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MERIT - Conference Paper, Perth May 2002 ‘MERIT’, a cooperative approach addressing drug addiction and recidivism. Authors: John Scantleton, Manager, Lismore MERIT Program Jeff Linden, Senior Coordinating Magistrate, NSW North Coast Bryan Boulton, Crime Manager, Richmond Local Area Command Peter Didcott, Research & Quality Officer, Lismore MERIT Program Abstract: This paper presents an overview of the MERIT program in three parts. Firstly a description of the program and preliminary data (John Scantleton & Peter Didcott); secondly, the judicial perspective (Jeff Linden) and finally the Police perspective (Bryan Boulton & Peter Didcott). The MERIT (Magistrates Early Referral into Treatment) program is a fresh approach to dealing with drug abuse. Offenders facing Court with identified drug-related issues are diverted from the Criminal Justice System into effective drug treatment programs. As MERIT is pre-plea, the accused is bailed to the program with adjournments until graduation, at which time the case is heard and matters are finalised. Of the 221 clients accepted into the program in the first twenty months of operation, 95 (50%) of those exiting the program graduated. 77% of the accepted clients were male; 23% female. 16% were Aboriginal. 62% presented with opiate abuse issues. Over 96% had prior criminal convictions with over 60% having served time in custodial institutions. This paper provides a description of the MERIT program, client profiles and preliminary client outcomes including sentencing outcomes and recidivism rates as identified through the New South Wales Police COPS system. It also considers advantages and disadvantages of the MERIT program from a judicial perspective. Finally, it describes a successful partnership of health, justice and enforcement agencies which maximises successful treatment outcomes while ensuring community protection. Introduction Authors: John Scantleton & Peter Didcott It has long been recognised that the Criminal Justice System’s ability to effect significant change in drug taking offenders’ behaviour has been limited in many cases and where recidivism occurs, the most effective treatment course is to incarcerate the offender so as to optimise community protection. In May 1999, the New South Wales Drug Summit identified the need for a fresh approach to tackle the issue of drug misuse and to encourage the various enforcement, health and welfare agencies to work better towards this end (1). As part of the NSW Government Plan of Action to implement the resolutions of the NSW Drug Summit, a range of innovative schemes was introduced or trialed for the police, courts and health to divert offenders from prosecution and custodial sentences. These schemes attempt to break the drugs-crime cycle by involving offenders in treatment and rehabilitation programs as a way of addressing their drug dependency (2-4). One of the schemes adopted from the Drug Summit initiatives was a pre-plea drug court diversion program targeting offenders with a drug problem, which became known as the MERIT program. MERIT is a positive acronym for Magistrates' Early Referral Into Treatment reflecting the innovative nature of the program. MERIT was originally based on the Court Referral and Evaluation for Drug Intervention and Treatment (CREDIT) developed at the Melbourne Magistrates’ Court (5). Though there are some 600 drug courts in the US there are at present few in Australia. MERIT was the first Australian drug court set up in a rural area and is the only pre-plea program in NSW. Commencing on 3rd July 2000, it was based at the Lismore Local Court. It is now being expanded state wide in New South Wales. MERIT has an emphasis on early referral and provides for entry into the program at the time of arrest or at any time up to the first court appearance. A feature of the MERIT program which distinguishes it from many other drug courts is the fact that the defendant is not required to enter a plea in order to participate in the program. Further, there is no requirement that a determination of guilt be made prior to entry to MERIT being extended. The primary eligibility criteria relate to the participant’s suitability for bail and their motivation to engage in treatment and rehabilitation for their drug use problems over a time framed and structured period. This paper will provide an overview of MERIT, a view from the judicial perspective and the police perspective. It will also examine the partnership approach and the benefits which have resulted from this collaborative approach. The MERIT program: a fresh approach. The MERIT program provides a fresh approach to dealing with drug abuse. The program aims to divert suitably motivated drug offenders who meet eligibility requirements from the Criminal Justice System into effective drug treatment programs. Whilst the clients originate through the legal system, it is a true diversion program in that it allows suitably motivated offenders to be removed from the legal system and placed into drug treatment which is operated and managed by the Health Service. The MERIT program is more intrusive than a conviction or a short sentence in that the treatment program is sustained, structured and intensive, requiring offenders to address many personal issues in addition to their drug taking