| Session Title: Evaluation Challenges in a Multi-State Program for Jail Diversion and Trauma Recovery for Veterans |
| Multipaper Session 766 to be held in Carmel on Friday, Nov 4, 4:30 PM to 6:00 PM |
| Sponsored by the Alcohol, Drug Abuse, and Mental Health TIG |
| Chair(s): |
| Amy Salomon, Advocates for Human Potential Inc, asalomon@ahpnet.com |
| Discussant(s): |
| Henry Steadman, Policy Research Associates Inc, hsteadman@prainc.com |
| Abstract: This session examines evaluation challenges in mental health and substance abuse treatment evaluation embedded in the world of criminal justice. State-level evaluators discuss process evaluation challenges and solutions stemming from participation in a national multi-state project aimed at diverting people entering the criminal justice system and offering trauma-informed care, with arrested veterans suffering from trauma symptoms as the primary target population. Funded by the Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, the Jail Diversion and Trauma Recovery Program-Priority to Veterans grant program calls for each state to begin with one or more pilot sites to be expanded statewide and sustained past the five-year period of the grant. This context for mental health service evaluation presents issues and opportunities for evaluators, and the four papers address the challenges that have emerged as most pressing in the first three years of the project. |
| Hitting a Moving Target: Strategies for Overcoming Program Referral Challenges |
| Susan Pickett, University of Illinois, Chicago, pickett@psych.uic.edu |
| Debra Ferguson, Illinois Department of Human Services, debra.ferguson@illinois.gov |
| As one of the SAMHSA-funded Jail Diversion & Trauma Recovery projects, the Illinois Veterans Reintegration Initiative (VRI) provides integrated mental health, housing and substance use treatment services to veterans with trauma histories who are involved in the criminal justice system. VRI takes place in two sites: Cook County and Rock Island County. Identification of program referrals-VRI participants-involves various criminal justice, mental health, and veterans services at each site. Program referral challenges vary per site as well: for example, at one site, sources we originally counted on to help identify potential participants have experienced budget constraints and administrative changes that have limited their referrals to the VRI program. This session discusses issues related to identifying eligible participants across sites and systems; developing strategies to deal with unanticipated referral challenges; and working with program partners to maximize referral sources. |
| The Heterogeneity of Intercept 2: Implications for Diversion |
| Annette Christy, University of South Florida, achristy@fmhi.usf.edu |
| Colleen Clark, University of South Florida, cclark8@usf.edu |
| Sarah Rynearson-Moody, University of South Florida, srynearson@usf.edu |
| Autumn Frei, University of South Florida, afrei@usf.edu |
| The Sequential Intercept Model is widely used in studies related to criminal justice, including the 13 states with funding via the Justice Diversion Trauma Recovery (JDTR) initiative. Florida has chosen to focus on intercept 2 (initial detention/court hearing) to identify veterans for their JDTR pilot. The lack of county sheriff's office willingness to identify veterans at booking has meant that veterans must be identified at multiple points within intercept 2, including daily magistrate court, public defender's office, violation of probation court, and VA veteran justice outreach referrals. There is heterogeneity of client needs, recruitment issues, and evaluator demands across these intercept 2 points. The nature of the diversion varies dependent on the point of recruitment in intercept 2. There is also variability in how trauma should be assessed at different points in intercept 2. These evaluation design and practice issues WITHIN an intercept are the focus of the presentation. |
| Seeking Safety and Veteran Outcomes: Issues of Program Fidelity and Impact on Outcomes Within a Broader Service Array |
| Stacey Manser, University of Texas at Austin, stacey.manser@mail.utexas.edu |
| Sam Shore, Texas Mental Health Transformation and Behavioral Health Operations, sam.shore@dshs.state.tx.us |
| Aaron Diaz, Center for Health Care Services, adiaz@chcsbc.org |
| The federally funded Veterans Jail Diversion and Trauma Recovery Project in Texas utilizes the Seeking Safety curriculum which has been proven effective to address the trauma/PTSD and substance abuse issues of veterans (Najavits, 1992). It was designed for flexible use, consisting of 25 topics that can be conducted in any order and provides client handouts and guidance for clinicians. Trained staff provide the program topics as part of a participant's individual treatment plan which also includes other individual/group therapy for substance abuse or mental health issues, case management, sober living, and linkage to other service needs. Measuring Seeking Safety fidelity as well as topic dosage for each participant in light of other federal cross-site evaluation requirements will be discussed. Local evaluation design and analysis must also consider not only the curriculum effects but the wide array of services received as predictors of outcomes. |
| Fidelity Issues for the Trauma, Addictions, Mental Health, and Recovery Model in Rhode Island |
| John Stevenson, University of Rhode Island, jsteve@uri.edu |
| Karen Friend, Pacific Institute for Research and Evaluation, kfriend@pire.org |
| Brenda Amodei, Pacific Institute for Research and Evaluation, bamodei@pire.org |
| Jordan Braciszewski, Pacific Institute for Research and Evaluation, jbrasciszewski@pire.or |
| Paul Florin, University of Rhode Island, pflorin@mail.uri.edu |
| Promoting recovery from trauma is a central focus for the Jail Diversion and Trauma Recovery Program in RI. The TAMAR model was selected by clinical staff leaders with the aspiration that it could become an evidence-based psycho-educational support intervention for veterans following arrest for criminal activities. An earlier TAMAR "manual" was developed for a different population, and this session addresses questions regarding the use of fidelity assessment by evaluators in a formative context, with an evolving intervention targeting varied client groups. What approaches to defining and measuring fidelity can help to formalize the intervention and support clinical staff trying to develop a training model for extending the application of the model across the state? Can session activities in individual modules be linked to clinician and client feedback methods for formative application? Distinct from a controlled trials context, this service-oriented project calls for its own solutions. |