Drug Treatment in a Direct Supervision Jail: Pima County’s Amity Jail Project

The Amity Jail project represents a cooperative effort between Amity, Inc., and the Pima County Sheriff's Department, Tucson, Arizona, funded by the Bureau of Justice Assistance, and administered by the. American Jail Association. This project intends to serve as a model of the value and practicality of a cooperative relationship between a correctional organization and a treatment agency. Development of these cooperative relationships will serve the needs of the public for protection and the needs of both inmates and the public for a reduction in substance abuse and criminality postrelease.

There are not enough interdisciplinary approaches to the drug abuse problem on the demand side of the "drug war." The Drug Enforcement Agency has used an interdisciplinary task force approach for interdiction with results. On the demand side of the equation, there has been no concerted replication of this effort. Within the prevention, treatment, corrections, and mental health communities, there are many rifts. Frequently, it is the -same population that passes through those many service and correctional doors. The lack of an interdisciplinary approach has served to further increase recidivism as inmates/drug addicts and the indigent travel from one professional group to another affording them more opportunities to manipulate and continue behavior that is destructive to self and society.

Pima County is located in Southern Arizona, just a few miles from the Mexican border; substance abuse is a critical community concern. The Epidemiology Report from the National Institute on Drug Abuse reports the cocaine purity in Arizona to be the highest in the nation: emergency room episodes have increased 162 percent in some cities in the state. The Pima County Sheriff's Department made the decision to actively engage itself not only in the supply side of the drug war, but on the demand side, getting involved in prevention and treatment efforts.

Pima County Adult Detention Center

The development of new strategies for more effective supervision is becoming a tradition for Sheriff Clarence Dupnik's department. The Adult Detention Center of the Pima County Sheriff's Department in Tucson, Arizona, was the fourth direct supervision county jail to open in the United States. Since the opening in June of 1984, the Pima County Adult Detention Center has earned a national reputation for excellence. The Jail Center for the National Institute of Corrections has used the Pima County facilities as a model for direct supervision jail management and operation. The Pima County Center hag received visitors from all over the United States as well as a number of foreign visitors. Major Russell Davis was a strong moving force in Pima County advocating the construction of the direct supervision model. Prior to the construction of the direct supervision jail, the Pima County jail had extreme problems. Today, Pima County is grateful to Major Davis.

In February of 1987, the Pima County Sheriff's Department opened its second direct supervision jail facility. That opening also marked the beginning of an Innovative approach to the problem of the chronically mentally ill. The department developed a holistic approach to this problem which involved the jail, the prosecution; the courts, and the mental health community. The mental health program is licensed by the state of Arizona as a treatment program. The program maintains inmates in jail at a competency level that facilitates court proceedings, prepares them for release, and networks with the community mental health treatment facilities to provide aftercare.

Amity, Inc.

Amity, Inc., is a nonprofit Arizona based organization dedicated to providing social and educational programs to those individuals who are alienated (e.g., alcoholism, drug addiction, delinquency, or criminality) or are in danger of becoming alienated from society.

Amity provides a comprehensive array of substance abuse services ranging from a prevention curriculum presented in public schools (beginning in third grade), to early intervention efforts in junior high schools, to intense long-term residential programs (therapeutic communities) for both adults and adolescents. These programs have close to two hundred residents.

Until 1987, the Amity staff had provided substance abuse groups twice a week at the Pima County Adult Detention Center on a volunteer basis for five years, During this time period, the program coordinator from the jail, Duane Durham, joined Amity's Board of Directors and became President, Amity staff met and was instructed by Major Davis, then the head of the jail. The construction of this particular model has made a significant difference in the ability of the Amity treatment staff to perform adequately.

Funding

Both the Amity staff and the Sheriff's Department decided that with the mounting drug problem, AIDS, and the lack of services and resources available in Arizona, a more intensive program was indicated. No funding was available within the state for a program behind the walls. Arizona ranks 51st in terms of social service programs of any sort. Therefore, Major Davis and Amity's Research Director, Dr. Peggy Glider, collaborated on a proposal that was submitted to the Bureau of Justice Assistance.

The Bureau of Justice Assistance awarded the $300,000 grant to the Sheriff's Department on October 10, 1987. After numerous meetings regarding classification and designation of space, the Jail Project opened and was in full swing for Thanksgiving in November 1987. This project was funded for 18 months and is one of two in the nation.

Staff

Staff were selected who were heavily committed to the success of the program: Fred Dillon, Corrections Specialist with years, of experience, with a successful history in the
Sheriff's Department, and Gary McDaniel, one of the Program Managers from Amity, Inc., who had worked in the substance abuse field for more than two decades, formed the core team both serving as Jail Program Coordinators.

These two men serve the function of overcoming communication difficulties between corrections and treatment personnel, enhancing good working relationships, and presenting a united front to the inmate population minimizing inmate "game-playing" behavior.

