Harford County has launched a program for prison inmates with drug problems and mental illness that experts say is the first of its kind in the state and among the first nationwide.
The program will provide free drug treatment, counseling, medical and mental health care and transportation to treatment centers, officials said. Counselors also will help former prisoners sign up for related state and federal services.
"It's innovative, and it's grounded in common sense," said Dr. Robert P. Schwartz, an expert on drug addiction and treatment.
"You bring people to the services they need. It's not very complicated, but it's not been done," said Schwartz, medical director at Friends Research Institute, a Baltimore organization that studies mental health and addiction, and a fellow at the Open Society Institute in Baltimore.
The approach is designed to tackle a problem that has frustrated public officials for decades: the large percentage of former inmates who repeatedly end up in prison for reasons related to addiction or mental illness. Experts say that up to half of all inmates fall into this group.
"There is a huge revolving door of people who have substance abuse problems and mental illness and end up getting arrested multiple times," said Dr. Yngvild Olsen, medical director of the Harford County Health Department and the primary architect of the program. "There has to be a way that we can intervene to stop that."
This program will provide an important component: free transportation from the Harford County Detention Center to the treatment center when inmates are released. That is crucial, Olsen said, because inmates often have no way to get to treatment even if they want to sign up. By enrolling them as soon as they are released, she hopes to help them avoid old routines that lead to drug use and crime.
"It's a captive audience, no pun intended," Olsen said.
In Harford County and elsewhere, programs assist inmates with drug problems. But many experts say such programs do little good because the lessons learned inside prison walls tend not to stick in the outside world.
Several Maryland counties, including Wicomico and Montgomery, offer programs, including drug treatment, for former inmates. But the Harford program, as yet unnamed, breaks ground by linking the various pieces into a comprehensive whole. The program offers not only drug treatment, but transportation, medical care, mental health treatment and help in applying for other services.
"The new part is linking people released from the detention center to all these services in a systematic way," Olsen said.
Olsen developed the idea for the program this year, along with Sharon Lipford, head of the Harford County Office on Mental Health. Olsen broached the subject with Harford County Sheriff L. Jesse Bane, who oversees the detention center, and with Warden Elwood J. DeHaven. Both were enthusiastic.
Bane, who was elected in 2006, has promised to lower recidivism rates. He said the program could help do that.
When Olsen first talked with him about the idea, "I jumped right on it," he said. "If you can get these people the services they need, they won't be coming back."
Olsen emphasized that the program's aim is not simply to help inmates but to cut crime and prison budgets by reducing recidivism.
"This can have enormous benefits to the community," she said.
Thomas McLellan, a University of Pennsylvania psychologist and professor who is an expert on drug treatment, said that on average, an arrest costs taxpayers $13,000 and that a year in jail costs $30,000 to $40,000.
"It's in everybody's interest to reduce arrests and incarceration," he said.
The program is open to any prisoner at Harford's Detention Center. The jail, which usually has a population of about 460, houses inmates serving sentences of less than a year. Those serving longer terms or who are convicted of federal charges go to state or federal prison.
The program, which officially began in September, has signed up 14 inmates. Two have been released and have started treatment; the rest are still behind bars.
It will be funded by a three-year, $484,000 grant from the Maryland Community Health Resource Commission. Bane agreed to add $3,000 from his department's budget to cover the cost of transportation. In a county like Harford, which has limited public bus service, many prisoners have a hard time getting to and from treatment or therapy.
"When people get out of prison, there's a very high relapse rate," Schwartz said. "There aren't that many jails that have a tight linkage to community rehab. The standard practice is that they're on their own."
He called the Harford County program a "fantastic idea" and praised the focus on transportation.
Many researchers say that effective treatment programs give addicts a good chance to kick their habit.
McLellan said that such programs have a 70 percent success rate. But he warned that without specific incentives, many participants in the Harford program might drop out.
Patients must have not only a substance abuse problem but must also have a mental illness, such as attention-deficit disorder, an anxiety disorder or depression.
Such problems are not unusual among inmates, said Linda Davis, a social worker in charge of identifying potential candidates. She has worked with inmates at the detention center for more than a decade, mostly on HIV-related issues.
"What I tell the guys in the jail is, 'You don't know if you're depressed if you've never not been depressed,' " she said. She said many inmates use drugs and alcohol to deal with depression.
"A lot of them self-medicate," she said. "We have to come up with a different solution."
When the program started, among the first inmates to whom Davis spoke was India James.
James, 35, has spent much of the past six years in the detention center, mostly for shoplifting convictions. By her estimate, she has served 13 sentences. She is now serving nine months for violating probation after being arrested in March for shoplifting at a Wal-Mart.
James, who lives in Aberdeen, said she has spent much of the past six years addicted to crack and steals to get money for drugs. After being released, she can usually last a few months without using drugs.
"After that, all it takes is the right person saying the right words; it takes you back," she said.
After she gets out, James said, she usually returns to her old life.
"I just go back to my old hometown, with all the old hometown friends, who of course are getting high," she said.
When Davis approached her about the program, James was intrigued.
"The more she talked, the more I said, 'That's wonderful,' " James said. "I have to have some structure."
James still has far to go. She will be released from the Harford Detention Center this month and will then spend a year in state prison at Jessup. The time in the detention center is for violating probation; the time in Jessup is for the shoplifting conviction.
James is optimistic that the new Harford approach will help her when she gets out.
"There's no reason that drug addicts can't thrive in this program," she said.
* Free outpatient substance abuse treatment
* Free mental health treatment
* Free transportation from the detention center to outpatient treatment program
* Low-cost medical care
* Help with applying for state and federal programs, such as Medicaid and Primary Adult Care, that cover costs of substance abuse, mental health and/or medical care