Course corrections

PHOTOGRAPHS BY MEGHAN MOORE

THE HAMPDEN COUNTY SHERIFF’S Pre-release Center in Ludlow looks pretty much like what you’d expect of a minimum security jail—clean but stark. Then, Zadie and Misty, two energetic young hounds bound down the hallway to greet the visitors, ears flapping, tails wagging. As they fill the otherwise institutional space with infectious energy, you start to get the sense that this is not your father’s jail anymore.

Zadie and Misty are part of what’s called the Freedom Pups program, a partnership between the county sheriff’s department and a local animal shelter that matches pre-adoption dogs in need of training with inmates who need the sort of connection the dogs can provide. It is one of the new programs that Sheriff Nicholas Cocchi has launched since he was elected in 2016.

The dogs bolt down the hallway when they see Raymond, one of the inmates assigned to take care of them (the sheriff’s department’s policy is that only first names of all inmates, or residents, as they are called in the Pre-release Center, are given to media). Raymond strokes their heads and then, after walking them down to the common room, starts to work on their training. He gives them each a treat for sitting and staying on command. “See what he’s doing,” says Cocchi. “He’s setting rules, and giving rewards when the dogs do what he asks. That will help him set rules with his kids when he gets out of here.”

The dogs are also helping Raymond regulate the peaks and valleys of his emotions. “When I see them come running at me with their tongues hanging out, it really changes my mood,” he says.

A repeat drug offender, Raymond has cycled through detox programs and the jail before, but his outlook sank to a new low after his son died less than an hour after birth. “That made me go off the edge,” he says. Soon afterwards, Raymond was arrested for distribution of cocaine. Before coming to the Pre-release Center, Raymond was at the jail’s Recovery and Wellness Center, where he received intensive treatment for his depression and drug problem. With his release imminent, he looks forward to moving back home with a deeper commitment to staying in recovery.

Freedom Pups is just one of many programs that jails across the Commonwealth and the nation are using to treat the underlying causes of criminal behavior and break the pattern of recidivism that has plagued the criminal justice system. These programs are slowly transforming the state’s houses of correction into comprehensive human service agencies, offering treatment for a wide range of behavioral problems from major mental illness to substance abuse.

Houses of correction have become the focal point of treatment and rehabilitation programs because their inmates generally have committed less serious crimes and their stay in prison is relatively short. The maximum sentence to a county house of correction is 2.5 years and the average stay is several months. The theory behind the treatment effort is to help people recover from substance abuse, regain their mental health, and develop life and work skills they will need to succeed on the outside and stay out of jail.

Sheriffs say the new approach has the potential to save money in the long run, but it doesn’t come cheap. Cocchi says the number of inmates in county corrections facilities is falling because of diversion programs designed to get lower-level offenders into treatment and keep them out of jail. But he says that leaves the jail system with inmates with more severe mental health and substance abuse problems. Intake assessments in Hampden County indicate 90 percent of inmates have a substance abuse problem and half of them have a co-occurring mental health issue. Traditional correctional staff are still needed to maintain order and prevent violence, Cocchi says, but additional staff or outside contractors are being hired to supply the programming needed to address the underlying drug and mental health issues facing inmates.

Questions have been raised, however, about spending patterns in the state’s corrections system. Reports issued last year and earlier this year by MassINC, the public policy think tank that publishes CommonWealth, said corrections spending continues to rise in the state despite a steady decrease in the number of inmates. Overall spending for state and county corrections grew by 18 percent from fiscal year 2011 to 2016, while the inmate population fell by 12 percent, according to the 2017 report. The reports also found that the number of employees dedicated to prison education declined at both state and county facilities, and that spending for such programs accounts for a tiny share of their budgets – just 2 to 3 percent of total expenditures.

