Until recently, a disproportionately high number of non-violent mentally ill offenders with a concurrent substance abuse disorder in Kings County, New York, had been denied the opportunity for treatment as an alternative to incarceration. In an attempt to resolve this problem, District Attorney Charles J. Hynes created, in 1998, Treatment Alternatives for Dually Diagnosed Defendants (TADD), an alternative to incarceration program. The program later expanded to also include offenders with serious mental illness but no substance abuse disorder.
Once a defendant is identified as mentally ill, the District Attorney's Office reviews the facts of the case to determine program eligibility. Those who are believed to be appropriate candidates for treatment are referred to TASC/LINK (a non-profit organization with trained mental health professionals) for clinical assessment, placement, and monitoring. A severe and persistent mental illness, often accompanied by a verifiable substance abuse disorder, generally determines clinical eligibility. Personal contacts are investigated to assist in the apprehension of the participating defendant in the event that he or she absconds from the treatment program. Defendants who meet program criteria must plead guilty prior to entering treatment. Predicate felons are placed in treatment for 18-24 months, while those with misdemeanor charges enter treatment for a period consistent with their charges. Upon successful outcome, the guilty plea is vacated, and the charges are dismissed. Upon failure, the defendant is sentenced in accordance with the agreement at the time the plea was taken. In 2002, the United States Department of Health and Human Services Administration awarded the Kings County District Attorney's Office a grant to expand TADD to serve more defendants, to create a replicable program, and to research and analyze the diversion process.
As of February 1, 2007, TADD has identified and screened 1,637 defendants, out of which 980 (59.8 %) have been accepted by the program. Of those accepted, (310) 31.6% have completed treatment, (340) 34.7% are currently in treatment, (224) 22.9 % dropped out and were returned to court to face their charges, (31) 3.2 % have outstanding warrants, and (15) 1.5% are currently pending placement. Of those defendants accepted by the program, 55.1% pleaded guilty to felony charges, 33.3% pleaded guilty to misdemeanors, and 11.6% have not yet taken a plea. Fifty-two percent of those accepted and placed went directly into residential treatment, 27% were referred to outpatient facilities, 3% entered hospital programs, 2% were placed in supportive housing, 6% were placed in crisis beds pending residential treatment, and 10% were referred to other forms of treatment.
Psychiatric diagnosis of defendants accepted into treatment include schizophrenia (14%), depressive disorders (32%), bipolar disorder (14%), neurological/cognitive disorder (2%), organic brain disorder (3%), psychosis NOS (11%), , anxiety disorder (3%), post traumatic stress syndrome(PTSD) (3%), schizoaffective (7%), adjustment disorder (8%), impulse control disorder (2%), and “other” diagnoses (1%). Of all defendants accepted into TADD, 67% were non-violent offenders, 15% had charges associated with domestic violence, and 18% were charged with crimes involving some violence but were nevertheless determined to be appropriate for treatment. Preliminary analysis of the criminal justice data for those 2002 TADD graduates who had entered the program pursuant to a felony charge reveals that over three-quarters (79%) had no re-arrests for the two years following completion of the program, and of those that did have re-arrests (21%), almost all had re-arrests for non-violent crimes.