Justice Programs Office

The Racial and Ethnic Disparities Initiative (REDI) at American University is proud to announce the publication of their article Maintaining fidelity to the treatment court model through evaluation: The racial and ethnic disparities (RED) program assessment tool, as featured in in the Journal of Human Behavior in the Social Environment. This study, which analyzed treatment courts nationwide, utilized the Racial and Ethnic Disparities (RED) Program Assessment Tool (RED tool). The web-based tool collects information on multiple aspects of treatment court programming where racial and ethnic disparities may exist. Additionally, based on the court’s responses, they receive scores on seven out of the eight sections on the tool and an overall score accompanied by recommendations that are generated for courts on how to alleviate racial and ethnic disparities in their program.  

The treatment court model has consistently been proven more effective at reducing recidivism than traditional approaches, such as incarceration or probation. However, treatment court outcomes have been disproportionately positive for white participants, compared to racial and ethnic minority participants. In a recent study with a sample of over 14,000 treatment court participants, African Americans and Hispanics/Latinos had a lower graduation rate than white participants.  

The current study, which was conducted from 2020 to 2022, was based upon the voluntary participation of treatment courts (n=151). The study collected data from nine states, utilizing targeted questions to analyze each court. The RED tool identified existing racial and ethnic disparities within each individual court and recommended steps to promote equity in outcomes.  

The objective of this study was to answer two research questions, which were as follows:  

1. Do treatment courts have fidelity to the model by completing evaluation on a regular basis to assess program effectiveness?  

2. Do racial and ethnic disparities exist in treatment court graduation rates? 

Participating treatment courts were scored in seven areas based on their responses to the RED tool: court background, intake criteria, assessments, court team, training, treatment and services, and evaluation and monitoring. The table below compiles the mean score in each category, with higher scores signifying better compliance with best practice standards. These scores are to be used as a baseline for courts to track their progress from their initial assessment to re-assessment after best practice recommendations are implemented.  

Regarding evaluation and monitoring, half of the participating treatment courts reported tracking outcomes in some capacity post-program. However, only 41% of the participating courts provided graduation outcomes based on race and ethnicity, suggesting the other 59% of courts lack the infrastructure to track or examine graduation outcomes based on race and ethnicity.  

The average score of treatment court best practice adherence across all categories for this study was 59.85%. REDI would like to emphasize that these results should not be viewed punitively, but as a testament to the importance of consistent evaluation and adherence to best practice standards with attention to disparities in outcomes and experiences that may exist for minoritized participants. 

The results of this study show evidence of racial and ethnic disparities in treatment court outcomes. Graduation rates were lower on average for minoritized participants (specifically African American and Hispanic participants) than for white participants. See the table below for more information. Furthermore, only 13% of responding treatment courts reported sometimes or always implementing policies to address racial and ethnic disparities in outcomes. 

The majority of the disparities in the sample identified with the RED tool can be rectified by following best practice standards. For example, completing regular and comprehensive evaluations for potential racial and ethnic disparities, as well as aligning with treatment providers that utilize individualized, evidence-based interventions. 

Treatment courts are an important sector of the recovery process for individuals struggling with substance use, connecting participants with resources and ensuring the path to recovery is accessible to all. This September marks the 35th annual National Recovery Month, according to SAMHSA. Established in 1989 to celebrate and destigmatize recovery from substance use and mental health conditions, National Recovery Month recognizes the millions of Americans that have struggled with substance use, and ensures that resources and support are accessible to all who need them.  

Thank you for supporting our work. For any questions or comments, please contact redtool@american.edu. 

In 2023’s edition of Painting the Current Picture, the National Treatment Court Resource Center reported that across the United States, over 140,000 people were served by treatment courts in 2019 & 2020. From humble beginnings in the late 1980s to over 3500 hundred programs currently operating in every state in union is a testament to the success of the treatment court model, and the thousands of dedicated staff and organizations who make treatment court happen day in, day out. The treatment court model is one of the most well-researched, well-funded, and empirically backed justice interventions ever created. Participants who complete treatment court programs are less likely to commit new crimes, show significant reductions in the symptoms of substance use disorder, and higher level of recovery capital, compared to those who fail to complete the program, or those who get standard responses such as jail or probation.  

As we enter National Treatment Court Month, in this 35-year anniversary of the treatment court model, it is important to acknowledge how far we’ve come, how many people we’ve helped, and, how much more we still must do. One of the biggest challenges facing the legal system, including treatment courts, is who is the program working for? At the most basic level, courts serving 140,000 people a year is a significant accomplishment, but, given that there are an estimated 8 million jail admittances each year, and that of those in jail, an estimated 70% have either a substance use disorder (SUD) or mental illness. There seems to be a huge pool of potential treatment court participants being missed.  

In addition, early scholarship suggested that treatment courts were failing to graduate Black and Latino participants at the same rates as their white counterparts, and while more recent data suggests that gap is narrowing, the fact remains that treatment courts are serving mostly white participants, in a legal system that disproportionately incarcerates and supervises Black and Brown individuals. Multiple recent studies have highlighted this disparity, generally, 70%+ of treatment court participants are white, compared to an average of about 40% of those in jails being white. Conversely, Black people make up almost 30% of the jail population, but less than 20% of the aggregate treatment court population. There are numerous reasons for this disparity, many outside the control of treatment court staff. Many decisions in the legal system also suffer from distributed responsibility, it’s rarely one decision that sets the course for an individual’s case processing, but many, small decisions by many different actors which cumulatively impact their experience, and racial disparities within the system. So how should treatment courts respond to these pre-existing disparities, and in compliance with the Adult Treatment Court Best Practice Standard (Standards) II, Equity and Inclusion, to ensure that their intake and eligibility policies and practices promote equity of access?  

