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Overview
Background
Case Study Examples from Region II
of Aging and Released Prison
Population/Persons with Disabilites
Recommendation
Overview Aging ‘Prisoner’ Crisis 2.3 million people in U.S
Custody Elderly defined in corrections as age 50-55 16% aged 50 and older in US prisons Disproportionately race/ethnic minorities and
persons with health, economic, & social care needs
Accelerated aging process in prison, including high rates of dementia
High rates of trauma and risk of prison abuse
Human made disaster (mass trauma)
Increase 5 fold since 1990s U.S. mass incarceration attributed to growth
in aging population and 1980s stricter sentencing and parole policies (ACLU, 2012; Aday, 2003; HRW, 2012; Maschi et al., 2011, 2012, 2013)
Towards a New Way of Thinking
about Old Social Problems
The problems that exist in the world today cannot be solved by the level of thinking that created them -Einstein (n.d.) Einstein (public domain photo;
http://www.fotopedia.com/items/flickr-101925777
Human Rights Framework
Well-Being Individual
Family
Community
The Whole Person in Social/Environmental Context
Human Rights Values
Dignity, Respect,
Intrinsic Value
Duty to Others
Human Rights • Political
• Civil
• Economic
• Social
• Cultural
(Maschi, 2011)
So How Did We Get Here?
Photos of Aging People in Prison courtesy of Ron Levine (Prisoners of Age)
Cumulative Social Determinants of
Health, Social Equity and Justice
CUMULATIVE DETERMINANTS (life course risk and protective factors)
WHOLE PERSON
Human Agency Well Being*
SOCIAL ENVIRONMENT & CONTEXTS
Life Course Process and Outcomes
Death
Birth
The ‘Critical’ Omega Point Mass Aging and Dying in Prison
Alpha ‘Beginning’
INDIVIDUAL LEVEL FACTORS • Age • Race/Ethnicity • Gender • Trauma/Stress/Victimization • LGBTQ • Physical & Mental Disabilities • Substance Use • Offense History • Literacy-, Health, Moral
SOCIAL STRUCTURAL • SES-Poverty • Education/Employment • Intergenerational Incarceration • Homelessness • Oppression, Stigma, Attitudes • Social Support
• Family • Peers • Community
• Access to Services, Fair Policies or Legal Assistance
• Prior Service Use • Environment (Prison, Violence,
Inadequate Healthcare)
Social Context Model for Human Development: For Interdisciplinary Prevention, Assessment, & Intervention
(Maschi , Viola, & Sun, 2012)
STATEWIDE DATA ON ADULTS AGED 50 AND OLDER IN NYDOCCS 2012-2013
Region II Case Examples
NY DOCCS Population* 1/1/13 Total General Population=54,865 Aged 50 and Older=9,269 (16%)
Total Male Female
Race n % n % n
Afr Am 27,178 96% 26,197 4% 981
Latino 13,189 97% 12,820 3% 369
White 13,051 93% 12,167 7% 884
Other 1,447 93% 1,380 7% 67
Age
40-49 12,894 95% 12,299 5% 595
50-59 7,165 96% 6,905 4% 260
60+ 2,104 96% 2,024 4% 80
*Also, Parents, Grandparents, Veteran’s, Immigrants, Hx of MH, SubAbu, Trauma
(NYDOCCS, 2013)
Region by Gender
New York
City
Suburban
New York
Upstate
Urban
Upstate
Other
Total*
Male
Female
Total
24,580
862
25,442
5,988
240
6,228
12,670
573
13,243
9,326
625
9,951
52,564
2,300
54,864
Male
Female
Total
468%
375%
464%
114%
104%
114%
241%
249%
241%
177%
272%
181%
1000%
1000%
1000%
Incarceration Status
Inmates
Incarcerated
Parolees
Total
25,319
123
25,442
6,173
55
6,228
13,021
222
13,243
9,721
230
9,951
54,234
630
54,864
Inmates
Incarcerated
Parolees
Total
467%
195%
464%
114%
87%
114%
240%
352%
241%
179%
365%
181%
1000%
1000%
1000%
Region of Commitment 1/1/13
(NYDOCCS, 2013)
NY DOCCS Time Served in Months- January 1, 2013 (NYDOCCS, 2013)
YEAR
<1 1-14 15-19 2-29 3-39 4-59 6-99 10-149 15-199 20+ LIFE
New York: Number of New York State Prison Deaths By Cause of Death, 2010 (BJS, 2011)
All Causes of Death N= 3,232
All Illnesses 2,867
Heart Disease 853
Liver Disease 239
Respiratory 224
AIDs-related 73
All Other 584
Suicide 215
Drug Alcohol Intox 39
Accident 34
Homicide 67
Pe
rce
nt
Re
turn
ed
60%
Return Rates by Age at Release, 2009
50%
40%
30%
20%
10%
0%
16-18 19-20 21-24 25-29 30-34 35-39 40-44 45-49 50-64 65+ Age at Release
Total Returned New Commitment Parole Violation 1985-2008 Releases
NYDOCCS 3 Year Recidivism Data
2009 Releases:25,060 Total Returned: 10,426 (41%); 10% New Commitment; 31% Parole Violation
Phase 2 & 4: Participatory Intervention Study
Sample of adults aged 50 and older released from NY prisons
