Modified Therapeutic Community and Intensive Case Management for the Reentry Population with Co-Occurring Disorders

The Second Chance Act of 2007 (Pub. L. 110-199) provides a comprehensive response to the increasing number of people who are released from prison and jail and returning to communities, including resources to address the myriad needs of these offenders to achieve a successful return to their communities. Section 201 of the Second Chance Act authorizes the Second Chance Act Reentry Demonstration Program Targeting Offenders with Co-occurring Substance Abuse and Mental Health Disorders Program, which is designed to provide treatment and recovery support services to offenders during incarceration and after their return to the community. This section specifically addresses the treatment needs of offenders who have substance abuse disorders and authorizes grants to states, units of local government, territories, and Indian tribes to improve the provision of drug treatment to offenders in prisons, jails, and juvenile facilities during the period of incarceration and through the completion of parole or other court supervision after release into the community.

The term co-occurring disorders (COD) refers to co-occurring substance-related and mental disorders. Clients said to have COD have one or more substance-related disorders as well as one or more mental disorders. At the individual level, COD exist when at least one disorder of each type can be established independent of the other and is not simply a cluster of symptoms resulting from [a single] disorder. Projects will implement or expand offender treatment programs for re-entering offenders with co-occurring substance abuse and mental health disorders. Programs should require urinalysis and/or other proven reliable forms of drug and alcohol testing for program participants, including both periodic and random testing, and for former participants while they remain in the custody, or under community supervision, of the state, local, or tribal government.

The Alcohol Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County will use the 2010 Second Chance Reentry Demonstration Program: Targeting Offenders with Co-occurring Substance Abuse and Mental Health Disorders grant to expand access to integrated, evidence-based treatment for clients with COD and reduce recidivism rates among the enrolled population from an average of 75% to 25%.

A profile of the County's typical adult re-entry population reveals that fully 22% were being treated for mental illness prior to incarceration and 71% were assessed as being in considerable need of substance abuse treatment. This is a proposal to expand the local behavioral health system by offering evidence-based, integrated treatment in the form of a Modified Therapeutic Community and Intensive Case Management to the reentry population returning to Cuyahoga County.

This project will enroll 40 men per year for two years. In-reach activities will take place in the correctional facility to orient potential participants to the CATS MTC. Program activities will follow the Substance Abuse and Mental Health Services Administration's Treatment Improvement Protocol (TIP) 42: Substance Abuse Treatment for Persons with Co-Occurring Disorders and TIP 27: Comprehensive Case Management for Substance Abuse Treatment. Participants will take place in an MTC track, with increased individual counseling and specific modifications to the TC experience designed for a COD population. Clients will receive Intensive Case Management during treatment and post-discharge to ensure linkage to housing, entitlements, and recovery support services. Funding will also be made available for housing assistance and purchase of psychotropic medications.

CA/NCF