View
219
Download
1
Category
Preview:
Citation preview
Evaluation of the
Court Integrated Services Program
Final report
Dr. Stuart Ross, Melbourne Consulting & Custom Programs
December 2009
Evaluation of the Court Integrated Services Program: Final Report December 2009
Table of Contents
Table of Contents ..........................................................................................................................2
Executive Summary .......................................................................................................................5
Program implementation findings...........................................................................................6
Program outcome findings.....................................................................................................12
Recommendations........................................................................................................................15
Part 1: Program description........................................................................................................20
Chapter 1 Introduction ...........................................................................................................20
1.1 Description of the Court Integrated Services Program........................................21
Chapter 2 Case flows & system load.....................................................................................24
2.1 Case flow and system load goals..............................................................................24
2.2 CISP program flow processes ..................................................................................25
2.3 Referrals to CISP .......................................................................................................26
Repeat clients .......................................................................................................................28
Source of referrals ...............................................................................................................28
2.4 Assessments and assessment outcomes..................................................................30
Assessment outcomes ........................................................................................................30
2.5 Case recommendations and outcomes ...................................................................31
Engagement rates................................................................................................................32
Consistency in allocation to program level .....................................................................33
Allocation to program level in relation to clients’ assessed risk...................................34
2.6 Use of judicial monitoring ........................................................................................35
2.7 Program completions ................................................................................................36
Court outcome at CISP exit ..............................................................................................38
Time on CISP......................................................................................................................39
2.8 Commentary on CISP case flow and system load issues .....................................40
Meeting program case flow targets...................................................................................40
Case flow and judicial support ..........................................................................................41
Part 2: CISP Case management and intervention model..................................................43
Chapter 3 Client characteristics and service needs..............................................................44
3.1 Client demography.....................................................................................................45
3.2 Prevalence of drug problems ...................................................................................47
3.3 Prevalence of alcohol problems...............................................................................50
Melbourne Criminological Research and Evaluation 2
Evaluation of the Court Integrated Services Program: Final Report December 2009
3.4 Prevalence of mental health problems, ABI and intellectual disability..............51
Acquired brain injury..........................................................................................................53
Intellectual disability ...........................................................................................................53
3.5 Combinations of problems.......................................................................................54
3.6 SF-12 survey of client physical and mental health ................................................54
Pre-CISP physical health....................................................................................................55
Pre-CISP mental health......................................................................................................56
Comparing pre- and post-CISP scores ............................................................................57
3.7 Comments on client characteristics and service needs.........................................58
Chapter 4 CISP service model ...............................................................................................60
4.1 Clinical and procedural basis of CISP.....................................................................61
Multidisciplinary team approach.......................................................................................61
Workers’ roles......................................................................................................................62
Team leaders ........................................................................................................................63
Program venues...................................................................................................................64
4.2 Referrals and interventions.......................................................................................65
4.3 Client feedback...........................................................................................................69
4.4 Support systems .........................................................................................................71
Policy and procedures manual...........................................................................................71
Assessment process ............................................................................................................71
Platypus Systems Case Management System ..................................................................73
4.5 Recommendations: ....................................................................................................74
Chapter 5 Drug and alcohol services................................................................................76
5.1 Provision of drug and alcohol services ...................................................................76
5.2 Drug and alcohol service needs of CISP clients....................................................76
5.3 Service output measures............................................................................................78
5.4 Change in drug and alcohol problems during CISP engagement .......................80
5.5 Relationship between CISP and drug and alcohol agencies ................................81
5.6 Recommendations .....................................................................................................83
Chapter 6 Mental Health and Acquired Brain Injury Services ..........................................84
6.1 Provision of mental health and ABI services ........................................................84
6.2 Mental health service outputs for CISP clients .....................................................84
6.3 Service relationships for mental health...................................................................87
6.4 ABI service outputs for CISP clients ......................................................................88
Melbourne Criminological Research and Evaluation 3
Evaluation of the Court Integrated Services Program: Final Report December 2009
6.5 Service relationships for ABI ...................................................................................90
6.6 Recommendations .....................................................................................................90
Chapter 7 Accommodation support services ......................................................................92
7.1 Provision of housing services...................................................................................92
7.2 Housing service needs of CISP clients ...................................................................93
7.3 Service output measures............................................................................................94
7.4 Relationship between CISP and housing agencies................................................97
7.5 Access to housing services for CISP clients ..........................................................98
Chapter 8 Magistrate perspectives on CISP and Therapeutic Jurisprudence .............. 100
8.1 Magistrates use of CISP ......................................................................................... 100
8.2 Relationship to practice.......................................................................................... 102
8.3 Satisfaction with CISP services ............................................................................. 105
8.4 Future directions for CISP .................................................................................... 108
8.5 Recommendations .................................................................................................. 109
Chapter 9 Reoffending and compliance outcomes ..................................................... 110
9.1 Outcome targets for CISP ..................................................................................... 110
9.2 Outcome assessment methodology...................................................................... 110
9.3 Bail compliance ....................................................................................................... 111
9.4 Order compliance ................................................................................................... 111
9.5 Re-offending rates................................................................................................... 113
Proportion of recidivists ................................................................................................. 113
Time to re-offence ........................................................................................................... 114
Melbourne Criminological Research and Evaluation 4
Evaluation of the Court Integrated Services Program: Final Report December 2009
Executive Summary
The Court Integrated Services Program offers a coordinated, team based approach to the
assessment and treatment to defendants at the pre-trial or bail stage. It links defendants
to support services such as drug and alcohol treatment, crisis accommodation, disability
services and mental health services. The program commenced at the beginning of 2007
after an establishment period in late 2006. CISP operates at three Victorian Magistrates’
Court venues: Melbourne, Sunshine and Morwell and is managed within the Court
Support and Diversion Services branch of the Magistrates’ Court of Victoria. This is
the final evaluation report on the Court Integrated Services Program (CISP). The
evaluation commenced in late 2006 and the findings presented here cover the
implementation and operation of the program up to the middle of 2009. The project
specification also included an econometric (cost-effectiveness) component. This was
conducted by PricewaterhouseCoopers and is reported separately.
Overall, the evaluation found that CISP:
• had achieved or exceeded its targets for the engagement and retention of clients,
• was able to match the intensity of intervention to the risk and needs of clients,
• achieved a high rate of referral of clients to treatment and support services.
Other key findings were:
• A study of CISP clients’ health and well-being showed they had much lower
levels of mental health than comparable community groups and that their mental
health improved during their period on the program;
• Magistrates and other stakeholders showed a high level of support for the
program and its outcomes; and
• compared with offenders at other court venues, offenders who completed CISP
showed a significantly lower rate of re-offending in the months after they exited
the program.
This Executive Summary reports on the evaluation findings against each of the questions
or issues specified in the project brief. Findings in relation to program implementation
issues are presented first, followed by findings in relation to program outcomes. Each
Melbourne Criminological Research and Evaluation 5
Evaluation of the Court Integrated Services Program: Final Report December 2009
finding is accompanied by chapter and section references showing where more detailed
analysis is presented. The recommendations from the evaluation are presented at the end
of this section. Details of the evaluation methods can be found in Appendix 2.
Program implementation findings
1. Is the number of defendants being referred to the CISP reflecting
those estimated by the demand modelling? If not, what factors are
influencing the referral numbers and the apparent variations?
There were 2,004 clients referred to CISP in the 2008 year, which is 86% of the target of
2,316 clients set when CISP was established. Referrals at the Latrobe Valley venue
exceeded the target by 50% (276 referrals compared with a target of 184) while Sunshine
and Melbourne venues achieved 88% and 78% of their referral targets respectively.
There was a gradual increase in referrals throughout 2007 and 2008, although these
increases were apparent at Sunshine and Latrobe Valley, but not Melbourne (see Chapter
2.8).
Generally, the characteristics of the CISP client population reflect the assumption made
in the demand modelling for the program. The most significant variation from the
demand estimates is in the high rate of clients with possible Acquired Brain Injury.
(Chapter 6.4)
2. From which source/s are referrals most commonly originating? Are
engagement rates variable according to referral source? Are
outcomes linked to referral sources?
The majority of referrals (75%) are made by clients’ legal representatives, with referrals
by Magistrates accounting for a further 15% of referrals. Self-referrals make up around
5% of referrals, although it should be noted that some clients who wish to be referred to
CISP may ask their legal representative to do this on their behalf. Clients referred by
Magistrates have a higher engagement rate than those referred by their legal
representative or self-referrals (see Chapter 2.5). There was no variation in program
Melbourne Criminological Research and Evaluation 6
Evaluation of the Court Integrated Services Program: Final Report December 2009
completion outcomes across the different referral sources. The key factors in
determining program outcomes were the offender’s custody status and accommodation
stability at program entry, and whether CISP was made a bail condition.
3. Is the number and proportion of referred defendants engaging in
the CISP reflecting those estimated by the demand modelling? If
not, what factors are influencing the variations in engagement
rates?
Overall, 64% of those referred to CISP become engaged clients. This is greater than the
estimated demand modelling take-up rate for referrals of around 60%. Referrals were
most frequently found to be unsuitable because the person failed to attend the
assessment (41% of unsuitable outcomes), was referred to Forensicare (26% of
unsuitable outcomes), or because the referral was withdrawn (22%). Overall, higher risk
clients are less likely to become engaged clients. (Chapter 2.4)
4. Are the deviations in referrals and engagement rates proportional
across regions? What factors are influencing the variations? What
has this highlighted about region-specific needs in relation to
various aspects of the CISP?
There is significant variation in engagement rates between the three program venues.
Engagement rates are around 40 % higher at Sunshine than at Melbourne and this
variation cannot be accounted for by differences in clients’ risk profile or referral source.
Proportionately more referred clients at Melbourne fail to attend their assessment, are
referred to Forensicare or withdraw their referral application. However, it is unclear why
these factors are more prevalent at this venue. (Chapter 2.5)
The rate of referral to the Latrobe Valley program site is affected by transport access
issues for defendants from communities away from the main Latrobe Valley, and to
some extent within the valley. This is mainly an issue of equity of access rather than a
limiting factor on overall referral rates at Latrobe Valley, which are higher than
anticipated (see Chapter 4.1).
Melbourne Criminological Research and Evaluation 7
Evaluation of the Court Integrated Services Program: Final Report December 2009
5. Is the CISP receiving priority access to treatment and support
services? Is this access adequate and timely? Are there any changes
to service-level agreements that would be beneficial?
In general, CISP clients receive appropriate and timely referral to treatment and support
services. Their engagement with these services is constrained by issues of service
availability that are common to all clients of forensic programs. The contracted service
agreements have resulted in improved access to accommodation, mental health and ABI
assessment services. Access to COATS drug assessment and treatment services is
consistent with previous service arrangements under the COATS service protocols.
Key problem areas for service access include:
Limited availability of places in residential drug and alcohol treatment programs
(Chapter 5.5)
Very limited availability of long-term housing under the Justice Housing Support
Program, and limited availability of emergency and temporary housing in the
community (Chapter 7.3)
Limited access to mainstream mental health service agencies (Chapter 6.3)
6. Are the existing court services that have integrated into the CISP
working effectively? What barriers are evident in achieving a co-
operative and co-ordinated response?
The CISP teams demonstrate a high degree of integration across the service areas of
drugs and alcohol, mental health, disability, indigenous support and accommodation
support. The primary barriers to effective team operation is the high level of staff
turnover which inhibits the development of stable, productive relationships between
team members, and the high level of work demand that means that cases are sometimes
assigned to staff members on the basis of availability rather than expertise. (Chapter 4.1)
One site-specific gap in the integration of contracted services exists at the Latrobe Valley
site where there appears to be limited use of mental health screening services (Chapter
6.3) and limited contact with the accommodation support agency (Chapter 7.4).
Melbourne Criminological Research and Evaluation 8
Evaluation of the Court Integrated Services Program: Final Report December 2009
7. What assumptions have been made in the development of the CISP
Service Delivery Model?
The CISP service delivery model is one of a range of clinical and support program
service approaches currently operating in Victorian courts. The other examples include
CREDIT/Bail Support, the Neighbourhood Justice Centre client services function, Drug
Court, Koori Court, and the applicant and defendant support functions for the Family
Violence Courts. Each is based on different assumptions and service models, and each
involves some specific skill sets. However, underpinning all these services is a general
body of clinical knowledge and technique and common case management, support and
other court-based functions. It is proposed that there should be a general review of
these approaches with a view to creating a court support services function that would
provide the basis for the delivery of a range of clinical, support, referral, supervision and
case management services to court clients.
8. Are clients being assigned to their appropriate level of intervention?
Is this being reflected in retention rates or other outcomes?
Engagement at the three program levels is matched to defendants’ risks (higher risk
defendants are engaged at higher program levels). Based on the risk assessment
component of the CISP Screening Assessment, clients assigned to the Community
Referral program stream are low risk, while those assigned to the Intermediate and
intensive stream are medium and high risk respectively. (Chapter 2.5)
There is consistency in engagement patterns across the three program venues (Chapter
2.5). Clients assigned to the Intensive program level have a lower completion rate than
those assigned to the Intermediate level, but this is consistent with their generally higher
level of risk.
Melbourne Criminological Research and Evaluation 9
Evaluation of the Court Integrated Services Program: Final Report December 2009
9. Do Magistrates’ Court staff, support staff, stakeholders and clients
have an awareness and accurate understanding of the CISP?
There is a high level of support by Magistrates for the CISP. This is demonstrated by the
high rate of agreement between workers’ recommendations and case outcomes as
determined by the court (Chapter 2.8), and an increasing preparedness by Magistrates to
refer defendants directly to the program.
Overall, external stakeholder knowledge about the CISP is good, with awareness about
the program increasing over time. Lawyers continue to be the primary source for
referrals to the program, and their engagement is critical to the program’s success. There
are real differences in approach between CISP and the treatment and support services,
especially in relation to accommodation and mental health programs, and this limits the
effectiveness of their engagement with CISP. Regular communication with external
stakeholders about the program’s goals and achievements is required to ensure that
stakeholders are able to respond appropriately to CISP’s service needs. (refer stakeholder
feedback sections in Chapters 5, 6, 7, and 8)
There are significant variations in the way that CISP services are incorporated into court
operations. This is primarily the product of the extent to which different Magistrates
adopt therapeutic jurisprudence practices. It is particularly important for CISP to
communicate its goals and achievements to this audience. However, it must be
recognized that the adoption of therapeutic jurisprudence approaches is ultimately the
responsibility of the Magistracy, and CISP staff and management should be available to
support these developments. (Chapter 8.1, 8.4)
The falling rate of judicial monitoring is of concern, although this may represent greater
confidence in the capacity of CISP case managers. (Chapter 2.6)
10. Are the Courts satisfied with the quality and timeliness of reporting
by the CISP team? Does the CISP meet defendants’ expectations of
service?
Melbourne Criminological Research and Evaluation 10
Evaluation of the Court Integrated Services Program: Final Report December 2009
Overall, there is a high level of stakeholder satisfaction with the quality and timeliness of
reporting by CISP team members. Where there have been problems, these are attributed
by stakeholders to the high level of staff turnover in the program and the consequent
inexperience of staff responsible for these reports. Case managers should be provided
with more explicit criteria to guide decisions about program entry, and more detailed
advice about client assessment and reporting procedures. (Chapters 4.3, 8.4)
Feedback from clients in the program was generally very positive but the evaluation
design did not provide for any systematic assessment of defendants’ expectations of
service.
11. What is the average and range of duration of client engagements by
level of intervention? Do these vary by factors such as region or
judicial monitoring?
The mean period of engagement for clients who completed CISP (from notification of a
program place to exit date) was 110 days (3 months and three weeks). For non-
completing clients, the mean number of days from notification to exit was 62. There
were no significant differences in time on the program between the three program
venues, the Intermediate and intensive program levels, or between clients who were
subject to judicial monitoring and those who were not. (Chapter 2.7)
12. Has the integration of various services resulted in a reduction in
duplication of assessments for clients, and a reduction in an overlap
of referrals?
This question is difficult to assess as there are no clear benchmarks for assessment and
referral overlaps prior to the program. There is no evidence of duplication in
assessments or referrals in the current program. However, it should be noted that some
service referrals (accommodation, mental health) need to be supported by continuing
case management by CISP. (see generally Chapters 5, 6, and 7)
13. Does the assessment tool utilised by the CISP team capture
adequate information? Is the assessment being administered
Melbourne Criminological Research and Evaluation 11
Evaluation of the Court Integrated Services Program: Final Report December 2009
appropriately? What improvements could be made to the
assessment tool?
A review of the Screening Assessment in 2008 found that CISP staff members were
administering it appropriately. The main weakness was in the collection of risk
information, but this appears to have been rectified. A number of refinements were
made to the instrument following the 2008 review. Staff members give generally positive
reports of the screening instrument, but also report that they find assessment one of the
most challenging aspects of their work. It is recommended that the CISP Policy and
Procedures Manual should be supplemented with training and procedural advice on
assessment procedures and working in a court environment. (Chapter 4.3)
Program outcome findings
The key outcomes for CISP include individual client outcomes in relation to the needs
addressed by intervention and support services, program completions, impact on court
workload and other elements of the justice system, bail and order compliance, and re-
offending.
14. Do clients show an improvement in social and physical health and
well-being, including a reduction in drug use and drug-related
harms?
There are indications across a number of measures that clients showed improved health
and social functioning as a result of involvement in CISP. The SF-12 health and well-
being survey showed significant improvement in clients reported physical and mental
well-being. Case manager assessments show reduced levels of problematic alcohol use.
However, there are a number of factors that make assessing the impact of CISP on
social, health and substance abuse factors problematic. CISP is a gateway to services, but
for many clients the main outcome of their engagement with CISP is referral to a service
agency, and looking for tangible outcomes is premature. This is most evident in relation
to housing issues. While CISP was successful in referring clients to housing services, the
waiting times associated with providing more stable accommodation are such that there
Melbourne Criminological Research and Evaluation 12
Evaluation of the Court Integrated Services Program: Final Report December 2009
was little change in actual housing status across the period of their engagement. A
second problem is that outcomes are only known for those clients who remain engaged
with CISP. (Chapters 3.6, 5.4 and 7.5)
15. What factors are important in determining program completion?
Around six in ten engaged clients complete CISP successfully. Statistical models to
predict completion outcomes were developed. The most important factors predicting
non-completion were whether the offender was in custody at the time she/he was
assessed for CISP, whether CISP was made a condition of bail, and the offenders’ level
of accommodation stability at the time of CISP entry. Court location was also an
important factor in predicting non-completion outcomes but it seems likely that this is
an artefact of the generally higher completion rates at Latrobe Valley.
16. What is the impact of CISP on court workloads?
Engagement in CISP affects court workloads in a number of ways. In order to be
considered for CISP, offenders must go through a screening assessment, and this may
involve some delay in hearing their bail application. Judicial supervision involving a
return to court may involve additional appearances and may require adjustment to
Magistrates’ work schedules. Positive impacts on court workloads include avoiding
adjournments required to arrange services for offenders, and avoiding new court
appearances associated with recidivist offending. Overall, Magistrates report that CISP
does require additional work on their part, but that this is justified by the better results
they achieve.
17. Does involvement in CISP lead to lower rates of non-compliance on
bail or Community Corrections orders?
For any pre-trial program, bail completion rates are obviously a key outcome. However,
bail data is not currently able to be extracted in a manner that allows reliable and
consistent analysis of bail outcomes for CISP clients and Victorian offenders generally.
Melbourne Criminological Research and Evaluation 13
Evaluation of the Court Integrated Services Program: Final Report December 2009
The absence of bail data constitutes a significant barrier to the evaluation of court
programs in Victoria.
Community corrections order compliance rates were not available for CISP clients as a
group. Again, this represents a significant information gap in evaluating programs of this
kind. Order compliance was examined for sample of 200 CISP participants, and 200
comparison offenders matched on gender, age, offence type and offence history. The
overall successful completion rates for orders up to June 2009 were 49% for the CISP
sample, and 45% for the control sample. While positive, this difference was not
statistically significant. The successful completion rate for CCS orders state-wide in
2007/08 was 58%, however the sampling process means that these rates cannot be
directly compared with one another.
18. Does involvement in CISP lead to lower rates of re-offending?
Re-offending rates were examined for the same 200 CISP and comparison offenders as
in the order compliance analysis. They were followed up for between 400 and 900 days
and any further offences or new charges were recorded. For the CISP group, around
50% were classed as recidivists, of whom 40% had proven charges against them, and a
further 10% had charges that had not been finalized. In the comparison group, 64%
were classed as recidivists, with 50% having proven charges recorded and a further 13%
having unfinalized charges. After 200 days around 30% of the CISP group and 32.5% of
the control group had recidivated. By 400 days the degree of divergence was six percent
(37% of the CISP group and 43% of the control group) and by 600 days it was eight
percent (40% of the CISP group and 48% of the control group. The extent of
divergence in re-offending rates reaches its maximum of ten percent by around 700 days.
Melbourne Criminological Research and Evaluation 14
Evaluation of the Court Integrated Services Program: Final Report December 2009
Recommendations
Recommendation 1: Establish a review of court support programs with the
aim of developing a general court support service model that provides state-
wide services to all the Victorian Magistrates’ Court at all its venues and across
all specialist lists and divisions.
The CISP program has achieved its primary output and outcome goals, including:
achievement of referral targets;
exceeding the target rate for engagements;
satisfying the requirement for level of engagement to be matched to need;
achieving a high rate of program completions;
achieving a high rate of treatment and support program referrals, and;
demonstrating a high level of support from Magistrates and other stakeholders.
The program has received continuing funding for two years. The primary issue is
therefore what should be the future of this program in the period after 2011?
The CISP service delivery model is one of a range of clinical and support program
service approaches currently operating in Victorian courts. The other programs include
CREDIT/Bail Support, the Neighbourhood Justice Centre client services function, Drug
Court, Koori Court, and the applicant and defendant support functions for the Family
Violence Courts. Each is based on different assumptions and service models, and each
involves some specific skill sets. However, underpinning all these services is a general
body of clinical knowledge and technique and common case management, support and
other court-based functions. It is proposed that there should be a general review of
these approaches with a view to creating a court support services function that would
provide the basis for the delivery of a range of clinical, support, referral, supervision and
case management services to clients of the Magistrates’ Court of Victoria.
This review should consider the following issues:
The contribution of court services to the continuing development of therapeutic
jurisprudence practices
Melbourne Criminological Research and Evaluation 15
Evaluation of the Court Integrated Services Program: Final Report December 2009
The creation of functional specializations that can be applied across a range of
court business streams and specialist lists and divisions. These might include:
− Client assessment
− Case management
− Victim counselling
The development of client services infrastructure for court services comprising:
− Information management tools
− Co-ordinated training and professional development
− Clinical and case management tools and systems (for example, common
assessment tools and procedures), and
− Professional resource kits (for example, centrally maintained databases of
service provider agencies).
The development of a mobile service capacity appropriate for regional courts
Recommendation 2: Continue to develop and support the connections
between CISP and therapeutic jurisprudence practices
CISP is an integral element in therapeutic jurisprudence processes that commence at the
bail stage and continue throughout the offender’s involvement in the court process and
through into supervision under court order. For the full value of the interventions and
support delivered through CISP to be realized there needs to be continued development
of the program’s connections with post-sentence support and interventions. This may
also include provision for ongoing judicial review in selected cases.
Recommendation 3: Legislative or procedural amendments are required to
allow defendants charged with serious indictable offences to be subject to
judicial monitoring through CISP.