Focus groups, in-person interviews, and self administered survey with adults aged 50 and older from prison
Barriers and Facilitators to Reentry
Housing, employment, lack of care transition planning, healthcare and benefit access
Phase 3: Staff Online Survey (N =13)
BARRIERS TO SUCCESSFUL REINTEGRATION
1. Lack of family support 2. Lack of support system to help provide moral support and
assurance that everything will work out 3. Family Problems 4. Finding employment, employment (3) 5. Not being able to find a job for those that are still able to
work 6. Homelessness, Finding placement to live 7. Not finding a job, no family they can count on or be able to
see 8. Substance abuse 9. Not able to adjust to the program standards, non-
compliance with authority figures, issues with trust/respect
Phase 3: Staff Online Survey (N =13) FACILITATORS TO SUCCESSFUL REINTEGRATION 1.Having positive communication 2.Family members, Family being part of their life, Family support 3.Support from family When the family is not supportive it makes it a little harder for a person who honestly have a desire to get on the right path 4.Family, employment, social security 5.Their mental / emotional maturity 6.Staying on top of them and guiding them where they have to go 7.Motivation Understanding 8. Transportation Services 9.Because our individuals have done so much time in prison when they come home They are thankful to be on parole and they strive to do what is required because they realize that they don't have many years left So once they get settled with a place to live some assistance their happy and completing parole because easy 10.Integration, asking for helpful feedback, putting them in healthy role model situations in the community 11.Following program guidelines
Phase 3 Front Line Staff Attitudes Survey-1 (N = 13)
Phase 3 Front Line Staff Attitudes Survey-2 (N = 13)
Vermont
About 1,000 adults aged 50 and older in prison with varying levels of functional capacity
Those with serious illness are hardest to treat and prison and place after prison release
Currently in needs assessment phase of a statewide Beta project for prison and reentry services development
RECOMMENDATIONS
From Prison to Care Transitions
Diagram of Recovery and Rehabilitation by Participants of the Senior Structured Living Program in Nevada State Department of Corrections
General Recommendations for Data Driven and Evidence-Based Solution
z
Legal
Services
Educatio
n
Health
Family
Social
Networks
Food
Protectiv
e
Services
Social
Services
Juvenile
Justice
Criminal
Justice
Substance
Abuse Mental
Health
Disability
Services
Person
Work
Housing Income
Religion
Transpor
t
Po
we
r
Life Course Human, Family and Community Development
Arts
&Leisure Aging
Services
Community
Clothing
Safety
Unity Circle Primary Avenue of Informal and
Formal Care (Self and Others)
Care Way Secondary Avenue of Formal Care
Government
Politics
A Reunification Model for Intergenerational Family and Community Health and Justice Prevention and Intervention Facilitating Release of Aging People from Prison
ELDER JUSTICE CARE TRANSITIONS ASSESSMENT TOOL CATEGORIES-1
(Maschi et al., 2015)
Section 1 (Pre-Parole Board Hearing/Pre-Release) A. Intake and Demographics ……..……………..…………….. 3-4 B. Release Status …………………………….……………….…………………….. 5 C. Locator Form ………………………………………...………………………….. 6-7 Section 2: Medical and Menatl Health D. Medical Information ........................................... …..... 8-11 E. Mental Health …………………………..………………………………………… 12 F. Substance Use/Addictions History…..………… 13 For a copy of the instrument, please email [email protected] to request permission
ELDER JUSTICE CARE TRANSITIONS ASSESSMENT TOOL CATEGORIES-2
(Maschi et al., 2015)
Section 3: Internal and External Supports G. Housing …………………………………………………….………………….. 14-15 H. Economic Security and Employment…………………………………………….... 16 I. Legal Issues…………………………………………………………..……………. 17 J. Relationships and Support Systems …...……………………….. 18 K. Client Strengths and Accomplishments……………………….... 19 Section 4 (Post-Parole Board Hearing/Pre-Release) L. Entitlements, Benefits, and Social Services …..…………….……….. 20 M. Immediate Release Checklist …………………………….. 21-22 For a copy of the instrument, please email [email protected] to request permission
ELDER JUSTICE CARE TRANSITIONS ASSESSMENT TOOL CATEGORIES-3
(Maschi et al., 2015)
