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Building Systems: Linking State AOD and Justice Systems

—Elizabeth A. Downes, Ph.D., and Mary Ann Shaening, Ph.D., Shaening and Associates, Sante Fe, New Mexico. Dr. Downes and Dr. Shaening are consultants on CSAT's technical assistance project to help States develop linkages between their AOD and justice systems.

The Center for Substance Abuse Treatment (CSAT) has recently launched a major initiative intended to improve linkages at the State level between the substance abuse treatment system and the criminal justice system. CSAT has adopted a systems approach to this effort, which involves diagnosis of organizational functioning as well as the building of systems-based models. The approach recognizes the complex pattern of interactions that affect the demand for—and supply of—treatment services for substance abusing offenders. Thus, the substance abuse treatment system and the criminal justice system of each State are viewed as subsystems within a larger "meta system" composed of numerous interactive and interdependent components.

Why use a systems approach?

Trying to influence and change the "substance abusing offender" is a complex problem; consequently, it is not amenable to simple solutions. One simple solution that clearly does not work is to try to place responsibility for the substance abusing offender in the lap of a single agency. Without some mechanism for stepping outside of any one individual agency's vantage point, it is impossible to capture the interactive, dynamic nature of this phenomenon—and therefore, to significantly affect it.

The substance abusing offender comes into contact with a wide range of individuals and agencies during his "career." More often than not, those various officials (i.e., the arresting officer, probation officer, judge, correctional official, parole officer, and treatment provider) have entirely different perspectives on what needs to happen to, and what can be expected from, the offender. Expected outcomes may not only vary, but they also may conflict with one another. Tensions between expectations usually arise out of the varying emphasis that officials place on their underlying goals, which may be public safety, accountability, cost effectiveness, punishment, or rehabilitation.

To significantly improve the ways this problem is addressed, the problem must be put in a broader, more inclusive context. In other words, the problem needs a "systems perspective." This will allow all the players and their "subsystems" to come together and gain a fresh understanding of how they participate in—and are affected by—the larger "system for the substance abusing criminal offender."

"It behaves like a system"...what does that mean?

General systems theory provides some guidance on how we might expect a "system" to be operating. In the ideal case, it means that the parts (the criminal justice "system" and the substance abuse treatment "system") are considered together, organized by some common purposes, and functioning as an integrated whole. This provides real advantages. These parts working together would offer a synergistic effect (that is, they would be able to accomplish more than their individual efforts). The larger conceived "system for substance abusing offenders" would have the necessary feedback mechanisms to provide information back into the system, thereby helping to correct the total system's performance. There would be a recognition of the "outside environment" (in this case, legislative expectations and society's concerns).

By framing this as a "system for substance abusing criminal offenders," a range of complex issues can then be attended to because all parts of the system are involved. Following are examples.

• Legislation regarding mandatory drug sentencing would be examined in light of its impact on court calendars, crowded correctional facilities, and strategies for treating substance abuse offenders in the community.
• Interagency policies could be developed to clarify who should be taking the lead in designing treatment for the substance abusing population, at what stage in the process, for whose resources.
• Strategies could be developed for systematically distinguishing drug dealers from substance abusers who are amenable to treatment, and determining what treatment circumstances are effective.
• Realistic treatment and performance outcomes could be identified for this population, which is often under supervision by both correctional and treatment agencies.
• Feedback mechanisms to the judiciary could be developed and treatment outcomes evaluated against approaches.
• The health-related dimensions to handling this population could be collaboratively addressed.
• Personnel in the various "subsystems" could be educated about each other's mutual expectations and interdependencies.
• There would be continual cross-agency planning on how to "maintain the gains" made with the offender through treatment and supervision.

How does CSAT's technical assistance project work?

CSAT's technical assistance project involves two phases of work with those State alcohol and other drug (AOD) directors who have elected to participate in the effort. This two-phased project helps key decision makers in the States begin to see where their agencies and jurisdictions fit into the bigger picture.

The process provides a mechanism for examining the impact each point in the system has on other points in the system. It can also lessen some of the tension between agencies resulting from blaming or competing with one another in a situation where resources are limited and the population of substance abusing offenders is ever-growing. Finally, the process provides a context of joint responsibility among the judiciary, the legislature, and the executive.

In the first phase, CSAT provides a systemic assessment and organizational analysis of the State's AOD and justice agencies, looking across traditional agency boundaries and examining the overriding roles, decision points, and service responses affecting the substance abusing offender. In effect, the State is assessed relative to an ideally linked system, or model, to determine where linkages are already in place and where the State might benefit from technical assistance.

After the review process, a "developmental action plan for technical assistance" is presented to the State AOD director. The action plan's recommendations reflect the priorities of the State AOD director, build upon existing State initiatives, and identify those leverage points in the systems where technical assistance would have maximum impact.

In the second project phase, technical assistance is actually delivered. This phase is sometimes launched by a "criminal justice round table" at which key AOD and justice decision makers come together to discuss where they want to go in their State and how best to use the technical assistance.

Lessons learned to date

Most States have linkages in place at various points that are working well. In fact, some States have model programs that could readily be shared with others. The challenge that remains is for States to get all key players to the table to see what their respective roles are, to determine how best to use limited treatment resources, to share each other's expertise, and to plan strategically for improved intersystem collaboration.

To assess the major components of a State's "system for substance abusing offenders," it is essential to identify and solicit information from a wide range of AOD and criminal justice professionals. Of primary importance are persons who can speak to:

• The identification, screening, and assessment of substance abuse at various points in the handling of offenders
• The diversion of this population from further involvement in the criminal justice system
• Alternative sentencing options for substance abusing offenders
• The availability of services for incarcerated and paroled offenders
• The supervision of substance abusing offenders in the community

How the process helps AOD treatment providers

Through this systems-building process, treatment providers are becoming increasingly aware of how interdependent the network is of people who influence effective treatment of the substance abusing offender. Assessment and referral processes naturally require collaboration with probation, the judiciary, prosecutors, detention administrators, court administrators, corrections officials, and parole. Yet this collaboration is also limited by systemic problems, such as:

• The impact of stricter drug statutes
• The lack of adequate screening and substance abuse assessment information prior to sentencing
• Insufficient sentencing alternatives
• Limited treatment resources
• Lack of consistent and effective sanctions in community supervision

The substance abuse treatment system cannot provide sufficient screening, assessment, treatment, or aftercare services without establishing a partnership with key players in the criminal justice system. In fact, this is one of the critical outcomes of the entire technical assistance effort.

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