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Posts Tagged ‘criminal justice’

Violence is a critical public health issue and one that contributes to an astounding number of years of life lost, with homicide and suicide among the top 5 causes of death for those aged 1-44.

Yet our response to violence as a society is not to treat and prevent but rather to criminalize and punish, which doesn’t seem to have helped prevent crime, much less have addressed the root causes of crime, as I have noted before.

The issue of criminal justice in the U.S. and the desperate need for a shift in the justice paradigm, from a system focused primarily on punishment to one emphasizing restorative practices, is one that has once again been on the forefront of my mind in the face of extensive coverage of the trial of Dharun Ravi last month.

Ravi and Clementi

Quick background: Dharun Ravi was charged on all 15 charges he faced for using a webcam to spy on his roommate, Tyler Clementi – Clementi killed himself soon after the spying incidents, though as this board member of the American Foundation for Suicide Prevention eloquently captures, blaming Ravi for Clementi’s suicide is utterly inaccurate and unfair. Suicide is an incredibly complex phenomenon, which always has multiple risk factors at play, including diagnosable mental health conditions which are present in over 90% of cases of completed suicide. You cannot draw a causal link between any one specific incident and suicide and you certainly cannot blame another individual for one’s suicide. Although Ravi was not charged for Clementi’s death, I find it highly unlikely he would be facing 10 years in prison as he currently is if it were not for the fact that Clementi killed himself.

Though Ravi’s actions – and any homophobic motivations behind them – were wrong, I am sure they have been, are, and will be repeated across dorm rooms everywhere – college kids can be foolish and immature, and I fail to see how putting Ravi behind bars for 10 years does anything to address the root issues here. We as a society need to be more tolerant of differences, more respectful of each other, and more communicative with those around us. We need to stop discriminating against others based on race, sexual orientation, religion, and any other such category. But instead of revisiting what we as a society are doing wrong that leads to incidents such as this one, we are instead throwing the blame at the feet of one college student, punishing him in a way that will neither help him, nor prevent cases like this in the future. It seems we perpetually take the easy way out – revisiting what we do as a society and as university, school, and other communities, would be much too difficult; blaming one individual and punishing them – far easier.

Moving beyond this one incident to the array of crimes that land people in prison, the true solution lies in prevention. At the individual level, depending on the nature of the issue, this means things like drug treatment, interventions with at-risk families, and school completion programs (among other things), all of which research has demonstrated to be “more cost-effective than expanded incarceration as crime control measures” according to this Sentencing Project report. At the population level, this means instilling values of respect and equality, tolerance and diversity, beginning at very young ages, at home, in our schools, and in our communities – through education, prevention programs, policies, laws, and more.

Yet, this does not seem to be the direction in which we are moving. I recently attended a symposium during which a prominent political figure, speaking on internet crimes (particularly child sex trafficking and sexual abuse), said “I really think the most meaningful solution is to put these people behind bars for as long as possible – as far as I’m concerned, that’s what prisons are for.”

I felt sick to my stomach – not a word about prevention or restorative practices in his talk, do people really not see how we are not only failing to treat and prevent and improve society, but also resigning ourselves to perpetually be throwing people in jail?

But there is hope, and there are ways out of this mess. A more recent publication of The Sentencing Project compiles the essays of 25 leading scholars and practitioners on their strategic vision for the next 25 years of criminal justice reform.

A truly incredible compilation of perspectives that is worth a read, but for now I will highlight some points from the essay capturing the public health perspective, written by leading violence prevention public health scholar and practitioner, Deborah Prothrow-Stith.

She writes, “We can’t address the many challenges in the criminal justice system without reducing the number of people entering the criminal justice system in the first place. This means prevention must be on par with law enforcement and punishment. As a nation, we already promise to respond to violence with expensive and sometimes harsh solutions. We need a companion promise, the promise of prevention.”

And, as she points out, this is an area in which we do have firm science as to what works and what doesn’t. Public health-based programs such as CeaseFire Chicago and the Urban Networks to Increase Thriving Youth (UNITY), school-based violence prevention efforts that have proven effective, programs like Boys and Girls Clubs and the Big Brothers Big Sisters of America initiatives, and the Nurse Family Partnership home visiting program have all proven to reduce crime and violence in meaningful ways.

Instead of focusing on punishment within a flawed and discriminatory system, instead of cutting prevention funds (as of last week, the Prevention and Public Health fund is yet again on the chopping block, much to my – and many other’s – dismay), let’s focus our attention on programs like the ones mentioned above – programs that prevent violence, promote health, and foster a more vibrant and productive society.

This post is cross-posted at http://occupyhealthcare.net

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The United States spends $60 billion each year on incarceration and has the highest incarceration rate in the world (due more to the length of sentences than the number of individuals incarcerated each year), as this New York Times article details. The only other major industrialized nation that even comes close to the U.S.’s rate is Russia, with others having much lower rates (1/5 the U.S.’s rate or lower). The U.S. has less than 5% of the world’s population but almost 25% of its prisoners, with 2.3 million criminals behind bars, more than any other nation. China is a distant second with 1.6 million people in prison.

And as this NAACP report points out, there’s a lot more to worry about:

–  The majority of the 2.3 million people incarcerated in U.S. prisons and jails are people of color, people with mental health issues and drug addiction, people with low levels of educational attainment, and people with a history of unemployment or underemployment. (According to a 2008 study, 1 in 100 U.S. adults of any age and 1 in 9 black men ages 20-34 are in prison).

