Veteran Treatment Courts

These documents are designed to serve as a set of minimum training guidelines for Tennessee Veteran Treatment Courts in the establishment of volunteer mentor training programs. While the use of these specific guidelines is not mandatory, there is an expectation that the core components will be incorporated into any customized training curriculum developed by a Veteran Treatment Court Program. The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) Recovery Court Certification process (Section II), includes steps for verifying that any volunteer mentor training programs established locally meet these minimum standards and are properly documented.

Sites are welcome to utilize and duplicate these materials for their own training purposes if they choose to do so. These guidelines are not intended to replace the more substantial and comprehensive Veteran Mentor Boot Camp training curriculum offered by Justice for Vets. They are being made available to Tennessee VTCs in order to bridge the gap between Veteran Mentor Boot Camps as new mentors are brought into a court program. All communities who are currently operating, or are interested in operating a Veteran Treatment Court Program are encouraged to reach out to Justice for Vets, which is a professional services division of the National Association of Drug Court professionals, a 501(c)3 non-profit organization based in Alexandria, VA. The primary contact for the volunteer veteran mentor training is David Pelletier who can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..
Justice for Vets website: http://justiceforvets.org/

Tennessee Veteran Treatment Courts must comply with a wide range of standards in order to achieve TDMHSAS certification, of which the veteran mentor program is only a part. The core components of a VTC Mentor Training Program that must be implemented and documented by a VTC seeking certification include the following:

• The presence of a training curriculum for mentors which includes:

TN Recovery Court Overview
Veteran Treatment Court description
Benefits of the Veteran Treatment Court Model for justice involved veterans
Basic training on the common issues facing justice involved veterans and protocol for responding to warning signs associated
Role of the veteran mentor and mentor coordinator including key characteristics, duties and responsibilities, communication skills, ethics and boundaries, family involvement and collaboration with veterans organization and community service providers.

I. TN Recovery Court Programs Overview

In July 2003, Tennessee lawmakers passed the Drug Court Treatment Act, establishing the legitimacy of the drug courts Statewide. In addition to enabling drug court programs, the new legislation named the Department of Finance and Administration, Office of Criminal Justice Programs as the office to oversee the state’s drug court program. This Act (Tennessee Code Annotated Title 16, Chapter 22) provides the opportunity for drug courts to share information, provide training, and facilitate collaboration between the State and local communities. It was also the first step towards a more institutionalized system of drug courts across the state by legislating a fee on certain drug offenses for counties with drug courts to use for programming. Counties that do not have a drug court program remit those fees back to the State. In addition, the legislation established goals for drug court programs, and established the State Drug Court Advisory Committee that is comprised of drug court professionals and stakeholders.

In 2012 the administration of the drug courts was transferred by Executive Order from the Department of Finance and Administration, Office of Criminal Justice Programs to the Department of Mental Health and Substance Abuse Services (TDMHSAS), Division of Substance Abuse Services (DSAS), Office of Criminal Justice Services (OCJS). Following the transition in 2013 the specialty courts that are administrated by TDMHSAS were titled Recovery Courts to better describe and the variety of treatment focused specialty courts that the department oversees and to highlight the recovery aspect of the programs.

In 2015 the Criminal Justice Veterans Compensation Act was enacted which established the veteran treatment court programs in Tennessee along with an additional fee mandate for those courts. The legislation also required 3 members representing the veteran population be added to the State Drug Court Advisory Committee. The Criminal Justice Veterans Compensation Act requires that Veteran Treatment Courts follow the “10 Key Components of Veterans Treatment Courts” established by Justice for Vets. Additionally, TDMHSAS requires all Recovery Courts that are seeking certification and/or state funding to adhere to required operational procedures by which each program will be designed and operate. The required operational procedures for Veteran Treatment Courts are the “10 Key Components of Veterans Treatment Courts”.

Key Component #1: Veterans Treatment Court integrate alcohol, drug treatment, and mental health services with justice system case processing
Key Component #2: Using a non-adversarial approach, prosecution and defense counsel promote public safety while protecting participants' due process rights
Key Component #3: Eligible participants are identified early and promptly placed in the Veterans Treatment Court program
Key Component #4: Veterans Treatment Court provide access to a continuum of alcohol, drug, mental health and other related treatment and rehabilitation services
Key Component #5: Abstinence is monitored by frequent alcohol and other drug testing
Key Component #6: A coordinated strategy governs Veterans Treatment Court responses to participants' compliance
Key Component #7: Ongoing judicial interaction with each Veteran is essential
Key Component #8: Monitoring and evaluation measure the achievement of program goals and gauge effectiveness
Key Component #9: Continuing interdisciplinary education promotes effective Veterans Treatment Court planning, implementation, and operations
Key Component #10: Forging partnerships among Veterans Treatment Court, Veterans Administration, public agencies, and community-based organizations generates local support and enhances Veteran Treatment Court effectiveness

