Amity In-Prison Therapeutic Community: Five-Year Outcomes

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Amity In-Prison Therapeutic Community Five-Year
Outcomes
Association of Criminal Justice Research
(CA) Sacramento, California March 17, 2005
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Prendergast, Michael Hall, Elizabeth Wexler,
Harry Melnick, Gerald Cao, Yan. (2004). Amity
prison-based therapeutic community Five-year
outcomes. Prison Journal, 84(1),
36-60. McCollister, Kathryn French, Michael
Prendergast, Michael Hall, Elizabeth Sacks,
Stan. (2004). Long-term cost effectiveness of
addiction treatment for criminal offenders.
Justice Quarterly, 21(3), 659-679. Funding from
the National Institute on Drug Abuse and the
Robert Wood Johnson Foundation
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Aims

• To assess long-term post-treatment outcomes of
  a prison-based TC program
• To determine differential outcomes within
  selected subgroups
• To examine factors that contribute to the
  long-term recovery of those who did not
  participate in treatment

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Aims

• To conduct secondary analyses of data previously
  collected
• To conduct a cost analysis of the prison TC
  program and the TC continuing care program

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Subjects

• 715 inmates enrolled in or on a waiting list for
  a prison-based therapeutic community drug
  treatment program (1993-1995)
• Randomly assigned to treatment or comparison
  group
• Housed in a Level 3 prison in San Diego
• Those completing treatment were eligible for TC
  aftercare at Amity Vista upon release

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Subjects

• Male
• White 37.8, Hispanic 30.1, African American
  22.4
• Average age at follow up 38 years (range, 26 to
  72)
• Low educational attainment
• Primarily users of methamphetamine, heroin, and
  cocaine
• Violent 75 had committed assault, kidnapping,
  rape, or murder
• Mean arrests (lifetime) at baseline 27
• Mean incarcerations (lifetime) at baseline 17
• Mean years in prison (lifetime) at baseline 6

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Methods

• Five-year follow-up interviews
• 576 completed (80 of original sample)
• Face-to-face
• Many interviews were conducted in jails and
  prisons
• Modified NDRI follow-up instrument and DARCs
  Natural History instrument
• Urine samples (31 of completed sample)
• Hair samples (19 of completed sample)

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Methods Follow-up Status
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Findings at Years 1, 2, and 3
Calculated from Lowe, Wexler, Peters (1998),
Wexler, De Leon, Kressel, Peters (1999) Wexler
Melnick, Lowe, Peters (1999).
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Outcomes for Intent-to-Treat Sample
(Chi-square)
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Outcomes for Treatment Subgroups
(Chi-square)
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Days to 1st Incarceration
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Cost Effectiveness
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Cost Effectiveness
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Summary

• After five years, reincarceration was high, but
  Amity participants were significantly less likely
  to have been returned to prison than comparison
  subjects.
• No difference between treatment and comparison
  groups in drug use and employment.
• Among treatment subgroups, those who completed
  Vista TC aftercare performed significantly better
  on reincarceration and employment measures, but
  not drug use.
• Prison treatment plus community treatment is a
  cost-effective policy for reducing
  reincarceration.

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Thank You

• Questions?
• ISAP website uclaisap.org