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A retrospective study on the relationship among social controls and individual factors as indicators in predicting desistance or persistence in the substance abusing mentally ill supervised offender population

Dissertation
Author: Rodney B. Delaney
Abstract:
This study investigated the relationship social controls and individual factors have on the persistence rate in the substance abusing mentally ill-supervised offender (SAMI-SO) population as measured by the number of persistent related incidents during a 3 to 5 year monitored period of active community supervision. The social controls predictor variables in this study were the type of community supervision, supervision by a mental health caseload specialist, length of time on active community supervision, linkage to a community-based linkage provider(s), and active treatment involvement. The individual factors predictor variables were chronological age, ethnicity, years of educational experience, employment, previous mental health and substance abuse treatment, mental health classification, housing classification, number of months spent in a correctional institution, and the number of positive drug screens or intoximeter tests. The criterion variable in this study was persistence, which was measured by the number of persistent related incidents during an active period of community supervision. The research involved a proportional sampling and analysis of 886 closed supervision cases from the Ohio Department of Rehabilitation and Correction's (ODRC) database of offenders released from community supervision with the Adult Parole Authority (APA). Independent samples t-tests revealed that SAMI-SO individuals who were supervised by a mental health caseload specialist, were linked to a community treatment provider, were actively involved in a treatment program, or were employed had significantly lower means of persistent incidents and were more desistant than SAMI-SO individuals who lacked these factors. An independent samples t -test revealed that a SAMI-SO individual who had previous treatment had a lower mean, but no discernable difference in persistent incidents than a SAMI-SO individual who had no previous treatment. A Kruskal-Wallis version of the chi-square nonparametric statistical test revealed that a SAMI-SO individual supervised at the intense supervision classification had a lower mean in persistent incidents and was more desistant then a SAMI-SO individual supervised at either the basic, basic low or monitored time classification. A one-way analysis of variance used to compare two ethnic groups revealed that the persistence means between African Americans and European Americans was not significantly different. A one-way analysis of variance used to compare the means between two mental health classifications revealed that C1 individuals had significantly lower means in persistent incidents and were more desistant than C2 individuals were. A one-way analysis of variance used to compare the means between three housing classifications revealed that SAMI-SO individuals placed in a permanent residence had a significantly lower mean of persistent incidents and were more desistant then SAMI-SO individuals placed in either a temporary or homeless shelter. Three separate Pearson product-moment correlation coefficients and one Spearman's rank-order correlation coefficient revealed no practical significance because of the small effect sizes, which were below Cohen's (1988) minimum cutoff of .10. However, one Spearman's rank-order correlation coefficient revealed that a relationship existed between high positive drug screens or intoximeter tests and high persistent incidents. Finally, a multiple regression and simultaneous multiple regressions to determine the best fitting model revealed that the fourteen predictor variables together are a good predictor in determining persistent incidents during an active period of community supervision. The main contribution of this research study to the literature and desistance research is the identification of potential markers that could lead to the development of new policies and treatments procedures in measuring desistance or persistent behaviors in the SAMI-SO population.

Table of Contents Abstract ......................................................................................................................... iii Acknowledgements .......................................................................................................vii Ta ble of Contents ........................................................................................................... ix List of Tables................................................................................................................ ixv List of Figures ............................................................................................................. xvii CHAPTER I .................................................................................................................... 1 I NTRODUCTION ....................................................................................................... 1 A ge-Graded Informal Social Control Theory ............................................................ 5 T he SAMI Population and Community Supervision ................................................... 8 C ommunity Linkages ................................................................................................ 9 T he SAMI-SO Population’s Individual Factors ....................................................... 11 P roblem Statement ................................................................................................. 12 P urpose of the Study ............................................................................................... 13 De finition of Terms ................................................................................................. 14 R esearch Questions ................................................................................................ 18 Summ ary ................................................................................................................ 19 Or ganization of Chapters ....................................................................................... 20 C HAPTER II ................................................................................................................. 21 L ITERATURE REVIEW .......................................................................................... 21