Where a defendant is charged with a serious indictable offence and then bailed, there is
limited capacity for a Magistrate to exercise judicial supervision with regular reviews of
the defendant. Legislative or procedural amendments are required to allow defendants
charged with serious indictable offences to be subject to judicial monitoring. This might
require establishing reporting dates intermediate between the Filing Hearing and
Melbourne Criminological Research and Evaluation 16
Evaluation of the Court Integrated Services Program: Final Report December 2009
Committal Mention appearance that would apply to defendants placed on CISP. These
legislative changes might also support the extension of the program to the County Court.
Recommendation 4: The CISP Policy and Procedures Manual should be
supplemented with training and procedural advice on assessment procedures
and working in a court environment.
The material on assessment procedures should include more detailed information about
the clinical aspects of forensic practice, assessment criteria for the elements of the
Screening Assessment, and the interpretation and integration of assessment information
across multiple problem domains (especially substance abuse and mental health). The
development of more explicit eligibility criteria may also assist staff by making such
decisions more externally accountable.
The material on working in a court environment should include advice on court
processes, reporting in court, and the roles of other professional groups in the court
(especially lawyers and police) and the development and management of effective
relationships with them.
Recommendation 5: The CISP Screening Assessment should be subject to
regular review and staff should receive feedback on the aggregated results of
assessments.
It is important to maintain staff commitment to the structured assessment model for
CISP. Two strategies for this are regular reviews of the assessment process (every
second year) to ensure that the assessment content and procedures remain up to date and
consistent with work practices, and demonstrating the value of the collection of
assessment data through communication with staff about the results of assessments.
Recommendation 6: Provide CISP staff with more explicit program eligibility
and suitability criteria.
Both Magistrates and case managers are aware that some referrals are made that are not
appropriate for the program. This can be addressed by providing more explicit referral
Melbourne Criminological Research and Evaluation 17
Evaluation of the Court Integrated Services Program: Final Report December 2009
criteria that take into account factors such as the defendants’ previous bail history, any
breaches of suspended sentences or Community Corrections orders, and other factors
relevant to the court’s bail decision. One possibility would be to establish three referral
outcomes: unsuitable and rejected referrals (as at present), referrals accepted for
assessment, and referrals where a Magistrate’s approval should be sought before
accepting the defendant for assessment
Recommendation 7: CISP program goals for drugs and alcohol should be
concerned with effectiveness of the referral process and maintaining clients’
engagement with treatment programs.
Improved drug and alcohol outcomes are part of the CISP goal set, however it seems
inappropriate to hold the program responsible for treatment goals that are beyond its’
direct control. The key service delivery issues for CISP are how effectively it operates as
a referral pathway and case management service. The indicators of success in this area
should be whether drug and alcohol program referrals are based on a comprehensive
assessment of clients’ risks and needs, and whether clients are provided with the support
and supervision that ensures they satisfy the attendance requirements for drug and
alcohol services.
Recommendation 8: Review the Justice Housing Support program protocol to
give greater weight to the needs of pre-trial defendants.
It is recommended that the service level agreement for the JHSP should be reviewed to
determine whether justice outcomes can be better achieved through greater focus on
short-term accommodation. This review process should consider:
• The likely future availability of long-term housing places for justice clients taking
into account patterns of intake and transition to permanent housing for justice
clients; and
• The need for short-term housing places for justice clients and the impact of
availability of this form of housing on justice system outcomes, in particular bail
and remand decisions.
Melbourne Criminological Research and Evaluation 18
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 19
Recommendation 9: Review the provision of services to justice system clients
with suspected Acquired Brain Injury
The rate of suspected Acquired Brain Injury in program clients is much higher than
allowed for in the demand modelling for CISP. This points to a high rate of ABI in
justice client populations generally, and indicates that a comprehensive strategy to
address this issue is required. While arbias1 provides a high-quality assessment and
service response for these defendants, the timescales involved are longer than can be
accommodated in a pre-trial program. CISP case managers should receive additional
advice on the management of such cases while awaiting full neuropsychological
assessments. There should also be consideration of the continuing management of these
clients as they progress through other stages of the justice system.
1 Alcohol Related Brain Injury Australian Service
Evaluation of the Court Integrated Services Program: Final Report December 2009
Part 1: Program description
Chapter 1 Introduction
This is the final evaluation report on the Court Integrated Services Program (CISP). The
evaluation commenced in late 2006 and the findings presented here cover the
implementation and operation of the program up to the middle of 2009. This report is
the fourth report on the CISP program arising out of the evaluation, and it incorporates
some material presented in interim evaluation reports prepared in 2007 and 2008. A
special report in 2008 examined the assessment of clients’ risks and needs. The
evaluation approach used for CISP focused initially on the conceptualization of the
program (that is, its theoretical and policy basis), followed by examination of program
implementation issues. This final report is mainly concerned with the outcomes of the
program, but where appropriate it makes reference to process and implementation issues.
The evaluation had two primary objectives:
To determine the effectiveness of the CISP in meeting its overarching objective
to reduce the re-offending rate of defendants
To gather objective evidence to support future decision making by the Victorian
Government in relation to the cost effectiveness of this initiative, and its
expansion state-wide.
The project specification also identified six areas of program effectiveness and efficiency
to be examined by the evaluation. These included:
Stakeholder satisfaction with services
Program process efficiencies
Reduction in re-offending rates
Enhanced order compliance
Reductions in drug use and drug-related harms, and improvements in clients’
health and well-being
The impact of the program on justice system load
Melbourne Criminological Research and Evaluation 20
Evaluation of the Court Integrated Services Program: Final Report December 2009
The project specification also included an econometric (cost-effectiveness) component.
This was conducted by PricewaterhouseCoopers and is reported separately.
1.1 Description of the Court Integrated Services Program
The Court Integrated Services Program (CISP) commenced at the beginning of 2007
after an establishment period in late 2006. The program represents a development of
existing pre-trial and bail support program models, and in particular the CREDIT (Court
Referral and Evaluation for Drug intervention and Treatment) and Bail Support
programs, established in Victoria in 1998 and 2001 respectively. The CISP model
diverges from traditional pre-trial programs in placing more emphasis on addressing the
underlying causes of offending through:
- Greater emphasis on individualized case management. Case management in
CISP involves more therapeutic interactions between clients and workers, in
comparison with the predominantly referral and advocacy approach of many
pre-trial programs;
- The CISP program teams are multi-disciplinary, and the referral and
assessment process is intended to match clients’ needs with workers’ skills
and expertise. CISP brings together a range of services that were previously
available to defendants as separate services;
- The case management model provides for three levels of service response
(Intensive, Intermediate and Community Referral) and clients are intended to
be directed to these levels of service response in a manner consistent with
their assessed level of risk and need.
- Establishing service agreements with housing agencies as part of the Justice
Housing Support Program, with arbias for the provision of Acquired Brain
Injury assessment and support services, and with the Community Offenders
Advice and Treatment Service (COATS) for drug and alcohol assessment and
referral services.
CISP operates at three Victorian Magistrates’ Court venues: Melbourne, Sunshine and
Morwell. The first two venues are metropolitan courts servicing inner Melbourne and
the western suburbs respectively, while the Morwell venue services the Latrobe Valley, to
the east of Melbourne. The program is managed within the Court Support and
Melbourne Criminological Research and Evaluation 21
Evaluation of the Court Integrated Services Program: Final Report December 2009
Diversion Services branch of the Magistrates’ Court of Victoria, and has a staff
complement of 26, including four team leader positions, 18 case manager positions and
four administrative positions.
Chapter 2 of this report gives more details of the volume and nature of the program’s
case-flows, and Chapter 4 provides a more detailed description of the clinical and case
management processes in the program. Readers of this evaluation report may find it
useful to understand how CISP operates in a day-to-day sense. The following case study
describes a typical case and illustrates the way the program interacts with court bail and
sentencing processes.
A CISP case history
A 32-year old male on remand was assessed, at his request, for CISP. The person had a
very long history of offending, had served a number of gaol and Community Corrections
sentences. At the time of his assessment he was facing two separate sets of charges
involving burglary and theft, and was in breach of a suspended sentence. The most likely
outcome for a defendant with this history would be a further gaol sentence. During the
assessment, the CISP case manager noted that the person showed indications of an
acquired brain injury (ABI) as well as other psychological issues. As part of his parole
conditions, the offender had been attending Turning Point for counselling where he had
established a beneficial therapeutic relationship with his counsellor which he wished to
continue. However, the case manager ascertained that the offender was ineligible for
CISP because he was currently serving a period of parole.
Bail was granted with various conditions. The case was adjourned to a date after his
parole expired. The CISP case manager liaised with the supervising Community
Corrections Officer in relation to the issues identified for the offender, and Corrections
worked with him on those issues for the rest of the parole period. On the return date,
the offender reiterated his commitment to CISP and his bail was varied to include
participation on CISP as a bail condition. While on CISP he continued his treatment at
Turning Point, attended all appointments with CISP, found housing, maintained
pharmacotherapy, remained abstinent from drugs, remained in a stable relationship,
participated on a Personal Support Program through Centrelink and maintained
psychological counselling as arranged through CISP.
Melbourne Criminological Research and Evaluation 22
Evaluation of the Court Integrated Services Program: Final Report December 2009
At the sentencing hearing a number of reports were tendered to the court from CISP,
Turning Point, and the Centrelink PSP case manager, as well as a report on his parole
from the Community Corrections Officer. The reports all attested to the effort that the
offender had put in whilst on the program and the progress he had made. In all, the
offender had been under court supervision for over eight months, including three months
on bail while completing parole and five months on CISP.
The magistrate imposed a further suspended sentence. It was deemed by the magistrate
that it would be counter-productive to impose an immediate custodial sentence given the
progress made by the offender and his prospects for long-term rehabilitation. The
prosecutor was invited to make a submission in relation to the restoration of the
suspended sentence. He indicated that in view of the offender’s excellent progress, he
declined to make any further submissions. The magistrate made no further order on the
breach of the suspended sentence.
At the conclusion of the proceedings, the offender asked to address the Court. He
thanked the magistrate and his CISP case-manager for the opportunity and indicated that
he was planning to attend TAFE to study social work.
Melbourne Criminological Research and Evaluation 23
Evaluation of the Court Integrated Services Program: Final Report December 2009
Chapter 2 Case flows & system load
2.1 Case flow and system load goals
A number of the goals of the CISP are concerned with the way that clients are recruited
for the program, enter and progress through the program, and finally exit. These
processes are referred to as case flow, and the case flow goals set for CISP included:
− The number of clients engaged at the three program venues would meet
specified targets. These targets were set on the basis of case flows for the
existing CREDIT/Bail Support, Disability Services and Aboriginal Liaison
programs, plus an estimated number of new referrals. These case flow targets
are shown in Table 2.1 below.
− Clients would be allocated to the appropriate program level based on their
assessed risk and needs.
− Clients would spend up to four months on the program, with case
management to monitor the defendant’s progress, address identified needs
and provide access to support services, and plan for the client’s exit.
− Judicial monitoring will be used where deemed necessary and appropriate by
the judicial officer.
Case location Referral targets Latrobe
Valley Melbourne Sunshine
Total
Existing ALO, CREDIT/BSP and DS
referrals
41 895 330 1266
New CISP referrals
143 581 326 1050
Targets for CISP referrals
184 1476 656 2316
Table 2.1 CISP case flow targets (annual)
This chapter examines the case flow outcomes of CISP, including:
− Numbers and sources of referrals to the program,
Melbourne Criminological Research and Evaluation 24
Evaluation of the Court Integrated Services Program: Final Report December 2009
− Engagement rates by program level
− Judicial monitoring rates
− Completion rates and non-completion factors
− Duration of engagement
Except where stated, all information presented in this chapter is derived from the CISP
Platypus Systems Case Management System (PSCMS).
2.2 CISP program flow processes
CISP begins when a person is charged with criminal offences. At this stage, the person
may be in custody awaiting a bail hearing, already on bail, or summonsed to appear. The
CISP case flow process includes the following stages:
• Prospective clients may be referred to CISP from a variety of sources, including
their legal representative, police, another treatment or support program, court
staff including the judiciary (via the court hearing as part of the bail application),
family and friends or self-referred.
• A referral application is completed to determine whether the person should be
further assessed for the CISP via the screening assessment process. This referral
application collects identifying information on the person and his/her legal
representative, offence and legal status, indigenous status, and any issues or
problems that might warrant assessment by CISP staff.
• The information on the referral form is used to determine allocation to a case
worker who completes a more detailed assessment. This Screening Assessment
includes a more detailed criminal and legal history, an assessment of the person’s
social and economic support needs, drug and alcohol use, and physical and
mental health. At the end of the Screening Assessment a brief assessment of
risks is also completed. Where a client is assessed as appropriate for a Level 1
(Community Referral) response, only basic information is collected at this
assessment.
Melbourne Criminological Research and Evaluation 25
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 26
• Following the screening assessment, the client may return to court where
conditions associated with his or her involvement in CISP may be attached to the
Bail Order. There is considerable variability in practice at this stage, with some
Magistrates making a Bail Order with conditions relating to CISP engagement,
while others recommend CISP engagement but without any court direction.
Magistrates may also order the person to re-appear at a later date for a progress
review.
• When a client is engaged with CISP, the case worker prepares a case management
plan that may involve referral to a range of treatment and support agencies, as
well as continued supervision through CISP. Program exit occurs when the case
management plan is completed, the client fails to satisfy the plan’s requirements,
or other legal matters arise.
The CISP pathway is shown in Figure 2.1
Figure 2.1 CISP Process Map (March 2005)2
2.3 Referrals to CISP
2 From CISP Service Delivery Model (Department of Justice, 16 March 2006)
Evaluation of the Court Integrated Services Program: Final Report December 2009
The CISP was launched in November 2006 at the Melbourne and Sunshine Magistrates’
Courts and the program took a small number of clients during the final months of 2006.
In the first year of the program (2007), a total of 1,752 clients were referred to the
program, and in 2008 this had increased to 2,004 referrals. Approximately 60% of
referrals were to the Melbourne venue of the program, 27% were to the Sunshine venue,
and 11% were to the Latrobe Valley venue. There was little evidence of a “ramp-up”
phase for the program (a period when referrals increased rapidly over a period of months
from an initial low level to a higher, more stable level), probably because the program
was seen as being a continuation of the earlier CREDIT/Bail, Disability and ALO
programs that were present at these venues.
However, there is evidence of a gradual increase in the referral rate over the two years for
the program as a whole, and for the Sunshine and Latrobe Valley venues. Figure 2.2
shows the monthly number of clients referred to CISP at each venue, and the linear trend
lines for each venue.
Monthly referrals to CISP
0
50
100
150
200
250
Janu
ary 20
07
March 2
007
May 20
07
July
2007
Septem
ber 2
007
Novem
ber 2
007
Janu
ary 20
08
March 2
008
May 20
08
July
2008
Septem
ber 2
008
Novem
ber 2
008
Latrobe ValleyMelbourneSunshineCISP totalLinear (Latrobe Valley)Linear (Sunshine)Linear (Melbourne)Linear (CISP total)
Figure 2.2 Monthly referrals at each venue
The trend line for Melbourne is stable (that is, the slope is not significantly different from
zero), but the trends for Sunshine, Latrobe Valley and the program as a whole all show
significant positive slopes. There is some evidence of a levelling off in referrals in the last
Melbourne Criminological Research and Evaluation 27
Evaluation of the Court Integrated Services Program: Final Report December 2009
six months of 2008 at each of the venues but it is too early to say whether this indicates
stabilization in the rate of program referrals.
It should be noted that the number of referrals to CISP reported in internal monthly
reports cannot be validated from PSCMS case management system records. Over the
2007 and 2008 years an additional 499 additional referrals were reported in monthly
reports, but these cannot be reliably identified from PSCMS referral records. Around
half of these additional referrals were not assessed for the program, and none became
program clients at program levels 1, 2 or 3.
Repeat clients
A substantial number of CISP referrals involve clients who have been previously referred
to this program or its predecessor (CREDIT/Bail Support). Of the 3,756 CISP referrals
in 2007 and 2008, there were 2,710 defendants who were only referred once over the
period, 384 who were referred twice, 73 who were referred three times, and 14 who were
referred four or more times. Overall, 28% of CISP referrals involve defendants who
have had previous contact with the program. Referrals are also cross-matched with client
records from the CREDIT /Bail Support (CBS) program. In the first six months of the
program, 19% of referrals were defendants who had previously been engaged with the
CBS program, but by the second half of 2007 this had fallen to 12% and by 2008 less
than 10% of referrals had prior involvement with CBS. Persons with significant criminal
behaviour frequently go through repeated court episodes in a given period, and hence
some level of multiple engagement in a program like CISP is to be expected. Since each
referral constitutes a separate assessment and case management process, the remainder of
this analysis will use referral episodes (“cases”) as the primary unit of analysis.
Source of referrals
The most common source of referrals to CISP was the defendant’s legal representative.
Eight in every ten referrals were from this source. Magistrates accounted for the next
largest group (12.5%), and self-referrals accounted for a further 5%. Referrals from
Magistrates were less frequently made at Latrobe Valley than at the other two sites, and
while referrals by police were uncommon at all three sites, they were least likely at
Melbourne. Within the “Other” category are nine referrals that were Crimes Family
Melbourne Criminological Research and Evaluation 28
Evaluation of the Court Integrated Services Program: Final Report December 2009
Violence cases: eight of these were referrals from the Sunshine venue. Note that
provision to record these CFV referrals on the CMS was only made in 2008. Prior to
this these were recorded as Magistrate referrals, and the real number in this group is
somewhat higher.
Case location
Referral source Latrobe Valley Melbourne Sunshine Total
N 368 1831 782 2981 Legal representative
%
86.4% 79.5% 76.1% 79.4%
N 19 291 163 473 Judiciary
%
4.5% 12.6% 15.9% 12.6%
N 17 122 42 181 Self referral/
family or friend %
4.0% 5.3% 4.1% 4.8%
N 11 34 9 54 Treatment or support
agency/service %
2.6% 1.5% .9% 1.4%
N 8 4 13 25 Police member
%
1.9% .2% 1.3% .7%
N 3 21 18 42 Other
%
.7% .9 1.8% 1.1%
N 426 2303 1027 3756 Total
%
100.0% 100.0% 100.0% 100.0%
Table 2.2 Source of Referrals by Venue
The source of referrals altered somewhat over the two years, with referrals by legal
representatives falling from 84% of all referrals in the first six months of the program, to
75% in the second half of 2008. Referrals by Magistrates increased from 10% to 14%,
and self-referrals increased from 3% to 6% over the same period. Magistrate referrals
were more likely where the defendant was female, and female defendants were also more
likely to self-refer.
Melbourne Criminological Research and Evaluation 29
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 30
2.4 Assessments and assessment outcomes
There were 3,736 assessments of referred defendants made in 2007 and 2008, of which
around 60% involved defendants who were in custody at the time. There were
substantial differences between the three venues in the likelihood that a referred
defendant was in custody. Two-thirds of defendants at Melbourne were in custody when
they were assessed, but only half of those at Sunshine and a third of those at Latrobe
Valley. This difference reflects the role of Melbourne as the central Magistrates Court,
with custody facilities for holding defendants who have been refused bail.
Case location Assessed in custody? Latrobe Valley Melbourne Sunshine Total
N 141 1523 511 2175 Yes
%
33.1% 66.6% 50.0% 58.2%
N 285 765 511 1561 No
%
66.9% 33.4% 50.0% 41.8%
N 426 2288 1022 3736 Total
%
100.0% 100.0% 100.0% 100.0%
Table 2.3 Assessments in Custody by Venue
Assessment outcomes
Approximately 70% of those referred to CISP were assessed as suitable for the program
and recommended for one of the three intervention levels, and one-quarter were assessed
as not suitable for the program, with a further 3% found not suitable but offered
consultancy services (provided with advice and referral to support or treatment services).
Referrals were most frequently found to be unsuitable because the person failed to attend
the assessment (417 cases, or 41% of unsuitable outcomes), was referred to Forensicare3
(262 cases, or 26% of unsuitable outcomes), or because the referral was withdrawn (220
3 Offenders with a serious mental illness or who have other significant forensic issues are referred to
Forensicare for assessment and specialist case management.
Evaluation of the Court Integrated Services Program: Final Report December 2009
cases or 22%). A further 40 cases were not accepted onto CISP because they were
adjourned to another jurisdiction or to the venue where CISP was not available.
Case recommendation outcome
Case location
Latrobe Valley Melbourne Sunshine Total
N 334 1489 874 2697 Suitable, recommended for
CISP engagement % 78.4% 65.2% 85.8% 72.4%
N 22 69 24 115 Not suitable - Consultancy
% 5.2% 3.0% 2.4% 3.1%
N 70 725 120 915 Not suitable
% 16.4% 31.8% 11.8% 24.6%
N 426 2283 1018 3727 Total
% 100.0% 100.0% 100.0% 100.0% 2.4 Case Recommendations by Venue
The proportion of referrals found unsuitable was relatively stable over the two years, and
the reasons for unsuitability were similarly stable over time. However, the proportion of
those assessed as unsuitable was significantly higher at Melbourne (32%) than the other
two venues (16% and 12% respectively). It is unclear why a greater proportion of
referrals were found unsuitable at Melbourne, as there was little site-to-site variability in
the reasons for assessments of unsuitability.
2.5 Case recommendations and outcomes
Following assessment, a report is made to the court on the defendant’s suitability for
CISP, and if assessed as suitable, recommending engagement in one of the three program
levels (Community Referral, Intermediate, Intensive). The Magistrate may accept or vary
this recommendation. Overall, nearly 80% of workers’ recommendations were accepted
by Magistrates. Over 95% of recommendations that a defendant was unsuitable resulted
in a case outcome of unsuitability and over 85% of recommendations for the Community
Referral level of CISP were accepted. The likelihood that a recommendation for
engagement in CISP would be rejected by a Magistrate was higher for more intensive
levels of the program. Twelve percent of recommendations for level 1 were ultimately
found to be unsuitable, compared with 19% of recommendations for program level 2
and 26% of recommendations for program level 3. The level of agreement between
Melbourne Criminological Research and Evaluation 31
Evaluation of the Court Integrated Services Program: Final Report December 2009
workers’ recommendations and case outcomes has remained stable over the two years
2007 and 2008.
Case outcome CISP worker recommendation
Level 1
Community
Referral
Level 2
Intermediate
Level 3
Intensive
Not suitable
Consultancy
Not
suitable
Total
N 289 3 3 14 28 337 Level 1
Community referral % 85.8% .9% .9% 4.2% 8.3% 100.0%
N 13 1700 47 28 372 2160 Level 2
Intermediate % .6% 78.7% 2.2% 1.3% 17.2% 100.0%
N 5 29 602 11 209 856 Level 3
Intensive % .6% 3.4% 70.3% 1.3% 24.4% 100.0%
N 2 1 1 52 14 70 Not suitable –
Consultancy % 2.9% 1.4% 1.4% 74.3% 20.0% 100.0%
N 1 0 1 10 292 304 Not suitable
% .3% .0% .3% 3.3% 96.1% 100.0%
N 310 1733 654 115 915 3727 Total
% 8.3% 46.5% 17.5% 3.1% 24.6% 100.0% Table 2.5 CISP Recommendations and outcomes
Engagement rates
In the remainder of this chapter, clients who had a case outcome of Level 2 or Level 3
and who received case management through CISP are referred to as engaged clients. In the
period July 2007 to June 2008, there were 1,833 clients who were assessed for CISP, of
whom 1,140 were accepted onto Level 2 or 3 of the program, 175 went to Level 1, and
518 were found unsuitable, giving an engagement rate of 62.2%. In the six months to
December 2008 there were 651 clients engaged at Level 2 or 3 out of a total of 1000
assessed, giving an engagement rate of 65.1%. The proportion of referred clients who
became engaged clients was highest at Sunshine (77.3%) and lowest at Melbourne
(56.5%). Clients referred by Magistrates were more likely to become engaged clients than
those referred by legal representatives or self-referrals.
