Problem:
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Too many women who needed mental health support were being incarcerated and left untreated.
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Solution:
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Divert women with mental health and substance use issues to support services.
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Los Angeles County, Calif. is reshaping its justice system with its Guiding Re-Entry of Women (GROW) program, which diverts women with mental health and substance use issues from incarceration, instead providing them with support services.
When a RAND Corporation study found that 74% of women in Los Angeles County Jail are suitable candidates for community treatment alternatives, the county’s Criminal Justice Coordination Committee and the Offices of the Public Defender and Alternate Public Defender teamed up to create a psychiatric social worker program focused on rehabilitation and getting its population the necessary support to not only benefit themselves, but also the greater community.
“Prison doesn’t provide the services that individuals need — they’re not doing comprehensive mental health services, substance use services and the reality is most individuals are going to get out of prison at some point,” said Dana Cherry, mental health program manager for the county’s Office of the Public Defender. “If you send a person to prison and you don’t provide any services to actually address the underlying issues, then in prison people are further traumatized, so you send them back into the community — what have you actually done?
“You’ve perpetuated the client’s mental health and substance use issues and trauma. It doesn’t serve them in any way, you’re sending them back into the community more traumatized and more harmed.”
In its first 18 months, GROW served 201 women — 95 of whom were diverted from state prison — and cut down on nearly 870 years of confinement time.
“We’re working to really look at a whole person, understand where the gaps have been and provide them with care and treatment and humanity,” Cherry said.
“People are not their crimes, they’re human beings, so giving people love and empathy and support is what we feel is a best practice for individuals to get care and hopefully get the treatment that they need so that they no longer need to even be in the system.
“… There’s women who are homeless on the street — that shouldn’t be a thing. We have clients who are sex trafficked, and nobody knows how to work with them because that’s a specialty unto itself. So, it’s really getting these clients linked with individuals that understand them.”
The program has three social workers — two from the Public Defender’s Office and one from the Alternate Public Defender’s Office — who work with the women and refer them to the services they deem are needed.
“We are not social workers in the typical sense — I’m not providing therapeutic services,” Cherry said. “What I’m doing is an intensive bio-psychosocial understanding of trauma history. Sometimes I’m the first person who the clients have ever told their trauma histories to. I’m looking for deficits that the system may have not picked up.
“Some of our clients have developmental delay and intellectual disabilities that they were never diagnosed with … so my social workers do the work to get them into the regional center if they qualify or get them enhanced services.”
All women in Los Angeles County who fall under the qualifications are eligible, regardless of what crime they’ve allegedly committed or how many times they’ve been through the justice system — or even the GROW program itself.
“We believe in second and third and 80th chances,” Cherry said. “The reality of the situation is when you have mental health or substance use issues, recovery is not linear ... So, we absolutely will help them as many times and hopefully at one time it’ll stick.”
Cherry highlighted a success story of the program, a woman who had two cases cleared through mental health diversion, one for theft and the other a drug charge, that Cherry said speaks to how important it is to connect people to the help they need and not give up on them.
“She’s 53 now and she had never been out of prison for more than a year of her [adult] life,” Cherry said. “She has schizophrenia, as well as substance use issues — crack specifically — and she lives in a single room occupancy on Skid Row, which plays a part because it’s very hard to be sober on Skid Row when you have an addiction problem …
“I got her linked to a full-service partnership program and got the court to understand that she has a severe mental health issue. She hadn’t been on meds, she’s now on [medication for her schizophrenia] … And she no longer has any cases. Both her cases got dismissed and she hasn’t had any charges in over two years, and she’s been out of prison for over four at this point.”
With a county budget of roughly $43 billion, Los Angeles County has significantly more resources than the average county.
However, Cherry emphasized the cost-effectiveness of the program and said it could be implemented anywhere. GROW is grant-funded through the California Department of Corrections and Rehabilitation and cost $2.3 million to implement. In its first 23 months, the county avoided $105 million in prison costs.
“This program is doable everywhere,” Cherry said. “All counties should have this — all counties should be focusing on this. For $2.3 million, we had a cost avoidance of that within the first three months. So, counties caring about money — this program is so cost-effective for counties it’s asinine.”