behaviour. One of the significant challenges in developing a drug court is integrating the Criminal Justice System and treatment agencies. The MERIT program model effects a partnership approach, which is a unique union of the health and justice systems with accountability to both the judicial and health arenas. Locally, the program is overseen by a Steering Committee consisting of representatives from local courts, NSW Attorney General’s Department, the Police Service, Legal Aid Commission, treatment providers and the NSW Health Department. There is also a central MERIT Reference committee. An important factor in choosing Lismore as the trial location was the commitment of the relevant agencies to a partnership approach. Referrals to MERIT may be made from a variety of sources: solicitors, legal aid, magistrates, Police, the Probation and Parole Service, or by the offender themselves. Ideally the offender is referred as soon as possible after arrest, though in practice most are referred by solicitors following arrest or at court by the Magistrate. To be accepted, the accused must have a demonstrable drug problem, be willing to participate in the program and reside in the catchment area. The scheme is restricted to adult offenders. Defendants charged currently or with outstanding serious violent or sexual offences, or charged with wholly indictable drug offences, are excluded from the scheme. At the bail hearing, the MERIT Team provides a written report to the Magistrate recommending whether or not the defendant should be entered into the MERIT Program. The Magistrate has discretion to determine whether the defendant is an appropriate candidate to be bailed to MERIT. If accepted into the program, clients are released to bail by the court and agree to enter a tailored treatment regime. Where possible, the same Magistrate deals with the defendant throughout the bail order. In difficult cases, the Magistrate may undertake an increased level of judicial supervision as a core element of the program. This judicial supervision may involve additional court appearances to establish how the offender is progressing and to offer encouragement. On the other hand, if the defendant is not going well, the magistrate can play an important role in reinforcing the serious consequences of non-compliance such as withdrawal of bail. Breach from the program is undertaken by way of a Breach of Program Conditions Report which is submitted to the court on the next adjournment date or re-listed to an earlier date where necessary. Where there are community protection issues and an acknowledgement that the participant is not complying with the program requirements, a Breach of Bail report can be submitted to the Police Service enabling the police to arrest the participant and to put them before the court at the earliest opportunity. As MERIT is essentially a voluntary program, participants can withdraw from the program at any stage without penalty. In this event, their court matters proceed in the normal way. The MERIT treatment program The pre-plea court diversion model, where offenders enter treatment without any acknowledgement of guilt, facilitates effective intervention. Offenders are told that their only motivation for being in MERIT is to address their drug abuse and associated lifestyle issues, with their legal matters being dealt with only at the conclusion of the treatment cycle. As a result, many of those referred to MERIT have been responsive to treatment and have been willing to address various lifestyle issues, the resolution of which are extremely important in drug abuse recovery. MERIT clients are managed by experienced caseworkers during their period of treatment in MERIT. The program relies on an intensive case management model with an emphasis on the participant acknowledging the severity of their drug abuse, their acceptance of intrusive and intensive formal supervision - and, in some cases, firm direction - by a caseworker assigned to them for the duration of their stay in the program, and an acceptance of realistic treatment options. Urinalysis for therapeutic purposes is an integral element in the client case management and provides verification of compliance with substance abstention. Many clients face complex problems ranging from drug dependence and health disorders through to unemployment and associated financial and housing difficulties. Families may be dysfunctional and children can be at risk. Additionally clients have to deal with their legal problems, some of which are complicated and long-standing. Thus on initial referral to MERIT the participant undergoes a comprehensive assessment to ascertain suitability for the program, assess the client’s needs and formulate a treatment plan. This includes an assessment of current drug use, previous drug use problems and previous treatment episodes, family relationships and family drug history; social situation; legal issues; any medical, mental health or psychological problems; motivation for change and potential to engage in treatment. Where MERIT differs from most other drug court initiatives is that all legal, supervision and treatment issues are dealt with by a single team of caseworkers. Whilst this is proving to be a very effective method of intervention, it is however challenging for caseworkers because of these potentially conflicting roles. If