II. Veteran Treatment Courts

VTC Team: A VTC is operated by a team of professionals who are primarily responsible for overseeing the day-to-day operations of the program and administering the treatment and supervisory interventions. The team members include, but not limited to: Judge, Attorneys, Probation, Treatment (VA and Other), Case Managers, Law Enforcement, Veteran’s Service Agencies, Veteran Justice Outreach Specialist, and Program coordination. The veteran mentor coordinator may also be a member of the team.

VTCs share the same Key Components as regular drug/problem solving courts. They are distinguished from other problem solving courts though a number of unique characteristics:

Participation is limited to members (current and former) of the United States Military
Programs are structured as a hybrid of both the drug court and mental health court models
Court and treatment team awareness, experience with and capacity to respond to common veteran treatment needs for issues such as post-traumatic stress disorder, traumatic brain injury, military sexual trauma, depression and crisis response.
Presence of a VA representative on the court team to coordinate treatment services and other benefits for the veteran participants.
Court team awareness of veteran and military culture, terminology, and benefits.
Presence of veteran mentors who support VTC participants.

TCA § 16-6-101-106 Criminal Justice Veterans Compensation Act ("CJVC") of 2015
In 2015 legislation was enacted establishing the powers of a veteran treatment court in Tennessee as well as the key components, administrative station at the Department of Mental Health and Substance Abuse Services, the process of applying for veteran treatment court grant funding, and the acceptable and unacceptable uses of those grant funds.
A veteran’s treatment court program shall have the same powers as the court that created it. Any disagreements shall be resolved prior to court and not in front of the participants. (§ 16-6-102)

TDMHSAS is responsible for: (§ 16-6-104)
Defining, developing, and gathering outcome measures for veterans treatment court programs, established by this chapter;
Collecting, reporting, and disseminating veterans court treatment program data;
Supporting a state veterans treatment mentor program;
Sponsoring and coordinating state veterans treatment court program training;
Awarding, administering, and evaluating state veterans treatment court program grants;
Developing standards of operation for veterans’ treatment court programs to ensure there is a significant population of veterans in the criminal justice system willing to volunteer to participate in veterans’ treatment court programs so that funds are allocated to meet the greatest need.

III. Why Veterans’ Treatment Courts for Justice-Involved Veterans?

Kathy McCormick, a spokesperson for the National Institute of Corrections gives this answer:

“Veterans Treatment Courts have been recognized as a creative and effective innovation in criminal justice. They emphasize accountability, while also providing treatment. They reduce recidivism, restore families, and provide a second chance for vets who have lost their way after serving their country. Veterans Treatment Courts demonstrate how various stakeholders come together with a common goal: to restore lives, save families, strengthen communities, and be efficient with taxpayer dollars.”

We are engaged now in the longest continuing conflict in American History.

When the sun came up this morning on jails and prisons across America, 9 out of every 100 inmates are veterans of military service. For some of those who served, post-military problems that seemed insurmountable often led to self-medication, substance and drug abuse, and then involvement with the law and the criminal justice system.

• Since 9/11 we have had approximately 2.5 million American military personnel serve in combat either in Iraq, Afghanistan, or both.

• Since 2001, nearly 1.3 million service members have been discharged from the military and many have utilized VA Health services for a myriad of complex emotional combat related issues, including: Post Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), depression, and anxiety.

• Despite these complex combat related issues and that most combat veterans had no involvement in the criminal justice system before their engagement in military service, these veterans or active duty service members are often being treated as any other civilian offender would be treated.

With the words, “To care for him who shall have borne the battle and for his widow, and his orphan,” President Lincoln affirmed the government’s obligation to care for those injured during the war and to provide for the families of those who perished on the battlefield. Our goal is to help foster an understanding and awareness of issues specifically relating to combat veterans who enter the criminal justice system.

Here’s what the National Institute of Corrections has to say about why Veterans’ Treatment Courts are an important answer to a growing problem:
”A lifesaving role is being played by Veterans Treatment Courts (VTCs) across the country.

From WWII through the continuing global war on terror, there are approximately 21.5 million veterans in the U.S. today. So many of these men, and increasingly women, return home damaged mentally and physically from their time in service. These wounds often contribute to their involvement in the criminal justice system. As a result, veterans are overrepresented in our jails and prisons.

For these justice-involved vets, Veterans Treatment Courts are providing a pathway to recovery so that they can be restored to functioning and contributing members of society.