In Hampden County facilities, however, there is not always a clear demarcation between programmatic and correctional staff. A correctional officer in the Wellness Center also works with residents in maintaining a vegetable garden in the backyard. Another officer teaches residents cooking and serving skills at the Olde Armory Grille. Cocchi says he consolidates housing units when feasible, though operational costs such as medical expenses and salaries continue to rise. “It is important to understand that housing inmates requires a set number of staff to provide care and custody. Our overarching goal is to return inmates to the community in better condition than when we received them,” he says, pointing with pride to an 11 percent reduction in overall recidivism over the past five years.

“The minute they walk into our facility, we are planning for reentry,” says Cocchi, who has continued the direction established by former sheriff Michael Ashe, who retired in 2016 after 42 years in office. “We’ve been doing this work for a long time here in Hampden County, but more and more departments across the country are moving into it. It used to be when you went to conferences, all they talked about were tasers and taser shields. But now it’s reentry, reentry, reentry.  We’re running a hospital here, not an asylum.”

Music and crafts

Nowhere is the changing face of jails more obvious than at the Western Massachusetts Recovery and Wellness Center in Springfield. A tour through the facility on a weekday afternoon finds residents gathering in groups to play music and make crafts after a morning schedule of therapy and educational programming. It’s about as far as you can get from a traditional jail.

Easy talk and laughter fill a room where a dozen women sit around a table weaving yarn and beads to make their own version of Native American dream catchers. Downstairs, a group of men in a drumming circle listen as their instructor pounds out a beat so they can repeat it. Posters featuring quotes that focus on resilience, hope, and determination line the hallways. A resident chats with the director of the Wellness Center about the maintenance work he has been doing as part of his treatment plan. The doors aren’t locked. Conversations between residents and staff are casual and unhurried. Nothing about the place suggests it is a jail.

“Some of the women on my unit have a hard time with the schedule. It’s like, ‘you mean we really gotta get up and start programs at 7:30?’ But I like the structure,” says Patricia, one of the residents at the Wellness Center. “Addicts don’t have any structure in their lives. They’re up all night and sleep all day.”

Patricia has cycled in and out of detox, jails, and prisons for the past three decades.  Her addiction began after she broke her neck in a car accident. She had been looking forward to going to college that fall, but the injury derailed those plans.  Doctors prescribed painkillers, but eventually they stopped refilling them. “A friend said, ‘Here, I’ve got something that will help you,’ and that was the start of it,” she says.

Patricia says the Wellness Center has helped turnaround her image of what she is capable of achieving after so many years of addiction.  “There is a lot of magic happening in these units.  In all the other facilities I’ve been at, the staff look at you and treat you like you’re a dirty addict.  But here, they treat you like you have a disease, and help you get better.”

Patricia recently progressed onto the final stage of her treatment, learning job skills she needs to support herself when she is released. She is starting work at the Olde Armory Grille, a cafe run by the sheriff’s department at the city’s technology park. The work will bring her into direct contact with real customers ordering lunch, chatting about the weather or politics, and complaining if they don’t like their food. “I’m really looking forward to it,” she says.

Cocchi emphasizes the need for skill building, as many people who are incarcerated have little or no marketable skills. Those without a high school diploma can also learn the basic academic skills they need to pass their  equivalency tests.

Treatment programs proliferating

The number of substance abuse and mental health treatment programs in sheriff departments across the state is growing. In the last few months, Worcester and Suffolk County sheriff departments announced the expansion of treatment centers within their correctional programs. Worcester broke ground on a $20 million facility that will allow inmates to more easily access medical and mental health services. Suffolk has partnered with AdCare to provide services to pre-trial detainees in a new 60-bed facility.

Even Bristol County Sheriff Thomas Hodgson, a lightning rod for criticism because of his hardline views on criminal offenders, says he believes in giving inmates the tools they need to succeed on the outside. “If we don’t add at least one tool to their toolbox, we’ve failed when they go out because they are going to come right back in again,” he says.