accepted into the MERIT program a client may be directed to one or more of a wide range of treatment and welfare services. These may include: hospital detoxification, home based withdrawal/detoxification with medical support, residential rehabilitation, methadone and other pharmacotherapies, individual and group counselling, including attendance at a Day Treatment Program numerous forms of welfare support and assistance. Intensive one-to-one supervision, often on a daily basis for the first few weeks of the program, and access to a full range of health and welfare services, is considered essential to effect changes in lifestyle and behaviour of what is in the main a very difficult client group. The MERIT team provides case management of clients and provides all required reports to the Court. They also conduct outpatient counselling and structured group therapy programs. The total number and the frequency of counselling sessions varies for an individual depending on the nature and extent of drug related and other problems. However, the program has a minimum treatment phase of three months. The MERIT model has avoided the need for dual supervision of offenders with other agencies while in MERIT unless there is a specific need for this, such as where mental health issues are evident. Specialist services such as medical, psychiatric, psychological, family and child services, may be accessed or purchased on a sessional basis as needed. Number and nature of referrals: Chart 1: Source of Referrals From about the second week of operation the program has received a fairly constant stream of referrals from the Court. After twenty months of operation, 302 persons have been referred to MERIT and of these, 221 (73%) were accepted into the program. Of the remainder, some declined admission and others did not meet the entry criteria. (Table 1). Table 1 - Assessed clients Number Assessed Accepted into MERIT Clients declined admission Ineligible/fail to meet entry criteria 302 221 (73%) 19* (6%) 62 (21%) * A further 10 clients were referred but failed to attend for assessment. The great majority of clients have been referred into MERIT at court and this prevents clients’ access into treatment up to a month prior to their presentation at court. However, referrals can be made by Police at the time of arrest; some police have embraced MERIT with much enthusiasm, which is very encouraging. Similar enthusiasm for the program is evident from the Legal Aid solicitors. Client profiles: 171 clients (77%) of those accepted for MERIT were male and 50 (23%) were female: Table 2: Sex MERIT accepted persons Male Female Total Number 171 (77 %) 50 (23%) 221 The average age of all accepted clients is 29.4 years. Twenty two (16%) of the accepted clients were Aboriginal: Table 3: Aboriginality MERIT accepted persons Aboriginal/TSI Non Indigenous Not Stated/ Unknown Total 35 (16%) 183 (83%) 3 (1%) 221 The majority of those accepted into MERIT were heroin users: 57% identified it as their drug of choice and 62% as a problem drug. A high proportion were cannabis users, though only 34% reported it as a problem for them. Chart 2: Drug of Choice Chart 3: Drug of Choice X Time The effect of the heroin drought has been significant during the last quarters with the substitution of amphetamines for heroin. The increased use of amphetamines, which is not as easily identified in the charge/court processes has necessitated a more confronting approach with the clients in order to have them engage fully in treatment. There is also evidence of increased poly drug use resulting from the short supply of heroin. Cannabis users considered eligible for MERIT are limited to those who present with a significant addiction such that their ability to live a relatively normal lifestyle is impeded due to their drug use. Client Profiles Health and criminal justice indicators show that the client group as a whole is severely disadvantaged and presents many challenges for the caseworker to effect meaningful and lasting changes: All clients present with a demonstrable drug problem 86% were either unemployed or in receipt of a pension Many were housed in poor accommodation (eg 17% caravan park/hostel/refuge, 57% rented) Many had poor educational attainment - 65% left school at or before year 10. Caseworkers report a high rate of abuse, physical or sexual, as children 60% have a prior prison record Over 90% have prior criminal convictions Extremely high incidence of dual diagnosis High rate of identified mental illness: 16% had a psychiatric diagnosis, admission or both 17% reported suicide attempts 26% reported overdoses 72% had injected within last 3 months. Table 6: Outcome Status of Accepted Clients Number Accepted Graduated Current Clients Withdrew Breached/Removed 221 95* 29 19 77 * A further 1 client completed but failed to graduate. Fifty percent of those exiting the MERIT program did so as graduates; that is they had completed all program requirements and had remained in the program for at least 3 months. It is noteworthy, in view of the criminal and personal profiles of the MERIT participants overall, that such a large proportion were retained in treatment for three months or more. An encouraging feature of the program is that some clients who have entered residential rehabilitation programs have shown a desire to continue with treatment on