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ItemAccess to Recovery and Recidivism Among Former Prison Inmates(Sage, 2015) Ray, Bradley; Grommon, Eric; Buchanan, Victoria; Brown, Brittany; Watson, Dennis P.; Department of Health Policy and Management, Richard M. Fairbanks School of Public HealthAccess to Recovery (ATR) is a SAMHSA-funded initiative that offers a mix of clinical and supportive services for substance abuse. ATR clients choose which services will help to overcome barriers in their road to recovery, and a recovery consultant provides vouchers and helps link the client to these community resources. One of ATR’s goals was to provide services to those involved in the criminal justice system in the hopes that addressing substance abuse issues could reduce subsequent criminal behaviors. This study examines this goal by looking at recidivism among a sample of clients in one state’s ATR program who returned to the community after incarceration. Results suggest there were few differential effects of service selections on subsequent recidivism. However, there are significant differences in recidivism rates among the agencies that provided ATR services. Agencies with more resources and a focus on prisoner reentry had better recidivism outcomes than those that focus only on substance abuse services. ItemAnticipated Stigma and Defensive Individualism during Post-Incarceration Job Searching(Wiley, 2016-08) Ray, Bradley; Grommon, Eric; Rydberg, Jason; School of Public and Environmental AffairsObtaining employment is one of the most difficult challenges for individuals released from prison. This research explores the strategies recently released male parolees employ in attempting to find work, with specific attention to the role of anticipated stigma from their ex-convict status. Through the use of in-depth longitudinal interviews, this research contributes to our understanding of returning prisoner's experiences in job searching. We find that although a majority of the sample anticipated stigma as a barrier to employment, those who did expressed an extreme self-reliance consistent with defensive individualism. This reluctance to draw on social networks may ultimately be counter-productive to the search for employment. ItemBarriers and facilitators to implementing an urban co-responding police-mental health team(Springer, 2018-11-22) Bailey, Katie; Paquet, Staci Rising; Ray, Bradley R.; Grommon, Eric; Lowder, Evan M.; Sightes, Emily; School of Public and Environmental AffairsBackgroundIn an effort to reduce the increasing number of persons with mental illness (PMI) experiencing incarceration, co-responding police-mental health teams are being utilized as a way to divert PMI from the criminal justice system. Co-response teams are typically an inter-agency collaboration between police and mental health professionals, and in some cases include emergency medical personnel. These teams are intended to facilitate emergency response by linking patients to mental health resources rather than the criminal justice system, thus reducing burdens on both the criminal justice systems as well as local healthcare systems. The current study examines the barriers and facilitators of successfully implementing the Mobile Crisis Assistance Team model, a first-responder co-response team consisting of police officers, mental health professionals, and paramedics. Through content analysis of qualitative focus groups with team members and interviews with program stakeholders, this study expands previous findings by identifying additional professional cultural barriers and facilitators to program implementation while also exploring the role of clear, systematic policies and guidelines in program success.ResultsFindings demonstrate the value of having both flexible and formal policies and procedures to help guide program implementation; ample community resources and treatment services in order to successfully refer clients to needed services; and streamlined communication among participating agencies and the local healthcare community. A significant barrier to successful program implementation is that of role conflict and stigma. Indeed, members of the co-response teams experienced difficulty transitioning into their new roles and reported negative feedback from other first responders as well as from within their own agency. Initial agency collaboration, information sharing between agencies, and team building were also identified as facilitators to program implementation.ConclusionThe current study provides a critical foundation for the implementation of first-responder police-mental health co-response teams. Cultural and systematic barriers to co-response team success should be understood prior to program creation and used to guide implementation. Furthermore, attention must be directed to cultivating community and professional support for co-response teams. Findings from this study can be used to guide future efforts to implement first-response co-response teams in order to positively engage PMI and divert PMI from the criminal justice system. ItemBeyond Collective Supervision of Youth: Informal Social Control, Pro-social Investment and Delinquency in Urban Neighborhoods(Office of the Vice Chancellor for Research, 2011-04-08) Leech, Tamara G.J.The concentration of delinquency in certain neighborhoods represents a pervasive