The NCJTP survey examines the treatment and other services provided by or through the CJS, as well as referrals by the correctional system to other services (e.g., drug treatment programs). The results focus on two issues presented in the first set of tables: (1) the prevalence of SA treatment services in correctional settings as well as the estimated number of offenders who participate in these programs on any given day and (2) the quality of the SA treatment services as offered in specialized and general/generic prison facilities.
The second set of tables examines the nature of the correctional programs offered in various settings. Again, we report on the prevalence of the services and the estimated number of offenders involved on a given day. We also included in the data whether the facilities indicated that they provide SA treatment services as part of the design of their correctional programs. The quality of the programs was measured as a function of two parameters: (1) the use of standardized risk and SA assessment tools to screen offenders for the program and (2) the duration of the program. Regarding duration, correctional programs that lasted 90 days or longer were considered to be sufficient to change offenders’ behavior based on the research literature, as discussed earlier.
Nearly all of the prisons (96%) reported that states funded their facilities. Community-based facilities reported much more diverse sources of funding, with 77% being funded by states, 27% being funded by county or local governments, and 13% being federally funded (respondents could have reported multiple funding sources). In addition, the funding for 14% of these facilities comes from states and is passed along to counties or local governments (pass-through). Jails also receive their funding from a variety of sources. Whereas 97% of jails are funded by county or local governments, 47% are funded via pass-through and 27% are state funded. Regardless of venue, roughly the same median percentage of the staff is dedicated to clinical services. On average, 11% of the employees in prisons, 10% of those in community-based facilities, and 7.3% of those in jails work in a clinic-related position (e.g., social worker, assessor, or clinician).
The survey of adult facilities covered 98 prisons (74 general prisons and 24 special drug treatment facilities) administered by state correctional systems. (Nationally, 94% of all prisons are classified as generic facilities and 6% are classified as specialized drug treatment facilities.) As discussed by Taxman et al. (2007)
, these are representative of the 1,018 prisons in the United States in 2003. The ADPs of the prisons in this sample ranged from 15 to 7,400 prisoners, with a mean of 1,045 inmates and a median of 800 inmates. provides an overview of the SA services available in prison facilities. The first column shows the percentage of prisons that offer a service, whereas the second column shows the estimated number of offenders who receive a service (sum of all offenders offered the service on an average day). Columns 3 and 4 show the results for specialized prisons regarding the median percentage of the ADP to whom a service is made accessible and the percentage of programs lasting more than 90 days, respectively. Columns 5 and 6 show the same information for generic prisons. (A specialized prison is that which has been designated for SA offenders, whereas a generic prison is that which serves offenders with an array of needs.)
Prevalence of SA services in prisons
As might be expected, drug/alcohol education is the service most frequently provided, with 74% of prisons offering this service. This is similar to the proportion found in the 1997 SAMHSA survey. It is estimated that more than 75,000 inmates receive drug/alcohol education on a given day. The other most frequently provided treatment services in prisons are group SA counseling (55% of prisons offer this service for up to 4 hours per week, and 46% offer it for 5–25 hours per week) and relapse prevention groups (45%). More than 52,000 inmates are receiving 5–25 hours of group SA counseling per week, and more than 39,000 are participating in relapse prevention groups. It should be noted that many prisons likely offered multiple (counseling and relapse prevention) or overlapping (TC and 5–25 hours per week of group counseling) SA services. Segregated TC programs are offered in 19.5% of prisons and serve more than 39,000 offenders at any given time.
Overall, approximately 170,597 individuals are offered SA treatment in generic prison facilities and 9,975 individuals are provided with services in specialized prisons. Generic prisons house a median of 860 offenders, and the percentages of the ADPs involved in SA services range from 4% (relapse prevention groups) to 19% (≥ 26 hours per week of group SA counseling). Fifteen percent of the ADPs in prisons are served in a segregated TC unit within the general prison population, nearly the same percentage of those served in nonsegregated TCs (14%).
As expected, specialized drug treatment prisons tend to offer more services to offenders as compared with generic prisons. The median ADP in a specialized prison is 770. Low-intensity group counseling and case management are provided to nearly all offenders, which is not the case in generic prisons. The services provided in generic facilities are less likely to meet the 90-day duration measure as compared with specialized treatment facilities. Eighty-five percent of the services provided in specialized prison facilities are of at least 90 days’ duration, whereas only 63% of the services offered in generic facilities surpass the 90-day threshold. The services most likely to surpass the 90-day threshold in both generic and specialized SA prisons are TCs (both segregated and nonsegregated) and group SA counseling for 5–25 hours per week, followed by drug/alcohol education and relapse prevention groups.