graduation. One noticeable feature is that MERIT appears to be reaching a number of long term addicts who have never accessed treatment services despite many years of drug use. Chart 3: Sentence Outcomes - Graduates/Non-Graduates (NB: Not all graduates have been sentenced) The sentences imposed on graduates of the program are significantly different from those received by the non-graduates. (Chart 3). A higher proportion of the graduates received a minimal or no penalty and fewer received a custodial sentence. This clearly indicates the willingness of the sentencing magistrate to acknowledge the significant effort made by the participant and impose a lighter sentence. Impact on recidivism rates: Ninety six participants have completed the MERIT program in the first twenty months of operation. Of these only 37 (38%) have been further charged, with 28 (29%) of the charges relating to theft or drugs. At the time of report preparation, these graduates had been on average 56 weeks since commencing the program and 40 weeks since completing it. Thirty nine (41%) of the graduates have not come under any police notice for criminal activity or through other Police intelligence This is significant given the participant’s criminogenic profiles and is discussed further later in the Police section of this paper. MERIT - The Judicial Perspective Author: Magistrate Jeff Linden The MERIT (Magistrates Early Referral Into Treatment) Scheme is a quantum leap in the treatment of and Judicial dealing with drug affected persons. From the Judicial perspective it is an almost complete turnaround from traditional dealings with offenders affected by drug problems. The Parramatta (Sydney) Drug Court and most Judicial dealings attack the problem at the conclusion of proceedings as a sentencing option. Often supervision and treatment are then made the subject of conditions of a Bond, suspended sentence or lengthy remand. The consistent overriding factor is the threat of breach action for non-compliance. With few exceptions the parties are “untested”, that is sent off without any prior intervention of Health to determine their level of compliance and therefore likelihood of success. MERIT changed the point of intervention from the end to the very beginning. Police referrals before the first Court appearance or identification of a drug problem at the first Court appearance sees immediate referral and assessment by the health team. If accepted the defendant then enters into the program for identified treatment for approximately 12 weeks. The intense treatment/counselling is therefore concluded when the defendant is called upon to enter a plea and the Court is armed with a large amount of health related material in considering the ongoing determination of the criminal matters. The MERIT Program has been described as the perfect marriage between the Health and Criminal Justice System and that view has not been tempered by the effluxion of time since the first trial of the scheme commenced at Lismore Local Court in July 2000. A planning group, including the Magistrate was formed to discuss policies and procedures prior to the trial commencing at Lismore. From those meetings the philosophical basis of the Program became settled and almost without exception has remained constant at the Lismore venue. The maintenance of these criteria is one of the key factors in the success of the scheme. From a Judicial perspective it has been found: 1. The fact that it is a pre plea scheme and therefore available to those users who request entry 2. 3. and who and who are assessed by the MERIT health team as being suitable is a potent encouragement for satisfactory completion of the minimum 12 week program. Other drug schemes in NSW, such as the Parramatta Drug Court are, as previously stated, based on after plea and longer term compliance with conditions. There is thereafter the real threat of incarceration for non compliance hanging over the participant’s head. MERIT offers no Judicial guarantees and threatens no consequences for non compliance. It is totally non compulsive from a Judicial perspective. Flexibility is paramount. History dictates that because of the early level at which the defendants enter the scheme there are likely to be rocky times with the treatment program. To that extent during the period of treatment adjournments are allowed at intervals and for such period as the health team requests. This will range from overnight adjournments to several weeks. Defendants are often excused from attending if in residential rehabilitation but otherwise are required to attend each adjournment. The Court Protocol for case management of Criminal matters, ie time standards and the ordering of briefs of evidence orders are totally suspended during the MERIT participation. Trust in the judgement of the MERIT team. The MERIT team have the face-to-face, daily contact with participants and to that extent bail conditions are usually granted in terms “Defendant to report to MERIT by and comply with all requirements of the MERIT team during the period of the adjournment”. Initially police expressed some concerns that these conditions took a measure of control out of their hands and could as a result lead to ongoing criminal activity. In the absence of MERIT intervention, bail conditions often would have included specific restraints, including