Ebony S. McDonald, MSW, LSW, MBAp

VISN 4 HCRV SpecialistLebanon VA Medical Center

Goal: Promote successful community integration by engaging in Tx & rehab programs which assists in preventing homelessness & decreasing recidivism

Every VISN has a HCRV Specialist• Many have at least 2 (39 nationally)• Incorporating HCRV specialists into individual

facilities

Outreach into state & federal institutions • 46 State, 13 Federal, & 49 CCC • Pre-release services

Education on benefits & services Assessment of needs (i.e. R-Form) Eligibility (i.e.10-10EZ)

Collaboration with DOC, BOP, & Parole Accessing healthcare upon release Assisting with homelessness Addressing mental health & substance abuse issues

Referrals• VA• Community

~1.2 million Veterans arrested in 2007 9 in 100 inmates in U.S. jails & prisons

is a Veteran• In mid 2007, 9.4% or 223,000 inmates in

prisons & jails were Veterans• Does not include those on community

corrections or supervision 703,000 Veterans incarcerated or supervised in

2007 ~10-12% (5,124-6,149) of PA DOC

inmates report military serviceBanks (2009); Bureau of Justice Assistance (n.d.); Gains Center (2008); Coleman (2009); PA DOC

(2010)

BASIC CHARACTERISTICS PROBLEMS

Mean age: 48 years 98.2% Male Race

• 52.3% White• 40% Black• 5.1% Hispanic

Marital Status• 54% Divorced/Separated

79% Vietnam Era 16% Served in Combat

Medical & Psych Diagnosis• 54.9% Medical• 54.4% Alcohol• 60.4% Drug• 22.3% Dual Dx• 28.6% Serious Psych Dx

Criminal Offenses• 36.7% Violent• 22.4% Property• 25.1% Drug• 14% Public Order (i.e. DWI,

prostitution)NEPEC Draft Data for HCRV Report (2010)

Trained to survive in combat which can change worldview• The world isn’t safe• Others want to harm me• Must be ready for danger at all times• No sense of purpose

Transition back to civilian life can be difficult Hypervigilance Aggressive driving Carrying weapons at all times Self-medication

Coming in contact with our criminal justice system

As of May 2010, ~7,930 men & women from PA deployed in Iraq & Afghanistan

Post-deployment incidences Substance abuse Domestic violence PTSD/TBI Depression/Anxiety Unemployment

Unmet mental health a growing concern for combat Vets• Survey of 1,965 OEF/OIF Vets found

18.5% mental health condition 19.5% experienced a TBI during deployment 14% prevalence of current PTSD & depression

• 2008 RAND Corporation study found 1/5 or 300,000 of the 1.6M U.S. troops witnessed combat action & reported

symptoms of PTSD & depression Many did NOT seek treatment

PA Dept of Military & Veterans Affairs (2009); Gains Center (2008)

Small proportion of justice-involved Veterans

Actual number unknown nationally

~4% in VISN 4 from 2007-2009(n=474 in state & fed prisons)*

NEPEC Draft Data for HCRV Report (2010)

More than 85% of people sent to prison are paroled back to the streets• More than 650,000 people are released from

state prisons in the U.S. each year• Est. 9 million released from local jails each

year In 2007, Est. 56,000 Veterans released

from prison each year ~80% of incarcerated Veterans have an

honorable or general discharge• 82% are eligible for VA services

Gains Center (2008); Noonan & Mumola (2007); Schaffer (2009)

Many released from incarceration at-risk for homelessness• Increases likelihood of recidivism• More than 10% of those coming in & out of

prison report homelessness in the months prior

• Mental illness increases this rate to about 20%• 49% of homeless adults reportedly spend 5+

days in a city or county jail over their lifetime• 18% has been incarcerated in state or federal

prisonBureau of Justice Assistance (n.d.)

States passing legislation to address increase in Veterans within justice system• Preference towards treatment over

incarceration Veterans Courts Veteran tracks within specialty courts Veterans Justice Outreach into jails Training police as first points of contact on how

to appropriately respond & defuse situations ReEntry Courts

Long-term housing solutions

Continued identification to barriers for Veterans

Continued work with corrections & the community to establish solid relationships & supports

Treatment to address PTSD/TBI & trauma

OEF/OIF Veterans increasing within justice system

Veterans have shorter criminal hx• Committing more violent crimes

Military mind-set Untreated PTSD/TBI & depression

• Serving longer sentences Veterans are less likely in the first place

to be incarcerated Treatment needed post-deployment Continued diversion & outreach needed

Ebony S. McDonald, MSW, LSW, MBAp

VISN 4 HCRV Specialist1700 S. Lincoln Ave (680)

Lebanon, PA 17042717-272-6621 ext 6215

ebony.mcdonald@va.gov