Substance abuse treatment services are often available within other types of correctional programs offered within prisons. Correctional programs are specific programs often designed to punish offenders and change their behavior. The average prison offers 2.2 correctional programs. provides an overview of the types of correctional programs offered by prisons and the number of inmates involved in such programs, as well as the proportion of these programs offering standardized SA assessment and treatment, the number of offenders receiving services, the proportion of programs using other risk assessment tools, and the proportion of programs lasting 90 days or longer. The most frequently offered programs in prisons are education/GED (General Educational Development) preparation (89%) and vocational training/job readiness (71%); boot camps, day reporting, and transitional housing are infrequently provided (4%, 5%, and 2.6%, respectively). As shown in , access is an issue with correctional programs in that few inmates are involved with any program. The median percentage of offenders involved in intensive supervision is 6%, whereas that of offenders involved in day reporting is 15%. Although education/GED preparation and vocational training/job readiness programs are offered in most prisons, these programs tend to have a relatively small percentage of the ADP involved (only 7%–8% of the ADP), for estimated national averages of 139,362 and 107,262 offenders, respectively, on any given day.
Offenders in correctional programs in prisons
The survey found that approximately 15% of the correctional programs administered by prisons are offered in community settings. Most likely, these prisons administer back-end release or transitional programs for offenders who are nearing their reentry to the community. Of the 1.2 million offenders in prison, the national estimate of offenders involved in back-end release programs (40,982 in ISPs and 5,022 in work release) is relatively small. Transitional housing programs are infrequently provided (~3%) and tend to be in stand-alone prison facilities where all of the offenders are in the program. They also serve a small number of offenders nationally (~6,847).
As shown in , many of the correctional programs include SA treatment services, most likely as a strategy to integrate services for offenders. The work and education programs (e.g., education, vocational training, and work release) are less likely to offer drug treatment services, but more than half of the day reporting, sex offender therapy, and ISP services provide them. All of the boot camps reported offering SA services.
This study used several measures of quality to examine the correctional programs, with the two main measures being the availability of SA as well as risk assessment standardized tools to determine the offenders’ need for a program and the duration of each program. Substance abuse assessment tools are more widely available in prisons as compared with risk tools (Taxman et al., under review). Most prisons that offer correctional programs tend to use some type of SA tool to screen and select for the programs. Overall, 54% of prisons use at least one SA assessment tool and 25% use a standardized risk assessment tool. The most frequently used standardized SA assessment instrument is the Addiction Severity Index (27%), whereas 38% of prisons reported using an assessment tool of their own design. The most frequently used standardized risk tool is the Level of Service Inventory–Revised (20%). Prisons, particularly those that have boot camps and day reporting programs, indicated that they use the risk assessment tools after offenders have been selected to participate in the program instead of as a mechanism to identify offenders in the prison who are suitable for the program. Sixty percent of facilities offering vocational training/job readiness use a standardized SA screening tool, whereas 51% of facilities offering education/GED preparation and day reporting use such tools. The same is true for back-end release programs, with 84% of facilities providing work release programs, 64% of those offering transitional housing, and 59% of the ISPs using standardized SA tools to screen inmates.
Most prison setting programs and back-end release programs are provided for more than 90 days. Overall, 68% of all in-prison programs and 83% of all back-end release programs last for more than 90 days. Boot camps are less likely to be of 90 days’ duration as compared with other programs, with the exception of transitional housing. Most transitional housing programs are of 30 days’ duration, although 36% of these are offered for at least 90 days.
The NCJTP sample consists of 57 jails, of which 74% are locally operated facilities, with the remaining 26% being state operated (either a regional jail or a regional facility). Jails range in population on a daily basis from 4 to 53,000 individuals, with a median population of 65 inmates. The median state-operated facility has a population of 405, whereas the median locally run jail holds that of 65. None of the jails defined themselves as specialized facilities.
Most local counties have a jail or detention facility for offenders who are awaiting trial or serving short sentences (generally ≤ 12 months, although offenders can spend up to 24 months in the local jail/detention facility in some states). The annual flow through jails in the United States is 9 million, and 70% of the population are released within 72 hours (Beck, 2006
). According to the survey, jails had a standing population of 713,990 in 2005.
describes the prevalence of SA treatment services in jails and the median ADP served. Drug/alcohol education is the most frequently provided treatment service (61% of jails), accompanied by up to 4 hours of group SA counseling per week (60%). Other services are infrequently provided, although 51% of jails offer relapse prevention groups. The treatment services in jail settings are provided to only a small portion of the ADP, ranging from 3% (≥26 hours of group SA counseling, segregated TCs, and relapse prevention groups) to 11% (5–25 hours of group SA counseling). Generally, the SA services provided in locally run facilities are even less accessible to offenders as compared with those in prisons.