At American University, we’ve been working with treatment courts on issues related to equity of access for decades, and we’ve found a few areas where courts can increase equity of access and ensure that courts are serving all eligible participants. Firstly, courts should ensure that they are setting their criteria using evidence, which the Standards require that treatment courts serve High Risk and High Need individuals, and that’s it. Too many courts we’ve worked layer subjective criteria on top of these evidence-based standards. Some refuse to accept those with previous or current violent charges. The limited evidence we have shows people with violent charges do just as well in treatment courts, and a growing body of evidence suggests that those who commit violent crimes are less likely to re-offend than those with drug, property, or public order convictions. Evidence also suggests that most of the disparities in jail admissions can be explained by those charged with violent crimes. For treatment courts, serving those with violent charges is likely to reduce disparities in access, and keep communities safe, while saving significant costs associated with incarceration.  

Treatment court should consider all the factors and not deny access to those who sell drugs. All the evidence we have suggests that almost all people who use drugs also sell some to support their habits. The decision to file a possession charge versus possession with intent to distribute, or other charges associated with drug sales, can derail someone’s access to treatment courts. Obviously, there is a significant difference between someone who is only selling for profit and who has no SUD (but they would likely not screen as High Need), and someone selling to support their habit, but blanket bans on those who sell or have sold drugs severely misrepresent the population of people who use, especially illicit, drugs.  

Finally, courts should avoid broad exclusions which may unintentionally harm Black, Indigenous, People of Color (BIPOC) participants, such as those without access to transportation, those without funds to pay program fees, those who have a “gang association” or those who “don’t seem motivated” etc. Part of the role of treatment court is to get people who have been struggling with addiction and its effect on their lives for a long time, back on their feet and re-integrated into their communities. For many, stopping using drugs is the primary need, and getting out of the gang, getting a job or financial security, access to a vehicle etc., are all goals that can be met after they stop using and start treatment.  

Treatment courts have been serving their communities effectively for 35 years, but to ensure we are reaching all those who are eligible for our services, we need to be sure we’re not excluding people based subjective, or worse, racially biased, character assessments or characteristics. Treatment courts exist to serve those who criminal behavior is driven by substance use and / or mental illness, and it’s important that we don’t add additional, unnecessary, barriers to access.  

I’m excited to announce the publication of the article Color in the Court: Using the Racial and Ethnic Disparities (RED) Program Assessment Tool to Promote Equitable and Inclusive Treatment Court Practice published in Alcoholism Treatment Quarterly. This study was conducted by a team from American University (AU) and Morgan State University (MSU). This commentary will provide a concise summary of the article’s key findings and implications for treatment courts. 

Instead of the typical punitive model in the criminal legal system, treatment courts address the root causes of substance use disorders (SUDs) and mental health disorders that often lead to incarceration or other forms of involvement in crime. Treatment courts have gained traction for their restorative and rehabilitative approaches. These courts reduce criminal recidivism rates, assist people on a path of recovery, and save communities money.

Nonetheless, it’s vital to acknowledge and address the racial and ethnic disparities that exist within the criminal legal system, including treatment courts. This is where the Racial and Ethnic Disparities Program Assessment tool (RED Tool)  plays a vital role in rectifying RED in treatment courts. The RED tool provides a comprehensive evaluation of RED in treatment courts to promote equity and inclusion within courts. The tool narrows in on distinct goals as part of its foundational design, which includes raising awareness about RED, highlighting existing inequities within courts, and offering recommendations on alleviating racial and ethnic inequities in programs. The tool sorts data into 8 different sections allowing for a thorough analysis of treatment court practices. 

The sample for this study consisted of about 13% of treatment courts in a Midwestern state. Below are several key findings from the study.

• The completion rates reveal that minoritized participants, including African American, Biracial, and Hispanic participants had completion rates of less than 30%. In contrast to their White counterparts, who attained a completion rate of 64.9%.
• Data from the study suggests that only 37% of courts have reviewed their graduation rates to examine disparities among different racial and ethnic groups. 
• On the topic of mandatory training, only 6% of courts required staff to complete cultural competency training. 
• Further data reveals that merely 47% of courts agreed with the statement, “our team is racially and ethnically diverse.”
• Within this study, it’s important to note that none of the treatment courts mentioned racial equity within their mission statements.

For more findings, please read the full article here. 

There is no doubt that treatment courts work, however, there is always room for growth. When treatment courts complete the RED tool and implement its recommendations, they should see improvements in access, retention, and overall program satisfaction for minoritized participants, which should lead to participants finding their path to recovery. According to SAMHSA, National Recovery Month is celebrated each September to promote and support new evidence-based treatment and recovery practices. We want to thank the treatment court professionals involved in providing prevention and treatment. Lastly, we celebrate those who are moving forward on their recovery journey.