Who’s Missing from our Treatment Courts – Increasing Access and Equity 

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.  

Court Chat: Enhancing Employment for Treatment Court Participants

Join advocate and 2014 treatment court graduate Carrie McCoy as she explores the benefits of enhancing employment opportunities for treatment court participants, and how employers can improve the hiring process to overcome systemic barriers to employment for individuals in recovery. This edition of Court Chat is proudly presented by the Racial and Ethnic Disparities Initiative (REDI) at American University, in Washington, DC.

New Publication! An Equity and Inclusion State of Mind: A Statewide Approach to Addressing Racial and Ethnic Disparities in Treatment Courts

The criminal legal system has a well-documented history of racial disparities and mistreatment of minoritized racial and ethnic groups. Treatment courts are a part of this same system and unfortunately, have not been exempt from racial and ethnic disparities in its programs. American University and the Center for Justice Innovation collaborated to assist treatment courts in several states in tackling racial and ethnic disparities. This report outlines results and policy recommendations derived from American University’s and the Center for Justice Innovation’s racial and ethnic disparities statewide training and technical assistance collaboration.

Read the report here.

If you’d like additional information, please reach out to Karen Otis (otisk@innovatingjustice.org) or Zephi Francis (zfarncis@american.edu). 

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.

Revelations from a Research Article on Racial and Ethnic Disparities in Treatment Courts

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.

Painting the Local Picture – Understanding Disparities Data in Local Treatment Courts

From the main stage at All Rise 2023, the largest ever gathering of treatment court professionals, participants and supporters, Doug Marlowe, Senior Scientific Consultant for All Rise (formerly NADCP), told the 5000 or so people in the room that, as a field, treatment courts have failed to address disparities in treatment courts. Over the course of the field’s 30-year history, report after report (including our research from this year), has shown that treatment court participants are predominantly white, and that Black, Indigenous, and People of Color (BIPOC) individuals graduate at half the rate (or worse) of their white counterparts.

Twenty-four hours later at the conference, an audience member in our session, who had been working with treatment courts since the late 90s bemoaned this same fact in response to our report on the statewide data we’d collected, “why do we keep gathering data” he asked, we don’t need more data, we need to fix this problem of disparities in courts. In a country with a 400-year history of legally sanctioned racial discrimination, it’s hard to stomach the reality that treatment courts, with our innovative approaches and individualized case planning, are at best not helping address disparities, and at worst, might be upholding them.

But part of the reason we keep telling courts to collect and analyze their racial and ethnic disparities (RED) data is that for 30 years many treatment courts have been bad at it. We do have national or state level reports, but they don’t tell us what’s happening in your court, and more importantly, the high-level data in national reports doesn’t capture the nuance of why people aren’t getting accepted into the program, what’s happening to them on their treatment court journey, and what’s stopping them from graduating.

I agree with the audience member from the conference (and I did tell him so personally), we don’t necessarily need more national data, but we do need courts to track and analyze their RED data regularly. There’s a reason the Adult Drug Court Best Practice Standard Two exists and stands alone, racial equity in courts does not just happen, we must pay attention to it, track data on it, and respond when we see inequalities and disparities. Not regularly and systematically tracking data on disparities is a violation of Standard Two (to paraphrase Dr. Marlowe).

So, if we want to take that warning seriously, what should we be paying attention to? We want to know about the people in the program, but what about those who didn’t make it? Are Black people excluded because their criminal history, where-as white people aren’t? Are Black and Brown men overwhelmingly opting for jail instead of the program while white people are 50/50? Are there specific requirements that are tripping up some folks and not others. Our colleague Anne Dannerbeck-Janku found that requiring participants to have a full-time job to graduate was impeding Black participants graduation much more than white participants. There are several of potential reasons for this, and I don’t have any concrete answers, but we know from employment and hiring research that it is easier for a white man who went to prison to get a job than for a black man with no criminal history to get the same job, so that may have been part of it. This doesn’t mean you should throw out the requirement to have a job completely (as a job is great for both maintaining recovery and reducing future crime), but are there ways to make it more equitable?

The data is the start to a conversation, what phases are people dropping out of / getting stuck in, are there patterns by race or ethnicity, are there consistent reasons participants give during exit interviews for their success (or lack thereof)? We are often beaten over the head with graduation data, but looking for disparities in your programs starts much earlier than that, who is in (and why), who is out (and why), who is dropping out in phases 1 or 2 (and why), etc. There might not be easy answers, but that’s where experts from American University can come in to support you and think about what your data might mean.