Substance abuse services in jails
Slightly more than half of all SA treatment services (56%) in jails are offered for more than 90 days. Segregated TC services (98%) and relapse prevention groups (94%) are more likely to be of 90 days’ duration than other services, although each is available to only 3% of the ADP. Less than half of the two most frequently provided services (drug/alcohol education and group SA counseling for up to 4 hours weekly) last for more than 90 days (20% and 48%, respectively).
presents the prevalence of various correctional programs in local jails, the estimated number of offenders in each program, the proportion of programs that include SA assessment and treatment, and the proportion of programs of 90 days’ duration. Overall, 84% of the jails reported offering a work release program and 60% reported offering education programs. Less frequently offered are transitional housing, sex offender therapy, and vocational training, which are offered in less than 10% of jails (provided in 2%, 3%, and 7%, respectively, of facilities). also shows the percentage of the ADP involved in correctional programs in jails, as well as the median daily population in these programs, and illustrates that offenders in jails have limited access to correctional programs. It should also be noted that locally run jails tend to offer more programs as compared with state-run or regionally administered facilities.
Correctional programs in jails
Correctional programs in jails are also less likely to offer SA treatment services as compared with similar programs offered in prison settings. Some type of SA treatment service is offered through 22% of correctional programs in jails. Facilities providing transitional housing offer these services most frequently (92%), followed by boot camps (75%). Far less than half (35%) of work release programs, the most frequently offered program, provide SA treatment services, and only a small number of offenders in jails are actually provided with drug treatment services as part of the correctional programs.
Roughly a third of jails (35%) reported using an SA screening tool. The most frequently used tool (by 30% of facilities) is the Drug Abuse Screening Tool, whereas 36% of jails use a screening tool of their own design. Jails that offer ISPs are the most likely to use an SA tool (56%), whereas those offering day reporting are the least likely to use one (3%). Few jails (1%) use standardized risk assessment tools, and, overall, such tools are used much less frequently as compared with SA screening tools. Jails that provide transitional housing are the most likely to use risk tools (23%), followed by those providing vocational training/job readiness (11%) and sex offender therapy (6%). Less than 2% of the remaining program types use standardized risk tools.
Owing to the turnover in population and shorter facility stays, jails are more likely to offer shorter durations of correctional programs. Approximately a third (36%) of the programs provided in jails are of at least 90 days’ duration. Only 3% of day reporting programs are offered for this duration, whereas 65% of work release programs are provided for this length of the time. Close to half of all ISPs (45%) last for 90 days or longer, and approximately a quarter of transitional housing (29%), vocational training (29%), and boot camp (25%) programs last for this length of time.
3.3. Community supervision (probation, parole, and local correctional agencies)
The drug treatment services and correctional programs offered in the 134 agencies that supervise offenders in the community are described in and , respectively. More than 4.5 million offenders are under some form of supervised release, ranging from 20 to 95,000 individuals per agency (Mdn = 600 individuals). Seventy-seven percent of facilities are operated by states or through state-funded contracts, and 23% are run at a local or community level. describes the SA services provided in supervision agencies. (Note. This does not include those services offered by other public health treatment services that may be accessed by referral from community supervision agencies. These are not captured because a pretest of the survey instrument found that community correctional agencies could not identify who they had referred to SA services in the community.) Only 2% of the supervision agencies indicated that they serve SA offenders only (classified to this point as specialized facilities), and 98% of supervision agencies are responsible for a broad array of offenders (classified to this point as general or generic facilities). The most frequently offered services, available in approximately half of the community agencies, are drug/alcohol education (53%) and low-intensity group SA counseling (up to 4 hours per week; 47%). Relapse prevention groups are offered by slightly more than a third (34%) of the supervision agencies. Group SA counseling lasting 26 hours or longer is the least frequently offered service (2%), although 21% of the facilities offer SA counseling for 5–25 hours per week.
Substance abuse treatment services in community supervision agencies
Correctional programs in community correctional agencies
The survey findings confirm that services are provided less frequently in community settings than they are in incarceration facilities and that fewer offenders have access to the available services. Offenders who can access SA treatment services range in number from 190,906 for drug/alcohol education to 141,263 for group counseling of up to 4 hours per week and to 93,088 for case management. The survey found that 538,379 of the nearly 5.7 million supervision offenders participate in some type of SA treatment service in community correctional programs, which is slightly less than 10% of the supervision population.