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Preliminary Overview of the Relevant Literature ....................................................... 22 De institutionalization in the Course of Trans-institutionalization ........................... 24 SA MI Inmates and the Correctional System ............................................................ 26 R etention and Reincarceration Rate ....................................................................... 31 Prevalence and Responsivity to Remedial Interventions .......................................... 34 Overall Functioning and Quality of Life Issues ....................................................... 38 T he Relationship between Social Controls .............................................................. 41 I ndividual Factors as Turning Points...................................................................... 45 Relevance of Laub and Sampson’s Theory .............................................................. 50 R eview and Summary of the Relevant Literature ..................................................... 52 C HAPTER III ................................................................................................................ 58 M ETHOD.................................................................................................................. 58 R esearch Design ..................................................................................................... 58 Identification of the Sample .................................................................................... 59 E thical Considerations ........................................................................................... 64 R esearch Questions and Statistical Null Hypotheses ............................................... 64 P rimary Data Collection ........................................................................................ 70 Sampling Procedures.............................................................................................. 71 T reatment of the Data ............................................................................................. 75

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Data Management .................................................................................................. 81 Summary ................................................................................................................ 82 C HAPTER IV ............................................................................................................... 83 R ESULTS ................................................................................................................. 83 De scription of the Case Samples............................................................................. 90 Descriptive Demographic Characteristics .............................................................. 91 De scriptive Characteristics of the Sample .................................................................. 92 Mental Health Classification .................................................................................. 92 P revious Mental Health Treatment ......................................................................... 92 Supervision Classification ...................................................................................... 93 M ental Health Case Specialist ................................................................................ 94 C ommunity Linkage ................................................................................................ 94 A ctive Treatment .................................................................................................... 94 Employment............................................................................................................ 95 Housing Classification ........................................................................................... 96 N umber of Months on Active Community Supervision ............................................. 96 Years of Education ................................................................................................. 96 N umber of Months Incarcerated ............................................................................. 97 Number of Positive Drug Alcohol Screens .............................................................. 97

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Persistent Incidents ................................................................................................ 97 R esearch Questions and Inferential Statistical Tests of the Null Hypotheses ............ 100 R esearch Question and Hypothesis 1 .................................................................... 101 Research Question and Hypothesis 2 .................................................................... 105 Research Question and Hypothesis 3 .................................................................... 107 Research Question and Hypothesis 4 .................................................................... 109 Research Question and Hypothesis 5 .................................................................... 112 Research Question and Hypothesis 6 .................................................................... 114 Research Question and Hypothesis 7 .................................................................... 116 Research Question and Hypothesis 8 .................................................................... 120 Research Question and Hypothesis 9 .................................................................... 121 Research Question and Hypothesis 10 .................................................................. 124 Research Question and Hypothesis 11 .................................................................. 126 Research Question and Hypothesis 12 .................................................................. 129 Research Question and Hypothesis 13 .................................................................. 132 Research Question and Hypothesis 14 .................................................................. 134 Assumption Testing for Multiple Regression ......................................................... 135 S ummary of the Results ........................................................................................... 140 I ndependent Samples t-tests .................................................................................. 140

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One-Way Analysis of Variance (ANOVA) ............................................................. 142 P earson product-moment correlation coefficient .................................................. 145 M ultiple Regressions ............................................................................................ 147 C HAPTER V ............................................................................................................... 148 DI SCUSSION ......................................................................................................... 148 The SAMI-SO Population’s Sample Characteristics.............................................. 149 Summ ary and Discussion of the Null Hypotheses .................................................. 150 Supe rvision Classification Null Hypothesis ........................................................... 150 Supe rvision by a Mental Health Caseload Specialist Null Hypothesis ................... 151 N umber of Months on Active Community Supervision Null Hypothesis ................. 152 C ommunity Linkage Null Hypothesis .................................................................... 152 Active Treatment Involvement Null Hypothesis ..................................................... 153 A ge Null Hypothesis ............................................................................................. 154 E thnicity Null Hypothesis ..................................................................................... 155 F ormal Educational Experience Null Hypothesis .................................................. 156 E mployment Status Null Hypothesis...................................................................... 157 Previous Mental Health Treatment Null Hypothesis ............................................. 157 M ental health Classification Null Hypothesis ....................................................... 158 Hous ing Classification Null Hypothesis ................................................................ 158