curfew, restrictions on entering or loitering in or near premises, removal from some towns or villages (Nimbin comes to mind) restraint on keeping certain company etc. These conditions gave police direct power to arrest for breach of bail and initially gave rise to some police scepticism when MERIT began that this may lead to increased criminal activity. From a practical perspective it is conceded by the police prosecutor that the professional and prompt manner in which breaches are reported has allayed to an enormous degree police concerns. Advantages and Disadvantages of MERIT from a Judicial perspective. ADVANTAGES: 1. Reduction in reoffending. Many of the participants have in the past as Claude Rains described in “ Casablanca” been “ the usual suspects.” There prevailed for a short time a degree of Judicial cynicism about the ability of the MERIT health team to manage these people from a Judicial perspective. One participant in particular was in the view of the magistrate doomed to failure. In such cases, history has proved those fears unfounded. By far the majority of referrals have not again come under adverse notice and those few that have relate to far less serious offences. This has been particularly noted by local police and has been one of the significant factors in the program being accepted by them as a valid and useful diversion tool. The advantages to the community would appear obvious. 2. Pleas of guilty where otherwise a plea of not guilty might be anticipated. This has been a 3. 4. 5. bonus not envisaged at the outset. History has generally shown that drug affected offenders rarely plead guilty at the first opportunity. As the first series of defendants completed the MERIT scheme it became apparent that pleas of guilty were almost invariably forthcoming. As this trend continued it has been assessed that less than 5% of those who completed the scheme pleaded not guilty and the vast majority of those have relied on a statutory defence only. This in turn has resulted in a significant saving of Court, Police and civilian time and therefore expense. Even the “failures” provide assistance for future dealing with defendants. Many if not most of the participants have had repeated dealings with the Criminal Justice System and have been through the court directed programs. MERIT, being pre plea and voluntary, blunts almost entirely the suggestion “ My client wishes to enter rehabilitation” when he or she has previously volunteered and failed to comply with MERIT. Conversely those who have successfully completed MERIT can with more confidence be placed on further supervision as a condition of a subsequent Court bond following sentence. Treatment /Rehabilitation is now provided where that was otherwise unavailable. Prior to MERIT the initial and ongoing MERIT Lismore manager was the head of the Casino Probation Service. That service was the primary supervisor of court mandated offenders. Facilities, particularly for rehabilitation and detoxification were difficult if not near impossible to access. Even expert ferreting by the Manager, which saw people taken interstate, and to far-flung centres could not cope with demand. MERIT from the outset was well funded and as a consequence otherwise unattainable facilities became available. For example The Buttery, previously a private rehabilitation centre and totally inaccessible to Court mandated people became MERIT friendly. In addition a Detoxification centre came on line in Lismore. These necessities, prior to MERIT, were almost unattainable luxuries. It goes without saying that proper funding of the scheme is vital to its success. Cost Benefits. With the current economic rationalistic approach to almost everything the MERIT scheme has been subject to ongoing research as to any cost benefits to the community. A number of anomalies can arise when taking the economic rationalistic approach to judicial proceedings but that is an issue for another time. Preliminary findings point to a diverse area of cost savings including savings in prisoner numbers, court and police time and in addition community savings by a reduction in re offending and an increase in community protection. Judicial Disadvantages: The only obvious disadvantage is the necessity of multiple adjournments while the program is completed. As identified at the NSW Magistrates Annual Conference last year all the Chief Magistrates Case Management Principles are suspended while participants are in the Program. The Chief Magistrate is extremely supportive of MERIT and has endorsed the need for special consideration to those matters. Judicial experience in any event shows that drug afflicted offenders are to say the least inventive in finding ways of obtaining adjournments to suit their needs. Any perceived disadvantages of MERIT requested and Court mandated adjournments is far outweighed by the distinct advantages that flow from the successful completion of the Program. In summary, from a Judicial perspective the MERIT Scheme provides an important tool in dealing with drug related crime. It has proved to be a success beyond the most optimistic expectations and is now being introduced throughout NSW. It received recognition in the Service Delivery section, second only to the Olympic Games, in the NSW Public Sector Awards and has received extremely favourable acceptance by Police and all