Although the SA services offered through community supervision only benefit a small portion of the ADP, most are offered for 90 days or longer. Specialized facilities are more likely to provide services for more than 90 days. Eighty-nine percent of all services in specialized facilities are of at least 90 days’ duration, ranging from 24% of the segregated TCs to 100% of the case management programs. None of the nonsegregated community-based TCs exceeds 90 days. In generic facilities, 65% of all services last for 90 days or longer, ranging from 24% (≥26 hours of group counseling) to 93% (5–25 hours of group SA counseling per week).
Community supervision agencies differ greatly from prisons and jails in terms of the availability of correctional programs and their accessibility for the nearly 6 million offenders on supervision. shows that sex offender therapy is the most frequently offered program (provided by 58% of the agencies), followed by intensive supervision (42%) and transitional housing (24%). With nearly 6 million offenders on supervision (as compared with 1.2 million in prisons and 713,000 in jails), the median percentage of offenders in correctional programs is lower than the percentages in prisons and jails, ranging from less than 1% (transitional housing and boot camps) to 9% (intensive supervision). Nearly 321,000 individuals are involved in ISPs nationally. (Some states have a policy that all parolees are to be initially placed on intensive supervision. Others use risk tools to determine who should be eligible for ISPs.) If ISPs are excluded, less than 5% of the ADP are involved in correctional programs in community supervision agencies.
As noted, some supervision agencies are administered by state agencies and others are administered by local governments. Locally run facilities offer day reporting to 3% of the ADP and intensive supervision to 3% of the ADP, whereas state-run facilities offer day reporting to 19% of the ADP and ISPs to 9% of the ADP. However, the other correctional programs offered through locally run facilities (e.g., drug courts and sex offender therapy) are accessible to a greater percentage of the ADP as compared with programs provided by state-administered facilities. Sixty-five percent of all community-based programs are offered for more than 90 days, ranging from 20% (transitional housing) to 96% (sex offender therapy).
The community correctional agencies reported different patterns of using standardized assessment tools. Less than half (42%) of community supervision agencies use some form of standardized SA screening tool. The most commonly used tool is the Substance Abuse Subtle Screening Inventory (27%). Twenty-five percent of agencies developed their own tool. Agencies providing transitional housing are the most likely to use such tools (89%). Vocational training programs (75%) and boot camps (71%) also regularly use standardized SA screening tools, whereas those offering work release programs are the least likely to use them (29%).
Standardized risk tools are used by 50% of facilities, with a version of the Wisconsin Risk and Needs Instrument being the most frequently used tool (36%). Agencies that offer transitional housing are also the most likely to use risk assessment tools (88%), whereas those that offer boot camp programs are the least likely (33%). State-run services are more likely to use standardized risk assessment tools and SA screening tools (55% for risk assessment and 48% for SA screening) as compared with their locally run counterparts (32% for risk assessment and 22% for SA screening).
Forty-two percent of all community supervision agencies offer some form of SA treatment service integrated into a correctional program. Work release programs are the most likely to include SA treatment services (82% of the programs), followed by drug courts (73%) and ISPs (69%). The community supervision program with the highest number of offenders receiving some type of SA service is intensive supervision, which provides SA services to nearly 10 times the population of the next highest total. Correctional programs offered through locally run facilities are more likely to provide treatment services as compared with programs offered in state-run facilities.
3.4. Other services provided in correctional settings
The last set of tables examines the prevalence of other services provided and the use of community referral strategies in prisons, jails, and community correctional settings. As discussed, other medical, social, and support services are more likely to be provided in prison settings than they are in jails or community correctional settings as these facilities are constitutionally mandated to provide psychomedical services because offenders are under the care of the state. illustrates that prisons are more likely to offer all types of medical, psychosocial, and religious services. In general, fewer services are offered by community correctional agencies, likely because of the assumption that offenders can obtain such services from other organizations in the community, although studies have found that offenders may not always be welcomed by such organizations (Duffee & Carlson, 1996
) and that waiting lists often prevent them from gaining access to services.
Prevalence of other screenings, assessments, and services
Community correctional agencies are more likely to have diverse referral strategies for SA offenders as compared with prisons and jails, as shown in . In general, nearly 60% of the parole and probation agencies reported that they make community-based treatment referrals for offenders, although less than half of them make an appointment with treatment providers. Roughly a third of jails make community-based referrals and establish contact with the offenders before their release, and prisons are less likely to make referrals or appointments to community-based organizations. Slightly more than a third of agencies reported using 12-step programs or establishing contact with service agencies for offenders before their release.