Veterans Treatment Courts, or VTCs, provide hope, restore families and save lives. The first VTC, founded in 2008 in Buffalo, New York, has inspired the creation of more than 220 courts of similar nature in jurisdictions, both large and small, across the country. Hundreds more are in various stages of planning and implementation.

These courts have the support of the communities they serve, as well as the U.S. and State Departments of Veterans Affairs and local service providing agencies.

Critical to the success of VTCs are veterans who volunteer to be trained and serve as mentors to justice-involved veterans.

Veterans Treatment Courts are an effective intervention and an alternative to incarceration for justice-involved veterans.
There are unique issues which contribute to veterans’ involvement in the criminal justice system at the local, state and federal levels;
They play and important role in improving public safety, reducing recidivism, saving taxpayer dollars and, most importantly, restoring the lives of those who have served our country;
There is a vital role for U.S. Department of Veterans Affairs, State Departments of Veteran Affairs, County Courts and Veteran Peer Mentors”
*(VTCs can incorporate their own local data here to provide context to the mentee)

1. The hybrid structure of a Veteran Treatment Court combines substance abuse and mental health treatment to attend to the needs of its participants. The utilization of VA providers and other appropriate community based treatment providers ensures that best practices in the treatment of veterans are employed.

TREATMENT

In a VTC program, the judge and court director oversee and monitor a JIV’s progress and coordinate services determined by the VTC team members. The judge will promote cooperation between law enforcement, prosecution and defense. The court director is responsible for the case manager, counselor, and ensuring inter-agency services, including mentors, are being provided to meet the JIV’s needs. The VTC approach to integrated treatment includes the cooperation and collaboration of traditional partners with the addition of the Veterans Administration Health Care Network, veterans and veterans family support organizations, and volunteer veteran mentors.

SUBSTANCE ABUSE and MENTAL HEALTH

Substance abuse and mental health issues are two of the most common co-occurring disorders observed in JIV’s. Veterans often turn to alcohol or drugs in an effort to self-medicate from real or imagined physical and emotional conditions. Many veterans have voiced concern about the potential for negative stigma associated with seeking screening and treatment for mental health disorders including: being seen as week, being treated differently by unit leadership, being unable to get time off from work and concern about negative career impacts. While mentors need to stay informed and be aware of this relationship, it is not their position to make a diagnosis or recommend any certain plan. The mentor can and should refer the JIV to professional, licensed clinicians who can make a proper diagnosis, prescribe medications if necessary, and support the veteran in following a specific recovery plan and program.

TRAUMA SENSITIVE

Trauma is an experience that can be physical or psychological. Examples of physical trauma could be the loss of an arm or leg, hearing, eyesight, or being shot or stabbed. Examples of psychological trauma could be witnessing an accident or tragedy, suffering a deep personal loss or observing or participating in combat. These experiences can leave a lasting, and sometimes, permanent damage to an individual’s psyche. This is particularly true in the case of our military, police and other first responders. The effects of psychological trauma are cumulative in nature, but may not be realized for weeks, months, or even years after the experience(s). Trauma-sensitive care is a practice that incorporates working respectively and collaboratively with an individual to realistically promote healing and recovery. JIV’s tend to be more open in conversing to mentors who are veterans and be more honest in sharing what trauma’s may be the triggering event for their behavior.

Taking a trauma informed approach in responding to justice-involved veterans is essential given the background of many veterans returning to civilian life. In a study of individuals who participated in 12 trauma and veteran focused jail diversion programs across the country;

94% experienced non-military trauma
73% experienced trauma before the age of 18
68% experienced physical violence by someone they knew
19% experienced sexual molestation by someone they knew

And of those included in the study who served in a combat zone:

82% saw someone get killed or injured
78% saw, smelled or handled a dead body
78% patrolled areas with landmines/IEDs
75% were shot at or received fire
69% were attacked or ambushed
35% were wounded or injured
31% felt responsible for the death of someone

PTSD and TBI

Post-traumatic stress disorder (PTSD) is a mental health condition triggered by experiencing or witnessing some horrific traumatic event. It does NOT mean that someone is crazy... it is a normal reaction to an abnormal event. A short-term, immediate reaction may be treated as shock; a longer, chronic condition may be diagnosed as PTSD. While anyone can develop PTSD, it is more common for military men and women and first responders who experience traumas for an extended period of time or on a daily basis. PTSD symptoms may not start immediately after a traumatic event, and often take months and years to manifest themselves to be debilitating. The effects of PTSD cause problems in all areas of life: social, economic, and family relationships. In some cases, associated depression and anxiety can lead to suicide.

