Background:
On April 1, 1991, Project Recovery began offering daily (six days per week) acupuncture treatments at both the men's and women's Honor Farms, which are minimum security annexes of the Santa Barbara County Jail.
Funding for this project was private. Subjective responses to the program from jail personnel have been very positive, with reports of fewer discipline problems and improved attitude on the part of inmates receiving treatment. Inmates report consistent relief from post-acute drug/alcohol withdrawal, including improvements in sleep and energy levels and reduced fear and anxiety. They report feeling a deeper resolve to continue sobriety upon release.
The intent of the program was to demonstrate a reduction in recidivism among inmates who volunteered for the daily acupuncture treatment for the thirty days prior to their release (an optimum total of 24 treatments).
Although treatment was voluntary, inmates often pursue treatment while incarcerated in order to achieve favorable parole hearings and, hence, an earlier release. This agency has been in dialogue with the judges, with the public defender, and with the district attorney as well as the jail administration concerning the possibility of making acupuncture treatment while in jail a condition of either sentencing or probation. This has not been possible during this project since not all inmates are eligible for Honor Farm placement and our treatment was available only at the Honor Farm sites.
This preliminary study is of the re-arrest rates of those inmates who volunteered for acupuncture treatment during their incarceration and who were subsequently released. A greater lapse of time and more statistical analysis is required for a more precise evaluation of this program.
Re-arrest in general among the Santa Barbara County Jail population is pervasive. The most recent inmate study showed that 91% of those incarcerated have been incarcerated before. It is also estimated that 85% of the inmates have a history of substance abuse which was a precipitating (if not sole) factor in the criminal behavior that resulted in incarceration.
Statistical Outcomes:
Between April 1 and July 29, 1991, one hundred and six male and female inmates volunteered for acupuncture. Of these one hundred and six inmates, this study concerns the seventy-six who had been released as of July 29. These seventy-six had received a total of 1,256 acupuncture treatments - ranging from one treatment to sixty-nine - for an average of 16.5.
According to the County Jail administrative department, of these seventy-six inmates who received treatment and were subsequently released, fourteen (18%) were re-arrested.
As we examined the treatment records of these fourteen re-arrests, we discovered that twelve of them (86%) had not completed the recommended daily treatment for the thirty days prior to their release.
The following chart shows the treatment distribution among inmates and the corresponding re-arrest rates:
|
Number of Treatments |
Number of Inmates receiving this number of treatments |
Number in this group re-arrested |
| 1 | 7 | 2 |
| 2 | 9 | 2 |
| 3 | 4 | 2 |
| 4 | 9 | 3 |
| 5 | 3 | 0 |
| 6 | 2 | 0 |
| 7 | 3 | 1 |
| 8 | 1 | 0 |
| 9 | 4 | 0 |
| 11-17 | 8 | 0 |
| 19-24 | 7 | 2 |
| 25-30 | 8 | 0 |
| 31-36 | 5 | 2 |
| 37 or more | 8 | 0 |
No data are available from the jail on "average turnaround time" - on the time typically elapsing between release and re-arrest. Individual cases indicate that this time is often short: our most prominent treatment "failure" - an individual who received 34 treatments - was homeless upon release and continued outpatient treatment for two weeks. Then he moved to the Faulding Hotel, resumed daily heroin use, and was re-arrested within one week.
One inmate received 24 treatments in custody, and was re-arrested for jumping bail three days following release.
Receiving a significant number of acupuncture treatments during the thirty days prior to release appears to have a positive influence on re-arrest rates.
Further study is required as to whether those inmates receiving treatment will continue to have lower rates of re-arrest than non-treated inmates over a longer period of time.
This preliminary data, however, indicates that continuation and expansion of this program is clearly indicated. The cost of the program is $36,000 per year per site. Providing this service at both Honor Farms and at the main jail would therefore cost $108,000. The number of inmates who would be treated for this amount is estimated at 600.
