Drug Treatment Court Funding Program Evaluation
The Drug Treatment Court Funding Program (DTCFP) is a contributions funding program that provides financial support and administers funding agreements to six drug treatment court (DTC) sites: Toronto (established in 1998), Vancouver (2001), Edmonton (2005), Winnipeg (2006), Ottawa (2006), and Regina (2006).
This report presents the evaluation findings and responds to the Treasury Board Secretariat’s 2009 Policy on Evaluation, which requires that all direct expenditures of the federal government be evaluated every five years. The evaluation, which was conducted between June and September 2014, covers the work of the DTCFP between fiscal years (FYs) 2009–10 and 2013–14.
The evaluation comprised three main lines of evidence:
- a document and data review, including relevant Justice Canada sub-studies and research studies, including a recidivism study and a study comparing the results of urine drug tests (UDTs) of graduates and non-completers during the program;
- 48 interviews with participants in the program; and
- an online survey of DTC stakeholders and staff.
The relationship between illegal drug use and criminal behaviour is well established, and represents a continuing and costly problem in Canada. Research has concluded that those with substance abuse issues are more likely to have committed crimes, and those who have had contact with the criminal justice system are more likely to have substance abuse issues. Drug-related crime is an ongoing issue as recent data on police-reported drug offences show an increase in the rate of drug offences by 33% between 1998 and 2012 (from 235 per 100,000 population in 1998 to 314 per 100,000 population in 2012) (Public Safety Canada, 2013). Given the high social costs related to illicit drug use, which have been estimated to total as much as $8.2 billion for one year (Rehm et al., 2006), there is a need to find effective interventions to address drug-related crime.
Evaluation results support both the DTC model and the DTCFP funding structure. DTCs, which combine a criminal justice and therapeutic response to drug-related crimes, were created to respond to the high recidivism rates for drug-addicted offenders (i.e., the “revolving door” to the criminal justice system for people with addictions). Indeed, numerous studies have shown that DTCs achieve positive results in reducing recidivism. In addition, the Program remains relevant as without its support, DTC stakeholders believe that DTCs in Canada would certainly not expand and may even contract in terms of numbers of courts, capacity for admitting clients, and/or the types of services offered.
The DTCFP is well aligned with federal priorities. As part of the National Anti-Drug Strategy, the Program responds to long-standing federal commitments to address crime and drug use in Canada. In addition, the DTCs are an integral component of the federal government’s criminal justice strategy, as the mandatory minimum sentencing provisions in the Criminal Code and the Controlled Drugs and Substances Act include an exemption for attending DTCs. Although still holding offenders accountable for their actions, the exemption allows courts to delay sentencing drug-addicted offenders while they attend provincially approved and court-supervised treatment programs, including DTCs.
The use of contribution funding through the DTCFP also aligns with federal roles and responsibilities in the area of criminal justice, which is a shared responsibility with provincial/territorial governments. By providing funding and not dictating or supervising DTC operations, the federal government respects the provincial/territorial authority for the administration of justice.
3.2 Design and implementation
Over the period of the evaluation, the DTCFP focused much of its efforts on building stronger relationships with provincial and territorial governments. Program officials have established connections with all provincial and territorial jurisdictions. An example of this close working relationship is the Ad Hoc Federal/Provincial/Territorial (F/P/T) Working Group on Drug Treatment Court (DTC) Efficiencies and Resource Allocations.
The DTCFP has also worked to maintain close contacts and improve communication among DTC stakeholders by resuming regular monthly DTC directors’ conference calls, which serve as a forum for information sharing and peer discussions. Survey results indicated that many respondents were unaware of other information-sharing tools, but that those who were aware were generally positive about the tools used by the DTCFP. That fact, coupled with only 6% of respondents reporting that the sharing of best practices and lessons learned is “very effective”, indicates that there is a continued need to work at information sharing with DTCs.
The evaluation compared many of the DTC processes to identify best practices in DTC literature and found, with few exceptions, that the DTCs are following these approaches.
The team composition and approach generally follow best practices. All of the DTCs have multidisciplinary teams that meet regularly (pre-court and court) to share information. The evaluation results indicate that there is strong collaboration among DTC team members — both within and among the treatment and court teams — and that the collaboration respects the professional expertise of the team members. For example, judges generally consult with treatment professionals prior to making decisions concerning Court participants.
DTCs vary from best practices in a few areas related to the DTC team. The literature suggests that consistently appearing before the same judge is important to participant outcomes. However, some DTCs have multiple judges who rotate so participants may appear before different judges. Another potential area for improvement is clarifying the roles and responsibilities of team members. While DTC stakeholders recognize that allowing variation in DTC structures is important to enable the courts to respond to local needs, they thought that written policies and procedures that outlined roles and responsibilities would be helpful. In addition, some of the variations in team member roles across the Court sites were questioned, such as whether counsellors should perform UDTs or whether that might compromise their relationships with their clients.