interested parties in Lismore. The Future of MERIT and Courts: As mentioned above the success thus far of the Program can be measured by a number of yardsticks but particularly the fact that it is being introduced in Local Courts State wide. The resident District Court Judge at Lismore is more than interested in the scheme. As nothing in practice reaches the District Court without Local Court intervention (either by committal for trial or sentence) the early intervention by MERIT at the Local Court stage and before committal to that Court is totally feasible. There is therefore potential to expand to that Jurisdiction which in turn would encompass nearly 100% of all drug related crime in the State. The MERIT model is commended to all States and the NSW State Government is to be particularly commended for their foresight and assistance in the implementation and ongoing support for this marvellous facility. MERIT - The Police Perspective Authors: Detective Inspector Bryan Boulton & Peter Didcott The MERIT Program is one of a series of initiatives generally known as Court diversion programs, which aim to divert offenders with a drug problem into treatment. The shift in viewing illicit drug use not only as a criminal justice but also a health issue represents a major cultural shift for police. It has to be acknowledged that this is likely to be difficult for some police to embrace. Cultural shifts in attitudes and practices take time, and there is a need for supportive environments and training for them to be effective. Many police perceive the addressing of drug use and addiction as a health issue and this is a step towards more enlightened policing. It is recognised that interventions such as MERIT do offer a practical solution to a difficult social problem. They are a possible means of breaking the cycle of drug use and related criminal activity. Though these programs are likely to ‘capture’ only a small proportion of the population using illicit drugs, they do offer another useful strategy in every day policing. During the first 6 months of the Program nearly 80% of MERIT clients had a heroin addiction. The cost of heroin being $300 a gram with some addicts using up to 2 grams a day (or even more in some cases) necessarily forces them to commit crime to support their habit. The precursor for entry into the MERIT Program is where the offender has been arrested for a drug related crime. It is no surprise then that offenders with a heroin addiction form such a large percentage of the program clients. Although the preference for heroin dropped significantly between December 2000 and December 2001 to 49%, the preference for a substitute drug in the form of amphetamines rose from 26% to 39%. The addicts shifted their preference in response to the relative unavailability of heroin during the so called ‘heroin drought’. Police officers are potentially the most important source of referral to the MERIT program since referral at time of arrest allows for immediate intervention, rather than up to a month later when the accused is to appear in court. Police referral to MERIT often relies on the discretion of relatively junior officers which means that training of police needs to occur at a variety of levels, including those police who are responsible for implementing the program at the street level. For police officers, there needs to be a clear appreciation of the potential benefits of the program. An advantage from an operational viewpoint is that the referral process fits within existing and familiar arrest and court referral processes. Recognition that taking a drug offender ‘out of the play’ is a crime reduction strategy which disrupts the drug crime cycle is paramount with long term prospects of rehabilitation and less potential for recidivist criminal activity. Partnerships One of the important strengths of the MERIT program is the partnerships and cooperative working arrangements which have developed between Health, Police, the Court and the community sector. These stakeholders normally have different agendas and often look for quite different outcomes from a program dealing with illicit drug use. Too often the agendas of police and treatment agencies are viewed as competing alternatives: treatment or enforcement. Programs such as MERIT, which divert offenders into treatment within a law enforcement framework, can enhance the effectiveness of both. Though admission to the MERIT program is voluntary, the law enforcement aspect of the program does encourage people to enter treatment who might not otherwise have contemplated doing so. Once there, they are likely to do as well as people entering treatment purely voluntarily. Similarly the threat of breach of bail can be useful in helping keep them in treatment when they might want to drop out. Richmond Local Area Command acknowledged the potential of such a program and embraced the strategy of referring offenders with a demonstrable drug problem at the time of the arrest for assessment by the MERIT team in Lismore. This partnership produced a Police referral form with an informed consent provision signed by the offender authorising the exchange of information between the Health Department and the Police Service. A degree of trust has developed between police and MERIT, which is backed by more formal links such as the Memorandum of Understanding between