Transcript Rehab - Background

Rehab - Background
Review:
Prison Outline
Walker Chap 11
Wedding cake model
Walker’s discussion is contemporary --- Some background should be helpful in
understanding policy issues with rehab
Comments:
Social/political policies like rehab usually have a history, and contemporary interest in policies pretty much
always arises from specific circumstances (usually problems) that have arisen. By looking at the history of
policies we can better tell where they come from, how they have worked in the past, their chances for
working under changes circumstances, etc.
As a smart philosopher once said:
“those who forget their history are doomed to repeat it”
Rehab - Background
Rehab is usually discussed in an individual context - not a policy (programs)
context.
There are important differences:
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Coercion issue (forced “help”)
“Program” issues (prediction, fit, etc.)
Measuring success (short vs. long term)
“Net widening” (vs. aging out)
Comments:
Rehab programs relating to target groups (prisoners, probationers, etc.) are almost always coercive (do it
or suffer some kind of consequences!). Program issues involve questions about who will be a good candidate
for rehab, which programs are appropriate for which people (e.g. non drug users don’t need drug
treatment). “Success” is often measured by short term results (e.g. improvements in behavior/attitude)
but long term results are more important (relapse? recidivism?). Aging out usually has better long term
results than any programs, so “net widening” might be a problem no matter how successful the program
appears to be.
Rehab - Background
Individual rehab
Sometimes it works, usually it doesn’t - dieting, smoking, alcohol, gambling, drugs,
self-help, financial problems, etc.
*** Two key problems: dropout & relapse
Given this – how to measure success – those who start, finish, etc.??
Comments:
All of us know how difficult it is to get rid of bad habits (like smoking) or adopt more effective ways of
doing things (eating right, working out, budgeting, etc.). All of these problems are magnified in a policy
approach where coercion is usually involved.
So how do we measure whether a program is successful (and worth the cost!)?
By how many people finish? by short term results? by long term results? or what?
Rehab - Background
“Aging is the best crime reduction policy we know about”
Aging = “doing nothing”
(Walker)
(as policy)
Measure: Rehab vs. Doing Nothing
Doing something makes things worse!
Comments:
Rehab (individual and policy) is further complicated by aging out – one of the patterns that emerges pretty
consistently from the research is that almost any “intervention” (doing something) hinders the process of
aging out and thus is counter-productive. For example, some researchers argue that both punishing illegal
drug use and drug education/treatment backfire by spreading drug use – they contribute to causing what
they are trying to prevent! So the key measure of success for rehab programs is whether it works better
than aging out (doing nothing) – and no rehab programs have clearly met this standard.
Rehab - Background
Where did rehab issue come from??
Before WW2, not much of an issue -- bigger problems - wars, depression, etc.
Rehab issue comes with prosperity!
(Maslow’s “hierarchy of needs”?)
Comments:
The focus on rehab appears to arise historically with prosperity. Psychologist Abraham Maslow argued
that humans tend to focus on basic needs first (food, shelter, etc.) and only after these are consistently
satisfied do we look beyond to secondary needs, e.g. “quality of life” issues.
Rehab - Background
Remember indiv side of rehab ....
But we want to talk about rehab directed at subgroups in the larger population
prisoners
drug users
“at risk” juveniles
parolees
etc.
Comments:
In terms of cj policy, most of the rehab focus is on changing targeted groups of people who are in a
“coercive context” (prisoners, detainees, probationers, etc.) “they” (almost always the poor/powerless) are
a problem for “society” (or more often the powerful people in a society) and rehab becomes the “nice”
alternative to confinement, extermination, etc. Thus conservatives tend to say “they are a problem, punish
them harshly” while liberals tend to say “they are a problem, help them change” – notice that neither
usually questions the social arrangements that give them power and render others powerless.
Rehab - Background
1950s and 1960s – post WW2 socialism – higher wages and benefits
Led to Prosperity, Optimism, Liberalism – and also the rise of rehab
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Expanding economy – consumer manufacturing
Expanding opportunity – service jobs
Civil Rights Movement and Feminism
War on Poverty - “bringing everybody up”
Comments:
Before WW2, most Amer were rural/agricultural/small town/etc. and low wages for workers, poverty,
wars, and economic depressions made life difficult for most people. After WW2, the govt adopted many
socialist reforms and this led to higher wages, broader opportunities, more prosperity, etc. The rapidly
growing "middle class" (basic needs now reliably met) then began to drive an interest in rehab.
Rehab - Background
Low but rising crime rates in 1960s
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baby boomers reaching the prime crime age
masked by Vietnam War & Civil Rights Mvmt
expanding drug use
Imprisonment Rate low - and dropping!
A good time to fix problems!!
Comments:
In the 1950s and into the mid-1960s, the economy was expanding, crime rates were low, and imprisonment
rates were dropping across most of the country. This seemed to many like a good time to fix problems, and
this was the heyday of the rehab movement.
In reality, crime rates were beginning to rise (baby boomers), but this was hardly noticed (and data was
manipulated by the FBI and other police agencies) because of attention drawn by the Civil Rights
Movement, the emerging anti-war movement, and emerging drug use.
Rehab - Background
Liberal rehab approaches
Diversion - into job programs, military
old manufac, new service jobs, military
For prisoners - rehab programs driven by indeterminate sentencing and the promise
of help on release - halfway houses, etc.