In terms of admissions and reach, the evaluation found that the DTC eligibility criteria and process of admissions met best practices in terms of being objective and evidence based. However, two issues related to reaching target groups were identified. Although currently DTCs are still primarily admitting clients at high risk to re-offend (which is also a best practice), concerns were expressed among some DTCs that lower-risk clients are applying. The inclusion of these offenders would mean that individuals with little prior criminal history are entering the DTC. The second issue concerned the continued difficulties in reaching the target groups of youth, Aboriginal men and women, and other historically disadvantaged groups. DTC stakeholders considered this an issue in the 2009 evaluation and still do. This perception was confirmed in the administrative data as Caucasians, men, and individuals over 30 still represent the majority of DTC participants. However, the Crown screens potential participants and determines whether or not an accused is suited to the DTC conditions and eligibility criteria.
In accordance with best practices, the court component provides structure to the DTC program, and the evaluation results indicate that the DTC court process is generally working well. DTC stakeholders approved of the intensity (regularity and number of appearances) and the appropriateness (of bail conditions) of the court process. The one issue raised by Court stakeholders and case study participants related to the use of sanctions. Although sanctions were considered a useful component of the court process and helped participants stay “on track”, there is the perception that they are not always consistently applied. As studies have shown that “swift and certain” sanctions are the most effective, this is an area of potential improvement for the DTCs.
The treatment component of DTCs also generally follows best practices in DTC literature. The Risk-Need-Responsivity (RNR) model is a well-tested, evidence-based approach for aligning DTC treatment with participant needs. The evaluation found adherence among DTCs to at least one or two of the RNR’s core principles. In particular, most DTCs use standardized, validated risk assessment tools, and the results of the assessments are factored into treatment plans. However, given that studies show that full adherence to the three core principles of the model results in the greatest reduction in recidivism, the DTCs may wish to consider how to make greater use of the RNR model.
The evaluation also found a robust continuum of care that relied on a variety of treatment options, which aligns with best practices approaches. The DTCs tailor treatment to meet the needs of participants. In particular, the evaluation found that DTCs are offering specialized programming to address the unique needs of certain target groups, such as women and Aboriginal people. However, potentially more could be done to meet the needs of these target populations, given that the DTCs continue to experience difficulties both attracting women, Aboriginal people, other visible minorities and youth into the program, and retaining them once they have entered it. The evaluation also found that the continuum of care largely ends once the recipient leaves the program. With continuing care (e.g., aftercare) identified as a best practice in the literature, DTCs may want to review their programming.
The DTCFP followed recommendations made in the 2009 evaluation and worked with Human Resources and Skills Development Canada to fund two pilot housing projects. Although evaluations of both projects showed promising results in terms of the retention of DTC participants, the evaluation found that the issue of sustainable funding for DTC housing remains.
3.3. Performance measurement
The 2009 evaluation noted issues with the consistency and completeness of the Drug Treatment Court Information System (DTCIS) data. Although the evaluation found that the 2014 DTCIS data were more complete and was able to support analyses of the data, the DTCFP needs to streamline the DTCIS so that it will support evaluations in the future. The evaluation also found that the DTCIS could improve in terms of capturing necessary qualitative information and providing statistics useful for case management and/or monitoring the operations of the DTCs.
3.4. Performance — effectiveness
DTCs have challenging target populations that are drug addicted, generally at high risk of re-offending, have multiple other issues (e.g., poverty, mental illness, low education levels), and often few supports (e.g., lack of family connections, negative peer associations). This context is important when considering the performance of the DTCs in achieving their outcomes.
The evaluation results indicate that, even with these challenges, the DTCs are showing promising results in several areas.
Retention and graduation: The DTCs have a retention rate of 36% and a graduation rate of 27%, which are similar to the 2009 evaluation results. As retention and graduation have been shown in the literature to have a positive effect on recidivism, and therefore the cost effectiveness of DTCs, determining how best to improve retention and graduation remains a key concern for the DTCs.
Reducing drug use: The evaluation results show that both graduates and non-completers have reduced drug use during the program. The reduction in “dirty” (failed) UDTs and increase in “clean” UDTs occurred quickly for both groups (after only three months). Graduates showed greater reductions in drug use than non-completers, but the results show substantial reductions in dirty tests for both. Although the study conducted for the evaluation focused on those who had been in the program for 15 months, these results indicate potentially very positive impacts for the DTCs.
Use of community supports and social stability: The available evidence from the survey and case study participants shows that DTCs make participants aware of and refer them to a variety of community supports. Participants also attribute various improvements in their social stability to their involvement with the DTCs. Improvements include better familial relationships, finding employment, and better housing situations.
Reducing criminal involvement: The recidivism study that was conducted as part of this evaluation compared DTC participants to a comparison group of similar offenders. The study found that post-program rates of re-offending were significantly lower among DTC graduates than non-completers or the comparison group. The difference in the rates of recidivism between the DTC participants (i.e., graduates as well as non-completers) and the comparison group was not statistically significant. The study also found that the DTC participants who re-offended had less drug offences than the comparison group. Thus, when the type of offence is considered, the recidivism rates could show that the DTCs reduce recidivism for drug-related offences. Although more study is needed, the results for graduates are positive.
3.5. Performance — efficiency and economy
Comparing the costs of the DTCs to incarceration (provincial or federal) and probation based on several cost scenarios, the evaluation found potential cost savings ranging from 20% to 88% if incarceration is assumed. If offenders in the traditional system receive a probationary sentence, then the DTCs cost substantially more. The analysis aligns with other studies that indicate the potential for substantial cost savings for DTCs.
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