social inequality in the United States. Today, the distribution of urban delinquency is perhaps best described as “pockets of crime,” largely confined to urban blocks with unique characteristics (Jean 2007). An expansive amount of scholarship has addressed neighborhood responses to this persistent social issue, including collective neighborhood efforts to control rates of delinquency. It is generally accepted that to fully achieve social control of public space, neighborhoods must not only intervene in problem behavior, but must also socialize youth to avoid deviance (Bursick 1988). We currently have a strong body of research on neighborhood supervision and monitoring of delinquent behavior. Yet, we are left with a paucity of work on the association between delinquency rates and pro-social investment in youth at the neighborhood level. The purpose of this study is to begin to address these gaps in the literature by simultaneously investigating collective supervision of and pro-social investment in youth. The data for the analyses focus on one urban area in Indianapolis spanning 92 census block groups. The dataset combines census and county court data with 603 interviews of local residents. The results of the analysis indicate that the meaning of collective supervision and investment seems to be context - specific. Areas with high levels of supervision over youth have fewer incidents of relatively moderate forms of delinquency such as truancy, underage drinking, curfew violations, etc. However, this same connection between supervision and slightly more serious offenses (i.e. misdemeanors) is only evident in neighborhoods with strong collective pro-social investment in youth. Areas with high levels of this prosocial investment also experience fewer juvenile felony charges, but these same areas are weaker in the supervision of youth behavior. Overall, the analyses indicate that neighborhoods dealing with minor delinquency among youth may be able to deal with the problem by monitoring and intervening in adolescent behavior. However, investment in youth organizations, positive intergenerational relationships, and informal mentoring may be a more effective option for neighborhoods facing more serious forms of juvenile delinquency. ItemThe Community Action Framework in Practice: An Illustration Based on the Ready by 21 Coalition of Austin/Travis County(2011-08) Travis, Raphael Jr.; Leech, Tamara G.J.The field of positive youth development has expanded focus from articulating and measuring desired manifestations of positive well-being to assembling the environmental conditions known to promote these desired outcomes. Evidence of the effectiveness of community-level efforts promoting positive youth development is still emerging, in particular theory-driven examples of community-driven youth development. This study examined the Community Action Framework, one theory-based community youth development model, through the experiences of the Ready by 21 Austin/Travis County coalition (RB21). The coalition connects youth-serving organizations and also regional coalitions, while promoting the positive development of area youth. Participant observation, interviewing, and archival strategies were integrated to capture information related to the complex and dynamic coalition. Results indicated that RB21 represents a practical and meaningful application of the Community Action Framework. Specific examples and recommendations are provided as guidance for other community level youth development efforts. ItemA Community Conversation on Adolescent Pregnancy and Parenting Services: Networks of Support, Gatekeepers to Care, and Non-Compulsory Fathering in a Black Urban Community(2014) Leech, Tamara G.J.; Adams, Elizabeth A.; Littlefield, MarciThis study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serves as a barrier to accessing prenatal care. Overall, participants want health agencies to uphold their formal social contracts with the community, but to entrust informal services to community members who have the necessary insight and expertise to deliver support and information that is usable in their social context. ItemDeveloping a Culturally Proficient Intervention for Young African American Men in Drug Court: Examining Feasibility and Estimating an Effect Size for Habilitation Empowerment Accountability Therapy (HEAT)(2018) Marlowe, Douglas B.; Shannon, Lisa M.; Ray, Bradley; Turpin, Darryl P.; Wheeler, Guy A.; Newell, Jennifer; Lawson, Spencer G.African American males between 18 and 29 years of age are substantially less likely than many other participants to graduate successfully from drug court. Unsuccessful termination from drug court can have serious repercussions for these young men, including possible incarceration and negative collateral consequences associated with having a criminal record. This article reports preliminary results from two pilot studies that examined the feasibility of implementing a culturally proficient intervention for young African American men in drug court, and estimated an effect size for the intervention in improving treatment retention and reducing termination rates. Results confirmed that participants with serious criminal and substance use histories were willing and able to complete the lengthy 9-month curriculum, were satisfied with the intervention, and graduated from drug court at substantially higher rates than are commonly observed in this at-risk population. A sufficient basis has been established to justify the effort and expense of examining this intervention — Habilitation Empowerment Accountability Therapy (HEAT) — in fully powered randomized controlled trials. ItemDeveloping Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT): protocol for a pilot randomized controlled trial(BMC, 2017-12-15) Watson, Dennis P.; Ray, Bradley; Robison, Lisa; Xu, Huiping; Edwards, Rhiannon; Salyers, Michelle P.; Hill, James; Shue, Sarah; Social and Behavioral Sciences, School of Public HealthBackground There is a lack of evidence-based substance use disorder treatment and services targeting returning inmates. Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT) is a community-driven, recovery-oriented approach to substance abuse care which has the potential to address this service gap. SUPPORT is modeled after Indiana’s Access to Recovery program, which was closed due to lack of federal support despite positive improvements in clients’ recovery outcomes. SUPPORT builds on noted limitations of Indiana's Access to Recovery program. The ultimate goal of this project is to establish SUPPORT as an effective and scalable recovery-oriented system of care. A necessary step we must take before launching a large clinical trial is pilot testing the SUPPORT intervention. Methods The pilot will take place at Public Advocates in Community Re-Entry (PACE), nonprofit serving individuals with felony convictions who are located in Marion County, Indiana (Indianapolis). The pilot will follow a basic parallel randomized design to compare clients receiving SUPPORT with clients receiving standard services. A total of 80 clients within 3 months of prison release will be recruited to participate and randomly assigned to one of the two intervention arms. Quantitative measures will be collected at multiple time points to understand SUPPORT’s impact on recovery capital and outcomes. We will also collect qualitative data from SUPPORT clients to better understand their program and post-discharge experiences. Discussion Successful completion of this pilot will prepare us to conduct a multi-site clinical trial. The ultimate goal of this future work is to develop an evidence-based and scalable approach to treating substance use disorder among persons returning to society after incarceration. Trial registration ClinicalTrials.gov (Clinical Trials ID: NCT03132753 and Protocol Number: 1511731907). Registered 28 April 2017. ItemDiversity in times of austerity: Documenting resistance in the academy(2014-05) Moscowitz, David; Jett, Terri; Carney, Terri; Leech, Tamara G.J.; Savage, AnnWhat happens to feminism in the university is parallel to what happens to feminism in other venues under economic restructuring: while the impoverished nation is forced to cut social services and thereby send women back to the hierarchy of the family, the academy likewise reduces its footprint in interdisciplinary structures and contains academic feminists back to the hierarchy of departments and disciplines. When the family and the department become powerful arbiters of cultural values, women and feminist academics by and large suffer: they either accept a diminished role or are pushed to compete in a system they recognize as antithetical to the foundational values of feminist priorities of social justice. Collaborative work to nurture diversity and interdisciplinarity does not register as individual accomplishment. This paper considers the necessity of this type of academic work to further the vision of a society committed to the collective values espoused by feminism and other areas in social justice. ItemEmergency department-based peer support for opioid use disorder: Emergent functions and forms(Elsevier, 2019) McGuire, Alan B.; Gilmore Powell, Kristen; Treitler, Peter C.; Wagner, Karla D.; Smith, Krysti P.; Cooperman, Nina; Robinson, Lisa; Carter, Jessica; Ray, Bradley; Watson, Dennis P.; School of Public and Environmental AffairsEmergency department (ED)-based peer support programs aimed at linking persons with opioid use disorder (OUD) to medication for addiction treatment and other recovery services are a promising approach to addressing the opioid crisis. This brief report draws on experiences from three states' experience with such programs funded by the SAMHSA Opioid State Targeted Repose (STR) grants. Core functions of such programs include: Integration of peer supports in EDs; Alerting peers of eligible patients and making the patient aware of peer services; and connecting patients with recovery services. Qualitative data were analyzed using a general inductive approach conducted in 3 steps in order to identify forms utilized to fulfill these functions. Peer integration differed in terms of peer's physical location and who hired and supervised peers. Peers often depend on ED staff to alert them to potential patients while people other than the peers often first introduce potential patients to programming. Programs generally schedule initial appointments for recovery services for patients, but some programs provide a range of other services aimed at supporting participation in recovery services. Future effectiveness evaluations of ED-based peer support programs for OUD should consistently report on forms used to fulfill core functions.