Comments:
The "top layer" of rehab (mostly for less serious offenders) involved factory jobs and often joining the
military - for more serious offenders who usually were sent to prisons for relatively short terms, the "new
rehab" was to include indeterminate sentencing to push prisoners into rehab (cooperate and get out
sooner) plus job training in prison, halfway houses upon release, and programs to help excons get jobs.
Rehab - Background
1970s The “lost decade”
everything went wrong!
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Vietnam disaster
War on Poverty abandoned
Declining economy
Pessimism & “Malaise”
Backlash against CRM, Liberalism, Fem’ism
Comments:
By the late 1960s, the US was beginning to come apart at the seams - the white/conservative backlash
against the Civil Rights Mvmt, the anti-war mvmt, anti-poverty programs, etc., plus a declining economy, led
to the disastrous decade of the 1970s (Richard Nixon resigned in disgrace - Gerald Ford gave Nixon a
pardon preventing criminal prosecution, and then lost the next election - Jimmy Carter was a one-term
president - etc.) - by the end of the 1970s, the US was (permanently?) split between mostly-white
conservatives (Ronald Reagan was elected in 1980) and everybody else. Long a part of the conservative
agenda, "get tough" approaches to crime (and the poor, drug users, etc.) now became the focus of much
govt policy, and this what has developed and deepened since.
Rehab - Background
Crime rates stabilized at a high level
(baby boomers aging out)
But distorted by conservative politicians & media crime and drug scares
“our ever-increasing crime rates”
Martinson Report - rehab a failure -“Get tough” approaches become popular
Comments:
Meanwhile, crime rates stabilized at relatively high levels (the baby boomers began aging out) even as
conservatives continued to promote the idea of "ever increasing crime rates" and the media increased
their focus on crime in both news reporting and fictional TV shows, movies, etc. The popularity of the "get
tough" approaches only increased with the Martinson report which (superficially) showed that rehab had
not been demonstrated to work despite the expenditure of large amounts of money on programs.
Rehab - Background
1980s - The conservative turn
Continuing econ probs - declining manufac, globalization effects
Continuing abandoning of the poor
War on crime, war on drugs escalate
Crime rates stable, but IR rising fast
Prison overcrowding, rehab declining
Comments:
Economic problems continued into the 1980s as manufacturing continued to decline and jobs continued to
move to other countries (mainly for cheap labor). As tax bases deteriorated (lower wages led to lower tax
revenues and govt expenditures) the poor were increasingly "abandoned" (services deteriorated) and poor
communities were left with high crime rates. Meanwhile, overall crime rates remained stable (baby
boomers aging out and "graying" of society). Popular conservative get tough approaches were sending huge
numbers of poor people to prison and prisons were overcrowded and disorganized (violence, gangs, etc.).
Rehab continued to decline as liberalism declined and there was no money anyway because of the cost of
expanding prisons.
Rehab - Background
1990s -
Clinton years (conservative turn continues with cons democrat admin)
economic boom - based on new technologies (computers, electronics, etc.)
double help for poor - econ & govt
crime rates falling fast as BBs age out
but - war on crime and drugs continues and
IR continues to grow rapidly
Huge prison expansion
(at a huge cost!!) Warehouse prisons - little rehab
Comments:
In the 1990s the US experienced an economic boom - the new jobs, rising wages, and rising tax revenues
provided some help for poor people (jobs and govt aid) and continuing aging out of the baby boomers led to
big decreases in street crime rates. But the cons war on crime and drugs continued (with even more govt
money to spend!) and the imprisonment rates grew rapidly. As prisons increasingly became very expensive
warehouses for the poor, rehab funding was further cut and programs disappeared.
Rehab - Background
2000s - return to more conservative Repub admin
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economy crashes + terrorism and war
double hit on the poor - econ & govt
crime decrease stops - rates level off
continuing war on crime and drugs
continuing imprisonment binge - and continuing growth of huge cost
Led to the current rehab dilemma
Comments:
After 2000, the economy turned down and many poor jobs were lost, plus a cons govt cut the few programs
for the poor that had emerged in the 1990s. The crime decreases stopped and crime rates leveled off at
still high rates (esp violent crime). The war on crime and drugs escalated again and the imp binge grew
faster at huge cost, and this led to a dilemma - the cost of "get tough" was finally beginning to create
huge problems for state budgets (schools, health care, colleges, etc.).
Rehab - Background
Rehab as a “political football”
Rehab (policy) mostly doesn’t work -- Long history of failure
But extremely high recidivism rates and the staggering costs of prisons poses a huge
problem that drives govts back to rehab.
Mostly at state level - states pay for most of the costs!
Comments:
This why "rehab is back" - it has a long history of failure and there is no reason to believe that it will work
any better today than it has in the past - but conservative "get tough" approaches are an even bigger and
more costly disaster - they don't work either and as prison pops grow so do recidivism rates and the cost
of prisons - meanwhile states are "de-funding" public schools, colleges, health care, and other services
that might actually reduce crime in order to pay for prisons. Thus states get both the high cost of prisons
and high crime rates - they have to do something, but what can they do? What are the politically viable
alternatives to rehab?
This is where Walker's discussion of rehab starts .......