Melbourne Criminological Research and Evaluation 32
Evaluation of the Court Integrated Services Program: Final Report December 2009
Engagement rates by referral source
.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Self referral Legal representative Judiciary
Prop
ortio
n of
refe
rrre
d cl
ient
s w
ho e
ngag
e
Figure 2.2 Engagement rates by source of referral
Consistency in allocation to program level
In the early stages of the evaluation substantial variations between the three venues were
identified in the allocation of clients to program levels. Clients at the Latrobe Valley
venue were much more likely than clients at the other two venues to be engaged at the
Intensive program level, while clients at Sunshine were more likely to be engaged at the
Intermediate program level. These variations could not be attributed to differences in
the characteristics of clients. Program guidelines about allocation were reviewed in
consultation with team leaders and by 2008 the level of site-to-site variation had greatly
diminished. Across the two years the proportion of clients engaged at each level showed
a high level of consistency between the three venues.
Melbourne Criminological Research and Evaluation 33
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 34
Proportion of CISP clients at each program level: 2007 and 2008
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
Community Referral(Level 1)
Intermediate (Level 2) Intensive (Level 3)
Latrobe ValleyMelbourneSunshine
Figure 2.3 CISP clients by program level
Allocation to program level in relation to clients’ assessed risk
The CISP assessment requires case mangers to assess clients’ risk in relation to a series of
risk criteria (see Screening Assessment at Appendix 3). These risk criteria were modified
slightly following the assessment review in 2007. The total number of items identified
provides an index of the client’s risk, and this index can be used to examine whether
clients are allocated to program levels in relation to their assessed level of risk. Table 2.6
shows the mean risk index scores for 2007 and 2008 clients at each of the three program
levels4. It can be seen that clients allocated to the Community Referral level program
were on average low risk in that less than one risk item was identified for each client.
Clients allocated to the Intermediate and Intensive program levels were of relatively
higher risk, with an average of three and over four risk items identified respectively.
4 There were 277 clients who had no risk items identified. Without examination of the original assessment
forms it cannot be determined whether these were blank risk assessments or clients who demonstrated no
risks.
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 35
Case recommendation outcome Mean N Std.
Deviation
Level 1 Community Referral .4871 310 1.59027
Level 2 Intermediate 3.0537 1732 2.06145
Level 3 Intensive 4.3645 653 2.61697
Total 3.0761 2695 2.41910 Table 2.6 Risk scores by program levels
2.6 Use of judicial monitoring
Where a magistrate directed that a defendant should take part in either Level 2 or Level 3
of CISP, he or she could also direct that this should involve monitoring of progress by
the court (judicial monitoring). Information on judicial monitoring was recorded for
approximately three-quarters of all engaged CISP clients. Judicial monitoring was most
often used at the Sunshine venue, where 80% of cases had this recorded, and least used
at Latrobe Valley where 26% of cases had judicial monitoring recorded5.
Case location Judicial Monitoring Latrobe Valley Melbourne Sunshine Total
N 51 537 488 1076 Yes
% 25.8% 53.3% 80.1% 59.3%
N 147 470 121 738 No
% 74.2% 46.7% 19.9% 40.7%
N 198 1007 609 1814 Total
% 100.0% 100.0% 100.0% 100.0% Table 2.7 Use of judicial monitoring by CISP venue
Judicial monitoring was more likely to be required where the defendant had been referred
to CISP by a Magistrate (77% of magistrate-referred cases received judicial monitoring)
and least likely where the defendant was self-referred (30% of cases). There were no
evident differences in the likelihood that judicial monitoring would be imposed on male
versus female defendants, or Indigenous versus non-Indigenous defendants. However,
there was a strong downward trend in the use of judicial monitoring throughout the life 5 The level of missing information about judicial monitoring was also highest a Latrobe Valley.
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 36
of the program (Figure 2.4). In the first six months after commencement, over three-
quarters (77%) of all engaged clients were subject to judicial monitoring but by the
second half of 2008 this had declined to less than half (43%). Magistrates were asked
about this trend and their comments are reported in Chapter 8.
Proportion of engaged CISP clients receiving judicial monitoring
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
First half 2007 Second half 2007 First half 2008 Second half 2008
%
Figure 2.4 Proportion of engaged clients receiving judicial monitoring
2.7 Program completions
Of the 2,387 defendants who became engaged CISP clients in 2007 and 2008, over 85%
had a program exit record6. Overall, around six in ten engaged clients completed CISP
satisfactorily, while 17% were unable to complete because they were remanded in
custody (either as a result of breaches of bail conditions or further offending), and 18%
were terminated for non-attendance. A small number terminated voluntarily. Included
in the ‘Other’ category were ten defendants who died while on the program. The
6 In theory, almost all clients who were engaged in 2007 and 2008 should have exited by the date of the
CMS extract on which these results are based (1 April 2009). The proportion of engaged clients with exit
records did not vary greatly between venues.
Evaluation of the Court Integrated Services Program: Final Report December 2009
completion rate was highest at Latrobe Valley, where three-quarters of all engaged clients
completed. Completion rates were higher for clients on the Intermediate program level
than for those on the intensive level (61% versus 52%) and Indigenous clients were less
likely to complete than non-Indigenous (46% versus 60%). However, there were no
differences in completion rates for men versus women, clients with judicial monitoring
versus those without, or across the main referral sources.
Case location Reason for exit Latrobe Valley Melbourne Sunshine Total
N 197 618 386 1201 Completed program
% 74.6% 56.1% 56.5% 58.6%
N 19 157 166 342 Did not complete program -
remanded % 7.2% 14.3% 24.3% 16.7%
N 35 234 106 375 Did not complete program-
non attendance % 13.3% 21.3% 15.5% 18.3%
N 9 38 9 56 No longer wanted to
participate % 3.4% 3.5% 1.3% 2.7%
N 4 54 16 74 Other
% 1.5% 4.9% 2.3% 3.6%
N 264 1101 683 2048 Total
% 100.0% 100.0% 100.0% 100.0% Table 2.7 Reasons for exit by CISP venue
Statistical models to predict completion outcomes were developed. These models and
the development process are described in detail in Appendix 1. The key findings of this
modelling process were that:
• Prediction of completion / non-completion outcomes yielded a more balanced
model than one designed to predict non-completion as a result of non-
attendance;
• The most important factors predicting non-completion were whether the
offender was in custody at the time she/he was assessed for CISP, whether CISP
was made a condition of bail, and the offenders’ level of accommodation
stability at the time of CISP entry;
• Court location was also an important factor in predicting non-completion
outcomes but this is mainly related to the generally higher completion rates at
Latrobe Valley.
Melbourne Criminological Research and Evaluation 37
Evaluation of the Court Integrated Services Program: Final Report December 2009
Court outcome at CISP exit
Over 60% of CISP clients had not had their court matters resolved at the time they
exited the program. The majority of these were cases that had not yet been determined
(980 cases or 48% of exiting clients), cases where a warrant had been issued (182 cases or
9% of exiting clients) and cases where the defendant had been committed for trial to a
higher court (87 cases or 4% of exiting clients). There were significant differences in exit
outcomes depending on whether clients exited after completing CISP. Clients who
completed CISP were more likely to have their matters resolved at exit, less likely to be
given a custodial sentence, and more likely to receive a community order, suspended
sentence, fine or bond.
Completion Court outcome at CISP exit Completed Not completed Total
N 17 79 96 Custody
% 1.4% 9.3% 4.7%
N 257 24 281 Community order
% 21.4% 2.8% 13.7%
N 139 9 148 Suspended sentence
% 11.6% 1.1% 7.2%
N 136 11 147 Fine, bond
% 11.3% 1.3% 7.2%
N 69 55 124 Other penalty
% 5.8% 6.5% 6.1%
N 581 668 1249 Matters not yet determined, warrant issued or
committed for trial % 48.5% 79.0% 61.1%
N 1199 846 2045 Total
% 100.0% 100.0% 100.0% Table 2.8 Court outcome at CISP exit by completion status
Melbourne Criminological Research and Evaluation 38
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 39
Time on CISP
The mean period of engagement for clients who completed CISP (from notification of a
program place to exit date) was 110 days (3 months and three weeks)7. For non-
completing clients, the mean number of days from notification to exit was 62. Clients
who were exited as a result of being remanded in custody tended to exit faster than those
who were exited for non-attendance or other reasons (50 days versus 64 days). There
were no significant differences in time on the program between the three program
venues, the Intermediate and intensive program levels, or between clients who were
subject to judicial monitoring and those who were not.
Mean number of days on CISP
0
20
40
60
80
100
120
Completedprogram
Did notcompleteprogram -remanded
Did notcompleteprogram-
nonattendance
No longerwanted toparticipate
Client death Adjournedto non CISP
location
Mattersadjournedto higher
court
Day
s fr
om n
otifi
catio
n to
exi
t
Figure 2.5 Mean number of days to completion by completion status
7 There are problems with accurate calculation of time on the program as some clients are placed on the
program but do not take up this place immediately. The 2% of cases with the longest durations (over 200
days) were deleted from the calculations of elapsed times.
Evaluation of the Court Integrated Services Program: Final Report December 2009
2.8 Commentary on CISP case flow and system load issues
Meeting program case flow targets
CISP was established on the basis that there was a very large unmet need for specialized
treatment and support services for defendants at court. The case flow targets for the
program were set by taking the levels of activity across the existing CREDIT/Bail
Support, Disability Services and ALO programs and adding an estimated flow of “new
business” arising from the expanded scope of the program. In all of the three venues,
this new business target was substantial when compared with the cases dealt with by the
existing programs. Prior to CISP, the Latrobe Valley venue had been dealing with
around 40 CREDIT/Bail Support, disability support and ALO cases a year, and it was
estimated that the establishment of CISP would increase this to 180 cases per year (that
is, a 450% increase). The estimated increase in case flow at Sunshine was around 100%
(from 330 per year before CISP to 656), and at Melbourne 65% (895 pre CISP to 1476).
Thus, when we ask whether the CISP program was able to meet these targets, we are also
asking whether the proposition that there was a large unmet service need in the courts
was valid.
Case location Referral targets Latrobe
Valley Melbourne Sunshine
Total
Targets for CISP referrals
184 1476 656 2316
Annual referrals 2007
150 1154 446 1750
Annual referrals 2008
276 1147 581 2004
2008 referrals as a % of target
150% 78% 88% 86%
Table 2.9 CISP targets and actual referrals 2007 and 2008
The analysis presented here shows that CISP was able to generate large increases in the
number of referred defendants over pre-CISP levels (Table 2.9). Overall, there were 2004
referrals in the 2008 year, equivalent to 86% of the target figure. The increase in case
Melbourne Criminological Research and Evaluation 40
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 41
flow at the Latrobe Valley venue was very large. The 276 referrals in 2008 are half as
great again as the target number of 184, and represent a seven-fold increase in referrals
over pre-CISP levels. Increases at Sunshine and Melbourne were relatively smaller but
nevertheless still represent large increases over pre-CISP levels. Both Sunshine and
Latrobe Valley show significant upwards trends in referral rates.
Case flow numbers in isolation provide only limited information about the effectiveness
of a program. In order to make a judgement about whether CISP has achieved its goals
it is also necessary to consider:
− Whether the risks and needs of clients are appropriate? That is, were the
additional clients who were referred and engaged the kind of people likely
to benefit from the services and supports offered through the program?
This issue is examined in detail in the next chapter of this report.
− Is the case-flow consistent with the level of resourcing for the program?
While this evaluation did not include an examination of staffing and
workload issues8, it is relevant to note that the translation of referrals into
engaged clients was relatively high (out of every ten referrals, seven
became engaged clients), and that the period of involvement with clients
was around four months for completing clients and two months for those
who did not complete.
Case flow and judicial support
The CISP model depends on achieving a high level of judicial support. There are two
measures that indicate that this was achieved (agreement between worker
recommendations and the referral of clients directly by magistrates) and one that is more
difficult to interpret (the falling rate of judicial monitoring). In general, Magistrates
endorsed the recommendations of CISP workers about program engagement. On the
question of whether or not a defendant was suitable for the program, Magistrates
endorsed around 90% of worker recommendation, and on the more specific issue of the
level of program engagement, Magistrates confirmed workers’ recommendation in
around 80% of cases. Over the period of the program, Magistrates showed an increasing
preparedness to refer defendants directly. 8 These issues were the subject of a separate review carried out in 2008.
Evaluation of the Court Integrated Services Program: Final Report December 2009
It is unclear why there are such large differences between the three program sites in the
rate of judicial monitoring, or why the rate of judicial monitoring has declined. Judicial
monitoring is central to the idea of therapeutic jurisprudence, and the large fall in its use
(from 77% of cases to less than half) is of concern. The decline in monitoring cannot be
attributed to changing referral patterns, as the proportion of magistrate-initiated referrals
increased from 2007 to 2008, and while self-referrals also increased they only accounted
for 4% of all engaged clients. Other possible reasons include greater confidence by
magistrates in CISP case management, increased work pressure on magistrates, and the
difficulty in organizing review hearings experienced by magistrates who work at several
court venues. It should be noted that there appears to be little if any relationship
between the use of monitoring and program completion. These issues are taken up in
more detail in Chapter 8 of this report.
Melbourne Criminological Research and Evaluation 42
Evaluation of the Court Integrated Services Program: Final Report December 2009
Part 2: CISP Case management and intervention
model
A fundamental principle in therapeutic jurisprudence is that how courts respond to
offenders should be targeted at the problems and disadvantages that give rise to criminal
behaviour. For the CISP to work effectively it must identify these problems and
disadvantages, provide the court with information about offenders that assists in
decisions about bail, judicial monitoring and sentencing, and establish case management
plans that respond to these issues. The CISP model is based on multi-disciplinary teams
offering a range of specializations, the members of which work together to screen and
assess defendants and respond their identified needs in a way that matches the level of
intervention received to the level of risk and need of the defendant. A key element in the
process is improving defendants’ access to, and the co-ordinated delivery of social and
health services.
This part of the evaluation report examines the case management and intervention
processes within CISP. The analysis presented includes:
A description of the demographic and problem characteristics of CISP clients
A description and critical analysis of the CISP assessment and case management
model, and
Detailed examination of the referral processes for three main forms of
intervention: drug and alcohol programs, mental health programs and
accommodation support.
Melbourne Criminological Research and Evaluation 43
Evaluation of the Court Integrated Services Program: Final Report December 2009
Chapter 3 Client characteristics and service
needs
Relatively little is known about the problems and disadvantages associated with
defendants at court. While the health and associated problems of custodial population
have been extensively and systematically studied, information about court defendants is
patchy. Studies of arrestee populations (most notably, the DUMA research conducted by
the Australian Institute of Criminology) show high rates of prevalence of drug, alcohol
and mental health problems, but these studies have not (until recently) included samples
of Victorian arrestees.
This chapter reports on the demographic, substance abuse, health and mental health
characteristics of CISP clients in order to address the following evaluation issues:
− The demand for programs and services
− The relationship between client needs and risks and program case flows
and outcomes
The demand modelling and service delivery model for CISP was based on assumptions
about the characteristics of defendants, and this chapter also provides commentary on
how the CISP model should evolve to take account of the knowledge of client
characteristics that has accrued since the beginning of the program. Unless otherwise
stated, the material presented here relates to the cohort of engaged CISP clients who
took part in the program from its commencement in December 2006 until March 2009.
The information presented here is derived mainly from the screening assessments carried
out by case managers when clients are first referred to CISP. Most of the information
collected is self-report (although case managers may be able to validate some information
from other sources) and should not be regarded as diagnostic. The references in this
report to drug, alcohol and mental or physical health problems should be read only as
identification that these problems were regarded as appropriate as a basis for engagement
in CISP. Where these problems are identified by CISP, offenders may be referred to
clinical or other specialists who are able to make a more authoritative diagnosis or
assessment. However, this information was not available to the evaluation team.
Melbourne Criminological Research and Evaluation 44
Evaluation of the Court Integrated Services Program: Final Report December 2009
Note that only clients who were engaged with program levels 2 or 3 (Intermediate or
Intensive) received a full screening assessment. Where appropriate, advice from
agencies providing services to CISP clients is also reported. The assessment data is also
compared with the results of a structured health and mental health survey conducted on
a sample of 197 CISP clients.
3.1 Client demography
The prevalence of health problems and social service needs varies greatly within the
population, and any assessment of these issues must begin with some consideration of
which segment of the population forms the CISP client group. Around four in five CISP
clients (81.4%) were male, and there was a high level of consistency in the gender mix of
clients across the three venues (Figure 4.1). Female clients comprised 16.4% of clients
on the Intermediate program level, and 24.3% of those on the Intensive program level.
Clients had a mean age of 32.7 years, and again there were no differences in the age
distribution of clients between the program venues or program levels. Half of all clients
were aged between 26 and 37 years, with around one-quarter of clients aged under 26
years, and one-quarter aged more than 37 years. In some later analyses these groups are
referred to as “young” (under 26), “middle” (26 to 37) and “older” (more than 37).
Sex of CISP clients by program venue
.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Latrobe Valley Melbourne Sunshine
MaleFemale
Figure 3.1 Sex of CISP clients
Melbourne Criminological Research and Evaluation 45
Evaluation of the Court Integrated Services Program: Final Report December 2009
Clients who identified as indigenous (Aboriginal, Torres Strait Islander or both)
comprised 8.1% of all CISP clients, but the proportion of indigenous clients was
significantly greater at Latrobe Valley and Melbourne than at Sunshine (12.3%, 10.5%
and 2.6% respectively – see Figure 3.2). Relatively more female clients were indigenous
than male clients (11.7% female versus 7.3% male), and indigenous clients were also
relatively more likely to be on the Intensive program level than the Intermediate level
(11.4% engaged as Intensive versus 6.7% engaged as Intermediate).
Proportion of indigenous (Aboriginal or Torres Strait Islander) clients
.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
Latrobe Valley Melbourne Sunshine
Figure 3.2 Indigenous clients by program venue
It is useful to compare these demographic characteristics with those of two reference
groups: arrestees and prisoners. The arrestee data is the first Victorian data from the
Drug Use Monitoring Australia research (Adams, Sandy, Smith, & Triglone, 2008) and
the prisoner data is from the national prisoner census for 2008 (Australian Bureau of
Statistics, 2008).
Characteristic CISP clients Victorian arrestees Victorian prisoners
% Female 18.6% 25.2% 5.6%
% Aged 26 or less 26.1% 29.0% 16.4%
% Indigenous 8.1% n.a. 5.8%
Table 3.1 CISP client characteristics compared with arrestees and prisoners
The CISP population has an age distribution that is generally similar to that of arrestees,
and younger than prisoners. There are more indigenous and female offenders in the
Melbourne Criminological Research and Evaluation 46
Evaluation of the Court Integrated Services Program: Final Report December 2009
CISP client group than in the prison population. While there appear to be fewer females
in the CISP population than for Victorian arrestees, it should be noted that the Victorian
DUMA sample is small (two quarters of data only) and amongst Australian arrestees
generally around 16% were female.
3.2 Prevalence of drug problems
Drug problems are assessed according to a four-level classification that distinguishes
between no use, use, abuse and dependence. The criteria for the most serious level of
the scale (dependence) include: tolerance (the need for larger amounts of the drug over
time), withdrawal (physical or psychological effects associated with cessation of use), and
an inability to voluntarily cease or restrict use of the drug. The criteria for the second
level of the scale (abuse) include recurrent use resulting in social, inter-personal or legal
problems or physical hazards. Drug use involves irregular or regular use that does not
satisfy the criteria for abuse or dependence. Assessments of drug problems are made for
each type of illicit drug that the person reports using, and for any individual the severity
of drug problems may vary greatly from one drug to another.
Case location Drug problems Latrobe
Valley Melbourne Sunshine Total
N 190 868 639 1697 Current use of drugs reported
% 65.1% 68.5% 80.9% 72.2%
N 114 709 503 1326 Past or present IV drug use
% 39.0% 56.0% 63.7% 56.4%
N 27 299 268 594 Current pharmacotherapy
% 9.2% 23.6% 33.9% 25.3%
N 45 261 143 449 Overdose history
% 15.4% 20.6% 18.1% 19.1%
N 292 1267 790 2349 Total
% 100.0% 100.0% 100.0% 100.0%
Table 3.2 Clients with identified drug problems (2007 & 2008) by CISP venue
Overall, around 70% of all engaged CISP clients reported some level of illicit drug use
(Table 3.2). Drug use was more prevalent at Sunshine than at Melbourne, and
Melbourne in turn recorded higher rates than Latrobe Valley. This pattern was evident
Melbourne Criminological Research and Evaluation 47
Evaluation of the Court Integrated Services Program: Final Report December 2009
across a range of measures of drug problems: rates of IV drug use; reported current
engagement in pharmacotherapy; and overdose history.
Where drug use was identified, clients were assessed in relation to each drug where use
was reported. On average, clients reported using around 1.5 drug types. The most
commonly reported drug was cannabis, and over half of those who reported using it
were assessed as dependent. Heroin was the next most commonly reported drug, and
again over half of those assessed were recorded as dependent. Amphetamines,
methamphetamine and benzodiazepine use were also commonly reported and in each
case between half and two-thirds of users were assessed as either dependent or abusers
of the drug.
This general pattern of drug use closely matches the pattern observed for arrestees in the
DUMA research, where cannabis was found to be the most common drug detected
through urinanalysis, followed by heroin and amphetamine/methylamphetamine and
benzodiazepines.
Melbourne Criminological Research and Evaluation 48
Evaluation of the Court Integrated Services Program: Final Report December 2009
Level of Drug Use Drug type Use Abuse Dependence None Unknown Total
N 266 144 475 7 14 906 Cannabis
%
29.4% 15.9% 52.4% .8% 1.5% 100.0%
N 116 134 352 4 5 611 Heroin
%
19.0% 21.9% 57.6% .7% .8% 100.0%
N 150 144 116 6 7 423 Amphetamines
%
35.5% 34.0% 27.4% 1.4% 1.7% 100.0%
N 55 70 96 1 2 224 Methylamphetamine
(“Ice”) %
24.6% 31.2% 42.9% .4% .9% 100.0%
N 29 69 46 0 1 145 Benzodiazepines
%
20.0% 47.6% 31.7% .0% .7% 100.0%
N 55 26 5 5 0 91 Ecstasy
%
60.4% 28.6% 5.5% 5.5% .0% 100.0%
N 27 52 52 0 4 135 Other
%
20.0% 38.5% 38.5% 0% 3.0% 100.0%
N 698 639 1142 23 33 2535 Total
%
27.5% 25.2% 45.0% .9% 1.3% 100.0%
Table 3.3 severity of drug problems by drug type
Age was the most important demographic characteristic related to drug problems.
Clients in the older age group (37 years or more) were much less likely to report drug
problems than those in the middle (26 to 37) or young (under 26) groups. Women
clients reported somewhat more drug problems than male clients. Women were more
likely to report heroin use, IV drug use and a history of overdose, however these
differences were small. In the case of indigenous clients, around one-quarter had an
“unknown” status in relation to drug problems and it is therefore difficult to draw any
conclusions about the prevalence or severity of drug problems in this client group.
Melbourne Criminological Research and Evaluation 49
Evaluation of the Court Integrated Services Program: Final Report December 2009
3.3 Prevalence of alcohol problems
The assessment process for alcohol problems is similar to that for drug problems.