Cross-Training The Pima County Sheriff's Department Academy provided four days of training for the Amity staff selected to work in the pod before any programming started. This insured that treatment personnel would have basic information regarding security issues, now generation jail supervision techniques, and emergency procedures. Those security personnel who were interested in working in the treatment pod received four days of training at Amity, Inc., facilities regarding basic treatment techniques that would be used, history of the sobriety movement, and teambuilding exercises. An emphasis was placed during cross-training on participants openly discussing anticipated problems with the project: e.g., correctional staff expressed concerns about introduction of contraband, instability of ex-addict staff, security problems, and low morale; treatment personnel expressed concern regarding confidentiality issues, fear of not being treated as professionals, institutional rigidity. Honest discussion of anticipated problems went a long way towards resolving these problems and matching expectations on both sides.

Site Selection

All research data indicated that the most successful programs within prison walls had been developed in an isolated unit with as much distance as possible from the main population. This has also been the case at the New York Stay'N Out program, functioning in a prison setting for ten years; the Stay'N Out program graduates have had an 80-percent positive parole discharge. Although there was not precedent for a "jail" substance abuse program, an isolated site was picked which made a significant difference in both motivation and behavior of inmates.

Selection of Inmates

Both coordinators reviewed all files of all sentenced inmates. Files were sorted for those inmates who:

1. Were serving more than forty-five days;

2. Were sentenced with a substance abuse charge;

3. Were sentenced with what appeared to be substance abuse related charges (i.e., theft-by-control) and/or appeared severely intoxicated during the booking photo; and

4. Inmates who reported an addiction at intake into the Detention Center.

Information was circulated throughout the jail that a new program would be opening for those inmates with a substance abuse problem who wanted to participate.

All inmates selected were interviewed by a treatment team of five in conjunction with the Corrections Specialist, Fred Dillon. The treatment team included recovered offenders/addicts who had graduated from Amity's programs and demonstrated success.

Expansion

The project is funded to provide services to fifty individuals at one time. Rather than starting with fifty, a pod was selected that housed twenty individuals. This core group introduced the program in the institution.

Now underway for seven months (May), expansion up to capacity is anticipated. This will probably include either moving to a larger pod or double bunking.

Program Highlights and Development

• Formation of a strong, positive, anti-drug culture within the pod resulting in inmates' holding each other accountable, e.g., recommending random urine samples.

• Physical inspection and high standards of cleanliness; a healthy competition between the Amity pod and other pods for high marks on inspections.

• Work teams restricted to those members of the Amity pod. Pod members who work within the institution work together in the kitchen when they are out of the pod. This insures increased accountability and keeps the individuals functioning as a group.

• Referral and aftercare system; any individual wishing to continue treatment is referred to an appropriate community agency. Continued treatment is strongly encouraged. Housing is found for those inmates in need of housing. Amity is providing on-the-street groups in addition to using Narcotics Anonymous and Alcoholics Anonymous. Providing Amity groups helps insure a continuum of care, Individuals wishing to continue in a long-term treatment setting are appropriately referred.

• Good working relationship between treatment and correctional personnel minimizing manipulation on the part of the inmate.

• Communication with probation officers, documentation, and recommendations give other criminal justice officials a mare accurate picture of needs and abilities of individuals.

Program Curriculum

Program curriculum is extensive and includes:

• Sequential videotaping of each inmate for feedback of behavior

• Encounter groups

• Denial reduction strategies; Educational videos

• The use of popular movies to teach family dynamics

• Monthly meetings outside the institution with family members (weekly support groups are offered)

• Working in teams through the institution

• Basic seminars regarding education; History of Therapeutic Communities and Alcoholics Anonymous

• A one-week workshop regarding problems surrounding addiction every month

• Family dynamics, codependence, adult children of alcoholics, etc.

• Parenting skills; Intensive AIDS education

• Support groups for families

The project is designed to BEGIN the process of socialization, positive value formation and education, and to refer inmates to other treatment agencies in the community.

It is expected that the most successful outcomes will be those of inmates that continued treatment. In many instances, the project personnel have recommended to probation that treatment be a condition of release.

Summary

Research evidence on serious substance abusers points clearly to the need for long-term (one- to two-year) intensive treatment and education. Incarcerated offenders are in need of habilitation and education rather than rehabilitation; there is nothing to rehabilitate them to-since they have never operated from a position of functioning in society. Best successes in all follow-up studies indicate that length of stay correlates with success. Success includes pro-social behavior, employability, positive probation discharge, and no substance abuse. Addicts do respond to multiple episodes of treatment. It stands to reason that intensive interventions during periods of incarceration can go a long way to reduce denial and begin the process of socialization.

Historically the message from our communities has been that treatment and habilitation efforts are too expensive and we cannot afford them. But today we know the inextricable link between drug use and AIDS, drug use and crime, drug use and violence. Last year, 38 million Americans used illegal drugs; the cost of this to our society is staggering not to mention the costs of the overcrowded prisons and jails. Today the cost of one AIDS victim from diagnosis to death is in excess of $75,000; no dollar figure can adequately describe the human loss of youth, or family members to addiction, nor the agony associated with the loss of a loved one through drug violence. It is unfair for a community to hold law enforcement solely responsible for fixing this problem. With today's complex social problems, the only effective strategies will be brought to bear by the entire community working together.

To do so we must overcome old prejudices, develop relationships where none existed, and match cur expectations for what our society can and should be. An ancient proverb says that it is better to light a candle than curse the darkness. If we are to overcome the drug problem in our country, every community, every agency, and every institution in that community must find ways to work together and light candles.