The Magistrates Early Referral Into Treatment (MERIT) Pilot Program: a descriptive analysis of a court diversion program in rural Australia

Diversion Programs for Individuals Who Use Substances: A Review of the Literature

Diversion programs connect individuals to treatment instead of criminal sanctions and are used more frequently to address substance use. This systematic scoping review included 31 published empirical studies to examine evaluations of diversion programs that address substance use and misuse. We assessed the program characteristics and implementation settings, as well as the outcomes measured and study methods used. We identified five prevalent study outcomes categories: (a) Service utilization (program retention and completion), (b) Recidivism/criminality, (c) Substance use, (d) Psychosocial functioning, and (e) Other outcomes (e.g., trauma, quality of life, and housing). Findings demonstrated limited but promising evidence for improvements in recidivism, substance use, and psychosocial outcomes. The limited evidence may be partly due to heterogeneity in diversion program implementation, study designs used, and differences among subpopulations. Most studies examined postbooking diversion programs; therefore, further examination of alternative approaches such as prebooking diversion programs is needed to fully understand diversion program impacts.

Court as a health intervention to advance Canada's achievement of the sustainable development goals : a multi-pronged analysis of Vancouver's Downtown Community Court

Background

The increase in problematic substance use is a major problem in Canada and elsewhere, placing a heavy burden on health and justice system resources given a spike in drug-related offences. Thus, achievement of Sustainable Development Goal (SDG) Target 3.5 to ‘Strengthen the prevention and treatment of substance abuse’ is important for Canada’s overall realization of the SDGs, including SDG 3 (Good Health and Wellbeing). Since 2008, Vancouver’s Downtown Community Court (DCC) has pioneered an innovative partnership among the justice, health and social service systems to address individuals’ needs and circumstances leading to criminal behaviour. While researchers have examined the DCC’s impact on reducing recidivism, with Canada’s SDG health commitments in mind, we set out to examine the ways health and the social determinants of health (SDH) are engaged and framed externally with regard to DCC functioning, as well as internally by DCC actors. We employed a multi-pronged approach analyzing (1) publicly available DCC documents, (2) print media coverage, and (3) health-related discourse and references in DCC hearings.

Results

The documentary analysis showed that health and the SDH are framed by the DCC as instrumental for reducing drug-related offences and improving public safety. The observation data indicate that judges use health and SDH in providing context, understanding triggers for offences and offering rationale for sentencing and management plans that connect individuals to healthcare, social and cultural services.

Conclusions

Our study contributes new insights on the effectiveness of the DCC as a means to integrate justice, health and social services for improved health and community safety. The development of such community court interventions, and their impact on health and the SDH, should be reported on by Canada and other countries as a key contribution to SDG 3 achievement, as well as the fulfillment of other targets under the SDG framework that contain the SDH. Consideration should be given by Canada as to how to capture and integrate the important data generated by the DCC and other problem-solving courts into SDG reporting metrics. Certainly, the DCC advances the SDGs’ underlying Leave No One Behind principle in a high-income country context.

The Magistrates Early Referral Into Treatment (MERIT) Pilot Program: Court Outcomes and Recidivism

Diversion programs for drug offenders have proliferated in the last decade in the belief that treatment of underlying drug use will decrease an individual's criminal activity. The NSW Magistrates Early Referral Into Treatment (MERIT) program diverts adult offenders with significant drug problems, on bail, from the court to a 3-month intensive drug treatment program. This article reports on the criminal justice outcomes of the Lismore MERIT Pilot Program. Findings indicate that participants who completed the program were significantly less likely to reoffend, took longer to reoffend and received less severe sentences than those who did not complete the program. The reduction in reoffending is significantly associated with program completion even when other factors associated with recidivism are controlled for, including previous incarceration. Overall these findings contribute to the growing literature indicating that providing treatment for offenders with illicit drug problems can be an effective crime reduction strategy.

Comparative analysis of recidivism outcomes following drug treatment court in Vancouver, Canada

Drug Treatment Courts (DTCs) integrate therapeutic interventions for substance using offenders with the administration of justice. Available evidence indicates that DTCs are effective at reducing recidivism, but it is not yet established whether they are equally effective for all subgroups of offenders. The current study investigates the comparative effectiveness of a Canadian DTC among subgroups defined by ethnicity, gender, prior offending, and the presence of a co-occurring mental disorder. Results indicate greater reductions in recidivism among female and Aboriginal participants, and no differences in recidivism associated with the presence or absence of co-occurring mental disorders or the number of prior convictions. Longer duration of involvement with the DTC program was positively associated with reduced recidivism. The effectiveness of DTCs with distinct subpopulations may be related to their composition and inclusion of expertise relevant to the needs of diverse participants.

Factors affecting criminal recidivism among participants in the Magistrates Early Referral Into Treatment (MERIT) program in New South Wales, Australia

INTRODUCTION AND AIMS

The Magistrates Early Referral Into Treatment (MERIT) program is a diversionary program for people with substance use (primarily illicit drug) problems, based in New South Wales, Australia. The aim of this study was to assess factors relevant to recidivism among MERIT participants.

DESIGN AND METHODS

A longitudinal study utilising administrative data was conducted. MERIT participants entering the program after 1 August 2004 and with a finalisation date of prior to 31 December 2005 were included in the study. Recidivism records for this cohort were obtained for the period 1 August 2004 and 31 December 2007 and linked to MERIT administrative data. Cox proportional hazards modelling was used to identify predictors of recidivism.

RESULTS

A total of 1160 MERIT participants were included in the analysis. Compared to non-completers, completion of the MERIT program was associated with a 30% reduction in risk of recidivism. Factors associated with increased risk of recidivism following MERIT included principal drug other than cannabis and higher number of prior convictions. Discussion and Conclusions. Although the design of this study does not permit causal conclusions, these results suggest the MERIT program may be associated with reduced criminal offending. The identification of factors associated with increased risk of recidivism may be helpful in identifying participants in need of higher intensity interventions.[Larney S, Martire KA. Factors affecting criminal recidivism among participants in the Magistrates Early Referral Into Treatment (MERIT) program in New South Wales, Australia.