Section 4 (Post-Parole Board Hearing/Post-Release) N. Community Assistance, Food Security, Nutrition and Safety.….. 23 O. To-Do List ………………………………………… 23 P. Transitional Care Referral & Biopsychosocial Assessment.. 24-26
Appendix: Copies of Official Records (When Available) 1) Parole: Comprehensive Medical Summary 2) Recent Assessment Medical Summary 3) Parole Stipulations (Parole Plan) 4) Rap Sheet 5) COMPAS Risk Assessment 6) Other Relevant Case Documents For a copy of the instrument, please email [email protected] to request permission
Sample Parole Prep Plan
Preparation
General Recommendations
HOLISTIC FULL SERVICE COMPONENTS (Care Transitions or Linkages for Services)
1. Family support services 2. Education, employment, vocational, retirement training 3. Housing 4. Social welfare benefits 5. Criminal record repair services 6. Intergenerational family services 7. Trauma (including elder abuse), grief, loss, stress assessment and
intervention (individual and family) 8. Moral, values, ethical education, emotional literacy, spiritual development 9. Victim-offender mediation, reconciliation 10. Ongoing staff training (generalist, specialized, and interdisciplinary
cooperation Self-care) 11. Linkages between criminal justice and other service providers 12. Agency certification-culturally responsive services (including for formerly
incarcerated) 13. Program Evaluation Unit
General Recommendations-2
HOLISTIC FULL SERVICE COMPONENTS (or Linkages for Services)
1. Seamless transitions systems of care (aging and disability services)
2. Culturally responsive medical services
3. Health literacy and psychoeducation (eg, smoking cessation, self-care)
4. HIV+ counseling
5. Mental health and substance use (screening/assessment/intervention)
6. Trauma-Informed Care
7. Palliative and end-of-life care (biological, psychological, emotional, social, spiritual components)
8. Peer support and empowerment (self-help) groups
9. Non-psychopharmacological interventions (eg, arts, pet therapy, folk healing)
10. Staff Training and Support
Be the Evidence You Want to See in the World…
What is Our Mission: The mission of the Be the Evidence Project is to create awareness of human rights and social justice issues through research, advocacy, and education. Be The Evidence Project activities foster dialogue and action on how human rights and social justice can be realized in everyday and professional practice.
Who We Are: The Be the Evidence Project is a collective of globally conscious researchers, practitioners, educators, policy-makers and advocates, and concerned citizens whose non-profit independent scholarly and creative ventures are designed to disseminate knowledge, values, and skills that will help improve the individual and community response to critical social issues and improve well-being using 'any media means necessary'.
What We Do: Be the Evidence Project activities that involve research, education, and advocacy provide a vehicle to disseminate information to raise critical consciousness and the recognition of psychological sociopolitical contexts in which injustices can occur. Transforming society first entails transforming ourselves to become "be the evidence we want to see in the world". Through participation in self or project-sponsored activities, we can help promote the achievement of a socially just world in which human rights, social justice, and well-being are realized for all. On a daily basis, the lived reality of "being the evidence" challenges individuals everywhere to look inside themselves to identify and eradicate oppressive attitudes, thoughts, and practices towards self and others.
-WHITE PAPER-AGING PRISONER: A CRISIS IN NEED OF INTERVENTION AND SCHOLARSHIP
Website: http://www.fordham.edu/btep Recent Article About the Project: http://www.fordham.edu/campus_resources/enewsroom/inside_fordham/november_4_2013/news/social_work_group_st_93589.asp,
Make a Difference Intergenerational Family Justice
QUESTIONS & COMMENTS
& HOW TO GET INVOLVED
GET INVOLVED
-If you and/or your agency would like to get
involved, please sign the sign up sheet for the
project team to contact you
-Or for more information about the study or
copies of project articles Tina Maschi, PhD, LCSW, ACSW
Fordham University Graduate School of Social Service
113 West 60th Street New York, NY 10023/
Tel: (845) 664-3159/212-636-6640
Email: tmaschi@fordhamedu