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Number of Months Incarcerated Null Hypothesis ................................................. 159 N umber of Positive Drug Screens or Intoximeter Test Null Hypothesis ................. 160 M ultiple Regression and Simultaneous Multiple Regressions Analysis .................. 160 Summ ary .............................................................................................................. 161 I mplications.......................................................................................................... 165 Limitations ........................................................................................................... 167 Directions for Future Research ............................................................................ 170 C onclusion ........................................................................................................... 174 REFERENCES ............................................................................................................ 177 A PPENDICES ............................................................................................................. 188 A ppendix A: University of Toledo Human Subjects Review Board Approval Letter................ ....................................................................................................... 188 A ppendix B: Ohio Department of Rehabilitation and Corrections (ODRC) Human Subjects Research Review Committee Research Proposal Approval ............ 189 A ppendix C: Ohio Department of Rehabilitation and Corrections (ODRC) Adult Parole Authority Regional Map ...................................................................... 190

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List of Tables Table 1: Proportional Sampling by Region 74 Ta ble 2: Descriptive Demographic Information of the Sample 92 Ta ble 3: Descriptive Characteristics of the Sample 98 Ta ble 3.1: Descriptive Characteristics of the Sample 99 Ta ble 3.2: Descriptive Characteristics of the Sample 100 Table 4: Kruskal-Wallis results comparing the Means and 104

Standard Deviations of the Four Supervision Classifications on Persistence

Table 5: Independent Samples t-test Results Comparing 106

Supervision by a Mental Health Caseload Specialist and General Caseload Specialist on Persistence

Table 6: Independent Samples t-test Results Comparing 111

Community Linkages on Persistence

Table 7: Independent Samples t-test Results Comparing 113

Active Treatment Involvement on Persistence

Table 8: One-Way ANOVA Results Comparing the Means 118

and Standard Deviations of the Three Ethnic Categories on Persistence

Table 8.1: One-Way ANOVA Results Comparing the Means 119

and Standard Deviations of the Two Ethnic Categories on Persistence

Table 9: Independent Samples t-test Comparing Employment 123

Status on Persistence

Table 10: Independent Samples t-test Comparing Previous Mental 125

Health or Substance Abuse Treatment on Persistence

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Table 11: One-Way ANOVA Results Comparing the Means 128

and Standard Deviations of the Two Mental Health Classifications on Persistence

Table 12: One-Way ANOVA Results Comparing the Means 131

and Standard Deviations of the Three housing Classifications on Persistence

Table 13.1: Simultaneous Multiple Regressions on the Means 136

and Standard Deviations, and Intercorrelations for Persistent Incidents and Predictor Variables

Table 13.2: Simultaneous Multiple Regressions on the Means 137

and Standard Deviations, and Intercorrelations for Persistent Incidents and Predictor Variables

Table 13.3: Simultaneous Multiple Regressions on the Means 138

and Standard Deviations, and Intercorrelations for Persistent Incidents and Predictor Variables

Table 13.4: Beta Coefficients and Simultaneous Multiple Regression 139

Analysis Summary for Supv Level, MH Case Spec, Months on Supv, Comm. Linkages, Active TX, Age, Ethnicity, Yrs. of Education, Employed, Prev. MH TX, MH Class, Housing Status, Mon. Incarcerated, and Pos. Drug Alcohol Predicting Persistence

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List of Figures Figure 1: Means Plot of Persistent Incidents and Supv Level 104 Fi gure 2: Means Plot of Persistent Incidents and MH Case Spec 107 Fi gure 3: Scatterplot Persistent Incidents and Months on Supervision 109 Fi gure 4: Means Plot of Persistent Incidents and Community linkages 111 Fi gure 5: Means Plot of Persistent Incidents and Active TX 114 Fi gure 6: Scatterplot Persistent Incidents and Age 116 Fi gure 7: Means Plot of Persistent Incidents and Ethnicity 119 Fi gure 8: Scatterplot Persistent Incidents and Years of Education 121 Fi gure 9: Means Plot of Persistent Incidents and Employment 123 Fi gure 10: Means Plot of Persistent Incidents and Previous MH TX 126 Fi gure 11: Means Plot of Persistent Incidents and MH Class 128 F igure 12: Means Plot of Persistent Incidents and Housing Status 131 Fi gure 13: Scatterplot Persistent Incidents and Months Incarcerated 133 Fi gure 14: Scatterplot Persistent Incidents and Number of Positive 135

