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can be regularly reviewed in a multidisciplinary team for- mat. MTCs can be established for those diagnosed with a COD upon intake by repurposing the existing infrastructure within an institution to provide housing, treatment space for individual and group sessions and a sense of communi- ty for the participants. Reentry coordinators would be cross trained to facilitate aftercare planning for continuity of services post-release. All correctional staff including secu- rity and administrative staff should be receiving continuing training about the nature of CODs and their effect on an in- dividual’s functioning within the correctional system. The realignment of already existing staff, housing and resources would be a small budget expenditure when compared to the cost of the revolving door of untreated mental illness, substance use and reincarceration. Ohio has deployed a program specifically targeting offenders diagnosed with CODs within their correctional system. 35 The Ohio Department of Rehabilitation and Corrections partners with the state’s Bureau of Men- tal Health Services to provide treatment through the Substance Abuse and Mental Illness (SAMI) Intensive Outpatient Program. SAMI is comprised of three distinct programs consisting of a 28-hour Treatment Readiness program, an 84-hour Intensive Outpatient program and a 24-hour Recovery Maintenance program. Each inten- sive program is delivered for a minimum of six hours weekly and involves additional hours of supplemental services. The Recovery Maintenance is delivered two hours weekly. The SAMI Non-Intensive Program is a 12- week education group that involves various mental health and substance use focused topics and related exercises. Groups meet weekly for up to two hours. 35 While different states choose to implement EBTs for CODs differently, the research reliably indicates that treatment participation reduces symptom relapse and recidivism. Proactively helping this population while they are incarcerated is an excellent return on investment as it increases the participants’ quality of life pre and post release and can reduce crime within our communities. To perfectly encapsulate these ideas, renowned journalist and author Malcolm Gladwell wrote in “The Tipping Point: How Little Things Can Make a Big Difference,” “If you want to bring a fundamental change in people’s belief and behavior ... you need to create a community around them, where those new beliefs can be practiced and expressed and nurtured.” 36

Endnotes 1 Walmsley, 2018. World Prison Population List (12 th Edition). World Prison Brief, Institute for Crime & Justice Policy Research. https://prisonstudies.org/ research-publications?shs_term_node_tid_depth=27. 2 Peters, R., Young, M., Rojas, E., & Gorey, C. (2017). Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system. The American Journal of Drug and Alcohol Abuse . 43. 1-14. https://doi.org/10.1080/00952990.2017.1303838. 3 Torrey E. F., Kennard A. D., Eslinger D., Lamb R., & Pavle J. More mentally ill persons are in jails and prisons than hospitals: A survey of the states. Arlington, VA: Treatment Advocacy Center; 2010. 4 Bronson, J. & Berzofsky, Z. Bureau of Justice Statistics, 2017 . Indicators of mental health problems reported by prisoners and jail inmates, 2011-2012. Washington, DC: U.S. Department of Justice, Office of Justice Programs. http://www.bjs.gov/index.cfm?ty=pbdetail&iid=5946. 5 Mumola, C and Karberg, J. Bureau of Justice Statistics. 2007 . Drug use and dependence, state and federal prisoners, 2004. Washington, DC: U.S. Department of Justice, Office of Justice Programs. http://www.bjs.gov/index. cfm?ty=pbdetail&iid=778. 6 Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068, NSUDH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/. 7 Substance Abuse and Mental Health Services Administration. (2019 ). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health ( HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/. 8 James, D.J. & Glaze, L.E. Bureau of Justice Statistics. 2006. Mental health problems of prison and jail inmates. Washington, DC: U.S. Department of Justice, Office of Justice Programs. http://www.bjs.gov/index. cfm?iid=789&ty=pbdetail. 9 National Alliance of Mental Illness, 2015. State mental health legislation, 2015: Trends, themes and effective practices. https://www.nami.org/Support- Education/Publications-Reports/Public-Policy-Reports/State-Mental-Health- Legislation-2015. 10 . Osher F, D’Amora MS, Plotkin J, et al.: 2012. Adults with behavioral health needs under correctional supervision: A shared framework for reducing recidivism and promoting recovery. New York, Council of State Governments, Justice Center. https://ps.Psychiatryonline.org/doi/10.1176/appi.ps.201700420. 11 Lurigio, A.J. Co-occurring disorders: Mental health and drug misuse. In: Leukefeld, T., Gullotta, P., & Gregrich, J., eds. Handbook of Evidence-Based Substance Abuse Treatment in Criminal Justice Settings. New York, NY: Springer; 2011:279–292. 12 Peters R.H., Kremling, J., Bekman N. M. & Caudy, MS. (2012) Co-occurring disorders in treatment-based courts: Results of a national survey. Behav Sci Law ; 30, 800–820. https://doi.org/10.1002/bsl.2024. →

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