Engaged clients are asked whether they currently use alcohol, and those who report any
alcohol use are assessed to determine whether this constitutes abuse or dependence on
alcohol. The screening process for alcohol problems examines self-reported problems
with alcohol, the presence of alcohol-related offences (eg. drink-driving) and the
involvement of alcohol in offending. There were very large differences between the
program sites in the proportion of clients who were recorded as having any current use
of alcohol (and who then went on to the next assessment stage), and in the severity of
alcohol problems.
Case location Latrobe
Valley
Melbourne Sunshine Total
191 507 320 1018 Any alcohol
use? 65.4% 40.0% 40.5% 43.3%
Severity of alcohol problems
N 62 182 90 334 Use
% 32.5% 35.9% 28.1% 32.8%
N 46 201 68 315 Abuse
% 24.1% 39.6% 21.2% 30.9%
N 81 97 158 336 Dependence
% 42.4% 19.1% 49.4% 33.0%
N 1 17 1 19 None
% .5% 3.4% .3% 1.9%
N 1 10 3 14 Unknown
% .5% 2.0% .9% 1.4%
N 191 507 320 1018 Total
% 100.0% 100.0% 100.0% 100.0% Table 3.4 Alcohol problems by venue
Nearly two-thirds of Latrobe Valley clients (65.4%) were recorded as having any current
alcohol use compared with around 40% at the other two venues (Table 3.4). However,
there were no consistent differences between the three sites in the severity of alcohol
problems. Overall a third of those assessed for alcohol problems were classed as
dependent, but this varied from nearly half of those assessed at Sunshine to less than
one-fifth at Melbourne. In our interviews with service providers, magistrates and case
Melbourne Criminological Research and Evaluation 50
Evaluation of the Court Integrated Services Program: Final Report December 2009
managers, there was a consensus that alcohol problems are more prevalent at the Latrobe
valley venue. Alcohol use was more prevalent amongst male clients and where present
alcohol problems were more likely to be assessed as dependent. As with drug problems,
the proportion of Indigenous clients with unknown alcohol use is high (around 20%) and
this makes any comparison problematic.
3.4 Prevalence of mental health problems, ABI and intellectual
disability
The screening assessment asks case managers to identify whether the client has any
indications of mental health problems, acquired brain injury or intellectual disability.
While the assessment questions include a range of known indicators of these conditions,
their purpose is solely to identify clients who may require more detailed clinical
assessment by a psychiatric nurse, disability worker or ABI clinician. Where serious
mental illness is identified, responsibility for the client may be transferred to Forensicare
or in the case of intellectually disabled persons charged with serious crimes, to Disability
Forensic assessment and Treatment Services.
Across the program, just over one-third of all clients were identified as having a possible
mental health problem, and there was little variation between the program venues in the
prevalence of these conditions. Where mental health issues were identified, the majority
of these clients were receiving some form of treatment (39.8%), had received treatment
in the past (14.2%) or had a current diagnosis of their condition (20.7%) (Table 4.5).
Around one in ten clients with an identified mental health problem had never received
treatment, been assessed but not treated, or were currently being assessed.
Melbourne Criminological Research and Evaluation 51
Evaluation of the Court Integrated Services Program: Final Report December 2009
Prevalence of mental health problems
.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
Latrobe Valley Melbourne Sunshine
Figure 3.3 Mental health problems by CISP venue
Mental health problems were much more common in women than in men (48.4% versus
34.7%) and became more prevalent as clients got older: 30.5% of young clients had an
identified mental health problem compared with 38.0% of clients in the middle age group
and 42.2% of clients in the older age group. Mental health problem status was unknown
for around one quarter of Indigenous clients.
Mental health treatment history N %
Currently receiving treatment 496 39.8%
Has a current diagnosis 258 20.7%
Received treatment in the past 177 14.2%
Requires assessment 138 11.1%
Current client of Mental Health Service 104 8.3%
Currently undergoing assessment 43 3.5%
Never received assessment or treatment 48 3.9%
Received assessment but no treatment 27 2.2%
Previously completed assessment 79 6.3%
No treatment required at this time 28 2.2%
Current client of Disability Services 4 .3%
Total clients 1246 100.0% Table 3.5 Treatment status for mental health problems at CISP assessment
Melbourne Criminological Research and Evaluation 52
Evaluation of the Court Integrated Services Program: Final Report December 2009
Acquired brain injury
The screening assessment included several items that are indicators of acquired brain
injury (head injury, periods of unconsciousness, inhalant use, long term drug or alcohol
use). A total of 174 clients or about one in ten (8.9%) was identified as having indicators
of ABI. Full assessment for ABI is the responsibility of arbias and client ABI status was
updated at the time of program exit, when a total of 141 clients were recorded with ABI
status. The proportion of clients with ABI status was significantly higher at Latrobe
Valley than at the other CISP venues (see Figure 4.4), possibly as a result of the higher
level of alcohol abuse at that site. There was no difference in the prevalence of ABI
indicators between men and women, but there was a significant relationship with client
age. Only 3.2% of young clients were recorded as having ABI status compared with
6.8% of those in the middle age group and 10.7% of those in the older age group.
Acquired brain injury at CISP exit
.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
Latrobe Valley Melbourne Sunshine
Figure 3.4 Acquired brain injury at CISP exit
Intellectual disability
A total of 87 clients were recorded as having intellectual disability, of whom 67 were
clients of Disability Services.
Melbourne Criminological Research and Evaluation 53
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 54
3.5 Combinations of problems
Around one third of CISP clients were recorded as having more than one offending
related drug, alcohol or mental health problem9. The most common combination was
drug and mental health problems, present in 16% of CISP clients. Drug and alcohol
problems in combination accounted for a further seven percent of clients. Around five
percent of clients were assessed as having all three problems.
Frequency Percent
Drug and alcohol problems 172 7.2%
Drug and mental health problems 383 16.0%
Alcohol and mental health problems 137 5.7%
Drug, alcohol and mental health
problems
126 5.3%
Total 2387 100.0%
Table 3.6 Combinations of offending-related problems
3.6 SF-12 survey of client physical and mental health
The SF-12 is a short (12 item) psychometrically valid instrument for measuring health
status. The SF-12 allows the self-reported physical and mental health status of the
surveyed group to be compared with values for other groups or for the same group over
time. The items that comprise the SF-12 are shown in the table below. The instrument
measures functional health status: that is, it asks about the impacts and consequences of
health issues rather than clinical or diagnostic details. While the instrument is not itself
diagnostic, it has been shown that it can reliably distinguish between groups that differ in
the severity of their health problems. The primary output measures are summary
physical and mental health scores, however the instrument also allows a health profile of
eight scales to be measured.
9 Drug problems were defined as current drug use plus any of the following: current involvement in a drug
treatment program, a history of IV drug use or an overdose history. Alcohol problems were defined as
alcohol use assessed as abuse or dependence. Mental health problems were defined as any identified
mental health problem.
Evaluation of the Court Integrated Services Program: Final Report December 2009
For the CISP evaluation, the SF-12 was administered to 197 clients at the time they
commenced the program, and 67 were re-tested at or near their exit from the program.
Participation in the survey was voluntary, and the survey questions were administered
verbally by case managers who also recorded the clients’ responses.
SF-12 scales Number of questions
Physical functioning 2
Role limitations because of physical health problems 2
Bodily pain 1
General health perceptions 1
Vitality 1
Social functioning 1
Role limitations because of emotional problems 2
General mental health 2
Table 3.7 SF-12 scales
Pre-CISP physical health
The first (pre-CISP) administration of the SF-12 provides a measure of how the physical
health status of clients compared with other groups in the community. The instrument is
constructed so that the general population mean for physical health is a score of 50 with
a standard deviation of around 10. The mean Physical Component Score (PCS) for the
CISP sample at program entry was 49.8 (with a standard deviation of 10.8). Figure 4.1
shows the CISP PCS score together with scores for comparison general population
samples in Australia and the USA, and a sample of US homeless people. It can be seen
that the CISP sample mean is essentially the same as that for the general population
samples, and higher than that of the homeless group.
Melbourne Criminological Research and Evaluation 55
Evaluation of the Court Integrated Services Program: Final Report December 2009
Physical Component Score
30
40
50
60
70
1
Mea
n Va
lue
CISP
AustralianCommunity
U.S.Community
AustralianClinical
U.S.Homeless
Figure 3.5 SF-12 mean physical component scores for CISP and comparison groups
Women typically report slightly lower CS scores than men (around two points lower) and
this was also the case with the pre-CISP samples, where men recorded a mean PCS score
of 49.0 and women a PCS score of 46.6.
Pre-CISP mental health
The SF-12 is constructed so that the general population mean for mental health is a score
of 50 with a standard deviation of around 10. The mean Mental Component Score
(MCS) for the CISP sample at program entry was 37.4 (with a standard deviation of
12.5). Figure 4.2 shows the CISP MCS score together with scores for comparison
general population samples in Australia and the USA, and a sample of US homeless
people. It can be seen that the CISP sample mean is much lower than the general
population samples, and somewhat lower than that of the homeless group. MCS scores
for women entering CISP were even lower (at 31.2), compared with 38 for men entering
CISP.
Melbourne Criminological Research and Evaluation 56
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 57
Mental Component Score
30
40
50
60
70
1
Mea
n Va
lue
CISP
AustralianCommunity
U.S.Community
AustralianClinical
U.S.Homeless
3.6 SF-12 mean mental component scores for CISP and comparison groups
Comparing pre- and post-CISP scores
Clients who completed CISP were also asked to do the SF-12 again at or near the time of
their exit from the program. Around 40% of those who are engaged as CISP clients do
not complete, and of those who do a proportion exit before a final meeting with their
case manager is scheduled (usually when they are sentenced). As a result, only 67 second
round surveys were completed. A comparison of the pre- and post-CISP SF-12 Physical
Component Scores showed an increase in the mean score from 50 to 54, and mean
Mental Component Scores also increased from 38 to 45. Paired sample t-tests showed
that both these increases were statistically significant10.
10 Pre- and post-CISP Physical Component Scores: t=3.56, df=66, p<0.001
Pre- and post-CISP Mental Component Scores: t=4.3, df=66, p<0.001
Evaluation of the Court Integrated Services Program: Final Report December 2009
SF-12 Component Score pre and post-CISP
.00
10.00
20.00
30.00
40.00
50.00
60.00
Physical Component Score Mental Component Score
Pre-testPost-test
Figure 3.7 Pre- and post-CISP PCS and MCS scores
As only about one-third of those who completed the first round SF-12 went on to
complete the survey a second time at or near exit, it is important to check that there were
no systematic differences between the two groups in their entry scores. An analysis of
variance test comparing the first round scores for those who, and didn’t go on to the
second round showed no significant difference in their first round scores.
3.7 Comments on client characteristics and service needs
The CISP client group exhibits the high prevalence of drug, alcohol and mental health
problems known to be a common feature of offender populations. Interestingly, their
self-reported physical well-being shows scores comparable to those of the non-offending
population, indicating that any detrimental physical impacts of their drug and alcohol use
are not apparent. This may be related to the relative young age of most clients.
There were two unexpected findings about client characteristics. The first was the high
prevalence of acquired brain injury in the group. The Australian Institute of Health and
Welfare (1999) provides five Australian population estimates of the prevalence of ABI, of
Melbourne Criminological Research and Evaluation 58
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 59
which four are in the range 0.2% to 0.4%11. Bearing in mind that the CISP only
provided a screening assessment designed to identify persons with indicators of possi
ABI, around 9% of clients were in this category. Chapter 6 provides further information
on ABI status at the end of clients’ engagement with CIS
ble
P.
The second unexpected finding was the very low levels of self-reported well-being for
mental health. While the prevalence of mental health issues is relatively high compared
with the general population, their self-reported well-being is significantly below
community levels.
11 The report cites rates of 161, 240-290, 290, 400 and 1,696 per 100,000. The higher figure is based on a
population modelling approach and is for brain injury in general.
Evaluation of the Court Integrated Services Program: Final Report December 2009
Chapter 4 CISP service model
The CISP service model is complex. The program provides a wide range of services to
clients and the courts (assessment, referral, reporting, supervision, and direct support)
across a variety of service sectors (mental health, ABI, alcohol and drug, accommodation,
employment, social support) each of which has its own distinctive referral and service
delivery processes. Prior to the establishment of CISP court services were provided
through a number of specialised programs that were available in certain court venues.
These included CREDIT/Bail Support program, an Aboriginal Liaison Officer,
Disability Co-ordinator, and Mental Health Liaison Officers. The establishment of CISP
involved the integration of these service functions into the CISP teams, although mental
health liaison officers remained staff members of the Victorian Institute of Mental
Health.
In addition, service agreements were established with housing agencies as part of the
Justice Housing Support Program, with arbias for the provision of Acquired Brain Injury
assessment and support services, and with the Community Offenders Advice and
Treatment Service (COATS) for drug and alcohol assessment and referral services. The
relationships between CISP and service agencies are set out in protocols that specify the
staffing, financial and other responsibilities and obligations between the parties, and the
referral, communication ands reporting systems. For some service arrangements, service
agency staff members are located at CISP venues and deal directly with clients.
This chapter provides an overview of the CISP service model and examines:
The clinical and procedural basis of the model, and how this aligns with the goals
of the program;
Trends and patterns in the level of service activity (referrals and interventions);
Client feedback on the support provided to them;
Support systems for the service model (assessment processes, policy and
procedures manual, Platypus Systems Case Management System); and
Staffing issues associated with the service model
Chapters 5 to 7 provide more detailed analysis of service issues associated with drug and
alcohol services, mental health services and accommodation services respectively. The
Melbourne Criminological Research and Evaluation 60
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 61
material presented in these four chapters is based on interviews with staff members and
team leaders at all three program venues, interviews with clients exiting the program,
review of program documentation and assessment and referral data from the PSCMS.
4.1 Clinical and procedural basis of CISP
The primary features of the CISP service model are:
A multidisciplinary team-based approach;
Case managers carry out a range of assessment, compliance, reporting, support
and referral functions;
Clients are allocated to the three program levels based on their assessed risk12;
Once engaged, a client is the responsibility of a CISP case manager, but other
specialists may be consulted;
CISP provides a range of direct services, with drug, alcohol, ABI and
accommodation service interventions delivered by contracted service providers;
Additional services may be delivered by referral to external agencies, with
brokerage funds available to pay for a range of treatment and support services
including emergency accommodation, pharmacotherapy assessment or
treatment, and education or other programs.
Multidisciplinary team approach
The multi-disciplinary team approach is generally regarded by program staff as successful
in addressing the complex needs associated with the program’s clients. Workers valued
the capacity to consult with other staff members who have more specialized knowledge
in particular areas, and to be able to refer clients with particular service requirements to
mental health, arbias and housing workers who were on-site. Magistrates commented
favourable on the capacity to have defendants’ problems addressed directly and quickly,
and to have independent advice to the court on a range of complex problems. Much of
the interaction between team members is informal (one spoke of the approach as an “all
in together” model), and it is apparent that the level of interaction between case
managers is higher than that between case managers and workers from the contracted
12 The allocation of clients across program levels is detailed in chapter 2.
Evaluation of the Court Integrated Services Program: Final Report December 2009
service provider agencies, who often felt that they were in a “twilight zone between being
accepted as part of the CISP team and feeling like you were not part of it”.
It was acknowledged that the CISP model had developed substantially over the life of the
program, from its origins in the CREDIT/Bail Support Program. Several who had
worked on the CREDIT /Bail Support program prior to coming to CISP commented on
the advantages of the CISP model. However, the multi-disciplinary approach also poses
problems of adjustment for new team members, and in the administration of the
program. Some workers who had come from a service area where they had been in
specialized roles found it a challenge to adjust to the more varied demands of CISP. One
commented that “if you’re a disability specialist and you expect that your caseload will
consist solely of clients with disability issues, then that’s a shock.” Ideally, clients and
workers should be matched on the basis of the clients’ priority needs, but high workloads
meant that this was not always possible. The high prevalence of drug and alcohol
problems in the client group means that there is a correspondingly high demand for
workers with drug and alcohol skills. Those from other areas of specialisation noted that
they had to pick up drug and alcohol skills in order to be able to work effectively.
Workloads also impeded workers’ capacity to consult with their colleagues about clients’
problems, and a commonly expressed source of frustration was the inability to engage in
systematic case reviews for clients with more complex problems.
Weekly allocation meetings involve CISP team leaders, case managers and contracted
services were implemented in August 2009. The purpose of the meeting was to assist
with the equitable allocation of case load for staff and enhance a collaborative approach
to the management of clients. These meetings commenced in the very final stages of
this evaluation and we are therefore unable to offer any comment on their impact on
these issues.
Workers’ roles
CISP case managers’ work involves a wide variety of roles, including carrying out
assessments, reporting to the court, providing direct support to clients, supervision and
compliance management, and making referrals to contracted and other services. The role
of case manager therefore involves elements of clinical forensic practice in combination
with the compliance and reporting responsibilities of a court officer. From the beginning
Melbourne Criminological Research and Evaluation 62
Evaluation of the Court Integrated Services Program: Final Report December 2009
of the program there has been uncertainty on the part of CISP staff about how these
roles should come together. Staff members feel a responsibility to engage with clients
directly (a clinical or case manager role) but are also aware that this role is time-limited
and will ultimately involve the client moving on to a longer-term relationship with one or
more treatment or support agencies (a brokerage/advocacy role). A related issue is that
the client-worker relationship that is central to conventional clinical practice must also
take into account the responsibilities to the court that are inherent in the CISP case
management role.
Workers who had come to CISP from other service areas often found the legal aspects of
the program very challenging. The support of Magistrates was seen as fundamental to
the success of the program, but it was recognized that different Magistrates had quite
different expectations of the program, and that it took some time learn how to manage
and respond to these differences in approach. A related problem was that workers felt
that there was a lack of recognition of their expertise by other court professionals. In
particular, lawyers were inclined to challenge in court recommendations they didn’t like.
Typically this involved defendants who were assessed as unsuitable for the program, with
the result was that workers were required to justify their recommendations in the
adversarial environment of the court.
Staff turnover has been a significant problem in the operation of the CISP service model.
All those consulted in the course of this evaluation (staff members, Magistrates and
external stakeholders) commented on the high rate of staff turnover and its
consequences. These consequences included difficulties in establishing stable and
cohesive program teams, ongoing requirements for training of new staff, and increased
workloads on existing team members. External stakeholders referred to the problems
arising from dealing with staff members who were unfamiliar with court procedures or
the operations of external services.
Team leaders
The role of team leader is central to the effective operation of the CISP model, and both
workers and Magistrates commented on the difference that having an experienced team
leader made to the quality of the work. Given the high rate of staff turnover in CISP,
Melbourne Criminological Research and Evaluation 63
Evaluation of the Court Integrated Services Program: Final Report December 2009
team leaders have to devote a substantial amount of time to the training and
development of new staff, as well as carrying a 50% caseload. Team leaders are also the
primary point of communication between CISP and the other court professionals.
At the Latrobe Valley and Sunshine sites the line management for the CISP team is
through the Senior Registrar, but this role is mainly concerned with administrative issues
concerning the team and responsibility for clinical and case management issues rests with
the team leaders. While some CISP team leaders came into the role with substantial
experience, new team leaders find the role very challenging. While training has been
provided to team leaders in case management, assessment, leadership and staff
management, team leaders also report that direct observation and hands-on experience
are critical elements in the development of these skills.
Program venues
Some important variations are apparent in the way the three program venues operate.
Melbourne is distinguished from Sunshine and Latrobe Valley in that it is a much larger
and more complex court environment, with greater work pressure demand on workers
and more variation across Magistrates in their expectations about the program. In
contrast workers at Sunshine and Latrobe Valley have more direct knowledge of
Magistrates and other court staff. One significant variation between the sites is in the
way teams are managed. At Melbourne line management is through the Program
Manager, which at Sunshine and Latrobe Valley line management is through the Senior
Registrar. Both arrangements have their strengths but the existence of both
simultaneously gives rise to uncertainty about who is responsible for the various CISP
functions.
Geographical barriers to access by clients are an important issue for the Latrobe Valley
site. Many defendants at the Morwell Court come from communities where only limited
public transport access is available. The court also sits at other sites in Gippsland like
Korumburra, Wonthaggi and Bairnsdale where the program is not available. Some of
the referral services available to the program are also located in other communities in the
valley, and again this can mean that clients find it difficult to access these on a regular
basis.
Melbourne Criminological Research and Evaluation 64
Evaluation of the Court Integrated Services Program: Final Report December 2009
4.2 Referrals and interventions
A total of 3,661 referrals to treatment and support services were made in 2007 and this
increased by three-quarters to 6,371 referrals in 2008. This is equivalent to 3.3 referrals
per engaged client in 2007, and 5.1 referrals per engaged client in 2008. A large part of
this increase was in material aid, which accounted for just over a quarter of all referrals in
2007 but around one-third in 2008 (see Tables 5.1 and 5.2).
Referrals to selected services : 2007 and 2008
0
500
1000
1500
2000
2500
Drug and alcohol- COATS
Pharmacotherapy Mental health ABI - CISP Housing CISP Material aid Medical
Num
ber o
f ref
erra
ls
20072008
Figure 4.1 Referrals to selected services: 2007 and 2008
The volume of referrals increased across all categories. Referrals to contracted ABI
services doubled between 2007 and 2008, referrals to the contracted housing services
went up by 270%, and there was an increase of 464% in referrals to medical services.
Some of this increase reflects the increasing caseload across the program as well as delays
in getting contracted services established early in 2007. The COATS alcohol and drug
services program was available at courts prior to 2007, and there was no increase in the
average number of referrals per engaged client between 2007 and 2008. In contrast there
were only four referrals to arbias in the first three months of 2007, compared with 70 in
the next three months. Similarly, there was only one referral to the contracted
accommodation service at Sunshine in the first three months of 2007, but 18 in the next
three months when a SASHS worker was present.
Melbourne Criminological Research and Evaluation 65
Evaluation of the Court Integrated Services Program: Final Report December 2009
There are also some significant differences in referral patterns between the three program
venues. Sunshine makes relatively more referrals than Melbourne (4.4 referrals per client
in 2007 and 6.8 per client in 2008 compared with 2.5 and 4.2 at Melbourne in 207 and
2008 respectively) with Latrobe Valley falling between the two in its referral rate (4.2
referrals per client in 2007 and 4.3 in 2008). Again, much of the difference is accounted
for by variations in the use of material aid, which accounted for half of all referrals at
Sunshine in 2008. Latrobe Valley makes very few referrals for pharmacotherapy and
contracted housing services, but makes ABI referrals at a higher rate than the other
venues. These service specific differences are discussed in more detail in the following
chapters.