Mental health professionals believe PTSD symptoms can be categorized into four types:

Intrusive memories (nightmares, flashbacks, emotional and physical responses such as shaking and sweats)
Avoidance (avoiding people, places and things that may bring back memories of a traumatic event)
Negative changes in thinking and mood ( survivors guilt, sense of hopelessness, emotional numbness, unable to maintain personal relationships)
Changes in emotional responses (hyper-alertness, irritability and anger, memory problems, interrupted sleep, perceived threats and paranoia, using alcohol and drugs to self-medicate in hopes of forgetting the trauma)

Traumatic brain injury (TBI) occurs when an outside force causes a sudden jarring to the brain. It could be physical, such as a bullet or shrapnel to the head or helmet, a head hitting the door or windshield of a vehicle, or a tackle in football. It could also be concussive, as experienced by being near any kind of explosion or blast. TBI conditions range from mild to moderate to severe.

Mild physical symptoms could include momentary loss of consciousness, acting dazed or disoriented, nausea or vomiting, tiredness, dizziness or loss of balance. In many cases, an individual may not even be aware of or remember experiencing these symptoms.

Moderate to severe TBI physical symptoms generally occur within a few hours or days after the injury or incident. These symptoms demand more immediate testing and care and include: loss of consciousness lasting from several minutes to hours, dilation of one or both pupils of the eyes, multiple episodes of vomiting, convulsions or seizures, loss of coordination and others.

Two other areas affected by TBI are sensory and cognitive. Sensory problems could exhibit blurred vision, ringing in the ears, changes in the ability to taste and smell and sensitivity to sound or light. Cognitive or mental symptoms include memory or concentration problems, mood changes, depression or anxiety, confusion, slurred speech, combativeness, and even coma.

SEXUAL TRAUMA

Military Sexual Trauma (MST) is the term used by the Veterans Administration to refer to sexual assault or repeated, threatening sexual harassment that occurred while a veteran was in the military. Examples of MST include rape or other sexual activities, unwanted sexual touching or grabbing, threatening, offensive remarks about a person’s body or appearance, or unwelcome sexual advances. Both men and women can experience MST during their time in service, and it can be from the same or opposite sex.

The rates of trauma exposure reported by female veterans are higher than the trauma exposure rate of the civilian population. Among female veterans;

81% - 93% have experienced any type of trauma
38% - 64% have experienced lifetime sexual assault
27% - 49% have experienced child sexual abuse
24% - 49% have experienced adult sexual assault
30% - 45% have experienced military sexual trauma
4% - 31% have experienced combat exposure

Female veterans are more likely to experience sexual assault when compared to their male counterparts.

DEPRESSION/SUICIDE AWARENESS

Studies on suicide have shown a strong link between suicide and depression. In a posting by SAVE (Suicide Awareness Voices of Education), they report research shows 90% of the people who die by suicide have an existing mental illness or substance abuse problem at the time of their death. Current information from the VA indicates 22 veterans a day commit suicide.

“Substance use often precedes suicidal behavior in the military, as indicated by the 30% of Army suicides and over 45% of suicide attempts since 2003 that involved alcohol or drug use (U.S. Army Center for Health Promotion and Preventive Medicine, 2010). Further, the Army Suicide Prevention Task Force (2010) reported that approximately 20% of 188 high-risk behavior deaths from 2006 to 2009 that were not combat-related were due to a drug or alcohol overdose.”

These signs may mean someone is at risk for suicide. Risk is greater if a behavior is new or has increased and if it seems related to a painful event, loss or change:

Talking about wanting to die or kill oneself
Looking for a way to kill oneself, such as searching online or buying a gun
Talking about feeling helpless or having no reason to live
Talking about feeling trapped or in unbearable pain
Talking about being a burden to others
Increasing the use of alcohol or drugs
Acting anxious or agitated; behaving recklessly
Sleeping too little or too much
Withdrawn or feeling isolated
Showing rage or talking about seeking revenge
Displaying extreme mood swings
Preoccupation with death
Suddenly happier, calmer
Loss of interest in things one cares about
Visiting or calling people to say goodbye
Making arrangements; setting one’s affairs in order
Giving things away, such as prized possessions

A suicidal person urgently needs to see a doctor or mental health professional!

A reference card is attached to the end of these guidelines containing information about Warning Signs of Suicide and Suicide Threat Response Procedures. Courts are encouraged to utilize this resource or other similar resources in the training of veteran mentors.

If there is an immediate threat of suicide i.e. (lethal means are present and an individual wishes to kill themselves, contact (911)

If the threat of suicide is not immediate, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

This is also the same number for the Veterans Crisis Line: 1-800-273-TALK (8255)