As soon as a teenager gets arrested for abusing drugs or alcohol in California’s Santa Cruz County, the treatment and support services begin.

Home supervision is strengthened; electronic monitoring may start. Weekly meetings bring the probation officer together with the teen and his family members, school administrators and teachers, counselors and social workers.
 

Santa Cruz County — which includes the southern agricultural town of Watsonville, home to a growing Latino and Mexican community, as well as the more affluent beach city of Santa Cruz to the north — provides a pretty accurate snapshot of teens in the U.S. juvenile justice system: Eighty percent are involved with drugs.

But that picture brightens considerably when a teen comes into the county’s Alcohol and Drug Program, which has undergone major reform in the past few years. Incoming youth are immediately screened and assessed; families are encouraged to take part in a “wraparound” treatment team that can include everyone from parents and cousins to probation officers, mental health counselors and the family’s clergy.

Frequent urine testing — used despite heated debate in the field over its value — leads to swift consequences: one drug court judge keeps a grab bag on the bench, to reward a teenager's good test results with movie passes, CDs and cookies. A bad outcome may result in anything from an essay to a strict curfew.

“What we do better now is coordinate the different offices,” says Jeffrey Bidmon, assistant division director of the Santa Cruz County Probation Department. “In the old days, the treatment provider would have to hide any knowledge about the teen's drug use from the probation officer. They weren't on the same page about therapeutic treatment; it was more about law enforcement, a belief that “We'll teach 'em a lesson.”’

The Santa Cruz County Mental Health & Substance Abuse Services also has supplemented the traditional 12-Step programs associated with Alcoholics Anonymous with something called The Seven Challenges, a behavioral therapy designed to help adolescents make healthy decisions about their lives. It builds on studies that have found that those who successfully break addictions pass through five stages: pre-contemplation, contemplation, preparation, action and maintenance.

The changes in Santa Cruz are part of a broad-based, $21 million initiative introduced in 10 cities around the country by the Robert Wood Johnson Foundation. Called Reclaiming Futures, the program is aimed at improving drug and alcohol treatment for young people in trouble with the law over a five-year period.

As evidence-based practice becomes the guiding principle of all medicine — from cancer to heart disease, and now depression and addiction — the science has begun trickling down from the lab to the real world. Multi-systemic therapy, also known as “ecological intervention” and “integrated treatment,” is one of the strongest. Regardless of its name, it draws on family involvement and looks at the teenager within a larger universe of family, school and the criminal justice system.

The paradigm shift — looking at drug addiction as a public health problem, not a criminal justice matter — has had remarkable results. Officials say the number of youths incarcerated in Juvenile Hall has been drastically cut, from a daily high of 60 to 70 in 1997 to 12 on a recent day this year.

“You can provide effective treatment in the community for $4,000 a year,” says Bidmon. “Or you can spend $45,000 to $80,000 a year for a residential, in-custody program. We had to take a look at what position we wanted to stand for.”

(Richard Scheinin is a reporter for The San Jose Mercury News.)
 

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