Melbourne Criminological Research and Evaluation 66
Evaluation of the Court Integrated Services Program: Final Report December 2009
Service Referrals in 2007
Latrobe Valley Melbourne Sunshine Total
N 211 960 580 1751 Drug and Alcohol - COATS
% 50.4% 58.4% 36.3% 47.8%
N 31 8 3 42 Drug and Alcohol - Non-
COATS % 7.4% .5% .2% 1.1%
N 0 101 200 301 Pharmacotherapy
% .0% 6.1% 12.5% 8.2%
N 40 59 16 115 Mental Health
% 9.5% 3.6% 1.0% 3.1%
N 40 69 42 151 ABI Services - CISP
% 9.5% 4.2% 2.6% 4.1%
N 2 0 1 3 ABI Services - Non-CISP
% .5% .0% .1% .1%
N 0 87 31 118 Housing - CISP HIR
% .0% 5.3% 1.9% 3.2%
N 4 23 0 27 Housing - Other
% 1.0% 1.4% .0% .7%
N 6 8 1 15 Disability Services
% 1.4% .5% .1% .4%
N 53 256 701 1010 Material Aid
% 12.6% 15.6% 43.9% 27.6%
N 10 18 6 34 Medical
% 2.4% 1.1% .4% .9%
N 18 30 9 57 Men's Behavioural Change
% 4.3% 1.8% .6% 1.6%
N 4 26 7 37 Other (inc. problem
gambling, vocational, family
services)
% 1.0% 1.6% .4% 1.0%
N 419 1645 1597 3661 Total
%
100.0% 100.0% 100.0% 100.0%
Table 4.1 CISP service referrals in 2007
Melbourne Criminological Research and Evaluation 67
Evaluation of the Court Integrated Services Program: Final Report December 2009
Service Referrals in 2008
Latrobe Valley Melbourne Sunshine Total
N 413 930 736 2079 Drug and Alcohol – COATS
% 50.7% 34.9% 25.5% 32.6%
N 2 32 20 54 Drug and Alcohol – Non-
COATS % .2% 1.2% .7% .8%
N 7 179 266 452 Pharmacotherapy
% .9% 6.7% 9.2% 7.1%
N 85 120 70 275 Mental Health
% 10.4% 4.5% 2.4% 4.3%
N 64 144 106 314 ABI Services - CISP
% 7.9% 5.4% 3.7% 4.9%
N 20 7 4 31 ABI Services – Non-CISP
% 2.5% .3% .1% .5%
N 7 219 104 330 Housing – CISP HIR
% .9% 8.2% 3.6% 5.2%
N 23 38 20 81 Housing – Other
% 2.8% 1.4% .7% 1.3%
N 1 19 4 24 Disability Services
% .1% .7% .1% .4%
N 116 603 1484 2203 Material Aid
% 14.2% 22.6% 51.3% 34.6%
N 11 113 34 158 Medical
% 1.3% 4.2% 1.2% 2.5%
N 30 50 7 87 Men’s Behavioural Change
% 3.7% 1.9% .2% 1.4%
N 36 212 35 283 Other (inc. problem
gambling, vocational, family
services)
% 4.4% 8.0% 1.2% 4.4%
N 815 2666 2890 6371 Total
% 100.0% 100.0% 100.0% 100.0% Table 4.2 CISP service referrals in 2008
Melbourne Criminological Research and Evaluation 68
Evaluation of the Court Integrated Services Program: Final Report December 2009
4.3 Client feedback
A small group of CISP clients were asked to participate in an interview about their first
hand experience of the program. Originally it was intended that a larger sample of CISP
clients who were about to finish the program would be asked to do the interview,
however logistically it was very difficult to arrange times to meet with clients before their
sentence hearing. Instead members of the evaluation team spoke with clients as they
came to the CISP office in MMC. In the interview clients were asked a set of questions
that were designed to help them reflect and evaluate their time on the program.
Question 1: Asked clients to indicate the main reason for referral to CISP:
Most clients interviewed said that they were referred to CISP to help them with issues
such as drug and alcohol addiction, homelessness, and mental health problems. A
couple of respondents identified that participating in the CISP program was likely to
improve their court outcome, and that this was their main reason for attending the
program.
Questions 2 &3: Asked clients whether they thought their access to treatment and support services
improved with being on CISP, and if so how much.
Eight of the nine respondents agreed that their access to services was improved by being
on CISP. Comments about accessing services were generally very positive. Of those
eight individuals who agreed that their access to services was enhanced by being on
CISP, six thought that their access was “a lot better”, and two thought that their access
was “slightly better”.
Question 4: Asked clients to report how CISP improved their access to services.
At least two respondents had difficulty answering this question, and didn’t provide a
response, for the individual who said their access wasn’t enhanced this question wasn’t
asked. The six individuals that did respond to this question made comments such as the
program: “put you in contact with the right people” or “I wouldn’t have known about
Melbourne Criminological Research and Evaluation 69
Evaluation of the Court Integrated Services Program: Final Report December 2009
[particular service]” or “Case managers explained the different services, type of
counselling, and which was suitable”.
Question 5 & 6: Asked clients to rate how satisfied they were with their individual case manager, and
what in particular they were satisfied or unsatisfied with.
All nine respondents said that they were “Very Satisfied” with their individual case
manager. Generally comments centred on the case managers’ high level of availability to
the individual, their empathy, support and knowledge of the court system.
Question 7: Asked clients to identify the most important aspect of support from CISP
Answers to this question depended to a large extent on the reasons that the individual
had been referred to CISP in the first place (e.g. drug and alcohol problems), however a
number of comments noted that having a sense of support, “loyalty”, “someone to talk
to” and “getting people to listen” were the most important aspects of their experience.
Question 8: Asked clients to identify any improvements that could be made to the service
Approximately half of the respondents could not think of any improvements. Some
improvements that were suggested include: Better communication between CISP and
legal aid; that the program was too short; that psychologists’ reports need to be able to be
integrated better into CISP reports; and being able to access and get referrals to primary
health care facilities.
Melbourne Criminological Research and Evaluation 70
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 71
4.4 Support systems
The CISP service model is supported by three elements of program infrastructure: a
policy and procedures manual, a referral and screening assessment process, and a client
records system (the Platypus Systems Case Management Systems – PSCMS). Each of
these systems was developed to support the specific features of the CISP program.
Policy and procedures manual
Work commenced on the CISP Policy and Procedures Manual in early 2007, but the
completed manual was not issued to staff in its final form until late 200813. The manual
set out the organisational arrangements for the program, eligibility requirements, case
management procedures, professional development arrangements and policies on a range
of matters including disclosure of information, records management, duty of care and
OH&S.
The manual is regarded highly by staff. Experienced staff members view the manual as a
source of detailed information that is relevant to the day to day demands of the work.
New staff members report that the information in the manual allows them to understand
the duties and procedures involved in their work, and get “up to speed” quickly. This
situation is contrasted with that before the manual was available when “we were flying by
the seat of our pants” and new staff had to be extensively briefed by existing staff on the
procedures involved in the program’s operations. A number of staff members suggested
additional material for inclusion in the manual, including advice on court procedures and
information about the management of blood-borne viruses.
Assessment process
Two assessment instruments were developed for CISP: a referral assessment with basic
details of defendants applying for entry to CISP, and a screening assessment to support
decisions about program engagement. The Referral Assessment is typically completed by
13 Draft versions of the manual were in circulation in 2007 and early 2008.
Evaluation of the Court Integrated Services Program: Final Report December 2009
the defendant or defendant’s solicitor, and the Screening Assessment is completed by the
case manager assigned to do the initial assessment. The Screening Assessment was the
subject of a detailed review in the first part of 2008 to determine whether it provides an
effective basis on which to assess and classify the risks associated with CISP clients. The
review was concerned with the following questions:
How well is the Screening Assessment being completed?
How frequently do the specific risks covered in the Screening Assessment occur?
Is the distribution of clients across risk categories appropriate?
Do the risk categories derived from the Screening Assessment align with the
CISP program levels of clients?
The review was conducted by selecting 40 cases from each of the three CISP program
venues and examining the Screening Assessment forms for each case. These cases were
selected on the following criteria:
The client was assigned to Level 2 or Level 3 of CISP, and
The assessment was completed after 30 June 2007.
The review found that:
The rate of completed data entry on Screening Assessment forms is high. For
most data items, information is recorded on around 95% of forms. There were a
few data items where recording rates were significantly lower (including
Indigenous status, whether receiving pharmacotherapy and indicators of ABI and
intellectual disability). The definitions and recording instructions associated with
these items were subsequently reviewed in consultation with CISP staff.
The specific risks in the Risk Assessment section all target risks that occur
frequently in the CISP client population and the distribution of the numbers of
risks across clients was appropriate. The sub-score sections of this part of the
assessment were not always completed, and the risk classification section is
completed in less than half of assessments. Where the risk assessment sections
of the form were not completed this was frequently in cases where the case
manager recommended or the court determined that the client was unsuitable for
CISP.
In cases where the risk classification section was competed, higher risk was
strongly related to more intensive program involvement, both as a
Melbourne Criminological Research and Evaluation 72
Evaluation of the Court Integrated Services Program: Final Report December 2009
recommendation and court outcome. Two risk items were identified as having
only a weak relationship with case outcome (problems with family relationships
and inability to cope with custody). It was recommended that these items be
removed from the form.
Following the 2008 review the Screening Assessment form was revised to improve clarity
and align the form more closely with the content and screen structure of the PSCMS. In
interview with staff during 2009 there was a generally positive view of the Screening
Assessment.
I quite like the assessment as it is – it’s quick and works well in the cells, with people who are
distressed or upset. It gives you the basics.
It gets the ball rolling, and then you can see where you should go after that, in a more relaxed
environment, after they’re on the program.
However, program staff also reported that assessment remains a difficult aspect of their
work. Around 60% of assessments are conducted while the defendant is in custody and
frequently when the defendant is distressed, anxious, suspicious or otherwise unable to
provide accurate information. They noted that assessment is frequently done under
considerable time pressure associated with the court process, and that this often takes
priority over and interferes with other aspects of their work.
Platypus Systems Case Management System
The Platypus Systems Case Management System (PSCMS) is used to manage client
records. The PCSMS records clients’ personal details, contacts with CISP, maintains an
assessment and referral history, keeps track of court dates, generates reminders for a
variety of events and produces a range of statistical reports on program activity. It is
supported by a detailed manual, and new staff members are trained in the use of the
system.
Staff members’ views about the system are mixed. While most agree that the system
provides ready access to client information and greatly assists in case management, there
are concerns about the amount of time required to input data into the system.
Melbourne Criminological Research and Evaluation 73
Evaluation of the Court Integrated Services Program: Final Report December 2009
4.5 Recommendations:
Recommendation: There should be a general review of clinical service approaches in the
courts, taking into account the CISP, CREDIT/Bail Support, Neighbourhood Justice
Centre, Drug Court, Family Violence Court and Koori Court services.
The CISP service delivery model is one of a range of clinical and support program
service approaches currently operating in Victorian courts. The other examples include
CREDIT/Bail Support, the Neighbourhood Justice Centre client services function, Drug
Court, Koori Court, and the applicant and defendant support functions for the Family
Violence Courts. Each is based on different assumptions and service models, and each
involves some specific skill sets. However, underpinning all these services is a general
body of clinical knowledge and technique and common case management, support and
other court-based functions. It is proposed that there should be a general review of
these approaches with a view to creating a court support services function that would
provide the basis for the delivery of a range of clinical, support, referral, supervision and
case management services to court clients.
Recommendation: The CISP Policy and Procedures Manual should be supplemented with
training and procedural advice on assessment procedures and working in a court
environment.
The material on assessment procedures should include more detailed information about
the clinical aspects of forensic practice, assessment criteria for the elements of the
Screening Assessment, and the interpretation and integration of assessment information
across multiple problem domains (especially substance abuse and mental health). The
development of more explicit eligibility criteria may also assist staff by making such
decisions more externally accountable.
The material on working in a court environment should include advice on court
processes, reporting in court, and the roles of other professional groups in the court
(especially lawyers and police) and the development and management of effective
relationships with them.
Melbourne Criminological Research and Evaluation 74
Evaluation of the Court Integrated Services Program: Final Report December 2009
Recommendation: The CISP Screening Assessment should be subject to regular review and
staff should receive feedback on the aggregated results of assessments.
It is important to maintain staff commitment to the structured assessment model for
CISP. Two strategies for this are regular reviews of the assessment process (every
second year) to ensure that the assessment content and procedures remain up to date and
consistent with work practices, and demonstrating the value of the collection of
assessment data through communication with staff about the results of assessments.
Melbourne Criminological Research and Evaluation 75
Evaluation of the Court Integrated Services Program: Final Report December 2009
Chapter 5 Drug and alcohol services
5.1 Provision of drug and alcohol services
The provision of drug and alcohol assessment, detoxification and treatment services is a
major component of the CISP service delivery model. Drug and alcohol service
arrangements are set out in a protocol between the Department of Human Services, the
Department of Justice and the Community Offenders Assessment and Treatment Service
(COATS). COATS provide drug and alcohol assessment services and a treatment
brokerage service. Under the brokerage model, COATS develops a treatment plan and
purchases treatment services from a range of community alcohol and drug treatment and
residential program providers for clients referred by Justice agencies including CISP.
Some CISP case managers are also accredited drug and alcohol clinicians and can make
assessments directly, and the COATS assessment service therefore supplements CISP in
this area. Some drug and alcohol services can also be provided outside the COATS
process, although this is usually only done as an interim measure while awaiting a
COATS assessment. CISP case managers can also arrange assessments for
pharmacotherapy through Directline, and where appropriate purchase pharmacotherapy
from general practitioners and pharmacies.
5.2 Drug and alcohol service needs of CISP clients
Drug and alcohol problems are highly prevalent in the CISP client group, with cannabis,
heroin and amphetamines the most commonly reported drugs. The prevalence of drug
problems varied across program venues, with the highest rates at Sunshine, followed by
Melbourne, and the lowest rates at Latrobe Valley. The service needs of clients are also
varied. A proportion of clients already have some involvement with a drug or alcohol
treatment program. For those assessed as having current drug use, around 40% had
some involvement in a drug program at the time of their entry to CISP, and 28% were
involved with some form of pharmacotherapy program (mainly methadone). Around
half of those with current pharmacotherapy recorded were also on a drug program.
While the proportion of clients with some drug program involvement was slightly higher
Melbourne Criminological Research and Evaluation 76
Evaluation of the Court Integrated Services Program: Final Report December 2009
at Latrobe Valley and lower at Sunshine, the proportion on pharmacotherapy shows a
substantially higher level of existing service involvement at Sunshine and a low level at
Latrobe Valley. This appears to be consistent with the greater severity of drug problems
at Sunshine (see Chapter 3).
Case location
Latrobe Valley Melbourne Sunshine Total
N 85 372 230 687 Drug program
involvement % 41.3% 38.6% 34.3% 37.3%
N 16 254 245 515 Current
pharmacotherapy % 7.8% 26.3% 36.5% 28.0%
N 206 964 671 1841 Total with current drug
use % 100.0% 100.0% 100.0% 100.0% Table 5.1 Drug program involvement for CISP clients
Case location Current alcohol
use level Latrobe Valley Melbourne Sunshine Total
N 7 25 5 37Abuse Alcohol
program
involvement
%
14.6% 11.0% 6.9% 10.6%
N 48 228 72 348Total with alcohol abuse
%
100.0% 100.0% 100.0% 100.0%
N 18 15 22 55Dependence Alcohol
program
involvement
%
21.4% 13.6% 13.2% 15.2%
N 84 110 167 361Total with alcohol dependence
% 100.0% 100.0% 100.0% 100.0%Table 5.2 Alcohol program involvement for CISP clients
For those assessed with alcohol dependence or abuse, between ten and fifteen percent
have some involvement with an alcohol program. For alcohol problems, there was a
higher likelihood that clients at the Latrobe Valley site had an existing involvement with a
treatment program than those at Melbourne or Sunshine.
Melbourne Criminological Research and Evaluation 77
Evaluation of the Court Integrated Services Program: Final Report December 2009
5.3 Service output measures
Referrals to COATS make up the largest single category of CISP program referrals.
There were 1,751 referrals to COATS in 2007 and 2,079 in 2008. Just over half the
referrals (53%) were for assessment, although where the client is assessed as requiring
some form of program intervention this is likely to result in referral to a detoxification,
treatment or support program. A typical CISP case where there were four referrals for
drug-related issues included: assessment by COATS, pharmacotherapy, and referral to
the Counselling, Consultancy and Continuing Care treatment program while awaiting a
place in a residential rehabilitation program. Taking into account all referrals to COATS
in the period January 2007 to March 2009, 30% of cases were referred for one service
(usually assessment), around half of cases were referred for two services, and 15% were
referred for three or more services (Table 5.3).
Number of referrals
Number of cases % of cases
More than 5 12 0.4% 5 28 0.9% 4 93 2.9% 3 341 10.6% 2 1803 55.9% 1 947 29.4%
Total cases 3224 100.0% Table 5.3 Number of COATS referrals per case (2007 – 2009)
COATS Assessments comprised a little over half of all referrals, and referrals to the
Counselling, Consultancy and Continuing Care (Four-Cs) treatment program made up a
further one-third of COATS services. About one in twenty clients were referred for drug
withdrawal, and small numbers were directed to residential and youth drug programs.
These referral patterns were stable over the two years 2007 and 2008, and there were few
differences between the three program sites other than a higher rate of drug withdrawal
services at Latrobe Valley (Table 5.4).
Melbourne Criminological Research and Evaluation 78
Evaluation of the Court Integrated Services Program: Final Report December 2009
Case location
Latrobe Valley Melbourne Sunshine Total
Drug and alcohol
assessment
94 (44.5%) 520
(54.2%)
330
(56.9%)
944 (53.9%)
Counselling, Consultancy
and Continuing Care
62 (29.4%) 363
(37.8%)
216
(37.2%)
641 (36.6%)
Drug Withdrawal 40 (19.0%) 39 (4.0%) 25 (4.3%) 104 (5.9%)
Residential Rehabilitation 7 (3.3%) 24 (2.5%) 3 (0.5%) 34 (1.9%)
Youth drug and alcohol
programs
7 (3.3%) 10 (1.0%) 4 (0.6%) 21 (1.2%)
Koori alcohol and drug
services
0 (0.0%) 1 (0.1%) 0 (0.0%) 1 (0.0%)
Supported Accommodation 0 (0.0%) 2 (0.2%) 2 (0.3%) 4 (0.2%)
2007
Total 211
(100.0%)
960
(100.0%)
580
(100.0%)
1751
(100.0%)
Drug and alcohol
assessment
188 (45.5%) 589
(63.3%)
408
(55.4%)
1185
(57.0%)
Counselling, Consultancy
and Continuing Care
156 (37.8%) 304
(32.7%)
288
(39.1%)
725 (34.9%)
Drug Withdrawal 47 (11.4%) 23 (2.5%) 22 (3.0%) 92 (4.4%)
Residential Rehabilitation 14 (3.4%) 11 (1.2%) 6 (0.8%) 31 (1.5%)
Youth drug and alcohol
programs
3 (0.7%) 2 (0.2%) 6 (0.8%) 11 (0.5%)
Supported Accommodation 1 (0.2%) 0 (0.0%) 5 (0.7%) 6 (0.3%)
Koori alcohol and drug
services
2 (0.4%) 1 (0.1%) 1 (0.1%) 4 (0.2%)
2008
Total 413
(100.0%)
930
(100.0%)
736
(100.0%)
2079
(100.0%) Table 5.4 Referrals to COATS drug and alcohol services: 2007 and 2008
CISP case managers can also make referrals to non-COATS drug and alcohol programs.
There were 42 such referrals in 2007 (of which 31 were made at the Latrobe Valley
venue) and 54 in 2008. These non-COATS referrals include a relatively higher
proportion (around 15%) of referrals to residential programs.
Melbourne Criminological Research and Evaluation 79
Evaluation of the Court Integrated Services Program: Final Report December 2009
Pharmacotherapy is also an important form of service response for clients with drug
problems. Frequently CISP referrals support a pre-existing treatment arrangement.
There were 301 pharmacotherapy referrals in 2007 and 452 in 2008, the majority for
methadone therapy (Figure 6.1). As might be expected from the higher rate of pre-CISP
involvement in pharmacotherapy at Sunshine (see above), the rate of referrals for
pharmacotherapy were higher at this venue. Two-thirds of all pharmacotherapy referrals
in 2007, and 60% of those made in 2008, were from Sunshine.
Referrals to pharmacotherapy: 2007 and 2008
0
50
100
150
200
250
300
350
Buprenorphine Methadone Naltrexone Suboxone Other
Figure 5.1 Pharmacotherapy referrals by program type: 2007 and 2008.
5.4 Change in drug and alcohol problems during CISP
engagement
The status of CISP clients’ drug and alcohol problems is recorded at program entry, and
again at program exit. In the case of alcohol problems, this assessment is made on the
same basis: an overall assessment is made as to whether the client’s alcohol use
constitutes use, abuse, or dependence. Table 5.5 shows the distribution of alcohol status
at program entry and exit for clients who successfully completed CISP. These data
Melbourne Criminological Research and Evaluation 80
Evaluation of the Court Integrated Services Program: Final Report December 2009
appear to show a dramatic reduction in the proportion with problems of alcohol abuse or
dependence, with almost all those assessed with problems of this severity no longer
having these problems at exit. In the case of clients’ drug use the pre- and post-program
comparison is more complex because clients are assessed at entry in relation to each drug
that they report using, while at exit only an overall assessment of their drug use is
provided.
However, these data represent case managers’ assessments of clients’ progress and need
to be viewed with caution. The majority of drug and alcohol treatment interventions
provided to clients are through the COATS brokerage program, and there is no
provision for post-program assessment results to be reported back to CISP. Many
clients will not have completed their treatment programs by the time they exit CISP, and
for some, treatment will continue under court order. Another problem is that post-
CISP outcomes are only known for those clients who complete the program. It seems
likely that those who fail to attend or continue to offend are also those who do not make
progress in addressing their drug and alcohol problems.
Entry Exit Assessed alcohol problem status
Number of
cases
% Number of
cases
%
Use 179 33.0 183 33.7
Abuse 158 29.1 33 6.1
Dependence 196 36.1 43 7.9
None 10 1.8 244 44.9
Unknown 40 7.4
Total 543 100.0 543 100.0 Table 5.5 Assessed alcohol problem status
5.5 Relationship between CISP and drug and alcohol agencies
The evaluation team met with the COATS and four drug and alcohol agencies that
provide services to CISP (Odyssey House, Anglicare, DASWest and Latrobe Community
Melbourne Criminological Research and Evaluation 81
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 82
Health14). CISP case managers were also asked about their relationships with agencies.
Drug and alcohol services to justice clients were well-established prior to CISP, and all
the agencies consulted receive justice clients from a variety of sources in the justice
system. CISP clients represent a small component in the overall stream of justice clients
who go through COATS and the service agencies, and their relationship with CISP is
seen in the context of this wider relationship. A comment that was made to the
evaluation team on a number of occasions was that most drug and alcohol clients have
histories that include involvement with the justice system. The various justice referral
processes thus constitute pathways into treatment rather than attributes of a client that
are important in terms of the services and supports that are offered to them. Clinical
issues (treatment readiness, severity of drug or alcohol problems) and support issues
(accommodation, family support and financial status) are much more important
considerations, and much of the feedback from drug and alcohol agencies concerned
how justice processes generally bore on these factors.
The main issues identified through consultation with drug and alcohol agencies were:
Clients are frequently referred from the justice system because their drug and
alcohol issues constitute a justice problem, rather than because they are ready and
motivated for treatment. While there is acknowledgement that the threat of
justice outcomes can be important in generating motivation, a genuine personal
commitment to change is more important. The “punitive” approach of justice
programs is considered to be inconsistent with the harm-minimization approach
of most treatment programs;
The main perceived advantage of the CISP model is that clients also receive the
social and material support that assists them to engage with drug and alcohol
treatment;
Availability of treatment places is an important constraint. This is particularly
acute for residential programs where there can be lengthy waiting periods for a
program place;
Clients who have both substance abuse and mental health problems are
particularly difficult to deal with. Agencies expect that CISP case mangers will
make appropriate clinical decisions about whether a client is able to engage with a
14 Latrobe Community Health is also a provider of mental health and ABI services.
Evaluation of the Court Integrated Services Program: Final Report December 2009
drug or alcohol program. However it is acknowledged that this is a complex
issue to determine that requires clinical experience with drug, alcohol and mental
health issues;
Generally, day to day relationships between agency workers and CISP case
managers are good, although all but one agency reported examples of poor
communication or inadequate knowledge of policies and procedures specified in
the protocols on the part of CISP staff. Frequently this was ascribed to CISP
staff being inexperienced;
There is relatively little information about clients exchanged with COATS. The
brokerage model means that direct contact should be between CISP case
managers and treatment agencies.