Drug Alcohol Screens

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CHAPTER I INTRODUCTION Since the initial movement to deinstitutionalize the mentally ill during the 1960s and 1970s (Farabee & Shen, 2004; Klerman, 1977), the number of incarcerated inmates serving time with a classification of mentally ill or chronically mentally ill with a history of substance abuse or dependence has doubled in the United States (James & Glaze, 2006; Maloney et al., 2003; Steven, 2000). “From the perspective of the criminal justice system, it is difficult to find a bright side to deinstitutionalization” (Kreig, 2001, p.373), especially when considering the increased number of mentally ill offenders supplanting the general inmate population. The rate of substance dependence or abuse in clients diagnosed with a mental health condition is relatively high in the general non-forensic population (Barrowclough et al., 2001) with approximately ten million people in the United States diagnosed with both a mental illness and a substance related disorder (Beaulieu & Flanders, 2000; Yeager, 2002). Clients diagnosed with both a mental health and substance abuse condition are commonly referred to as substance abusing mentally ill or SAMI for short (Stevens, 2006; Telias, 2001). Even though substance abuse or dependence is generally accepted as a type of mental illness by the medical and mental health fields, some community treatment providers, including providers in the forensic field, such as the Ohio Department of Rehabilitation and Correction (ODRC), deal with the problem of

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mental illness and substance dependence as two dissimilar problems. However, for purposes of this study, these two areas of interest were treated as two separate but related constructs. As suggested by Stevens (2006), clients diagnosed with both a mental health and substance abuse condition present with a complex cluster of symptoms that fluctuate or change depending on their stage of addiction or abuse. For example, in instances where clients are abusing stimulants such as amphetamines or methamphetamines, they may experience a number of symptoms during any specified stage of their use varying from mania subsequent to ingestion, psychosis during intoxication, and finally, depression or agitation resulting from withdrawal. Depending on the client’s stage of use and the context in which these symptoms occur, the symptoms may mask or distort a true clinical picture of a preexisting mental illness not evident during presentation (American Psychiatric Association, 1994). As well as the lack of clarity during presentation, SAMI clients have a high prevalence of relapse and medication non-adherence that may be a precursor to self-medication with mood-altering illegal substances (Telias, 2001). What is more, SAMI clients have a low treatment engagement rate, and numerous emergency room visits in comparison to other clients diagnosed with only a mental illness (Ho et al., 1999). Other contributing factors include ineffective psychotropic or psychosocial interventions (Barrowclough et al., 2001; Swartz et al., 1998), which according to Lurigio (2001) and Farabee and Shen (2004) increases the SAMI client’s exposure to arrest and reincarceration. Abramsky and Fellner (2003) point out what differentiates the SAMI

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population from other offenders within local jails and the corrections system is that SAMI offenders are often neglected, receive little or no treatment, may be accused of malingering, and are treated as disciplinary problems by the court system and correctional staff. Considering that the SAMI population comes from disenfranchised, disorganized, and poor communities, it is no wonder why they may have a higher rate of arrest and incarceration than the non-SAMI population (Harwell, 2004). A new term, coined by Steven (2000), that characterizes the SAMI population’s transition from community-based mental health care to correctional system care is “trans- institutionalization” (p. 5). According to Steven, trans-institutionalization is the process of shifting SAMI offenders from community-based mental health care to correctional institution care. Both Lamb et al. (2004), and Steven suggested that this phenomenon resulted from a decrease in funding to community mental health providers and a change in the attitudes of criminal justice policy decision makers, corrections industry, and the mental health field in regard to effective therapeutic interventions and services for the SAMI population. Following the trans-institutionalization of the mentally ill into prisons throughout the United States, jail and prison administrators were obligated to accommodate the influx of mentally ill offenders by converting inmate dorms and in a few cases entire prisons from a general inmate holding facility to a therapeutic treatment facility (Abramsky & Fellner, 2003; Groom, 1999; Maloney et al., 2003). This conversion was the result of three preexisting weaknesses within the jails and correction’s system. The three preexisting weaknesses were: (a) an increase in the number of institutional infractions and mental health problems associated with the SAMI

