The 12th Judicial District Adult Treatment Drug Court (ATDC) Expansion Project will expand and enhance access and availability of the ATDC program for 200 (40 annually) adult defendants/ offenders with a primary substance use disorder (SUD) diagnosis in six (6) rural Appalachian counties. The project will establish 40 new treatment slots and provide the evidence-based Matrix Model for Criminal Justice Settings, Seeking Safety, MRT, DBT, MAT, and recovery supports.
The project’s catchment area (Bledsoe, Franklin, Grundy, Marion, Rhea, and Sequatchie counties) epitomizes rural Appalachia. It is an area locals know as “the other side of the mountain” and is steeped with poverty, economic stagnation, educational inequities, limited/no access to services, lack of transportation, and a rising number of persons involved in the justice system needing comprehensive SUD/co-occurring mental health disorder (COD) treatment. All six counties are designated as a High Intensity Drug Trafficking Area, and 1 in 5 local offenses are substance related. The focus population is expected to be primarily male (60%), ages 18 to 60, white (98%). Veterans comprise 9% of the adult population and are at high risk for SUD/COD. In the existing ATDC program, 64% of people enrolled for substance abuse have a co-occurring mental illness. Some of the greatest local gaps in services that the project will address include: limited availability of local treatment services, limited training and coordination for local law enforcement and social service providers, and limited drug court treatment slots.
Project goals and measurable objectives include: (1) Expand/Enhance access and availability of ATDC services for offenders/defendants with SUD—establish 40 new treatment slots; expand/enhance a culturally competent team of therapy, case management, outreach, education, peer support, and evaluation staff, with background/experience/training in behavioral health, including Matrix and specialty SUD and mental health assessments/treatments; establish and provide treatment for 200 participants; expand/enhance services with Matrix Model for Criminal Justice Settings, complemented as appropriate by Seeking Safety, Moral Reconation Therapy (MRT), Dialectical Behavioral Therapy (DBT) and Medication Assisted Treatment (MAT); (2) Expand/Enhance the existing infrastructure and capacity to increase and sustain increased access to ATDC—establish an advisory council with community/consumer representation; establish/maintain telehealth capability; develop/sustain community linkages; educate 500 law enforcement, judicial, medical, social services, and other community partners; (3) Improve outcomes for offenders/defendants with SUD or co-occurring disorders—reduce substance use by 70%; increase abstinence from substance use by 70%; reduce costs related to SUD/COD by 35%; reduce mental health symptomatology by 50%, 90% clean urine screens; 80% retention in treatment; (4) Develop and disseminate a thoroughly documented service model for replication in other rural areas across the state and the nation—conduct a comprehensive evaluation, track/assess and reduce subpopulation disparities, produce manuals, materials, publications, etc.