5.6 Recommendations
Drug and alcohol services are the most well-developed services component of the CISP
model. The COATS brokerage model provides a broad-based assessment and treatment
referral process, and draws on a range of community –based service providers with
substantial experience in the delivery of treatment and related programs.
Recommendation: CISP program goals for drugs and alcohol should be concerned with
effectiveness of the referral process and maintaining clients’ engagement with treatment
programs.
Improved drug and alcohol outcomes are part of the CISP goal set, however it seems
inappropriate to hold the program responsible for treatment goals that are beyond its
direct control. The key service delivery issues for CISP are how effectively it operates as
a referral pathway and case management service. The indicators of success in this area
should be whether drug and alcohol program referrals are based on a comprehensive
assessment of clients’ risks and needs, and whether clients are provided with the support
and supervision that ensures they satisfy the attendance requirements for drug and
alcohol services.
Melbourne Criminological Research and Evaluation 83
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 84
Chapter 6 Mental Health and Acquired Brain
Injury Services
6.1 Provision of mental health and ABI services
Court-based mental health assessment and advice services are provided by the Victorian
Institute of Mental Health (Forensicare). A full-time mental health clinician is present at
Melbourne Magistrates’ Court and Sunshine. Forensic mental health assessments at the
Latrobe Valley venue are provided by the Latrobe Valley Community Mental Health
Service which has a staff member at the court for around 2.5 days per week. Mental
health clinicians are not part of the CISP multi-disciplinary team, but are co-located with
the team members at Melbourne and Sunshine, and in practice there is a great deal of
day-to-day contact between them.
Direct case management and secondary consultation services for defendants with
Acquired Brain Injury are provided by staff from the Alcohol Related Brain Injury
Australian Service (arbias) who are attached to the CISP teams15. This service comprises
1.5 EFT positions at Melbourne, 1.0 EFT at Sunshine and 0.5 EFT at Latrobe Valley. In
addition, the protocol with arbias provides for two pro-bono full neuropsychological
assessments each month for CISP clients. CISP case managers can also use brokerage
funds for additional neuropsychological assessments by arbias or appropriately qualified
clinicians.
6.2 Mental health service outputs for CISP clients
Around 35% of CISP clients are identified as having some form of mental health
problem, and of these around 40% are currently receiving treatment. Around one in
eight clients (12.7%) with an identified mental health problem had never received
treatment, had been assessed but not treated, or were currently being assessed. Case 15 Some CISP case managers are also undertaking training in ABI screening.
Evaluation of the Court Integrated Services Program: Final Report December 2009
managers made 115 referrals for mental health services in 2007, and 275 referrals in 2008.
Unlike drug and alcohol referrals, most clients (87%) were referred for only one mental
health service. The rate of referrals therefore represents one referral for every ten
engaged clients in 2007, and one referral for every five engaged clients in 2008. There
were large variations in the patterns of mental health service referrals between 2007 and
2008. In 2007, the largest number of referrals was for counselling services (41.7%),
followed by referrals to the Area Mental Health Service (29.6%). However, in 2008 the
largest group of referrals was to psychologists (including psychological assessment),
accounting for 36.4% of referrals, followed by general practitioner referrals (18.9%). The
number of Area Mental Health referrals was about the same across the two years, but fell
as a proportion with the large rise in total mental health referrals in 2008.
There were also significant variations in the rate of mental health referrals across the
three program venues. Latrobe Valley made mental health referrals at a much high rate
than the other two program sites. In 2007, there were 40 referrals across 100 engaged
clients at this site, compared with 59 across 654 engaged clients at Melbourne in the same
year. The pattern in 2008 was similar. This may relate to the problems in accessing the
mental health court service at Latrobe Valley (see below) and the consequent use of
external referrals to address this need.
Assessing the change in clients’ status during their engagement with CISP is problematic.
For those who were identified as having mental health issues at program entry, around
half were recorded as also having issues at exit. In contrast, for those who weren’t
identified as having mental health issues at entry, 80% were also identified as not having
them at exit, while nine percent not identified at entry were recorded as having issues at
exit. However, it needs to be borne in mind that the CISP assessment is not a clinical
assessment, and the change in status from entry to exit may represent better knowledge
about clients’ mental health status rather than some change in condition for better or
worse. Given the relatively short period of engagement with CISP, it seems
unreasonable to expect any significant change in anything other than relatively minor
mental health problems.
Melbourne Criminological Research and Evaluation 85
Evaluation of the Court Integrated Services Program: Final Report December 2009
Case location
Latrobe Valley Melbourne Sunshine Total
N 18 26 4 48 Counselling
% 45.0% 44.1% 25.0% 41.7%
N 18 8 8 34 Area Mental Health Service
% 45.0% 13.6% 50.0% 29.6%
N 0 8 1 9 General Practitioner
% .0% 13.6% 6.2% 7.8%
N 0 4 0 4 Psychiatrist
% .0% 6.8% .0% 3.5%
N 2 10 2 14 Psychologist
% 5.0% 16.9% 12.5% 12.2%
N 2 3 1 6 Psychological Assessment
5.0% 5.1% 6.2% 5.2%
N 40 59 16 115
2007
Total
%
100.0% 100.0% 100.0% 100.0%
N 8 16 5 29 Counselling
% 9.4% 13.3% 7.1% 10.5%
N 15 10 7 32 Area Mental Health Service
% 17.6% 8.3% 10.0% 11.6%
N 4 24 24 52 General Practitioner
% 4.7% 20.0% 34.3% 18.9%
N 4 9 1 14 Psychiatrist
% 4.7% 7.5% 1.4% 5.1%
N 6 38 11 55 Psychologist
% 7.1% 31.7% 15.7% 20.0%
N 11 8 15 34 Forensicare
% 12.9% 6.7% 21.4% 12.4%
N 2 7 5 14 Psychiatric Assessment
% 2.4% 5.8% 7.1% 5.1%
N 35 8 2 45 Psychological Assessment
% 41.2% 6.7% 2.9% 16.4%
N 85 120 70 275
2008
Total
%
100.0% 100.0% 100.0% 100.0%
Table 6.1 Referrals for mental health services
Melbourne Criminological Research and Evaluation 86
Evaluation of the Court Integrated Services Program: Final Report December 2009
Mental health issues at CISP exit Mental Health issues indicated at CISP entry
Yes No Unknown Total
N 219 142 61 422 Yes
% 51.9% 33.6% 14.5% 100.0%
N 55 512 62 629 No
% 8.7% 81.4% 9.9% 100.0%
N 23 49 23 95 Unknown
% 24.2% 51.6% 24.2% 100.0%
N 297 703 146 1146 Total
% 25.9% 61.3% 12.7% 100.0% Table 6.2 Mental health issues at CISP entry and exit
6.3 Service relationships for mental health
The service relationships around mental health are complex in that Forensicare court
staff can take referrals from CISP but can also take referrals direct from defendants’
lawyers. The Forensicare criteria for taking on a case are essentially the presence or
suspected presence of a major mental illness, while CISP may also record other forms of
mental disorder (like personality disorders, anxiety or depression) as a mental health
issue. Thus, the mental health clinicians are part of the CISP team but also work
independently (the Melbourne clinician estimated that the bulk of his work came directly
rather than through CISP), and not all mental health issues can be referred through them.
This process appears to work well in two locations (Melbourne and Sunshine). The
mental health clinician provides a secondary consulting service for cases that fall outside
the Forensicare eligibility criteria and there appear to be close and productive working
relationships with the CISP team members. This is not the case at Latrobe Valley, where
a clinician is only present on a part-time basis and there is little contact on a day-to-day
basis with the CISP team. It was reported that there was little referral to this service
from the court.
A major problem with court mental health services is that difficulty in organizing referral
to area mental health services. It was reported that these services were reluctant to take
referrals of any clients who were not in crisis, and that CISP team members generally
Melbourne Criminological Research and Evaluation 87
Evaluation of the Court Integrated Services Program: Final Report December 2009
were required to organize a psychiatrists’ assessment before area mental health services
would agree to take a referral. The lack of a specialist response for borderline and anti-
social personality disorders was also acknowledged as a gap in this system, as these clients
are likely to re-offend but have little access to community-based treatment services.
6.4 ABI service outputs for CISP clients
One of the unexpected results of the CISP was the high rate of apparent ABI in the
client group. Around one in ten engaged clients were identified at screening as having
indicators of ABI, with a much higher identification rate at Latrobe Valley than the other
two venues. The result was that there was a high level of demand for arbias assessment
services. In 2007 there were 122 screening assessment conducted and 29 full
neuropsychological assessments, and in 2008 the level of ABI assessment activity
doubled to 247 screening assessments and 59 neuropsychological assessments. The
increase in demand for ABI assessment services is also reflected in the use of non-arbias
services. In 2007 there were three referrals for non-arbias assessments, but in 2008 this
had increased 30. The relatively high level of identified cases at Latrobe Valley is not
reflected in the rate of referrals for assessments which are more or less proportionate to
caseloads, especially in 2008.
For those who were identified as potential ABI cases at CISP entry, around one-third
were recorded as having this status at exit. However, there were also significant numbers
of cases recorded as unknown or not-ABI at entry that had ABI status recorded at exit.
At least some of the unknown cases at exit may also ultimately be determined to have
ABI. In the middle stages of this evaluation there were long waiting times for full
neuropsychological assessments, however by late 2008 additional assessment resources
had been organized and delays had been reduced to around four weeks. Demand for
ABI assessments is likely to remain an issue in the management of CISP.
Melbourne Criminological Research and Evaluation 88
Evaluation of the Court Integrated Services Program: Final Report December 2009
Case location ABI assessments
Latrobe Valley Melbourne Sunshine Total
N 16 12 1 29 Neuropsychological
Assessment % 40.0% 17.4% 2.4% 19.2%
N 24 57 41 122 Screening Assessment
% 60.0% 82.6% 97.6% 80.8%
N 40 69 42 151
2007
Total
%
100.0% 100.0% 100.0% 100.0%
N 6 29 27 59 Neuropsychological
Assessment % 9.4% 20.1% 25.5% 18.8%
N 57 112 78 247 Screening Assessment
% 89.1% 77.8% 73.6% 78.7%
N 1 3 1 5 Case Management (Internal)
% 1.6% 2.1% .9% 1.6%
N 64 144 106 314
2008
Total
%
100.0% 100.0% 100.0% 100.0%
Table 6.3 Referrals for arbias assessments
Acquired brain injury at CISP exit Acquired Brain Injury indicated at CISP entry
Yes No Unclear Total
N 36 30 36 102 Yes
%
35.3% 29.4% 35.3% 100.0%
N 12 730 54 796 No
%
1.5% 91.7% 6.8% 100.0%
N 32 112 103 247 Unknown
%
13.0% 45.3% 41.7% 100.0%
N 80 872 193 1145 Total
%
7.0% 76.2% 16.9% 100.0%
Table 6.4 ABI at CISP entry and exit
Melbourne Criminological Research and Evaluation 89
Evaluation of the Court Integrated Services Program: Final Report December 2009
6.5 Service relationships for ABI
The service relationship for ABI is simpler in that arbias workers are placed with the
CISP teams and virtually all of their work is the result of referrals from CISP case
managers. The arbias team has also experienced a fairly high rate of staff turnover, and
at some venues no specialist ABI worker has been available at times. The most
problematic issue for ABI services is the volume of referral and assessment work
generated by CISP. As noted earlier, the number of neuropsychological assessments
referred greatly exceeds the number that was anticipated in the planning for CISP, and
one consequence was that waiting times for full assessments increased. It was reported
that during late 2007 and early 2008 there were waiting times of six to eight months for
full assessments, which greatly exceeds the period of time clients are likely to be on CISP.
This problem has now been resolved. The problem of demand for ABI assessments is
exacerbated by the uneven distribution of referrals in relation to the allocation of arbias
staff. The CISP team at Melbourne refers relatively fewer cases to arbias staff than
those at Sunshine or Latrobe Valley, but Melbourne has the largest arbias staff allocation.
In this kind of situation it is important that initial screening of clients of clients is as
effective as possible, that communication between workers is clear, and that protocols
are followed. All of these issues have been sources of dissatisfaction for arbias, although
there have been steps taken in 2008 to address these problems through staff training.
6.6 Recommendations
While there are specific issues with the delivery of ABI services to CISP clients, it seems
unlikely that they can be resolved without some more general strategy to address the
needs of ABI clients in the justice system. This should include training of CISP staff in
the management of ABI cases, but should also take into account the need to provide
long-term outreach services for those clients.
Melbourne Criminological Research and Evaluation 90
Evaluation of the Court Integrated Services Program: Final Report December 2009
Recommendation 8: Review the provision of services to justice system clients
with suspected Acquired Brain Injury
The rate of suspected Acquired Brain Injury in program clients is much higher than
allowed for in the demand modelling for CISP. This points to a high rate of ABI in
justice client populations generally, and indicates that a comprehensive strategy to
address this issue is required. While arbias and other ABI service providers offer a high-
quality assessment and service response for these defendants, the timescales involved are
longer than can be accommodated in a pre-trial program. CISP case managers should
receive additional advice on the management of such cases while awaiting full
neuropsychological assessment process. There should also be consideration of the
continuing management of these clients as they progress through other stages of the
justice system.
Melbourne Criminological Research and Evaluation 91
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 92
Chapter 7 Accommodation support services
7.1 Provision of housing services
The Justice Housing Support Program (JHSP) is a collaborative project between the
Homelessness Assistance Unit of the Office of Housing, Department of Human Services
under the Victorian Homelessness Strategy, the Department of Justice, Magistrates’
Court of Victoria and the Neighbourhood Justice Centre. The program was established
to provide clients in the justice system with transitional housing, referrals and links to
support services in the short-term, and secure permanent housing in the longer term.
Housing services are provided to the CISP program through HomeGround Services at
Melbourne, the Salvation Army Social Housing Services (SASHS) at Sunshine16, and
Quantum Support Services (QSS) at the Latrobe Valley venue.
The arrangements for the provision of housing advice and referral services to CISP are
set out in the JHSP Inter-agency Protocols, issued in June 2008. This protocol covers
the full range of JHSP services to the CREDIT/BSP, CISP and Neighbourhood Justice
Centre programs, as well as other venues of the Magistrates’ Court of Victoria. The
protocol specifies the roles and responsibilities of co-ordinators and workers from the
participating agencies, collaborative work protocols, data collection and reporting
arrangement and grievance procedures. The primary relationship between CISP and the
JHSP agencies is through the Housing Information & Referral workers. A
HomeGround worker is present at Melbourne four days a week, and a SASHS worker is
on-site at Sunshine Court, also for four days each week. Quantum Social Services is
mainly used on a referral basis at the Latrobe Valley venue.
The JHSP funding and service agreement sets a target of a total of 55 Transitional
Housing Properties (THM) available to justice clients, including 18 properties available
through the Melbourne and Sunshine venues and two properties available to clients at
the Latrobe Valley venue. Not all properties covered by the JHSP are available at any 16 Note that SASHS is the referring agency at Sunshine but support services are provided by
HomeGround.
Evaluation of the Court Integrated Services Program: Final Report December 2009
time, as a result of delays in acquisition, turnover in properties, or repairs or
refurbishment of properties. In June 2008, a total of 38 properties were available to the
JHSP, including ten to CISP at Melbourne and Sunshine and two to CISP Latrobe Valley
and by June 2009 this had increased to 45 properties.
In addition to placing clients in properties where CISP has nomination rights, the JHSP
agencies can place clients in temporary accommodation, assist in preparing applications
for public housing, and provide case management and support on housing-related issues.
The preparation of housing applications involves compiling a detailed account of a
client’s case history, and this in turn may require access to information from the client’s
file to support the application. Where clients are referred through CISP but continue to
require housing support after they exit this program, case management responsibility may
be transferred to the housing support agency.
7.2 Housing service needs of CISP clients
Improving access to stable housing is an important element in the CISP service delivery
model. While poor or unstable housing does not directly cause crime, it is a critical
factor in achieving other program outcomes. Defendants who are homeless or in
emergency accommodation have a higher risk of non-compliance with bail, are more
likely to be remanded in custody, less likely to attend treatment programs and have
poorer outcomes from treatment and support interventions (Baldry, McDonnell,
Maplestone, & Peeters, 2003). The housing services component of CISP is specifically
targeted at improving outcomes for clients who are homeless or in emergency
accommodation, and forms part of the Justice Housing Support Program. Six percent of
CISP engaged clients were assessed as homeless in 2007 and 2008, a further nine percent
were in emergency or transitory accommodation, and 12% were in boarding house or
other short-term rental accommodation (Table 7.1). In total, over a quarter of all
engaged clients were in unstable accommodation when they were assessed for entry to
CISP. Overall, housing issues are most prevalent in clients at Melbourne, with little
difference between Sunshine and Latrobe Valley.
Melbourne Criminological Research and Evaluation 93
Evaluation of the Court Integrated Services Program: Final Report December 2009
Case location Accommodation stability at entry Latrobe Valley Melbourne Sunshine Total
N 25 107 122 254 Owned or buying
% 8.6% 8.4% 15.4% 10.8%
N 171 540 394 1105 Long-term public or private
rental % 58.8% 42.4% 49.7% 46.9%
N 29 147 90 266 Living with family
% 10.0% 11.5% 11.3% 11.3%
N 31 195 66 292 Boarding house or short-
term rental % 10.7% 15.3% 8.3% 12.4%
N 18 147 54 219 Emergency or transitory
% 6.2% 11.5% 6.8% 9.3%
N 15 76 45 136 Homeless
% 5.2% 6.0% 5.7% 5.8%
N 0 14 1 15 Supported accommodation
% .0% 1.1% .1% .6%
N 2 47 21 70 Unknown
% .7% 3.7% 2.6% 3.0%
N 291 1273 793 2357 Total
% 100.0% 100.0% 100.0% 100.0% Table 7.1 Accommodation stability of CISP clients at program entry
7.3 Service output measures
The JHSP reports on a quarterly and annual basis against a number of performance
criteria, and these reports provide summary data for each of the CISP venues. The
following service measures are drawn from the 2007/08 report which covers the period
February 2007 to February 2008, although some activity measures up to March or May
2008 are reported.
The HIR service at the Melbourne Magistrates Court saw 293 clients between
February 2007 to March 2008 for a total of 822 contacts (an average of 2.8
contacts per client) and has submitted a total of 120 housing applications
The HIR service at Sunshine Court recorded a total of 511 contacts between
August 2007 and May 2008. These resulted in 26 completed Segment 3
applications, with 12 submitted for approval and the remainder on hold awaiting
further documentation or contact from the client. Twelve Segment 1
applications were commenced with 2 submitted for endorsement.
Melbourne Criminological Research and Evaluation 94
Evaluation of the Court Integrated Services Program: Final Report December 2009
At the Latrobe Valley venue, QSS reported five clients successfully housed out of
a total of six referrals. In total, three Clients have exited from transitional
properties and both properties were occupied as of February 2008.
Referrals made by CISP staff to the JHSP services are also recorded on the CMS, as are
other housing-related referrals (mainly referrals to emergency or temporary
accommodation). In the 2008 year there were 324 cases where a CISP HIR referral was
recorded, of which 215 were made at Melbourne, 102 at Sunshine and only seven at
Latrobe Valley. In addition, there were 79 referrals to other housing services, of which
37 were from Melbourne, 20 from Sunshine and 22 from Latrobe valley. Direct
comparison between these two sources is difficult as they are based on different time
periods and may use different ways of counting service activity. If the referrals counts
from the CMS are expressed as a proportion of the number of engaged clients at each
venue in 2008, it can be seen that the likelihood that clients will be referred to the CISP
HIR is greatest at Melbourne but that relatively few Latrobe Valley clients receive this
form of referral, and this appears to be consistent with the general patterns of activity
reported by the JHSP.
An important limiting factor on access to THM properties by CISP clients is that the
average period of tenancy for clients in the JHSP is around 35 to 40 weeks. As a result,
vacancy rates are low and the ratio of referrals to property vacancies in the JHSP is
around four times. JHSP reporting shows that 28 CISP clients were housed in the period
to December 2008, of whom 19 were allocated to properties in 2008. The average length
of tenancy so far is around 60 weeks, and since only three CISP clients have exited JHSP
properties to date it is inevitable that the actual length of stay will be much greater. This
problem is particularly serious where the number of properties is small, as in the Latrobe
Valley. Two CISP clients who were referred in mid-2008 and exited CISP in December
2008 were still in the properties 50 weeks after entry. As a result, there is effectively no
access to JHSP properties for clients at this venue. It also seems likely that relatively few
new CISP clients will be able to enter the JHSP in 2009.
Melbourne Criminological Research and Evaluation 95
Evaluation of the Court Integrated Services Program: Final Report December 2009
Proportion of engaged clients referred to housing services
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
Melbourne Sunshine Latrobe Valley
Clients referred to CISP HIR
Clients referred to otherhousing
Figure 7.1 Proportion of engaged clients referred to housing services
CISP clients’ accommodation status is recorded at their initial assessment, and again
when they exit the program. Table 7.2 shows accommodation status at entry and exit for
those clients who exited CISP after having successfully completed the program. The
aggregate number of clients who were homeless fell from 42 to 12 over this period,
although this is slightly misleading as only four of the 42 who were recorded as homeless
at program entry were still homeless at exit, while another eight who were not homeless
when they entered the program had become homeless by the time they exited. Of those
who had been homeless, around a third were in emergency or transitory accommodation
at exit, and 20% were each in long-term rental, supported accommodation and boarding
house or short-term rental.
However, there was no change between entry and exit in the aggregate number recorded
as in emergency or transitory accommodation, and only a small reduction in those in
boarding house or short-term accommodation. The number who were in the owned or
buying category fell by a third - most of these clients moved to long-term rental or
residing with family status. Again, it should be noted that these are aggregate changes
and there was substantial movement within these groups.
Melbourne Criminological Research and Evaluation 96
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 97
Status at entry Status at exit Accommodation status
Frequency Percent Frequency Percent
Owned or buying 149 12.4 99 8.2
Long-term rental 607 50.5 667 55.5
Residing with family 119 9.9 153 12.7
Supported accommodation 8 .7 23 1.9
Boarding house or short-
term rental
144 12.0 126 10.5
Emergency or transitory 100 8.3 100 8.3
Homeless 46 3.8 12 1.0
Unknown 27 2.2 21 1.7
Total 1201 100.0 1201 100.0 Table 7.2 Accommodation status at CISP entry and exit
7.4 Relationship between CISP and housing agencies
While both the JHSP and CISP recognize the importance of dealing with housing issues,
each program has different priorities and each works under different constraints. The
priority for the JHSP is to tackle the problem of homelessness in the population of
justice clients. The screening process for JHSP services is primarily concerned with risks
and needs relating to homelessness17 and the goal of their interventions is to provide
long-term stable accommodation. It is accepted that this is likely to require long-term
engagement with clients, partly because the application and placement process for public
housing takes a long time, and that this engagement should continue until a satisfactory
outcome is achieved. In contrast, CISP is concerned with accommodation as a means to
an end – achieving better bail outcomes and allowing clients to engage in other forms of
treatment. The process of CISP engagement is driven by the timelines imposed by the
court, and the process of engagement is time-limited. When a client exits CISP the case
manager’s involvement ceases whether or not the person’s housing issues have been
resolved.
