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EXECUTIVE SUMMARY
INTRODUCTION AND BACKGROUND
Drug Courts were initially developed in the USA in the late 1980s. Scotland's first Drug Court was established in Glasgow Sheriff Court in October 2001 and a second pilot Drug Court was introduced in Fife in August 2002, making its first order on 9th September 2002. The Fife Drug Court sits in Dunfermline and Kirkcaldy Sheriff Courts.
Both Drug Courts are aimed at offenders aged 21 years or older of both sexes, in respect of whom there is an established relationship between a pattern of serious drug misuse and offending. They aim to reduce the level of drug-related offending behaviour, to reduce or eliminate offenders' dependence on or propensity to use drugs and to examine the viability and usefulness of a Drug Court in Scotland, especially, in the case of Fife, in a non-urban centre. All Orders made by the Drug Court - Probation Orders or Drug Treatment and Testing Orders ( DTTOs) are subject to drug testing (urinalysis) and regular (at least monthly) review.
The Glasgow Drug Court has the Shrieval capacity to operate on four days a week, with two sheriffs covering it on alternate weeks. In Fife, the Drug Court sits for two days per week in Kirkcaldy and for one day per week in Dunfermline. One sheriff sits in the Fife Drug Court, with a stand-in sheriff to provide back-up during periods of absence. The Drug Court Sheriffs have responsibility for reviewing Orders and responding to non-compliance. Other designated staff include Sheriff Clerks, court officers and, in Glasgow, a Procurator Fiscal and Co-ordinator. In both Drug Courts a Supervision and Treatment Team has been established to support the Drug Court in all aspects of assessment, supervision, treatment, testing and reports to the court.
In many respects there are operational similarities between the two Drug Courts. However there are also important procedural differences, which were instituted to enable the Drug Court model to be adapted to different local contexts.
METHODS
A variety of qualitative and quantitative research methods were employed. They included: interviews with professionals associated with the Drug Courts; interviews with Drug Court clients; collection of information from Drug Court records; observation of the Drug Courts in action; and the completion of individual client questionnaires by members of the supervision and treatment team. In addition to these more formal methods, the researchers spent time informally familiarising themselves with the Drug Courts and becoming acquainted with the role of the various professionals involved in its operation.
REFERRAL AND SENTENCING
Potential candidates for the Fife Drug Court were usually identified by sheriffs sitting summarily in Dunfermline or Kirkcaldy Sheriff Courts or were brought to the attention of the bench by defence agents. In Glasgow, referrals, particularly from the police, remained lower than expected. In practice most were referred by marking deputes or, following the expansion of the referral routes, directly by other Sheriffs. Professionals were generally content with the referral criteria, though some suggested that younger offenders should be given the opportunity to participate in Drug Court Orders. In Glasgow relatively few women were referred because their offences were often deal with by the District Court.
In September 2002, 73 existing DTTOs were transferred into the Fife Drug Court. A total of 872 additional referrals involving 382 individual offenders were made during the pilot period. Males accounted for 82 per cent of referrals, the majority of which emanated from Kirkcaldy Sheriff Court. In Glasgow, 271 cases had been referred for assessment by the middle of November 2004, 202 (75%) via a screening group/interview and 69 (25%) via a direct referral from another Sheriff. Over 90 per cent of individuals referred to the court were male. Cases considered by the Fiscal to be potentially suitable for the Glasgow Drug Court were referred for screening - initially a group attended by various professionals and later an interview conducted by a social worker. This was viewed as an effective mechanism for filtering out inappropriate referrals and was seen as particularly valuable early in the pilot period.
Drug Court assessments involved the client attending multiple appointments with the Supervision and Treatment Team and submitting to a drug test. Sheriffs were content to continue such cases on bail as this provided a more realistic test of the offender's motivation and willingness to comply. Clients were well informed about the purposes and requirements of Orders prior to consenting to their imposition. While some offenders apparently agreed to an Order to avoid a custodial sentence, most were also motivated by the possibility of getting off drugs. Views were divided over whether the possibility of participating in the Drug Court encouraged offenders to enter earlier guilty pleas. There was no evidence, however, that it encouraged them to plead guilty to offences that they were not, in fact, guilty of committing.