–  The nation’s reliance on incarceration to respond to social and behavioral health issues is evidenced by the large numbers of people who are incarcerated for drug offences – nearly a quarter of all those incarcerated.  (And as mentioned here, in 1980, we had 41,000 drug offenders in prison; today we have more than 500,000, an increase of 1200%.)

– During the last two decades, state spending on prisons grew at six times the rate of state spending on higher education.  (And according to a Pew report, total state spending on corrections, the bulk of which is spent on prisons, quadrupled during the past 20 years, making it the second fastest growing area of state budgets, trailing only Medicaid.)

Even worse – much of what we do in terms of incarceration does not seem to be preventing crime, much less helping people escape the various vicious cycles that can lead to things like poverty, crime, substance abuse, poor education, poor health, etc. This can be seen not only in the recidivism rates mentioned above (with about 1 out of 4 American offenders ending up right back in prison within three years of release), but also limited drug offender effects,  negative impacts on family and community, and other issues detailed in this Sentencing Project report. Moreover, as the report goes on to say, “a variety of research demonstrates that investments in drug treatment, interventions with at-risk families, and school completion programs are more cost-effective than expanded incarceration as crime control measures.”

The call is echoed in editorials such as this one, written to describe a consensus reached in a Pennsylvania conference among prosecutors and defenders, victim advocates, prison reformers, and parole officers and judges. The consensus: the need for a change in the justice paradigm, from a system focused primarily on punishment to one emphasizing restorative practices. The editorial goes on to highlight a number of public health strategies as promising alternatives including therapies that address addictive behaviors and mental and emotional disorders.

And there have also been repeated calls to take some of the billions of dollars we spend on incarceration and put it toward education, one of the more recent calls coming from Gaye Tuchman, a University of Connecticut sociology professor, in one of this week’s New York Times Room for Debate articles about Rick Perry’s “plan” for a $10,000 B.A. degree – “New money for education has to come from somewhere,” Tuchman writes. “Why not a new kind of retrenchment: Cut back on imprisonment for some victimless crimes — like marijuana possession — and use the money for higher education. As The New York Times reported in February, arrests for marijuana use have been skyrocketing in New York City alone. Better to educate people than lock them up.”

And indeed better to educate and support high risk youth than lock them up. Let’s target youth in high risk communities (a la “hot spotters”) for intensive tutoring and mentoring support, provision of safe spaces, and more, providing them with role models and people and places to turn to when in distress or in need of help accessing various resources.

John F. Kennedy once said “children are the world’s most valuable resource and its best hope for the future” – let’s invest in this resource and nurture this hope, preventing our children from entering the criminal justice system in the first place.

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At a conference on gang awareness and prevention that I attended last week, I heard folks from a local community service board speak about their work supporting youth in the community through in-school and after school programs. They showed video testimonials from some of the youth they worked with, and it was just amazing to hear these teens’ heartfelt words about the CSB personnel and the impact they had on these young people’s lives as tutors, mentors, role models, and trusted sources of support and advice. These were for the most part high-risk youth, growing up with a number of factors against them – poverty, unsafe neighborhoods, unstable family lives, constant exposure to drugs and alcohol, and more – making the impact of the CSB’s work even more valuable. One girl, breaking into tears, said that this group saved her life.

And it got me thinking…

In Atul Gawande’s New Yorker article “The Hot Spotters”, he talks about how medicine’s primary mechanisms of service, the doctor visit and the E.R. visit, are vastly inadequate for people with complex problems, comparing them to “arriving at a major construction project with nothing but a screwdriver and a crane.”

In some ways, I feel like the way we handle young people in this country is like that too. On one end, you have the regular public education system, which is fine for those of us lucky enough to have grown up in a stable family and neighborhood environment, with all our basic needs and much besides that met. On the other end, you have the highly punitive criminal justice system, which some would argue is necessary to keep dangerous youth off the streets.

I have many qualms about the latter point, but that notwithstanding, there’s still a major problem here: both systems are vastly inadequate for the vast majority of high risk youth in this country, who need one-on-one mentoring and support, consistent role models and safe spaces, etc. that organizations like the CSB I mentioned above provide. This could result in a much healthier, happier, better-educated population of youth that are far more likely to break through the cycles of poverty, substance abuse, etc. that often contribute to their behavior. Neither the traditional education system nor a punitive approach is going to the trick for these youth.

In addition to being punitive, the criminal justice system makes it incredibly hard for young people to get back to living happy, healthy lives – their criminal records make it hard to become gainfully employed and the system does very little to help address the root causes of criminal behavior, and provides little in the way of education or job skills. And as this recent Pew Report details, more than four out of 10 adult American offenders return to prison within three years of their release, suggesting that “the system designed to deter them from continued criminal behavior clearly is falling short”.

Gawande points out in “The Hot Spotters” that if we recruited staffs of primary-care doctors and nurses and social workers, based right in the neighborhoods where the costliest patients lived, staff expenses would be more than covered with the tens of millions of dollars in hospital bills that could be saved.

Similarly, if we recruited staffs of mentors, tutors, social workers, educators, and prevention specialists, based right in the neighborhoods where the highest risk youth lived, expenses would likely be more than covered by the money saved in criminal justice expenses.

Seems like an investment worth making, doesn’t it? If I haven’t convinced you yet, more on U.S. criminal justice statistics and ways to support youth coming in Part II!

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