17 See Appendix A in JHSP protocol
Evaluation of the Court Integrated Services Program: Final Report December 2009
These distinctly different views are reflected in the feedback about the relationships
between case workers on each program. A common theme in our interviews was that
workers reported that the other party didn’t adequately understand the capacities and
limitations associated with their role. For example, one housing worker reported that a
problem with working with CISP was that “referrals are made based on the clients’ need
to receive bail rather than their actual need for housing”. Conversely, there were
concerns expressed by CISP workers that the JHSP properties were “permanently
occupied”, that housing workers were mainly concerned with clients’ long-term needs at
the expense of short-term issues that were more directly relevant to case management in
CISP, and that as a result the program was of relatively minor significance for CISP.
The time pressure of work was also a source of dissatisfaction, with some housing
workers arguing that up to two weeks were required to make a full assessment of CISP
clients’ housing needs, while CISP workers wanted a response within days. Another
source of dissatisfaction for housing workers was lack of access to client assessment and
treatment information. Each of these issues reflects the differences in program goals and
processes, and the frustration experienced by workers attempting to solve intractable
problems in an environment where resources are strictly limited.
A related theme in the interviews with workers was that the two services don’t always
work together as effectively as possible. It was claimed that housing workers aren’t
invited to take part in CISP team meetings. One proposal was that there should be
monthly case reviews involving all support workers and the client, to provide an
opportunity for the team involved with the client (including the housing worker) to
discuss the issues affecting the client.
7.5 Access to housing services for CISP clients
The fundamental problem about access to housing services for CISP clients is the lack of
available accommodation. While the JHSP provides a pool of medium- and long-term
housing, the number of properties is limited and vacancy rates are low. Access to these
properties represents an undeniable improvement for those who are placed in them, but
the number who benefit is small in comparison with the total demand. Nevertheless,
there is evidence that the JHSP is able to reduce the rate of homelessness in CISP clients,
at least where clients are able to successfully complete the program. Access to
Melbourne Criminological Research and Evaluation 98
Evaluation of the Court Integrated Services Program: Final Report December 2009
temporary and private rental properties is also limited. Interviewees noted that with the
increasing pressure on the rental market, even previously accessible options such as
boarding houses have become difficult to access, especially for justice clients, and that
waiting times of six weeks are common for emergency housing. The long-term solution
for many CISP clients is public housing, but the application process is detailed and there
are long waiting times. The result is that for most CISP clients any change in their
housing situation is likely to take longer than the period of their involvement with the
program.
Melbourne Criminological Research and Evaluation 99
Evaluation of the Court Integrated Services Program: Final Report December 2009
Chapter 8 Magistrate perspectives on CISP and
Therapeutic Jurisprudence
8.1 Magistrates use of CISP
The assessment and case management services provided by CISP can only be effective if
the program is used appropriately by Magistrates. This chapter examines Magistrate
perspectives on the program, and asks how Magistrates use the services offered by CISP,
how this bears on their daily practice, whether they are satisfied with the quality and
timelines of CISP services, and how they see CISP developing in the future. This
analysis is based on interviews and focus groups conducted with Magistrates at each of
the CISP venues, together with feedback from senior Magistrates in the Magistrates’
Court of Victoria. In the last year, CISP services have been extended to the County
Court and to persons appearing in relation to family violence matters, and this chapter
also examines the implications of these developments in the CISP model.
There is considerable variation in the extent to which individual Magistrates use CISP.
Some Magistrates use the program on a regular basis, others use it only for cases where
there is a pressing need for support, and others use it rarely or never. Variation in
frequency of use is present at each of the three CISP venues, although it is less evident at
Sunshine where the majority of Magistrates are frequent users of CISP. The Magistrates
who agreed to be interviewed for this evaluation were mainly the more frequent users of
the program. Magistrates reported using the services provided by CISP in four ways:
i Providing a comprehensive and independent assessment of the problems and
issues associated with a defendant.
Magistrates noted that they frequently deal with cases where claims are made about
defendants’ problems. These may be made by the defendant’s legal representative, the
police or by other parties, and Magistrates must take these claims into account in their
decision-making. Magistrates noted that while they deal with these problems on a daily
basis, there are often complex clinical, social or personal issues involved that they do not
Melbourne Criminological Research and Evaluation 100
Evaluation of the Court Integrated Services Program: Final Report December 2009
have the expertise or time to deal with directly. CISP case managers are recognized by
Magistrates as officers of the court who can be relied on to provide independent advice.
In this way, CISP provides a means whereby defendants can be formally assessed and the
status of their issues or problems can be quickly and independently validated.
Before CISP the concept of dealing with people with special needs was “hit and miss”
ii Selecting and organizing an appropriate therapeutic response
Where a Magistrate identifies that a therapeutic response is appropriate, there remains the
problem of determining what this response should be, and identifying an appropriate
service agency. CISP allows Magistrates to know what treatment resources are available,
assists in choosing the most appropriate form of intervention, and generally improves the
court’s timeliness and efficiency in organizing a therapeutic response.
I have no idea about the scores of institutions, programs and resources that are available. The fact
that the CISP workers know about that is just fantastic. We wouldn’t have a clue about those
things, where to send someone or how to get assistance.
iii Supervising defendant’s through the course of their bail period
Magistrates saw the supervision and case management process as helping to keep
defendants “on track” and providing them with regular feedback on the progress of
defendants. A key element in this was the idea that the case manager was part of the
chain of accountability between the defendant and the court.
The CISP workers are responsible to me, and if they (defendants) are in breach, they know that I
will be told and told quickly.
iv Preparing defendants for a CCS order
Involvement in CISP helps to prepare clients for a Community Corrections Order by
“reducing the chaos in their lives” and giving them the experience of being a client in a
highly structured and accountable program. Successful completion of CISP
demonstrates that a defendant is likely to be able to handle the requirements of a CCS
order.
Melbourne Criminological Research and Evaluation 101
Evaluation of the Court Integrated Services Program: Final Report December 2009
The way that Magistrates view CISP is largely a function of the extent to which their
practice incorporates elements of therapeutic jurisprudence. In general, Magistrates saw
CISP as a vital element in making therapeutic jurisprudence work effectively. A
comment that was frequently made was that CISP “makes it possible for me to do my
job properly”. Several Magistrates referred to cases that would previously have been
regarded as “hopeless” or a “waste of the court’s time” but who were now able to be
successfully placed on bail in the expectation that this would result in real improvement
in their problems.
I’ve seen great results from it, what seemed like hopeless cases but seeing them over the four
months, there are huge transformations that take place.
8.2 Relationship to practice
When CISP commenced it was evident that some magistrates were uncertain about
whether it was a distinct program or simply a “rebadging” of the CREDIT/Bail Support
program model, and whether CISP staff were only concerned with the assessment and
referral of defendants, or whether they were clinicians in their own right. These issues
appear to have been resolved – the Magistrates interviewed were all clear about the
features of the CISP service delivery model and the role of staff, and some noted that
they found it significantly better than the CBS model. However note that CISP staff
members continue to express concerns about the recognition of their role and functions
(see additional comments in Chapter 5).
Magistrates were asked how CISP related to their daily practice in court. There were two
distinct practice approaches described, with their use depending on the circumstances of
the case. The first can be described as an intensive supervision approach. Where a
defendant was judged to be high risk, the Magistrate would be directly and regularly
involved in their supervision while on bail. Frequently the Magistrate would mark the
case as part-heard, and the defendant would be required to report back at frequent
intervals. An important part of this approach is communicating to the defendant that the
Magistrate is taking a direct interest in their case, and that he or she is personally
accountable to the Magistrate for their performance on CISP.
Melbourne Criminological Research and Evaluation 102
Evaluation of the Court Integrated Services Program: Final Report December 2009
It’s important to know who is really making an effort, and I find having the CISP worker
presenting the report in court and being able to ask them questions is quite useful. And the
defendant’s in court and they hear that – they hear that we’re taking an interest in the case, and it
makes them aware that it really is important, that the Magistrate really does take this seriously.
The feedback from clients is that the feedback is important, the penny drops for them.
In the second approach the emphasis is on CISP as a referral and support service. This
approach is appropriate where defendants don’t pose a serious risk but require support
(eg. where the defendant is homeless)and possibly treatment (eg. where the defendant
has a mental disorder) in order to be eligible for bail. In such cases there is less need for
direct personal involvement by the Magistrate, or for frequent reporting by the
defendant.
For the others, I think they should be brought back for supervision but I won’t mark myself as
part-heard. Anyone can review the file and deal with that case.
In both of these practice approaches there is an acknowledgment that not all defendants
will comply with the requirements of the court. Most Magistrates see that involvement
in CISP can place significant demands on defendants and that not all defendants will be
willing or able to comply with them. For some defendants (especially those with a
history of failure to comply with court orders) CISP is a “waste of time” and they should
be screened out at the beginning. Realistic assessment and judicial monitoring are critical
to ensuring that appropriate defendants are placed on CISP, and that they then act in
accordance with the program requirements.
Sometimes it is difficult for people, in the first month, to appreciate what’s required. I invariably
give them one go, I’ll read the riot act to them but if that doesn’t wake them up then I have no
hesitation in taking them off.
Magistrates were asked to comment specifically on the decline in rates of judicial
monitoring (see 2.6 above). Those who responded to this enquiry expressed strong
support for the principle of judicial monitoring. It was noted that judicial monitoring
was central to therapeutic jurisprudence and “should generally be encouraged as a
constructive adjunct to all CISP referrals”. A general issue that was acknowledged by
Melbourne Criminological Research and Evaluation 103
Evaluation of the Court Integrated Services Program: Final Report December 2009
Magistrates was the impact of work pressure on their capacity to deal with complex cases
effectively. The process of assessment and repeated case review means that defendants
on CISP require more court time than those where the court is only concerned with
whether bail should be granted or refused. Effective screening of cases to ensure that
only those who genuinely warranted CISP interventions were placed on the program was
seen as a key requirement in limiting the work-flow impact of the program. Two other
possible reasons for the fall in rates of judicial monitoring were nominated:
• Movement and certainty of Magistrates’ scheduling. Judicial monitoring is more
difficult if a Magistrate is not certain that she/he will be around to deal with a
matter marked part-heard. It was noted that this is particularly an issue at
Melbourne where there are relieving Magistrates “coming in here for a day or
so, or regulars who themselves do a bit of relieving and therefore they cannot
guarantee they will be here on the next occasion”;
• The availability of police prosecutors. It was suggested that the former
arrangement of “part-heard Fridays” at Melbourne allowed Magistrates to
schedule part-heard matters in the knowledge we would have a dedicated
Prosecutor in that Court for as long as we needed them”.
Magistrates were also asked about the impact of CISP on their sentencing decisions.
Generally, involvement in CISP was viewed as relevant to sentencing but not a
determinant of the sentencing outcome. It was noted that with CISP there was “no deal
being”, but that in general good performance on CISP would be taken into account
when sentencing. However, where cases involved serious offences, the court would be
unable to make any significant reduction in sentence severity. Conversely, Magistrates
noted that failure to comply with CISP didn’t mean any increase in sentence severity,
although it might mean that some rehabilitative sentencing options might not be
considered as suitable. Several Magistrates made the point that successful involvement
in CISP demonstrated that the defendant was committed to his or rehabilitation,
provided evidence of an established and effective treatment relationship, and allowed
decisions about rehabilitative sentencing to be made with greater confidence.
If you’re dealing with really serious offences (drug trafficking, sex offences against kids) you can’t
give people any major benefit for being on the program. But overall I tend to treat success stories
Melbourne Criminological Research and Evaluation 104
Evaluation of the Court Integrated Services Program: Final Report December 2009
from the CISP with a reduction in the level, the type of penalty, changing a prison term to a
suspended term or a community based order.
There is no deal being offered - that if they do CISP they’ll get a certain outcome, that they won’t
go to jail where they would otherwise. But if they do CISP, a good performance on CISP is a
relevant matter to consider in sentencing.
Successful participation in CISP may also be a consideration in suspending a sentence of
imprisonment. Section 27 of the Sentencing Act (1991) specifies that a court must not
suspend a term of imprisonment unless it is satisfied that such an order is appropriate
because of the existence of exceptional circumstances. Similarly Section 31 provides that
where a person breaches a suspended sentence of imprisonment, the court should order
that the original term of imprisonment be restored unless exceptional circumstances
mean that it would be unjust to do so. In each case successful participation in CISP may
be held to qualify as exceptional circumstances.
An important constraint on the use of CISP in cases involving serious indictable offences
was identified by Magistrates. Where a defendant is charged with this kind of offence
and then bailed, there is limited capacity for a Magistrate to exercise judicial supervision
with regular reviews of the defendant. In conventional summary or indictable matters
dealt with in the Magistrates’ Court, bail can be managed such that the defendant can be
required to report for review at intervals. In the case of serious indictable matters the
defendant can be placed on CISP but the next appearance date may be months in the
future. Arguable, such cases warrant greater levels of judicial supervision but no
mechanism for this exists in the current bail arrangements.
8.3 Satisfaction with CISP services
In general, Magistrates expressed a high level of satisfaction with the quality and
timeliness of CISP services. Assessment reports were considered to be of a high quality
and were generally provided within a reasonable time. Similarly, case management and
monitoring were reported to be of a high standard. CISP staff members were viewed as
being strongly commitment to helping their clients, knowledgeable about the clinical and
support issues involved in case management, and generally as an important source of
Melbourne Criminological Research and Evaluation 105
Evaluation of the Court Integrated Services Program: Final Report December 2009
information and advice. Magistrates reported that they trusted the judgment of most
CISP staff (especially experienced team leaders) and welcomed their input into the
judicial monitoring process.
If I get some material put to me (by the lawyers) about the effect of certain therapies, I use them as
a resource, I can bounce ideas off them, pick their brains.
The two most commonly cited sources of dissatisfaction were limitations on case loads,
and “naïve” or unrealistic assessment of clients. These two problems were present at all
three venues but were more apparent at some times than others. Inappropriate “gate
keeping” by CISP staff resulted in unsuitable cases filling up the available program places
with the result that Magistrates were advised that caseloads for the month were fully
occupied and no new cases could be accepted. This in turn was seen as being the
consequence of inexperienced staff providing inadequate reports, accepting clients onto
the program who were unsuitable, or failing to terminate those who were not showing an
acceptable level of commitment. A number of Magistrates commented on the high
turnover in CISP staff and the impact that this had on the quality of service, both as a
result of vacancies in case manager positions, and the loss of experienced case managers.
Before we had (team leader), every defence lawyer would refer everybody to CISP, and there was no
gatekeeper, and CISP would take them all. But (team leader) was able to identify the ones who
were not suitable for the program.
We were getting emails to say that caseloads for the month were full, sometimes by the middle of
the month
While CISP was viewed by Magistrates as greatly enhancing their capacity to identify and
organize treatment and support services, there was also recognition that sometimes the
necessary program or service resources were not available. The two areas most
commonly nominated were places in residential drug detoxification or treatment
programs, and assessments for Acquired Brain Injury. Magistrates reported that there
might be delays of weeks before a place in a drug program became available, and that this
was a significant impediment to dealing effectively with such cases. It was noted that the
bail process was a “window of opportunity” where defendants with drug problems were
highly motivated to deal with their problems, but if no effective response was made
Melbourne Criminological Research and Evaluation 106
Evaluation of the Court Integrated Services Program: Final Report December 2009
available their continuing drug use made them unsuitable for CISP, and if remanded they
were unlikely to receive any effective treatment. In the case of ABI assessments, it was
acknowledged that the rate of referral to arbias had been much greater than anticipated,
with the result that arbias were “drowning in demand”.
At the beginning we were told we would get 5 ABI assessments a month, but within 6 months
there were 40 people waiting for assessment, so if you work that out, half of them weren’t going to
get to the head of the queue within the 4 months.
These comments were made by magistrates after the delays in ABI assessments had been
addressed. This indicates that regular communication with magistrates about the
availability of specialist assessment and treatment services is an important part of
maintaining confidence in CISP.
Melbourne Criminological Research and Evaluation 107
Evaluation of the Court Integrated Services Program: Final Report December 2009
8.4 Future directions for CISP
Magistrates were asked how they would like to see CISP develop in the future. The most
commonly nominated enhancement to the program was its extension to other court
venues, including regional courts and other specialist courts. Several referred to the
variations in practice that were apparent when they were working at court venues where
CISP was not available, and the inherent unfairness of this to defendants (“postcode
justice”). Magistrates whose work took them to regional courts commented on the
limitations this placed on their capacity to respond effectively to defendants. Similarly, it
was noted that the availability of a CISP-style program would greatly enhance the
effectiveness of the Koori Court, especially in regional venues where it was perceived
that the local Koori-based service organizations were under a great deal of strain and
close to being “burnt out”. It was noted that extension to regional venues would
involve some modification to the existing program model such as telephone or video-link
access, or a visiting case management team.
As CISP has demonstrated that it is capable of managing defendants charged with more
serious offences, it raises the question of the extension of the program to the County
Court. The primary services offered by CISP will always remain in the domain of the
Magistrates’ Court, but as more serious offenders make their way into the County Court
either on bail or for sentencing, the case management information from CISP becomes
relevant. It is already the case that some County Court judges are aware of this and take
these matters into account in their decisions. However, for this to be fully effective,
County Court judges need to have access to information about the program and the
services that it offers.
The future of CISP is intimately bound up in the future of therapeutic jurisprudence in
the courts. While there is a general acknowledgement that therapeutic interventions are
neither suitable nor appropriate for all defendants, the feedback from Magistrates also
makes it clear that they see the availability of the services offered by CISP as a necessary
investment to make therapeutic jurisprudence work. Magistrates view CISP as more than
just a service that allows defendants to be safely managed while on bail. CISP is viewed
Melbourne Criminological Research and Evaluation 108
Evaluation of the Court Integrated Services Program: Final Report December 2009
as a key element in the process of therapeutic jurisprudence that generates tangible
outcomes for defendants in the form of better understanding of the issues that lie behind
their offending, and effective responses to those problems.
8.5 Recommendations
It is clear from Magistrates’ comments that CISP is integral to the process of therapeutic
jurisprudence. However, this also means that for CISP to work effectively, therapeutic
jurisprudence processes must also be supported. That is, CISP should be seen not just as
an intervention intended to produce better outcomes at the bail and pre-conviction stage,
but as an integral element in therapeutic jurisprudence processes that commence at the
bail stage and continue throughout the offender’s involvement in the court process and
through into supervision under court order.
This analysis also suggests that for CISP to work effectively, two areas of program policy
and procedure should be examined with a view to reform. These are:
Provision of more explicit referral criteria. Both Magistrates and case managers
(see Chapter 5) are aware that some referrals are made that are not appropriate
for the program. This can be addressed by providing more explicit referral
criteria that take into account factors such as the defendants’ previous bail
history, any breaches of suspended sentences or Community Corrections orders,
and other factors relevant to the court’s bail decision. One possibility would be
to establish three referral outcomes: unsuitable and rejected referrals (as at
present), referrals accepted for assessment, and referrals where a Magistrate’s
approval should be sought before accepting the defendant for assessment
Legislative or procedural amendments to allow defendants charged with serious
indictable offences to be subject to judicial monitoring. This might require
establishing reporting dates intermediate between the Filing Hearing and
Committal Mention appearance that would apply to defendants placed on CISP.
Melbourne Criminological Research and Evaluation 109
Evaluation of the Court Integrated Services Program: Final Report December 2009
Chapter 9 Reoffending and compliance
outcomes
9.1 Outcome targets for CISP
The primary goals of CISP are concerned with improving treatment, court, sentence and
re-offending outcomes for program participants. These goals are all linked to one
another: effective treatment of the causes of offending is intended to bring about better
health and well-being outcomes and reduce bail breach rates. These outcomes lead in
turn to an increased likelihood of rehabilitative sentencing and improved order
compliance. The ultimate outcome for CISP is reduced rates of post-release re-offending.
Treatment, health and well-being outcomes were reported in earlier chapters of this
report and this chapter examines data on the three justice process outcomes of bail
compliance, order compliance and re-offending.
9.2 Outcome assessment methodology
CISP clients are selected in two ways. Firstly, they must apply or be referred to the
program and this referral must be based on some identified problem or disadvantage.
Secondly, the decision to accept the referral and engage the person as a CISP client is
based on an assessment of the person and a judgment about the suitability of the person
and the likely outcome of the case. Defendants with no or only mild problems either
don’t apply, are screened out during the assessment process, or are referred to Level 1 of
the program. Defendants who are judged likely to be remanded in prison because of the
seriousness of the offence or their criminal history are also likely to be excluded. Thus,
in order to make meaningful comparisons of outcomes between CISP clients and other
defendants, it is necessary to look at outcomes for defendants who present at court
venues where CISP is not available and who share the same general demographic and
criminal profile as CISP clients.
Melbourne Criminological Research and Evaluation 110
Evaluation of the Court Integrated Services Program: Final Report December 2009
The general methodology for this analysis involved comparing the post-court records of
200 persons who had completed CISP in 2007 with a sample of 200 persons sentenced in
other Magistrates’ Court venues in the same period. There were 100 CISP clients
selected from Melbourne, 51 from Sunshine and 49 from Latrobe Valley. CISP clients
who had exited without completing the program as a result of re-offending, non-
compliance or who were remanded were excluded from the CISP sample. Each CISP
client was matched with a person from a non-CISP venue. Unfortunately, court records
provide little information about defendants other than their age, sex and court history.
The primary matching criteria used were age, gender, major charge and number of
charges. Records of any subsequent court records and outcomes occurring between the
primary episode date in 2007 (CISP exit for the program group or sentence date for the
comparison group) and 30 November 2008 were collected. Re-offending events
included proven offences and unproven charges yet to be determined, as well as any
records of ICO and CBO breach matters. Minor traffic and public transport offences
were not counted as a re-offending event.
9.3 Bail compliance
For a pre-trial program like CISP, improving bail compliance rates is obviously a critical
outcome. However, bail data is not currently able to be extracted in a manner that allows
reliable and consistent analysis of bail outcomes for CISP clients and Victorian offenders
generally. There are several factors that complicate these calculations. Bail may be
granted by police and not recorded on any court data systems. Calculating compliance
rates with bail orders is difficult, as any individual may have multiple bail orders in the
course of a single case, and any bail order may give rise to multiple charges of fail to
appear. The absence of bail data constitutes a significant barrier to the evaluation of
court programs in Victoria.
9.4 Order compliance
Advice from Magistrates indicates that successful participation in CISP is viewed as an
important indicator of suitability for a CCS order. In addition, the treatment and support
referrals provided through CISP have the potential to prepare offenders for longer-term
Melbourne Criminological Research and Evaluation 111
Evaluation of the Court Integrated Services Program: Final Report December 2009
case management under a CCS order. Community corrections orders are a common
outcome for CISP clients: for those clients whose court outcomes are known at the time
they complete CISP, around one-third receive a community corrections order (ICO or
CBO) (see Chapter 2). This compares with less than ten per cent of defendants in all
Magistrates’ Court cases. Thus, the impact of CISP on successful completion of CCS
orders is a key outcome for this program.
Ideally, the order breach rate for all CISP clients placed on a CCS order would be
compared with the breach rate for other CCS orders. Unfortunately, data on CCS order
completions for CISP clients was not available for this evaluation. As an alternative,
breach rates were compared for the sample of CISP orders and comparison sample as
described above. However, this must be seen as a less desirable basis of comparison
than a comparison based on all CISP clients.