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population; (b) a lack of proper treatment interventions; and (c) a limitation on the number of trained mental health staff to treat the problem behaviors associated with managing the special needs of mentally ill inmates (Lamb & Bachrach, 2001; Maloney et al.). Despite being overwhelmed and struggling to find a workable solution to manage the influx of SAMI offenders, prisons and municipal jails in the United States progressively hired licensed mental health staff to develop therapeutic programs that specifically targeted the special needs of mentally ill inmates (Adams & Ferrandino, 2008; Lurigio, 2001). Such programs not only involved medication management and therapeutic interventions, but also involved therapeutic centers/therapeutic communities (TCs) that specifically focused on mental health management and substance abuse prevention (Groom, 1999; Wang et al., 2000). The central purpose of TCs was and still is to reduce the number of institutional infractions through cognitive behavior modification, mental health treatment, substance abuse education, and more importantly, reintegration of SAMI inmates back into society (Groom; Wang et al.). Regardless of these and similar intervention efforts to accommodate the special needs of the SAMI inmate population, their rate of retention and reincarceration within the correctional system continues to be, on average, higher than those offenders with no history of mental illness (Maloney et al., 2003). Furthermore, SAMI offenders are more likely to receive longer prison sentences, are less likely to be paroled back into the community, and, when paroled, have their parole status revoked and returned to prison on

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either a parole technical violation or new criminal conviction (Draine & Solomon, 2001; Groom, 1999; National Research Council, 2007). Notwithstanding an increase in the number of mentally ill offenders in the criminal justice system, new taxonomies have emerged in the criminal justice and mental health lexicon that characterizes the SAMI population’s non-offending/offending behaviors such as desistance and persistence. First coined by Laub and Sampson (2001) in their age-graded informal social control theory, desistance is viewed as a process where an individual’s offending behaviors subsides or abruptly stops, whereas persistence is viewed as an individual’s continuation or repetition of those offending behaviors, especially after experiencing the negative consequences associated with the undesirable behaviors. Changes in either desistance or persistence according to Laub and Sampson are subject to formal as well as informal social controls, which become more salient with age. Over and above persistent criminal involvement, one contributing factor for the SAMI population’s high arrest rate is the preference for community supervision staff and arresting officers to detain or reincarcerate persons with mental illness as mercy bookings or detainers. The rationale for this approach is that the availability of shelter; food, safety, and mental health services can be provided to the mentally ill while they are being detained (Cooper et al., 2004; Department of Justice, 2003; Lamb et al., 2004). Age-Graded Informal Social Control Theory Numerous difficulties exist that are associated with servicing, managing, and treating the SAMI population (Cooper et al., 2004; Lamb et al., 2004). While it is

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generally accepted, though widely lamented by mental health specialists, criminologists, and social scientists that finding a workable solution that interrupts this population’s propensity from repeatedly cycling through the criminal justice system is an ongoing serious problem (National Research Council, 2007). Over the last century, numerous theoretical approaches exist to explain criminal behavior from Sigmund Freud’s Personality Development Theory, which asserts that deviant behavior results from an abnormal or weak ego development (Tellings & Hafften, 2001), to Sutherland’s Differential Association Theory, which asserts from a social perspective that criminal behavior is learned from interacting with others (Matsueda, 1988). These theories and others have attempted to explicate this conundrum to no avail with the exception of Laub and Sampson’s (2003) longitudinal study of offender behavior with their age-graded informal social control theory. Starting in the early 1990s with their age-graded informal social control theory -- C rime in the making: Pathways and Turning Points Through Life (1993) -- and culminating in their most recent study of persistence and desistance over t he life course -- Shared Beginnings, Divergent Lives: Delinquent Boys to Age 70 (2003) -- L aub and Sampson approached the problem of criminal offending by shifting the general focus from why people begin offending to questions related to factors associated with continued (persistence) or stopping (desistant) criminal offending over the life course. As a category of informal social control, it could be argued that Sampson and Laub’s (2005) theoretical construct of the marital relationship as having an effect on either maintaining desistance or reducing persistent offending behaviors in the offender