In Fife, 205 (24%) referrals resulted in Drug Court Orders being made. Most Orders imposed (78%) were DTTOs, and their average length was 18.7 months. Over four-fifths of offenders made subject to an Order were male; their average age, 26 years. Nearly all were unemployed or not seeking work and, from limited data, it appears that most had an extensive list of previous convictions and custodial sentences. In Glasgow, 150 (55%) referrals resulted in Drug Court Orders being made, most of which were DTTOs (73%) of an average length of 18 months. Of offenders made subject to an Order, 91 per cent were male and their average age was 31 years. Nearly all were unemployed or not seeking work and most had an extensive list of previous convictions and custodial sentences.
Drug Court Sheriffs considered the range of sentences available to them to be effective and appropriate and believed that their sentencing decisions were better informed than in the Sheriff Court due to the highly comprehensive and focused reports made available to them. Deferred sentences were also seen to afford some flexibility in sentencing, although Sheriffs expressed reservations about the usefulness of Restriction of Liberty Orders for offenders in receipt of drug treatment. Information about outstanding charges was seen as problematic by Fife Sheriffs who bemoaned the lack of a dedicated Drug Court Fiscal.
SUPERVISION AND TREATMENT
Multi-professional and multi-agency working are key characteristics of the Drug Court despite having the potential for minor difficulties in practice. The services made available to offenders through Drug Court Orders were comprehensive, with treatment and testing as the main component of all interventions. Treatments included a range of services provided by the Drug Court Teams and external service providers. The services included counselling, prescribing, access to day programmes and primary medical care. However, it was notable that substitute prescribing (using methadone) constituted the core element of the treatment service in practice. Concerns were expressed by members of the Supervision and Treatment teams and Drug Court participants that the operational regimes lacked flexibility, and that levels of medication provided were not always in compliance with the wishes of individual participants. There also appeared to be a broadly based desire for more comprehensive service provision and a wider range of services to be made available to the Drug Courts. Participants were, however, generally satisfied with the treatment and other services that they had received at different stages of their Orders and most appeared to have engaged with the Supervision and Treatment Teams.
Drug testing forms a key component of Drug Court Orders with participants tested twice weekly at the beginning of an Order. Relapse is recognised as a possibility and time is allowed to enable participants to stabilise their drug use before reducing/ending it. Drug Court participants saw testing as a largely positive element of the Order, viewing it as a significant motivating factor as well as a deterrent. Obtaining negative test results was viewed as a clearly defined goal, particularly given the prominence of this issue during reviews and the dialogue between participants and the bench.
Multi-disciplinary teamwork had been identified as less effective than it might be in the early stages of the pilot and was a particular problem for the Fife Drug Court. These difficulties had been recognised and were being addressed. Communication between different professionals involved in the Drug Court in Glasgow was now seen as very good and positive relations had developed within the multi-disciplinary team. This had been facilitated by a move to better equipped and more conveniently located premises, though some shortcomings of the new building were also identified.
The availability and management of substitute providing has become the focus for much of the internal frustrations over different treatment philosophies and management systems. Indeed, the issue of prescribing has achieved such symbolic importance that other approaches to the problem appear to have been sidelined in many ways and their relevance may have been undermined. In Fife, the development of effective, multi-disciplinary approaches to the treatment of drug-related offenders has not been assisted by the existence of duplicate case management systems such as the two-stage assessment system, the dual system of formal warnings and the lack of any coherent linkage between the weekly case discussions and the clinical meeting. In spite of these difficulties, a great deal of excellent work has been accomplished with individual clients and at the day-to-day case management level, individual practitioners have clearly found practical ways of working together effectively for the good of the client.
