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TASC Weighs in on Pretrial Reform in Illinois

(Chicago) – Jail is a place where some people with substance use and mental health disorders get treatment, but it is unjust to hold people behind bars simply to increase their likelihood of access to such services.

This was the central point made by TASC to the Illinois Supreme Court Commission on Pretrial Practices, which is preparing a report with recommendations regarding the administration of pretrial justice in Illinois.

The commission recently held public hearings in Springfield, Champaign/Urbana, and Chicago to gather input from individuals, organizations, and entities interested in voicing their opinions on pretrial reform in Illinois.

For over 40 years, TASC has provided connections to substance use treatment and other services in the community for people involved in the justice system, from prosecutorial diversion to court-based sentencing alternatives to community reentry services for people leaving state prisons. Offering substance use screening and assessments, service planning, linkage to treatment, and ongoing case management, and reaching more than 40,000 adults and youth annually, TASC has a front-row view of how and where opportunities exist to access treatment for justice-involved individuals.

“As the Commission considers issues related to pretrial reform, we strongly recommend meaningful consideration and incorporation of current scientific knowledge related to substance use and mental health conditions, symptomology, access to care, and appropriate delineation of roles and responsibilities related to such care,” wrote TASC in its testimony to the Commission.

This scientific knowledge includes the fact that, across the country, nearly two thirds of individuals sentenced to jail meet diagnostic criteria for a substance use disorder, compared to five percent in the general population. In recent years, recognition of the prevalence of substance use disorders in justice-involved populations—and of its associated costs to taxpayers—has grown, along with leaps in scientific understanding of addiction as a treatable condition. 

This recognition has coalesced with widespread acknowledgement of iatrogenic effects of incarceration on the health and well-being of individuals and families; that is, incarceration itself—even for short jail stays—increases risks of recidivism.

Some jurisdictions have engaged in efforts to better identify treatment need among justice-involved populations, and to provide or facilitate connections to appropriate care, often in community settings rather than jail.

“Further, while jails are required to provide necessary healthcare, and should be lauded for increased efforts to do so and to improve the quality and scope of care, it is a misuse of incarceration when individuals are sent to or kept in jail longer than legally required as a means of connecting them with care,” wrote TASC. “While perhaps well-intended, this function falls well outside of the fundamental purpose of jail, and may well do more harm than good….Since even short stays in jail can have harmful, long-lasting effects on individuals, families, and communities, any of us who might be inclined to hold people in jail so they can get treatment should ask ourselves if we would make the same choice in order to help someone get treatment for diabetes or hypertension.”

To address substance use disorders among justice populations through a systems-based collaborative approach, various approaches are recommended to grow community capacity for a full range of evidence-based substance use treatment and services, including withdrawal management, counseling, FDA-approved medications, distribution of overdose reversal medication to individuals (and their family and friends), recovery/peer support, cross-discipline referral networks, and robust diversion options that redirect individuals out of the justice system and into community-based treatment.

“People in jails in prisons who need substance use treatment should certainly have access to it, but should not be held there as a way to facilitate it,” concluded TASC in its testimony.

The commission’s final report will be released in December.

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