Hodgson says his jail offers medication-assisted treatment for inmates with addictions as well as counseling. He says it also helps inmates develop parenting and job skills and explore mindfulness. “I’m a big believer in mindfulness,” he says, after hearing from people in recovery that retraining their minds is a critical aspect of treatment. Hodgson says the state’s sheriffs often have had to be creative to fund their treatment programs, as the Legislature has failed to fund the “bare bones” budget of every sheriff across the state. In addition to state funding, Hodgson says he uses volunteers and grants to implement the programs in Bristol County.

Franklin County, a rural county in western part of the state, has received more than $1 million in federal funding over the last five years to implement programs targeting inmates with substance abuse problems. According to Assistant Superintendent Ed Hayes, the department has moved away from self-help groups and implemented a “modern, evidence-based treatment model” that has achieved national recognition as a model for abuse treatment.  He says inmates with addictions are given medications that help them wean themselves off drugs, but in addition, and just as important, they are given “trauma-informed” counseling that uses mindfulness and other techniques that are proven to be effective.

The Franklin County sheriff’s department is even reaching out to people who aren’t in jail but known to be struggling to stay clean. Recently, Jeremiah, who cycled through the Franklin County jail before its treatment program opened, says he was contacted by the sheriff’s outreach counselors. “They have been really helpful,” he says. “It’s really important to have that connection.”

Jeremiah grew up in Orange, a small town in Franklin County with high rates of poverty and opioid addiction. As a teenager, he had tried different drugs, but once he started using heroin, he was ensnared in a decade-long pattern of getting high, getting caught, going into detox, then jail, then back out.

After his last release, it wasn’t long before he was back on drugs. He tried taking methadone to reduce his craving for heroin, but he ended up selling the methadone and using the money to buy more heroin. He lost his job, then his housing.  He lived on couches and in a tent until he became so desperate that he started stealing from friends and family. “I never thought I would steal from my mother, but I did,” he says.

In the winter of 2017 he lived in his van, the temperature dipping well below zero on many nights.  “I finally came to the conclusion that I should give up my life,” he says. He was walking to a bridge to commit suicide, but when he passed the hospital, his resolution wavered. “I just couldn’t do that to my kids,” he says.  After spending several days in the emergency room, he moved from detox to several other longer-term treatment programs.

The support he’s recently received from counselors and an outreach worker has helped him realize that he needs to build a new social network and abandon ties to old friends in his hometown. “My kids live there, I want to live near them,” he says. “But every time I walk into town, I see people I used to sell drugs to.”

Reaching out beyond the jail’s walls

Middlesex County is also reaching out beyond the jail’s walls, attempting to help people make positive social connections and gain access to treatment during, after, and even before they end up in jail.

“We’re all human beings and we need social sustenance,” says Peter Koutoujian, sheriff of Middlesex County. “One of the things that drives people into the criminal justice system is their lack of social network. People don’t choose to associate with a bad social network, they do it because that’s all they have.”

In Middlesex County, outreach counselors called navigators keep in contact with former inmates long after they have left jail.  “The navigators may be the only positive social contact they have in their lives,” says Koutoujian. “The first call they make when they have a baby, or get married, is to their navigator.”

Jails in Middlesex County also cater to the individual needs of inmates. The county has specialized units for veterans and young offenders that are designed to develop a positive social culture within the jail and encourage treatment. The interior design of the Housing Unit for Military Veterans (HUMV) replicates the look of a barrack. Military symbols and the insignias of the five military branches line the walls.  The unit is divided into smaller squads, providing a familiar environment and encouraging the camaraderie of military life that many veterans miss when they become civilians.  Koutoujian says the inmates on the veterans unit have significantly lower recidivism rates than the general inmate population of Middlesex County.  Only 4 percent of the 135 people who have been on the HUMV unit since it opened a few years ago have reoffended, in comparison with 28.5 percent of the general inmate population.

The jail’s MATADOR program (for Medication Assisted Treatment and Directed Opioid Recovery) has also been successful in lowering recidivism rates for a population of hard-core drug users that tend to have recidivism rates in excess of 60 percent. By contrast, 18 percent of people who had completed the six-month MATADOR program reoffended. “What our data has shown us to date is that drug-free equals crime-free. If we can address an underlying substance-use disorder, we can decrease the likelihood that these individuals will return to our custody,” says Koutoujian.