Two particular issues were highlighted as presenting challenges to the Drug Courts. The first was the increased incidence of cocaine use among participants, especially in Glasgow. This may require a wider range of resources, including residential rehabilitation, and will have clear resource implications. The second issue concerned the use of random drug tests, which team members considered desirable. The practical difficulty appeared to centre upon how random tests could be accommodated within participants' other commitments, though this issue does not appear to have been insurmountable in other jurisdictions and the potential for introducing random tests should be more fully explored.
REVIEWS AND ENFORCEMENT
Pre-court review meetings were perceived to be a beneficial component to the process of supervising and treating participants on Drug Court Orders. The thorough private exchanges of information around the multi-agency table, chaired by the Drug Court Sheriff, informed and shaped the nature of the dialogue with the participant during the review. In particular, pre-court review meetings enabled discussion of issues of a highly sensitive nature that it would be inappropriate to air publicly in open court. Most offenders were confident that their progress was discussed in a fair and appropriate manner.
Review meetings were held in open court, a transparency that was perceived by the Drug Court Sheriffs as valuable to maintaining public confidence in the Drug Court during its pilot stage. Sheriff-participant dialogues were at the heart of reviews and were regarded as a distinguishing feature of the Drug Court approach. Participants were very positive about this aspect of the Drug Court and regarded continuity of sentencer at reviews as important. The concept of drug use as a relapsing condition was recognised by Drug Court Sheriffs and particularly emphasised in Shrieval dialogue.
Supervision and Treatment Team workers took active steps to respond to instances of non-compliance. The Drug Court Sheriffs had a limited range of options in the event of non-compliance, though intermediate sanctions of imprisonment and Community Service had been made available to the Drug Court from July 2003. There were also relatively few options available to reward progress on an Order, other than reducing certain requirements associated with the Order or discharging the Order early on the basis that sufficient progress has been made. At most of the observed reviews, participants were deemed to have been compliant (or sufficiently compliant) with all aspects of their Orders and most reviews involved no changes being made to the treatment plan or to the frequency of testing or attendance at reviews.
Procedures for ensuring that outstanding charges were rolled up and new offences brought to the Drug Court were considered to work well, especially in Glasgow, though this was not always possible (for example, if a participant re-offended outside the jurisdiction of the Drug Court). The imposition of custodial sentences for outstanding or new charges by other courts could make it impractical for an Order to continue, with the result that it would have to be revoked.
Participants were generally accepting of the sanctioning role of the Drug Court Sheriffs and were positive about receiving praise in recognition of their progress. Although the options available to the court to reward progress were limited, an expansion in the repertoire of culturally appropriate 'rewards' presented challenges. However in view of the participants' appreciation of positive reinforcement through praise, this, along with appropriate variations in the requirements associated with Orders, may prove a sufficient incentive in the Scottish context.
Overall, the Drug Court was viewed by participants as fair in its response to non-compliance and it was acknowledged that participants would usually be given several chances before their Orders were breached. Participants generally regarded sentences imposed on revocation or breach as fair, though a minority considered them unduly harsh and their treatment overall to have been inadequate.
Completion rates for the Glasgow and Fife Drug Courts were commendable given the high tariff nature of the Drug Court Orders. In Glasgow 47 per cent had completed their Orders compared to a completion rate of 30 per cent in Fife.
THE OUTCOMES OF DRUG COURT ORDERS
Professionals were cautiously optimistic that the Drug Court was proving effective in addressing drug use and associated offending behaviour. Although it had not worked with all of those who participated in it, there had been clear instances of success. 'Success' was acknowledged to be difficult to define, but reductions in drug use and offending were to be welcomed.