NSW Police and NSW Health. It has resulted in an on-going two-way exchange of information between the MERIT program and the Richmond Local Area Command. Examples are: The MERIT program keeps Police informed (by weekly lists) of new clients, clients who have completed or have been breached to the court, and those currently in residential rehabilitation; Police report to MERIT adverse activities of clients and associates through the exchange of relevant intelligence. The MERIT Manager may notify Police of a breach of bail so that the accused can be arrested, when it is considered that the client’s behaviour is a risk to the community; Police provide criminal histories, including interstate criminal histories, to MERIT on request. Police provide relevant intelligence on identified associates of MERIT clients particularly when they are living together. Community Protection One possible difficulty with programs such as MERIT is the NIMBY (Not In My Backyard) syndrome. Many people who might otherwise support the idea of treatment for offenders who are chronic drug abusers will be concerned about disorder or burglary by clients while they are on the program. This is because the clients may need to be moved to the Lismore area for the duration of the program. They may not favour any local initiative which might result in an increased risk of offences against the person and property . The MERIT program takes these concerns, and the broader issue of community protection, very seriously and addressing them is a central feature of the program. Prompt information exchange between police and MERIT, and the assurance that the activities of program participants are monitored, can do a lot to allay this concern. All clients are released to bail or if entering the program pre-court, may be subject to a Field Court Attendance Notice (FCAN). If a client breaches program conditions, a Breach of Program Conditions Report is prepared. This is submitted to the Court which may re-list the matter to an earlier date or ‘call up’ the defendant. If the defendant fails to attend, the court may issue a bench warrant for their arrest. If the client is considered a risk to the community, a Breach of Bail Report is submitted to the police who may arrest and hold the defendant until the Court can consider the issue of the breach and the identified community protection issues. Recognising that substance abuse is a chronic and recurring disorder, the MERIT program maintains constant supervision over the recovery process of each participant. Progress is demonstrated by showing up at all required court appearances, regularly appearing at the treatment program on time, attending and cooperating fully in the treatment sessions, cooperating with MERIT staff, and submitting to regular supervised urine testing. In appropriate situations, particularly where public safety is an issue or a participant wilfully fails to comply with program requirements, they may be referred back to the Court as breaching program conditions and dealt with immediately. MERIT, like most diversion programs, does not accept offenders with charges which are sexual or seriously violent in nature. However, this relates only to current charges and may not be the best indicator of a person’s criminal history. Some clients have mental health issues. Consequently some clients may pose a risk to the community, though this may not be evident when they are accepted onto the program. In this event, close and effective collaboration between the MERIT program and the police can prove crucial to the program’s success. It is important that Police identify career or professional criminals who might otherwise fit the program entry requirements and advise the MERIT team accordingly so as to prevent their admission. The MERIT program has had a significant effect on the local crime rate in being able to temporarily remove from the community individual offenders who may constitute a ‘one man crime wave’. Placement of a single client in residential rehabilitation has been known to reduce the crime rate in a local neighbourhood by an astonishing 50%. Even more remarkable is that these success stories have continued after the three months at MERIT have been completed, the case has been finalised at Court and the accused is back in the community Is MERIT Effective? When people ask: “Does the program work? Is it effective?” the yardstick often used is: does it reduce crime? We have attempted to answer this question by using the NSW Police COPS system (Computerised Operational Policing System) to carry out a criminal record and intelligence check of MERIT clients. The results show the proportion of clients so far who have re-offended whilst on the program or afterwards. Of the 96 persons who completed the Program between the 3rd July 2000 to the 12th April 2002, 39 (or 40.6%) have not come under the notice of Police in any way during or after the Program. A measure often used in evaluating outcome is whether there is a legal action resulting in a court appearance. Only 37 (39%) of the 96 persons completing the program had such legal action between their entry into MERIT and 12th April 2002 - an average of 13 months. Twenty eight (29%) of the ex-MERIT participants had charges relating to theft or drugs. Most of the drug charges involved cannabis only. There were six charges in total