In the sample of 200 CISP cases there were 70 who had received a CCS order (35%), and
in the control group 84 defendants (42%) received a CCS order. This suggests that the
members of both groups were on average more serious offenders than lower court
defendants overall, which is to be expected given the selection process for the two
groups. It is unclear whether the variation between the two groups in CCS order rates is
indicative of a difference in overall case severity.
The overall successful completion rates for orders up to June 2009 were 49% for the
CISP sample, and 45% for the control sample. The successful completion rate for CCS
orders state-wide in 2007/08 was 58%. While the proven breach rate for CISP clients
was 3% lower than for the control group, a chi-square test showed that there was no
statistically significant difference in CCS order outcomes between the two groups
(Likelihood ratio value 0.17, df=2, p=0.9).
Melbourne Criminological Research and Evaluation 112
Evaluation of the Court Integrated Services Program: Final Report December 2009
Breach category Group No breach Proven
breach
Breach
charge
unfinalized
Total
N 38 41 5 84 Control
% 45.2% 48.8% 6.0% 100.0%
N 34 32 4 64 CISP
% 48.6% 45.7% 5.7% 100.0%
N 72 73 9 154 Total
% 46.8% 47.4% 5.8% 100.0% Table 9.1 CCS order outcomes for CISP and control groups
9.5 Re-offending rates
There are three measures of re-offending that are bear on the assessment of program
outcomes: whether a person re-offends at any time, the period that elapses until they do
re-offend, and the number of offences they commit in a given period.
Proportion of recidivists
For the CISP group, around 50% cent were classed as recidivists, of whom 40% had
proven charges against them, and a further 10% had charges that had not been finalized.
In the comparison group, 64% were classed as recidivists, with 50% having proven
charges recorded and a further 13% having unfinalized charges. A chi-square test
showed that there was a statistically significant difference in the proportions of recidivists
between the two groups (Likelihood ratio = 6.87, df=1, p<0.05).
Melbourne Criminological Research and Evaluation 113
Evaluation of the Court Integrated Services Program: Final Report December 2009
Outcome CISP Comparison
group
N 79 99 Proven charges
% 39.5% 49.5%
N 20 26 Unproven
charges % 10.0% 13.0%
N 101 75 No further
charges % 50.5% 37.5%
N 200 200 Total
% 100.0% 100.0% Table 9.2 Proportion of recidivists in CISP and comparison groups
Time to re-offence
Re-offending was measured from the time that the members of the CISP exited the
program and the members of the control group were sentenced until 30 June 2009. For
each CISP re-offender, the number of days between their program exit and their first
proven subsequent offence was calculated. For the control group, the number of days
between their matching case sentence date and their first proven subsequent offence was
calculated. Any time spent in custody was deducted from the “time at risk”. Where a
prison term incorporating a maximum and non-parole period was given, only the non-
parole period was deducted. The follow-up period for non-re-offenders varied from just
under 400 days to over 900 days, with a mean of 670 days for the CISP group and 720
days for the control group.
In order to examine whether there is a difference between the time distribution of re-
offending between the two groups, the Kaplan-Meier Survival Analysis procedure was
used. This procedure plots the “survival” function for event history data (in this case,
the time to first re-offence) and calculates whether there is a significant difference in the
survival functions for the two groups. For this analysis only proven offences were
classified as recidivist events.
Melbourne Criminological Research and Evaluation 114
Evaluation of the Court Integrated Services Program: Final Report December 2009
Melbourne Criminological Research and Evaluation 115
Figure 9.1 Kaplan-Meier Cumulative Survival Function for CISP and Control groups
The plot of the survival function18 (Figure 9.1) shows that for both groups the rate of
recidivism increases fastest in the period immediately after the commencement of “time
at risk” (i.e. exit from CISP or sentence date). Initially the two survival curves overlap
but after about 180 days there is a divergence between the curves that is maintained
thereafter. At 100 days, around 20% of both groups have recidivated, and at 200 days
around 30% of the CISP group and 32.5% of the control group have recidivated. By 400
days the degree of divergence is six percent (37% of the CISP group and 43% of the
control group) and by 600 days it is eight percent (40% of the CISP group and 48% of
the control group. The extent of divergence reaches its maximum of ten percent by
around 700 days.
18 The 1-survival function is plotted as this is equivalent to a recidivism function and hence more readily
interpreted.
Evaluation of the Court Integrated Services Program: Final Report December 2009
The Mantel-Cox log-rank test compares whether these two survival curves have equal
distributions. The test has a chi-square distribution and yields a value of 2.36 with one
degree of freedom, and a probability of 0.125. This is not a significant difference but it
should be noted that the group sizes of 200 are the minimum recommended by the
Home office to detect variations in recidivism between a program and control group.
Melbourne Criminological Research and Evaluation 116
Evaluation of the Court Integrated Services Program: Final Report December 2009
REFERENCES
Adams, K., Sandy, L., Smith, L., & Triglone, B. (2008). Drug Use Monitoring in Australia: 2007 annual report on drug use amongst police detainees. Research and Public Policy Series No. 93. Canberra: Australian Institute of Criminology.
Australian Bureau of Statistics. (2008). Prisoners in Australia. Cat. No. 4517.0. Canberra: Australian Bureau of Statistics.
Australian Institute of Health and Welfare. (1999). The definition, incidence and prevalence of Acquired Brain Injury in Australia. AIHW Cat. No. DIS 15 Canberra: Australian Institute of Health and Welfare.
Melbourne Criminological Research and Evaluation 117
Evaluation of the Court Integrated Services Program: Final Report December 2009
APPENDIX 1
REGRESSION MODELLING OF PROGRAM COMPLETION
Around four in ten CISP clients fail to complete the program. If the likelihood that
client was going to fail to complete the program could be accurately predicted, program
targeting could be improved. There are a number of factors that show a statistically
significant relationship to failure to complete, and this analysis examines a range of
bivariate and multivariate models of program completion.
Defining program completion
Program completion can be defined in simple terms of completed/not completed or by
taking into account why a client fails to complete. The main reasons for failing to
complete are that the client fails to attend the program, is adjourned to another court
level or venue or is remanded in custody. Non-completion as a result of being adjourned
or remanded can arise from a breach of bail conditions, or further offences committed
while on CISP, or additional offences which may predate the CISP episode. These
outcomes cannot be accurately distinguished from one another from CISP records. The
PSCMS system distinguishes between clients who fail to attend and those who no longer
wish to attend, however these can be regarded as equivalent “fail to attend” outcomes.
Thus, in examining program completions it is appropriate to distinguish between
completion as a general category, and completion and non-completion as a result of
failing to attend (excluding non-completion as a result of adjournment or remand). In
the following analyses these are used as the two dependent variables and have the
following value distributions and group sizes based on all completing clients to March
2009:
Completion status Completion Non-completion Non-attendance
Number of cases 1201 847 431
Bivariate relationships
The first stage in the analysis was to examine variables that were likely to show a bi-
variate relationship with the outcomes of interest. These bivariate relationships help to
Melbourne Criminological Research and Evaluation 118
Evaluation of the Court Integrated Services Program: Final Report December 2009
select variables for inclusion in the multi-variate analysis and show whether any re-coding
is required to eliminate categories (eg of unknown value) or re-order or combine
categories in relation to their relationship with the dependent variables. The set of
variables selected included the primary demographic characteristics of clients (age, sex,
indigenous status), key program participation attributes (court venue, referral source,
custody status at assessment, judicial monitoring and whether CISP was a bail condition)
and client characteristics likely to be related to future risk (drug and alcohol status, ABI
and mental health status, accommodation and financial status).
All variables except age are categorical, and the bivariate analyses were done using Chi-
square tests. To facilitate comparison with the other analyses, age was converted to a
categorical variable (young, middle, older). For all variables, unknown values were set
to missing. The tables below summarize the results of these bivariate analyses. The
independent variables referral source, judicial supervision, current alcohol use, ABI
status, and mental health issues did not show a statistically significant relationship with
either of the dependent variables and were eliminated from further analysis. This left
nine variables with statistically significant relationships with completion that were
included in the multivariate analysis.
Dependent
variable
Independent variable Chi-square
(L.R.) value
P value
Court location 33.6 0.000
Referral source 10.94 N.S.
Custody status at assessment 111.16 0.000
CISP as a bail condition? 16.77 0.000
Gender 1.36 N.S.
Indigenous status 10.93 0.000
Judicial monitoring 2.36 N.S.
Age group (young, middle, older) 12.92 0.002
Current drug use 25.36 0.000
Current alcohol use level (use, abuse,
dependence)
3.18 N.S.
ABI indicated? 0.43 N.S.
Mental health issues indicated? 0.81 N.S.
Accommodation stability at entry 45.09 0.000
Completed or not completed
Level of financial support (none, some,
significant)
7.41 0.025
Bivariate relationships for completion / not complete outcomes
Melbourne Criminological Research and Evaluation 119
Evaluation of the Court Integrated Services Program: Final Report December 2009
Dependent
variable
Independent variable Chi-square
(L.R.) value
P value
Court location 19.73 0.000
Referral source 6.58 N.S.
Custody status at assessment 30.64 0.000
CISP as a bail condition? 9.71 0.002
Gender 6.32 0.01
Indigenous status 16.09 0.000
Judicial monitoring 0.31 N.S.
Age group (young, middle, older) 18.32 0.000
Current drug use 19.05 0.000
Current alcohol use level (use, abuse,
dependence)
3.66 N.S.
ABI indicated? 0.37 N.S.
Mental health issues indicated? 0.39 N.S.
Accommodation stability at entry 62.6 0.000
Completed or not attend
Level of financial support (none, some,
significant)
16.90 0.000
Bivariate relationships for completion / not attend outcomes
Multivariate analysis
The two dependent variables are categorical (complete/not complete and complete/not
attend) and a logistic regression method was used for the multivariate analysis. This was
done in two steps. Firstly, all variables were entered into the logistic regression (ENTER
method), and then the same variables were entered using a FORWARD STEPWISE
method, with the Likelihood ratio as the entry criterion. Court location was entered as a
categorical variable. Only one of the nine variables (sex of the offender) was excluded
from the forward stepwise model for completion/non-completion, and two were
excluded from the model for completed/not attended (sex and court location). It seems
likely that the exclusion of cases with a completion outcome of remanded or adjourned
also removed much of the variance associated with the court location variable. With this
exception, the final models produced by the two methods are more or less identical.
These models are shown in the two summary tables below.
Melbourne Criminological Research and Evaluation 120
Evaluation of the Court Integrated Services Program: Final Report December 2009
Variable B S.E. Wald df Sig. Exp(B)
Court location 13.058 2 .001
Court location (Latrobe V vs other) -.683 .189 13.057 1 .000 .505
Court location (Melbourne vs other) -.146 .114 1.655 1 .198 .864
CISP as bail condition .768 .151 26.038 1 .000 2.156
Age group -.194 .071 7.432 1 .006 .823
Current drug use -.435 .126 11.948 1 .001 .648
Accommodation stability .232 .050 21.539 1 .000 1.261
Financial support -.074 .034 4.806 1 .028 .929
In custody at assessment .939 .107 77.187 1 .000 2.556
Indigenous status -.465 .211 4.852 1 .028 .628
Constant -1.279 .587 4.753 1 .029 .278Final logistic regression model for completed / not completed
Variable B S.E. Wald df Sig. Exp(B)
CISP as bail condition .740 .182 16.571 1 .000 2.096
Age group -.278 .090 9.512 1 .002 .758
Current drug use -.543 .160 11.565 1 .001 .581
Accommodation stability .100 .031 10.325 1 .001 1.105
Financial support -.153 .044 12.368 1 .000 .858
In custody at assessment .644 .131 24.270 1 .000 1.905
Indigenous status -.473 .241 3.865 1 .049 .623
Constant .139 .699 .039 1 .843 1.149Final logistic regression model for completed / not attended
The Exp(B) values and Wald statistic provide measures of the contribution of each
variable to the regression model. It can be seen that the two models show a similar
ordering of variables, with CISP as a bail condition and In custody at assessment the two most
important components of the models, followed by Accommodation stability. This ordering
of variables is also reflected in the order of inclusion in the forward stepwise process,
with In custody at assessment and CISP as a bail condition the first and second selected
variables in both models.
Melbourne Criminological Research and Evaluation 121
Evaluation of the Court Integrated Services Program: Final Report December 2009
Both models provide a good fit for the data, as measured by the Hosmer & Lemeshow
goodness of fit statistic. However, the classification tables show an important difference
between the two models. For the regression model for completed/ not completed the
model correctly predicts the outcomes of two-thirds of the cases, but is about twice as
good at predicting completion outcomes as it is at predicting non-completion outcomes.
In contrast, the regression model for completed/ not attended correctly predicts a higher
proportion of cases overall, but fails to predict not attended cases. This suggests that the
partitioning of completion outcomes is not a useful strategy as the excluded cases
contribute important predictive information to the model.
Actual value Predicted values
Completed Not completed Percent correct
Completed 862 194 81.6
Not completed 418 283 40.4
Overall Percentage 65.2Classification table for final logistic regression model for completed / not completed
Actual value Predicted values
Completed Not completed Percent correct
Completed 1027 29 97.3
Not completed 336 14 4.0
Overall Percentage 74.0Classification table for final logistic regression model for completed / not attended
Melbourne Criminological Research and Evaluation 122
Evaluation of the Court Integrated Services Program: Final Report December 2009
APPENDIX 2
EVALUATION METHODS
Analysis of PSCMS data
The analysis of client case flows, service referrals and program outcomes used data
extracts from the Platypus Systems Case Management System (PSCMS) used by CISP
staff to record assessment and case management information. Extracts were provided in
the form of de-identified unformatted text documents. These were transferred to Excel
format and from there into SPSS data files. Data files incorporating information from
multiple PSCMS files were compiled by matching on case and client numbers. The client
number is retained by an individual across multiple CISP episodes, while a new case
number is assigned at each new contact episode. Details of the file structures can be
found in the PSCMS Export Manual.
Extracts were made at five points during the period of the evaluation. An initial extract
is March 2007 allowed data quality issues to be checked. The first interim report on
program case flows was done using an extract taken in June 2007 (six months after
program commencement). A third extract at the end of 2007 allowed further
monitoring of case flows and served as the basis for the second interim report in
February 2008. A third monitoring report was based on data extracted in June 2008, and
a final extract in March 2009 provided the basis for the final evaluation report.
Note that some internal CISP reporting is based on end of month or quarter PSCMS
reports while the evaluation extracts were done some weeks after the end of the period
of interest. As a result there are likely to be minor discrepancies in reported case
numbers and other measures.
SF-12 Survey of Health and Well-being
The Sf-12 survey was administered to CISP clients at the beginning and near the end of
their time on the program. Survey forms were distributed to CISP staff at each venue
together with notes on administration, and evaluation team members visited each venue
and briefed staff on the administration of the survey. Participation in the survey was
Melbourne Criminological Research and Evaluation 123
Evaluation of the Court Integrated Services Program: Final Report December 2009
voluntary, and the survey questions were administered verbally by the participant’s case
manager who also recorded the clients’ responses. Only participants in the intermediate
and intensive levels of the program were eligible. Completed forms were held at the
program venue and either collected directly by evaluation team members or mailed to
them. The SF-12 was administered over a twelve month period from February 2008. A
total of 197 clients completed the survey at the time they commenced the program, and
67 were re-tested at or near their exit from the program.
CISP staff and stakeholder interviews
Stakeholder interviews were conducted over the course of the evaluation. The initial
round of fifteen interviews (January to June 2007) focused on feedback from staff about
program implementation issues. In a second round of staff interviews in the second half
of 2008 covered a further eight staff members. Evaluation team members also attended
conferences of CISP staff at the outset of the program and after the submission of the
interim report, and team meetings at each venue throughout the project.
Stakeholder interviews covered a range of service providers including Homeground,
Quantum, Latrobe Community Health, DASWest, arbias, Odyssey House, Anglicare,
Forensicare. Some service provider agencies were interviewed on more than one
occasion over the course of the evaluation. In addition, interviews were conducted with
Registry staff and lawyers at two program venues. Magistrates were interviewed in mid-
2007 in relation to program implementation issues, and a second round of interviews was
conducted in late 2008 and early 2009.
Copies of the staff and stakeholder interview schedules used in the implementation and
outcome stages of the evaluation follow:
Melbourne Criminological Research and Evaluation 124
Evaluation of the Court Integrated Services Program: Final Report December 2009
IMPLEMENTATION INTERVIEWS WITH STAFF AND STAKEHOLDERS
2007
1. Training and experience of program staff
• What professional training do you have? • What is your experience in working with offenders? • How are program staff recruited and selected? • To what extent are program managers involved in delivery of program services
and the supervision of staff?
2. Development of program policy and content
• What work was undertaken to develop the program model? (literature review, pilot program, study of comparable programs)
• What assessments were undertaken regarding the need for the program? • How do the values and goals of the CISP program align with the existing values
of the courts and related programs (CREDIT-BSP)? • Is program funding adequate?
3. Assessment of participants
• Is there a clear definition of the program’s target group(s)? • How are presenting problems (e.g. substance abuse, sexual offending, violence
etc.) assessed? Is this assessment process effective and reliable? • Appropriateness: Is the type of client presently received appropriate to the target
group? • Exclusions: Is there a rational basis for the exclusion of certain clients? • Are styles or modes of service matched to characteristics of offenders?
4. Intervention model
• What do stakeholders understand to be the theoretical basis for the program? • What documentation exists for program policy and practice? How adequate is
this? • What training do program staff members receive in program policy & practice?
How effective was this? • What criminogenic behaviours and attitudes are targeted? • What other behaviours or deficits are targeted? • How are interventions structured in relation to assessed risks and needs?
5. Feedback and quality assurance processes
• What quality assurance is provided through program checks, clinical supervision, client feedback
Melbourne Criminological Research and Evaluation 125
Evaluation of the Court Integrated Services Program: Final Report December 2009
• Is consumer satisfaction measured? How is this information used? • What ongoing assessment is conducted of clients in relation to target behaviours? • What other follow-up data is gathered? • How is feedback about program implementation and outcomes disseminated to
stakeholders?
Melbourne Criminological Research and Evaluation 126
Evaluation of the Court Integrated Services Program: Final Report December 2009
CISP SERVICE PROVIDER INTERVIEW SCHEDULE 2007
What does your agency do?
What services does your agency provide that are required by CISP referees?
What is your role in relation to CISP service provision?
What is the basis for your service relationship with CISP? (Written protocols etc)
How useful, comprehensive, effective is the policy framework for your relationship with
CISP?
Is funding adequate?
Can you assess the quality of your service links with CISP staff in relation to:
- Communication about individual clients? - Information about legal status issues (bail, sentence, supervision
requirements)? - Review and development of services and programs/
1. What are the main problems or issues that characterize clients referred to you
by CISP?
(Circle more than one if appropriate, rank in order of significance)
a) _ Drug and alcohol abuse/ addition b) _ Homelessness or accommodation problems c) _ Poor educational achievement and/ or long term unemployment d) _ Mental illness e) _ Physical health problems f) _ Limited social and familial support links g) _ Other, please specify___________________________________________
2 a. To what extent are these problems related to their offending behaviour?
1. Very related 2. A little related 3. Neither related nor unrelated 4. A little unrelated 5. Very unrelated
2 b. How are the problems related to their offending behaviours (e.g. need to
support additions, etc)?
Melbourne Criminological Research and Evaluation 127
Evaluation of the Court Integrated Services Program: Final Report December 2009
3. In general, how receptive were the CISP referrals to the services provided?
1. Very receptive 2. A little receptive 3. Neither receptive nor unreceptive 4. A little unreceptive 5. Very unreceptive
4 a. In general, how useful was it to provide services to CISP referee’s while they
were on bail?
1. Very useful
2. A little bit useful 3. Neither useful nor useless 4. A little useless 5. Very useless
4 b. (IF RESPONSE NOT 3) Why was it useful or not useful to provide CISP
referees with services while they were on bail (e.g. were they more motivated
because of what was at stake, or were they in too great a state of crisis)?
5 a. In general, how appropriate do you view CISP referrals in relation to the
services provided by your agency (e.g. does your agency provide services that are
often required by CISP referees)?
1. Very appropriate 2. Somewhat appropriate 3. Neither appropriate nor inappropriate 4. Somewhat inappropriate 5. Very Inappropriate
6. In general, what level of priority for treatment do CISP referrals receive from
your agency?
1. High priority 2. Moderately high priority 3. Moderate priority 4. Low priority 5. Very low priority
What needs to be done to improve things?
Melbourne Criminological Research and Evaluation 128
Evaluation of the Court Integrated Services Program: Final Report December 2009
SERVICE PROVIDER INTERVIEW SCHEDULE 2009
Description of the services provided to CISP clients
Relationships and communication
1. Are there formal protocols for engagement between CISP and the referral agency? How well are these protocols understood and adhered to, both on the part of your own agency and CISP staff?
2. How much investment of time and other resources goes into developing links between CISP and your own service agency?
3. Do you ever encounter grey areas or contradictions in treatment models that formal protocols do not adequately address? Example? Does double up occur is the services provided by CISP and your service?
4. Are there formal protocols for identifying and meeting specific cultural/ linguistic/ religious needs of clients from different cultural backgrounds?
5. Does the assessment and screening done by CISP case mangers prior to referral provide you with adequate information about the client to make a decision about accepting or not accepting a referral? What further assessments would you need to conduct with a client post referral?
6. Are there consistent referral strategies between case managers? Do some case managers refer to you more than others? (e.g. both under and over-referral
7. In general, how appropriate are the referrals you receive from CISP case managers? If not, in what way are referrals inappropriate? What resources are available to case managers to inform them of the specific services that your agencies do and do not provide?
8. How satisfied are you with communication about client and case information from CISP staff? If you are not satisfied, what specific things are not being communicated well? What are the consequences of this (e.g. risks, double up in assessment of clients etc)?
9. In general, do clients seem to understand what it is that you can or can’t do for them as an advocacy worker in the context of the justice system?
Melbourne Criminological Research and Evaluation 129
Evaluation of the Court Integrated Services Program: Final Report December 2009
Appraisal of CISP model
1. How effective is the assessment and referral model of intervention at meeting the needs of CISP clients? (As opposed to a model that incorporates direct service provision to the client).
2. Are assessment outcomes and treatment recommendations made by your service made available to CISP staff for the purposes of follow up and case management?
i. If so, what processes or systems support this to happen? ii. In what ways could these processes or systems be improved?
3. Is appropriate intermediate support provided to CISP clients referred to services with long wait lists, given CISP’s time limited period of involvement with clients? In particular, in cases of suspected ABI or mental illness, what safety nets are provided to ensure appropriate treatment is provided in a timely fashion.
4. How effective is CISP at meeting the needs of clients (e.g. addressing drug and alcohol or mental health issues) given the time limited nature of the program.
5. Should CISP continue as a pre-sentencing program? Or is there scope for continued involvement with clients who are not given custodial sentences?
6. General views about their experience of working with CISP staff and clients:
i. Does CISP improve upon other existing service models in the justice system? If so, in what ways does it do this? Are there particular kinds of clients that CISP services well? Are there some clients the program is not effective for?
ii. Are there ways in which CISP is not as effective at meeting the needs of clients on bail, as other existing programs
Melbourne Criminological Research and Evaluation 130
Evaluation of the Court Integrated Services Program: Final Report December 2009
APPENDIX 3:
CISP SCREENING ASSESSMENT FORM
Melbourne Criminological Research and Evaluation 131
Recommended