The average cost of incarceration is $14,000 per inmate per year. If only 8 of the 600 inmates treated achieved recovery as a result of the program and hence avoided re-arrest, the total cost of the program would be justified from a cost point of view.
The annual $14,000 per inmate cost of incarceration is a theoretical figure in that costs of operations of the County Jail are fixed costs and remain relatively constant whether or not the jail is substantially overcrowded. Like all County services, the jail is currently under severe budget constraints.
However, substantial inmate reduction using this treatment modality is likely over time. This reduction in recidivism will ultimately impact not only the cost of incarceration but also the entire spectrum of criminal justice service delivery from arrest, judication, public defense and prosecution, to probation services, all of which are dramatically overburdened at this time.
Funding from the private sector is required to extend this service for an additional year to more clearly demonstrate the ultimate impact on our community. More definitive outcome statistics can then be used to influence the State to adopt this treatment protocol in order to effect substantial savings throughout the criminal justice system, not only in Santa Barbara but throughout California, and hopefully in the State Prison system as well, where the average cost of incarceration is $22,000 per year per inmate.
(Note: Private funding was secured to continue this service in the Santa Barbara County Jail's Women's Honor Farm. The results follow.)
A research project was initiated in October, 1992, to study re-incarceration rates of female inmates of La Mirada, the County Jail's Women's Honor Farm, comparing, with a non-acupuncture control group, re-incarceration rates of those women who received acupuncture treatment over a 13 month period.
Project Recovery administrative staff, in cooperation with the County Jail's administrative staff, selected, at random, 29 women who were incarcerated at La Mirada during early 1989, before the acupuncture program was initiated. The Jail administrative staff then determined, from their computer data base, re-incarceration data for these 29 women.
There were no identifiable variables at this facility between 1989 and 1992. The facility is a minimum security annex of the County Jail, providing no on-site drug treatment except weekly 12-step meetings. A number of inmates are on a work furlough program, and virtually all inmates have a history of substance abuse regardless of the reason for their incarceration. Nor was there any significant change in sentencing philosophy on the part of the court, nor changes in arrest priorities on the part of the City or County law enforcement agencies, between the period during which the control group and the treatment group were subject to re-incarceration.
Of the 29 women selected for the control group, the jail administrative staff determined that:
21 of the 29 (72%) were re-incarcerated following release.
3 of the 29 (10%) were re-incarcerated within 30 days of release.
10 of the 29 (30%) were re-incarcerated within 90 days of release.
15 of the 29 (52%) were re-incarcerated within 120 days of release.
Project Recovery provided Jail administration with the names of 29 women who had volunteered for at least 10 acupuncture treatments while at La Mirada during 1991 and 1992. We selected only those women who had been subsequently released prior to June 1, 1992 - 120 days prior to the date of the study. Jail administration did a search of their computer data base to determine re-incarceration data for these 29 women, finding that:
16 (55%) were re-incarcerated following release (compared with 72% of controls).
2 of the 29 (7%) were re-incarcerated within 30 days of release (compared with 10% of controls).
7 of the 29 (25%) were re-incarcerated within 90 days of release (compared with 30% of controls).
7 of the 29 (25%) were re-incarcerated within 120 days of release (compared with 52% of controls).
The treatment protocol used was a basic five-point auricular protocol developed by the National Acupuncture Detoxification Association. Since clients were not generally detoxifying, expanded treatment protocols were used from time to time in response to inmate complaints of insomnia, anxiety, irritability, depression, menstrual difficulties, viral infections, or digestive problems.
Women in the acupuncture group all received 10 or more treatments, with an average of 31.2 treatments each. Sixteen received fewer than 32 treatments, and 13 received more than 32 treatments. Of the group who had fewer than 32 treatments, 10 (63%) were re-incarcerated following release; of the group receiving more than 32 treatments, 6 (46%) were re-incarcerated.
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