Koutoujian is also working on supporting people in crisis so they never enter the criminal system in the first place. “The best reentry is no entry,” he says.  To that end, he is spearheading two projects that will keep people out of his facility. The first is an effort dubbed the Data Driven Justice Initiative, which analyzes data from criminal justice, mental health, and health care agencies to identify the “super utilizers” of the criminal justice and health care systems. These are people who have serious mental health and substance use disorders requiring multiple police calls and emergency-room visits.  The initiative provides a workaround to privacy laws so that partnering agencies can share information about super-utilizers.

“Once we identify these people, we can proactively engage them and provide services that can help them stay out of crises and rebuild their lives. Sometimes that’s as simple as helping them get housing,” Koutoujian says. There are a lot of resources in the communities within Middlesex County, he says, that the collaborative nature of the Data Driven Justice Initiative can tap into, helping people gain access to services they wouldn’t be able to access on their own.

Middlesex County is one of three pilot sites across the nation funded by the Laura and John Arnold Foundation, a private foundation focusing on criminal justice, education, and evidence-based policy. The total budget for the three sites is $1.6 million. Data Driven Justice was initiated originally by the Obama administration. The Arnold Foundation picked it up when Trump was elected and federal funding was cut off.

Many of the promising programs for offenders are funded with federal or private foundation grants, a situation that leaves them vulnerable to being closed down if grants end or aren’t renewed, something that has happened in recent years with reentry programs serving inmates in Boston and Worcester. To address that, the 2017 MassINC report on corrections spending urged adoption of a line item in the state budget for “evidence-based services.”

Koutoujian has also been working with local legislators, health providers, and police departments in the region to develop a restoration center for assessing and stabilizing people in extreme crisis. The center, which he hopes to open over the next few years, has four years of pilot funding through the Legislature, at $250,000 per year. Koutoujian says the center will be insurance-blind and open around the clock, serving as a cost-effective alternative to local emergency rooms.

“We will be able to treat people with extreme behavioral or substance-abuse crises more efficiently than an emergency room, and we will be more effectively able to get people to the treatment and services they need,” the sheriff says. According to Koutoujian, the hospitals in the county welcome the new center and are integral to its planning. Emergency room staff, he says, are not equipped to deal with extreme behavioral problems of people in crisis.

With all these programs, Koutoujian says, his department is rigorously collecting data so the initiatives can be replicated or revised as necessary. “Vision without data is just a hallucination,” he says. “We test all of our programming and we look at the data, which allows us to make changes midstream, or if it’s not working, move onto a program that will be successful and efficacious.”

He is hoping that in the future, several of the programs Middlesex County is now testing will able to be replicated in other parts of the state and country. He says Middlesex County is a good place to test these approaches because it has over a million people spread out over a fairly large geographical area.

“The unique nature of Middlesex County is one of the reasons we were chosen as a pilot site by the Arnold Foundation,” he says. “It’s big, it’s urban, and it’s densely populated in some areas, but other areas are suburban and still other areas are rural. If we can make it work here, it can work anywhere.”

There’s no doubt that jails are addressing some of society’s worst problems, often with resources that wouldn’t otherwise be available, but Koutoujian is quick to point out that the resources would best be used further upstream, helping people long before they get into crisis. “We have become too reliant on correctional facilities to correct the problems we are facing today. The issues that ail society— mental health, trauma, failures in education system, substance abuse—manifest themselves in the populations we are seeing in our jails and prisons. We need to invest our resources in the communities, so people not only don’t get into trouble, but so they are fulfilled members of society.”

Hodgson agrees, “Jails aren’t the best place to recover from substance abuse issues. We have gang members here and scheduling issues. If we looked 10 years ahead and invested in evidence-based programs in the third and fourth grade, it would make a lot more sense than detoxing people in jail.”