The Intervention: Short-Term Alternatives and Referrals to Treatment (START)
Who is Served: Adults facing misdemeanor charges in New York County Criminal Court, including those with a history of frequent low-level convictions and behavioral health treatment needs
For people with histories of chronic low-level criminal involvement, incarceration is costly and often ineffective as a deterrent of future crime. For many years, New York City has struggled to address the challenges presented by this population. Back in 2002, Mayor Bloomberg stated that nearly 30% of all misdemeanor crime citywide could be attributed to only 6% of people involved in the criminal justice system.1 Then in 2014, the Action Plan issued by Mayor de Blasio’s Task Force on Behavioral Health and the Criminal Justice System identified a group of just more than 400 people who have accounted for more than 10,000 jail admissions and 300,000 days in jail over a recent five-year period–with 85% of these being related to misdemeanors or parole/probation violations.2 Because of the low-level nature of their crimes, these defendants typically receive short jail sentences, requiring expensive transportation and court and jail processing. A high percentage of individuals within this population have behavioral health needs, including mental illness and/or substance abuse disorders. For these individuals, short jail sentences provide limited opportunities for diagnosis and treatment. As a result, many remain mired in a cycle of arrest, confinement, release, and re-arrest that prevents them from ever accessing the rehabilitative treatment they need to reduce their criminal involvement and begin to work toward recovery and wellness.
The Manhattan START Approach
For many years, CASES has worked to develop effective alternative sanctions in New York County Criminal Court that
- emphasize brief interventions of a duration that will be an acceptable alternative for defendants and defense attorneys, given the likelihood of the defendant otherwise facing the usual short jail sentence
- incorporate strategies to promote a powerful combination of personal accountability and access to ongoing services in the community
In 2012, CASES consolidated three of these alternative sanctions as Manhattan Short-Term Alternatives and Referrals to Treatment (START). Manhattan START provides a streamlined screening and intake process to support the rapid identification and diversion of appropriate defendants at arraignment in Manhattan Criminal Court. The program includes screening and in-court advocacy by a doctoral-level psychologist to help judges and court stakeholders understand the risks and appropriateness of diverting individuals with significant behavioral health needs to a CASES jail alternative.
START services are guided by evidence-based approaches including motivational interviewing and trauma-informed care. Specific program tracks include:
- Daytime Custody: a 3-5 day sanction, in which men with histories of chronic low-level criminal involvement report during daytime hours to a secure NYC Department of Correction facility at which they perform community service; engage in clinical assessment, individual and group counseling, and presentations by community providers; and receive referrals to community providers for ongoing support following the program
- Community Case Management: a 3-5 day sanction for men and women with histories of chronic low-level criminal involvement and mental illness and/or other behavioral health needs—services include clinical assessment, individual and group counseling, and referrals to ongoing services in the community along with innovative, voluntary case management services lasting up to four months (within this service track, CASES provides Women’s Diversion Services, a gender-responsive intervention for justice-involved women)
- Treatment Readiness: a one-day drug and alcohol education program for first- and second-time drug offenders that includes behavioral health assessment and referrals to and in-reach by community treatment providers
Manhattan START has a high level of judicial support within Manhattan Criminal Court: nearly 20% of START referrals come directly from judges, and when CASES staff advocate for a defendant to receive a START mandate, judges refuse in only 8% of cases. Across the three service tracks, START annually serves more than 2,000 participants, with recent outcomes including:
- Treatment Readiness: served 1,394 individuals, with 1,146 (84%) successfully completing the one-day mandate
- Daytime Custody: served 754 defendants, among whom 28% had indications of mental illness and 54% had indications of substance abuse, with nearly 70% of all clients successfully completing their court mandate
- Community Case Management: served 265 defendants, all of whom had indications of mental illness and 66% of whom had indications of substance abuse, with nearly 75% of all clients successfully completing their court mandate
Of graduates of the Community Case Management track, about half chose to voluntarily continue in our ongoing case management services. These individuals—nearly all of whom have serious mental illness, a significant criminal history, and a high risk of re-offending—experienced a nearly 50% reduction in recidivism.