Veterans Treatment Courts: Uplifting Programs and Participants with the RED Tool

A VTC graduate is presented with a handmade quilt upon his program graduation in Buncombe County, North Carolina. Wright, Angeli. “The Frame: Buncombe County Veterans Treatment Court Graduation.” The Asheville Citizen Times, January 25, 2018.

As we reflect on the sacrifices of those who served in our armed forces, it is timely to bring awareness to the countless number of veterans across the country who struggle with mental illness and substance use disorders (SUDs), often stemming directly from their time in combat, which can cause those who served their country to find themselves in the crosshairs of the legal system and even incarceration. Since 2004, veteran treatment courts (VTCs) have used a multi-disciplinary team of professionals from courts, community corrections, treatment agencies, and social service organizations to address veterans’ SUDs and mental health issues, with the purpose of eliminating criminal behavior.

A recent report by the US Bureau of Justice Statistics, published in 2016, estimates that 107,400 veterans were incarcerated in state or federal prison at the time, and that about 8% of all state prisoners and 5% of federal prisoners were veterans. Furthermore, a 2017 study by the Social Psychiatry and Psychological Epidemiology Journal found that about a third of the United States’ 19 million veterans report having been incarcerated at least once.

Veterans are in a uniquely vulnerable position to developing SUDs, especially due to their susceptibility to post-traumatic stress disorder (PTSD), a psychiatric condition that can occur as a result of exposure to extreme trauma. PTSD has been shown to be a significant risk factor for veterans in terms of developing SUDs, with the US Department of Veterans Affairs reporting that more than a fifth of veterans with PTSD also experience SUD, while nearly a third of veterans seeking treatment for SUD experience PTSD. Symptoms of PTSD, which usually manifest within 3 months of a triggering event or series of events, are numerous, and can involve flashbacks, difficulty sleeping, avoidance of triggering thoughts, objects, or situations, depression, and memory loss. It is the intensity of these symptoms and a desire to mitigate them that often leads veterans to develop SUDs and therefore an increased risk of involvement in the criminal justice system, according to the National Institute of Mental Health.

The Racial and Ethnic Disparities Initiative (REDI) at American University (AU) is proud to work with VTCs across the country, using the Racial and Ethnic Disparities (RED) Program Assessment Tool (RED tool) to identify and rectify instances of RED in their programs. Between 2020 and 2023, 14 VTCs from Georgia, Ohio, Oregon, and Wisconsin completed the RED tool. These VTCs’ participation resulted in the accumulation of vital information about the operations of these VTCs, and the services they provide veteran participants. For example, 100% of the VTC respondents reported having at least one Veterans Justice Outreach (VJO) specialist on staff. This is a critical data point, as VJO specialists are instrumental in identifying veterans who could benefit from VTCs and connecting these veterans with the services they need. VJO specialists operate within communities, as an extension of the local justice system, to provide direct outreach and assessment services to veterans that have come in frequent contact with law enforcement, often called “justice-involved veterans.”

The results of the RED Program Assessment Tool also demonstrated that 100% of the VTC respondents reported having their eligibility requirements for program participation in writing. This may seem like a minor detail, but in fact having VTCs with written clear, objective eligibility requirements is critical to mitigating bias in the admissions process and improving participant access, particularly veterans from diverse racial and ethnic backgrounds. 

However, there is always room for improvement, and the results of the RED Program Assessment Tool demonstrated that VTCs are no exception. For example, even though 100% of  the VTC respondents reported having their eligibility requirements in writing, only 57% of those courts reported sharing a copy of those written eligibility requirements with all referral sources. Referrals can come from a variety of sources, such as judges, the VA, defense attorneys, VTC staff, and even friends and family of the veteran experiencing SUDs. If clear and objective written eligibility requirements are not distributed to all possible referral sources, outreach to potential VTC participants becomes difficult. It is crucial that all referral sources receive concrete guidance on who is eligible for VTC programs, which can then increase program referrals. By creating more accessible community resources such as flyers, updated websites, or maintaining a strong connection with the local VA, outreach of accurate and relevant information to these referral sources can be maximized.

By using the RED tool to identify where there are instances of RED in their programming and utilizing REDI’s educational resources for guidance on next steps, VTCs are empowered to ensure that their veterans from diverse racial and ethnic backgrounds are receiving the support they need. VTCs play a critical role in promoting the racial equity of their programming, which can be improved through many avenues such as: implementing culturally intuitive policies, promoting open dialogue, and emphasizing resources for mental health issues and SUDs are only a handful of examples of this.

This Veteran’s Day and every Veteran’s Day, it is important to recognize all of those who have served our country, especially those who are struggling with SUDs or mental health. Whether you are a veteran experiencing SUD or mental health issues, working with veterans, or simply a  community member invested in the rehabilitation process, learning more about VTCs can be an important first step in supporting the vital work they do. The REDI recognizes the importance of uplifting VTCs and their participants, and is committed to improving VTC programming by identifying and helping to eliminate instances of RED.

Be sure to check out the REDI’s website to learn more about the RED Program Assessment Tool and our mission.