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population is analogous to the relationship between community supervision and community linkages as a type of social control on the SAMI offender population. Given that social controls such as community supervision and community linkages act as mechanisms that underlie the desistance process and afford the opportunity to alter their behaviors is indistinguishable to the opportunities that are involved in a martial relationship suggested by Sampson and Laub’s four factors that facilitate long-term behavioral change and stability over the life course. Sampson and Laub’s four factors include, (1) new situations that “knife off” the past from the present, (2) new situations that provide both supervision and monitoring as well as new opportunities of social support and growth, (3) new situations that change and structure routine activities, and (4) new situations that provide the opportunity for identity transformation (p.18). Correspondingly, Sampson and Laub’s four factors have relevance to community supervision and community linkages by providing an offender the opportunity to shed off the past by exposing them to community resources such as employment, education, training, and treatment opportunities. Additionally, community supervision and linkages presents an offender the opportunity to invest in new meaningful relationships with professional staff and treatment providers who offer social support, a sense of direction, as well as, direct and indirect supervision including monitoring of behaviors and personal growth. Another benefit to maintaining meaningful relationships are the structural routines that center on informal as well as formal obligations associated with family, children, and self-maintenance. Finally, community supervision and linkages provide an offender the opportunity for identity transformation from previous perceptions about self

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that allows for the emergence of a new self or script, which contributes to the continuation of the desistance process. Considering the relationship between Sampson and Laub’s four factors, the parallels are evident between marriage, community supervision, and community linkage services. For purposes of brevity and simplification, both formal as well as informal social controls were referred to as social controls, because formal and informal social controls are interlinked along the social controls continuum, which significantly contributes to the desistance process paradigm. For example, even though informal social controls such as community linkage services, family members, spouses, and close relatives are not generally considered formal social control agents similar to community supervision. Informal social control agents directly influence as well as have an invested interest in the overall stability of the SAMI individual and therefore directly act as catalyst in enhancing the desistance process. The SAMI Population and Community Supervision Although not well explored, the substance abusing mentally ill-supervised offender (SAMI-SO) population present a different set of challenges to community supervision (county probation, and state parole). Normally, the term parole, or, for purposes of this study, the synonymous term “community supervision” is a branch of the department of corrections that asserts legal control of the SAMI-SO individual (as ward of the state). Community supervision usually lasts 1 to 5 years, or until the SAMI-SO individual is formally dismissed and no longer obligated to serve the remainder of his or her sentence (National Research Council, 2007). As a form of social control, the intended purpose of community supervision is to monitor and in some respect control or

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reduce persistent type criminal behaviors of an offender while under community supervision (Skeem et al., 2006). Common in the United States, community supervision occurs after offenders have served a portion of their sentence in a correctional institution or a local jail (Texas Department of Criminal Justice, 2000). According to the National Research Council, there is a high parole revocation rate of approximately 300,000 supervised offenders throughout the United States. Of those returned to prison, 16 percent were returned because of a drug related violation (National Research Council). Challenged with a higher than normal revocation rate and an added responsibility of servicing an increasing number of SAMI-SO individuals being released to the community with multiple needs, community supervision staff are presented with a dilemma in effectively supervising and managing an ever increasing caseload. SAMI-SO individual needs include substance abuse testing and monitoring, employment, housing procurement for homeless supervisees, and multiple linkages for hard to find services for which supervision staff are ill equipped to handle due to their large caseloads (Department of Justice, 2003; National Research Council). According to Lurigio (2001) an d the Department of Justice, there has been an emphasis for specialized caseload supervision of SAMI-SO individual as well as in-house treatment to reduce the number of SAMI-SO individuals being recycled back through the corrections system. Community Linkages In addition to community supervision, another potential form of social control is community linkages. Community linkages involve using a holistic approach to treating and matching offender needs to specific community services. An example of community