If you want to start a conversation with us about how to collect, and understand, data on disparities in your program, reach out to us today at redtool@american.edu

Rectifying Racial and Ethnic Disparities (RED) in Treatment Courts  

Treatment courts are working and there’s evidence to support it. A drug treatment court is a judicially supervised court docket that provides a sentencing alternative to incarceration for people facing drug charges and who have substance use disorders. Treatment courts support clients through recovery using judicial oversight and evidence-based treatments, reduce the likelihood of participants committing new crimes, and save communities money. However, some treatment courts have experienced racial and ethnic disparities (RED), with minoritized individuals having differential access to programs, as well as completing programs at a lesser rate than their white counterparts.  

To assist treatment courts in understanding and examining disparities in their programs, faculty and staff at American University’s (AU) School of Publics Affairs (SPA) along with subject matter experts in the field developed the Racial and Ethnic Disparities (RED) Program Assessment Tool (RED tool). The RED tool is a web-based assessment designed to examine treatment courts’ policies and procedures to determine where racial and ethnic disparities (RED) may exist in programs. It’s been four years since the RED tool was launched. During this time, over 150 treatment courts have completed the assessment. 

After completing the RED tool, some treatment courts were trying to figure out the next steps for their court to address equity and inclusion issues. Hearing the need for next steps motivated a team at AU to apply for funding to do a deeper dive with courts on RED issues. In 2022, having heard the same calls from the field, the Bureau of Justice Assistance (BJA) opened a solicitation to fund exactly this type of innovation in programming. The team at AU led by Preeti Menon and Zephi Francis, along with partners at Florida State University, Morgan State University,  the University of Central Florida, and Aeon applied for the Field Initiated solicitation and received good news in the fall of 2022. 

BJA awarded the team a grant of $1 million over a period of three years to establish the Racial and Ethnic Disparities Initiative (REDI). Through research, policy development, and training and technical assistance (TTA), REDI will work with treatment courts to understand and reduce disparities in their programs.   

“When Preeti and I found out that we received the award, we were on campus for the first time together since COVID-19 struck. On that day, we were preparing for an in-person documentary screening and panel discussion on the intersection of substance use, mental health issues, and homelessness,” REDI’s Project Director Zephi Francis said. “We knew that this project was going to be a great opportunity for us to continue the work that we both are passionate about, while advancing BJA’s priority of racial equity.”  

With this funding, the REDI team will recruit treatment courts to complete the RED tool, analyze the data, and release guidance on best practices to assist treatment court professionals with decision-making. Another component of REDI entails offering intensive TTA to treatment courts. TTA involves courts participating in multiple virtual sessions with expert faculty to discuss topics identified by the court as priority areas to make their programs more racially and ethnically inclusive. Finally, the REDI team will create online modules for treatment court professionals to learn about best practices and innovative strategies regarding RED.  

May is National Treatment Court Month. It’s a time to celebrate all the good work that treatment courts are doing. The REDI team would also encourage treatment courts to use this month as an opportunity to learn more about the RED tool, and take proactive steps to address any disparities in their programs. 


Honoring Unique Identities in JDTCs

diverse group of hands put togetherAt almost every decision point in the US justice system, disparities of gender, race, and ethnicity can be observed. Even in the juvenile justice system, which is meant to be rehabilitative, black youth are locked up at almost five times the rate of white youth for the same crimes. It is also estimated that as many as 39% of incarcerated girls may identify as LGBTQ. Upstream in the justice decision-making process, black youth are far more likely to be arrested and charged compared with white youth, and white youth are more likely to be offered diversion (an intervention or alternative to incarceration) programs. Sadly, Juvenile Drug Treatment Courts (JDTCs) are no different, a 2016 study found that minority youth are underrepresented in JDTCs, and even if they are offered the opportunity to participate, minority youth have a lower rate of graduating JDTCs than white youth.

Of all the interventions in juvenile justice, JDTCs, with their explicit dedication to individualized case planning, engaging the participant’s family and community, and individualization of programming and responses to behavior, should, in theory, be equipped to support all youth in their access to, and graduation from, their programs. But, despite the incredible potential in the JDTC model, and the deeply committed and caring staff who work in JDTCs nationally, something isn’t quite working for all the young people they serve.

