models, the outcomes for individuals and families are greater, all to the betterment of our communities and our nation.

1 comment:

  1. I largely agree with the observations in the posting, but I would like to add a few points. As we heard in class, assignment to the drug treatment court docket is a voluntary one for the judges. The particular judge that we saw did not seem to be very enthusiastic, and was almost confrontational when one incarcerated participant said that he wanted to do straight time instead of continue waiting for a bed to open up somewhere. That did not seem very therapeutic to me. And I do not think it was for 'lack of resources', either. A few years ago, I got to observe drug court at the circuit level, and what I saw then was much the same as our recent visit. The prosecution either told the judge the defendant was making progress or not, and the judge decided what to do with them. What we saw was a process that retained its adversarial nature, although defense counsel did not appear very interested in fighting. That might be a good characteristic when all parties share it, but when only one party doesn't put up a fight, it becomes a problem. I have a hard time believing that what we saw was representative of the true drug treatment court model (or any problem solving court, for that matter), but in reality I think this is the way business is done in many courtrooms. Regardless of how much funding you have, money cannot drive up willpower, at least not as much as coercion can, and we must remember that drug court retains a coercive ability in the form of sanctions. This 'carrot-and-stick' approach is not too great an advancement from a typical court and I question how therapeutic it can be. The people you mentioned that were invested in the model clearly made a choice in their own lives, but had less severe circumstances than those who were incarcerated. At the end of the day, we must not forget that the word 'treatment' is followed by the word 'court' and all of a defendant's rights still apply. However, all of the risks of an adjudicated approach, including anti-therapeutic sanctions like incarceration, apply as well.

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