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linkage services is the assertive community treatment team (ACT) model. The ACT team model utilizes a coordinated approach in matching SAMI-SO individual’s needs to community services. Community service can include psychiatric care, substance abuse counseling, housing procurement specialists, rehabilitation and vocational counselors, mental health clinicians, nurses and peer counselors who offer essential services and assist in monitoring the behaviors of SAMI-SO individual if necessary (Department of Justice, 2003; Morrissey et al., 2007). What drives the community linkages process is the brokering of services between correctional staff, community supervision staff, and community linkage providers. The brokering of services is the principle goal of community linkage services in aiding the SAMI-SO individual transitioning from an institutional environment to community supervision (Lamberti et al., 2001; Morrissey et al.). What differentiates community linkage services as a form of social control from other community treatment provider programs is the relationship community linkage services has with community supervision staff. According to Draine and Solomon (2001), a community linkage services provider becomes an extension of community supervision by way of supervision agreements and stipulations between the community supervision staff and the SAMI-SO individual to attend mandated mental health and/or substance abuse linkage services. Because of this relationship, community linkage providers such as mental health workers can monitor and report any changes in the mental health status or program participation of the SAMI-SO individual to their community supervisors, which may prevent or stop continued persistent behaviors before they result in the SAMI-SO individual being return to prison. Based on the limited

Full document contains 208 pages
Abstract: This study investigated the relationship social controls and individual factors have on the persistence rate in the substance abusing mentally ill-supervised offender (SAMI-SO) population as measured by the number of persistent related incidents during a 3 to 5 year monitored period of active community supervision. The social controls predictor variables in this study were the type of community supervision, supervision by a mental health caseload specialist, length of time on active community supervision, linkage to a community-based linkage provider(s), and active treatment involvement. The individual factors predictor variables were chronological age, ethnicity, years of educational experience, employment, previous mental health and substance abuse treatment, mental health classification, housing classification, number of months spent in a correctional institution, and the number of positive drug screens or intoximeter tests. The criterion variable in this study was persistence, which was measured by the number of persistent related incidents during an active period of community supervision. The research involved a proportional sampling and analysis of 886 closed supervision cases from the Ohio Department of Rehabilitation and Correction's (ODRC) database of offenders released from community supervision with the Adult Parole Authority (APA). Independent samples t-tests revealed that SAMI-SO individuals who were supervised by a mental health caseload specialist, were linked to a community treatment provider, were actively involved in a treatment program, or were employed had significantly lower means of persistent incidents and were more desistant than SAMI-SO individuals who lacked these factors. An independent samples t -test revealed that a SAMI-SO individual who had previous treatment had a lower mean, but no discernable difference in persistent incidents than a SAMI-SO individual who had no previous treatment. A Kruskal-Wallis version of the chi-square nonparametric statistical test revealed that a SAMI-SO individual supervised at the intense supervision classification had a lower mean in persistent incidents and was more desistant then a SAMI-SO individual supervised at either the basic, basic low or monitored time classification. A one-way analysis of variance used to compare two ethnic groups revealed that the persistence means between African Americans and European Americans was not significantly different. A one-way analysis of variance used to compare the means between two mental health classifications revealed that C1 individuals had significantly lower means in persistent incidents and were more desistant than C2 individuals were. A one-way analysis of variance used to compare the means between three housing classifications revealed that SAMI-SO individuals placed in a permanent residence had a significantly lower mean of persistent incidents and were more desistant then SAMI-SO individuals placed in either a temporary or homeless shelter. Three separate Pearson product-moment correlation coefficients and one Spearman's rank-order correlation coefficient revealed no practical significance because of the small effect sizes, which were below Cohen's (1988) minimum cutoff of .10. However, one Spearman's rank-order correlation coefficient revealed that a relationship existed between high positive drug screens or intoximeter tests and high persistent incidents. Finally, a multiple regression and simultaneous multiple regressions to determine the best fitting model revealed that the fourteen predictor variables together are a good predictor in determining persistent incidents during an active period of community supervision. The main contribution of this research study to the literature and desistance research is the identification of potential markers that could lead to the development of new policies and treatments procedures in measuring desistance or persistent behaviors in the SAMI-SO population.