At different stages of their Orders most participants reported that they had reduced their use of drugs and their involvement in drug-related offending. The treatment and other services were believed to have impacted upon their drug use and offending, though many participants also stressed the importance of personal motivation to initiate and sustain change. Most participants viewed the Drug Court as a positive opportunity for change and many reported that being on an Order had bought about other improvements in their lives. A small minority whose Orders had been terminated early were somewhat more disenchanted. Participants stressed the importance of being linked into a wider range of services and supports if they were to sustain achievements made. Therefore while the aspects of the Drug Court regime - such as the treatment, testing and regular reviews - were important in helping to initiate change, they needed to be located within a wider framework of support.
Analysis of questionnaires completed by social workers at different stages of participants' Orders indicated that reductions in drug use and offending were anticipated in most cases and improvements that were made appeared to have been sustained over time. The questionnaires suggested that participants were more likely to have effected changes in their drug use and offending and to have addressed other problems in their lives after twelve months on an Order. This was particularly so in Glasgow, with less evidence of change over this period in Fife.
Social workers' perceptions that drug use had decreased over the course of Orders was supported by the analysis of drug test results. In both Glasgow and Fife there was a steady decrease in the proportions of clients testing positive for opiates and benzodiazepines over the course of an Order.
Fifty per cent of Drug Court clients had been reconvicted within one year and 71 per cent within two years. The reconviction rates were similar in Glasgow and Fife and similar for men and women. The ages of those convicted and not convicted were similar but those who were reconvicted had more convictions in the two years prior to being placed on an Order. Probationers were slightly (though not significantly) more likely than those on DTTOs to be reconvicted while those who completed their Orders were slightly less likely to be convicted than those who did not. Clients who completed their Orders had fewer convictions in the two years after being made subject to an Order than in the two years immediately before.
THE COSTS OF DRUG COURT ORDERS AND THEIR ALTERNATIVES
The average cost of a Drug Court Order was estimated to be £18,486 compared with the average costs of a non Drug Court DTTO at £14,085. In addition, three major areas of potential cost savings can be identified. Firstly, the Glasgow Drug Court was operating well below capacity for a substantial proportion of the pilot period. Secondly, there was a significantly higher level of breaches and revocations in Fife compared to the rates in Glasgow and these discontinuations generally happened much earlier in the Order. Thirdly, in both pilots (though this was particularly evident in Fife), a complex multi-disciplinary assessment procedure appeared to engage a substantial element of staff time and did little to encourage access to treatment. None of these issues is insoluble and steps have already been taken in both pilots to begin to address these problems. However, it is important to note that resolving these issues has a serious cost benefit not just for the two pilots which were evaluated, but also for the wider savings that can be achieved by reducing levels of drug-related crime amongst a group of offenders for whom existing treatment interventions have either failed or failed to make themselves properly accessible.
CONCLUSIONS
Drug Courts cannot provide a panacea for the problem of drug-related crime. However there is evidence that a sizeable proportion of clients made subject to Drug Court Orders were able to achieve and sustain reductions in drug use and associated offending behaviour. Given the difficult client group with whom they were engaging and the challenges of providing a co-ordinated multi-professional response, the pilot Drug Courts can be deemed to have been a success. While operational difficulties were encountered during the establishment and operation of the pilots, there was widespread support for the Drug Courts both from those working within them and from other criminal justice professionals, such as Sheriffs sitting in other courts.
The main strengths of the Drug Court can be summarised as the 'fast-tracking' of offenders (in Glasgow), the existence of a trained and dedicated team with regular contact with participants, and the system of pre-court review meetings and reviews. The dialogue between the bench and Drug Court participants was viewed almost universally as a central component of the Drug Court process. The Drug Court Sheriffs reported being better informed about drug use and therefore better able to respond appropriately to those appearing before the Court.
Challenges faced by the pilots that would need to be considered if further Drug Courts were to be developed included: obtaining sufficient appropriate referrals; dealing with staff turnover and ensuring that the Supervision and Treatment Team is adequately resourced; developing effective multi-professional teamwork; dealing with changing patterns of drug use; providing for longer-term support for those on Orders; and developing appropriate IT systems to support the work of the Court.
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