I don’t claim to have all the answers, but I would like to offer one suggestion. We must avoid falling into the trap of treating everyone equally, rather we must ensure we are treating everyone equitably. Equitable treatment means we must acknowledge differences in experience and culture and incorporate those differences into the case plans we develop for our young people.

Our nation has a history of mistreating and subjugating people based on race, gender, sexual identity, indigeneity, and a myriad of other identities, and people get understandably nervous when we start talking about acknowledging and giving the space for racial and gender differences. But in the context of a young person seeking recovery, this may not just mean recovering themselves, but also recovering and grounding themselves back in their identity within their community, ancestors, family, or tradition. As we recognize Global Diversity Awareness Month this October, with its explicit call to recognize and honor diversity and cultural differences, it seems timely to reflect on the services JDTCs provide, and how we can ensure cultural traditions and diverse racial experiences are honored in our programs.

Despite our commitment to honoring the individual experience, JDTCs may not offer therapy targeted at addressing generational trauma, or the historical impact of racism on people of color, despite research showing that these traumas manifest themselves in both physical and emotional ways. This is not to say that all black children experience, or internalize, racism in the same ways, but a holistic approach to recovery must include the opportunity to acknowledge, process, and begin healing from scars inflicted as a result of one’s race. Normal Cognitive Behavioral Therapies do not focus on this, but there are programs, such as the HEAT program, that do. HEAT was designed by black men, for black men, to help them rediscover themselves through spirituality, community, and family. This program goes beyond the idea that to engage in therapy it helps young black men to have someone who looks like them, and instead demands that the therapist and the curriculum help them process all their experiences, including those directly related to race, in order to begin to recover.

Not every JDTC can access the HEAT Program, but all JDTCs can think critically about the populations they have; or, based on demographics in their systems, the populations they should be targeting, and what needs or programming might aid the recovery of those populations. I was in a JDTC a while back that had an influx of refugees, and aside from the standard issues with finding translators and interpreters, the team had made very few adjustments to their program to help youth and families cope with the trauma of fleeing home, seeking asylum, or adjusting to life in the US. Skilled therapists would be able to help these young people process some of the trauma, but they should also consider what community or spiritual practices the family holds dear that would aid them in their healing process. JDTCs should consider how they might be a partner with the community to facilitate this healing (without being appropriative).

Given our history, and contemporary fears around racism and sexism, it is understandable that JDTC staff become nervous when discussing race or gender-based interventions for young people. However, it is important to understand that the way to help young people recover is to allow them to connect with all areas of their identity, and that requires us as staff to acknowledge them, honor them, and provide services based upon their unique needs, including needs related to race and/or gender.

By recognizing these different identities and experiences in our case plans, JDTCs may finally be able to live up to their true, individualized, potential.


Want to know more about addressing racial and ethnic disparities (RED) in your JDTC? Check out the NDCRC’s new RED Program Assessment Tool, or email jdtc@american.edu to learn more about our RED focused TTA.

New Assessment Tool Aims to Help Treatment Courts Identify Racial Bias

Diverse people group

The upcoming presidential election, the 25th anniversary of the federal 1994 crime bill, and the enactment of the First Step Act, have rekindled the national debate on the urgent need for criminal justice reform at the federal level.

But much of the work to reform the criminal justice system is happening at the state and local level. State prisons house 1.3 million of the 2.3 million people confined nationwide (88% at the state level and 12% at the federal level); and that population is disproportionately people of color. However, state courts are finding that the mass incarceration model is expensive and does little to enhance public safety or reduce crime.

Continue reading “New Assessment Tool Aims to Help Treatment Courts Identify Racial Bias”

A Social Work Professor Serves the Court

What’s celebrated in March? In addition to St. Patrick’s Day, Women’s History Month, and National Criminal Justice Month, we also celebrate Social Work Month. In honor of the many contributions social work has made to treatment Photograph of Dr Annecourts, I decided to highlight a person whose work is beneficial to the practices and procedures of treatment courts. Dr. Anne Dannerbeck Janku is an associate research professor at the University of Missouri. For almost two decades, she has conducted research on racial and ethnic disparities in treatment courts. Continue reading “A Social Work Professor Serves the Court”