for Break Enter and Steal, one during the program and five after completing the program. Again, this is in a time period averaging 13 months. There were 99 intelligence reports submitted concerning 41 MERIT clients. Twenty five were linked to heroin with 17 of those during the program and only 8 after the program. One report was linked to amphetamines during the program with 5 reports linked after the program. In view of the client group, this is considered to be an exceptionally good result which demonstrates that as far as criminal recidivism is concerned, the program is proving to be effective. When MERIT was set up, it was envisaged that most of those referred would be early in their criminal career, and thus stand a good chance of a successful outcome within the three month program. In fact, statistical profiles of MERIT clients show they are in the main a highly criminalised group. Of the 221 clients accepted into MERIT in the first twenty months of operation, at least 90% had a previous criminal record and 60% had served time in jail. Also, a high proportion had a diagnosed mental illness. Some clients were well known to local law enforcement agencies as having a long history of offending and frequently, mental health problems. The positive results obtained by the MERIT program with this difficult and recidivist group are testimony to the intensive and intrusive nature of the program and the persistence of the MERIT caseworkers. An evaluation is also being conducted which compares the offence rates of those accepted into the MERIT program with a matched group of accused who would be eligible for MERIT but who reside in an area which does not have a MERIT program. When the results are available they will provide a more rigorous assessment of the effectiveness of MERIT. Other measures of the success of the program are a reduction in drug abuse, improved life functioning and improved life skills and health. Here too the program is demonstrating good outcomes though it is early days yet to draw firm conclusions. MERIT has demonstrated that treatment programs for drug-dependent offenders do work, provided they remain within the program and the program is of sufficient duration, structure and intensity. There is compelling justification for requiring criminal offenders with drug problems to submit to treatment programs. Conclusion The challenges facing the MERIT New South Wales state roll-out and similar diversion and drug court programs is to ensure a coordinated approach by the relevant agencies involved. In the Lismore and the Northern Rivers Area Health Service areas, a successful trial has concluded demonstrating a clear commitment by justice, enforcement and health service agencies to better address drug issues and associated offending behaviour. From a police perspective, it is seen as a practical and strategic response to the often intractable problem of repeat drug abusing offenders. The program is a timely and necessary response to the issue of illicit drug use. While maintaining an emphasis on community protection and due processes of criminal justice, it is a way of breaking a pattern of drug use and making a difference to the lives of people apprehended. From a court perspective, MERIT challenges some of the court case management practices as offenders are permitted to remain pre-plea for an extended period. There are clear financial benefits when almost all MERIT graduates plead guilty at the first opportunity. More importantly, from a magistrate’s perspective, offenders are observed to be making significant lifestyle changes and addressing drug using behaviours without the normal court mandated orders. They are doing this because they want to not because they have been ordered to do so! Traditional Health drug (and alcohol) intervention strategies have had to rely largely on the client’s willingness to engage in treatment. Those with limited motivation tend to access these services only when in crisis. MERIT clinicians have extended powers to ensure compliance and cooperation by clients. With the endorsement of the court and cooperation of Police, clients feel more compelled to endure a structured and intensive treatment program offered by MERIT. It works for the client as the onus is clearly on them to take responsibility for their actions, but within the confines of a structured process. Acknowledgements The Crime Prevention Division, NSW Attorney General’s Department as the lead agency coordinating NSW court diversion programs The Drug Programs Bureau, NSW Department of Health. Members of the Lismore MERIT Steering Committee. The health and welfare services and other agencies providing assistance to the MERIT program. References (1) New South Wales Government. NSW Drug Summit 1999: Government Plan of Action. Sydney: NSW Government, 1999 (2) Frieberg A. Australian drug courts. Criminal Law Review 2000; 24: 213-235 (3) Swain M. The illicit drug problem: drug courts and other alternative approaches. Sydney: NSW Parliamentary Library Research Service, 1999 (4) Spooner C, Hall W, Mattick R. A strategic overview of the diversion of drug-related offenders in NSW. Sydney: National Drug and Alcohol Research Centre, 2000. (5) Heale P, Lang E. A process evaluation of the CREDIT (court referral and evaluation for drug intervention and treatment. Drug Alcohol Rev 2001; 20: 223-230.