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Pesuading Policy Makers: Effective CIT Program Evaluation and Public Relations

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Presented by: Maria Felix-Ortiz, Ph.D. and …

Presented by: Maria Felix-Ortiz, Ph.D. and
Megan Brodie University of the Incarnate Word

Published in Health & Medicine , Technology
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  • How can you convince local and state policy makers and stakeholders to support your CIT program? Build relationships with friends in your state capitol. Advocacy is something that occurs over time; it is the process of education through relationship building and sharing personal experiences that “move” people to action. In contrast, lobbying tells someone how to vote. Advocacy takes months and years because it involves changing a lot of minds; cultural and societal beliefs and customs change very slowly. Defining goals and showing “results.” Why? Accountability for state and federal funding of programs requires us to offer evidence of success.
  • Use new and old technology for speaking to policymakers. The use of scientific data obtained through regular program evaluation is our new technology for speaking to policymakers. This means numbers not just interviews or observations. Even just descriptive statistics (numbers that summarize) are better than interviewing participants who say, “yea, it was great!” At the same time, it is very important to use old technology in speaking to policy makers. This means putting a human face on the problem, and taking these human faces with you on visits to the policymaker and or their aides. Policymakers are influenced by consumers, stakeholders, other policymakers, and campaign contributions.
  • In one page of bullets, Show that your program stretches the dollar, that it is efficient as well as effective.Show that your program impacts “real people” for whom the public has sympathy: women who have been abused (33% of women in jail/prison have PTSD), “families” (e.g. women and their children), veterans, etc. Identify who your community is most likely to support and target that population for your first program(s).
  • The public has definite opinions on public safety. Families can offer insightful perspectives on what works and what needs changing. This is important to legislators. However, involving the community, especially consumers is time consuming and involves patiently sifting through a variety of opinions to get consensus on a message your community wants to take to the policymakers.Community “buy in” This means people will use your program, refer others, and be your best publicity. They are also the ones who will call your legislator on your behalf (cause if you’re a state or fed employee, you can’t lobby for your organization/program). Constituents who vote can be very persuasive to policymakers.Stakeholders (businesses, health systems, religious communities, social services, schools/universities, civic organizations like homeowners’ associations) can provide a variety of resources to the program.
  • What is it?A needs assessment is a lot like what you do when your TV cuts off. What do you need to solve the problem? Do you have to call the TV repair man? Well, maybe not. First, you have to determine what the problem is. You consider the various possible causes, and go check those causes. You first check to make sure the cat didn’t turn off the surge suppressor switch. You check the lights to see if the power is on in the room. If there’s no power to anything in that room, you check the house. If lights work in the other parts of the house, you check your circuit breakers. Maybe it’s not just your house so you look outside to see if the streetlight is on. You call your neighbors to see if they’ve got power. If the neighbor’s houses are dark, too, you call the power company…The power eventually comes on, but the TV is still dark. A needs assessment is about getting lots of information about what’s happening, and using it to develop a response, a program.Benefits of? Important so you can show results (get the TV going again…).Challenge of? In a needs assessment, you often discover that you were wrong about what “the community” needs. A needs assessment teaches you humility! You think your community needs A, but a bunch of different communities tell you they need B. It’s important to get everyone’s perspective on it so you know what to include in your program and how to measure success. In many cases, criminal justice discovers that they have to add to the mental health programming in addition to formalizing ways to divert to it. For example, you may also need to think about what “step down” or transitional services you will offer to support individuals after they are released from the hospital to which you diverted them.
  • Needs AssessmentHow’s it done? Begin with formal or informal talks with everyone to determine what is needed in your communities (e.g. focus groups conducted with stakeholders). Ask your stakeholders to identify other possible stakeholders. Meet with a variety of people, including consumers and their families. Check the information gathered at one meeting by presenting it to another meeting, and look for “themes,” observations that reappear across all your meetings. Identify resources that stakeholders can offer, and possible options for collaboration.Organize a “town hall”-style meeting or legislator’s lunch where you invite the local media and policy makers to hear the results of your needs assessment and to offer you ideas for how to address the needs. This will always identify new needs, but also serves to involve policy makers early on.
  • What is your time frame?Looking for short-term effects: Survey at the beginning and end of your training to measure attitude and behavior change; workshop evaluations. Easy, but you have to have a good survey.Looking for long-term effects: Surveying/interviewing trainees 3, 6, or 12 months after the training to see what they remember, what skills they’re using, and gauge the persistence of attitude change. Involves tracking trainees who may or may not want to participate; more labor intensive, but very impressive to see long-term effects of the program on “culture change.”
  • Collecting dataWho’s the focus of the study? Surveying/interviewing consumers/families of consumers who have had experiences with CIT officers. Confidentiality issues, tracking issues, labor intensive BUT very impressive to have consumer/family corroboration of trainees attitude change.Rookie/cadet vs. veteran officer’s perspective (just ask for status/years on duty in demographics section)Surveying other first responders to gauge awareness of and use of CIT (e.g., dispatchers, fire dept., EMT) Keep them in your study from start to finish! Compensation, incentives, etc.How will you gather your information? What will be your method of data collection?Observation to offer on-site evaluation of incidents (through “ride along” program)Visiting other programs: How are programs similar? Different? What resources can you develop? What resources might you be able to share?Case study: following one or some people through your system, or following a few officers for a certain amount of time to see what works in your system or program, and what’s needs changing. Interviews: Computer-assisted interviews allow you to input directly into a computer.Surveys: Surveymonkey and other on-line tools make it easier now…
  • Document changes that spontaneously emerge in your system, like new ways of solving problems as they emerge, new collaborations, new policies, etc., and to show cultural adaptations that you made for your particular community’s ethnic, religious, or other culture.Outcomes in your officersAttitudinal changeIncrease in skills and knowledgeBehavior in the fieldFewer incidents of excited delirium and it’s consequencesFewer incidents of excessive force and it’s consequencesKeep track of costs so that you can show higher community mental health costs for your diverted population is still lower than the costs of keeping them in jail/prison where they’ll stay longer and require more services while incarcerated.
  • Allow stakeholders and consumers themselves to see the data and help you interpret your findings. They can often see the bigger picture, and identify for you how small differences might actually be a big deal. When the cost of not having an intervention is loss of life and the deterioration of a family, the small gain may not be so small and might be worth the program cost.
  • Choosing an evaluator. An “evaluator” helps you plan your program so that it can be evaluated for effectiveness. Generally, program evaluators are either professors based at a university or professional program evaluation companies. The advantages of a University-based evaluator is that they may be less costly than professional evaluators (or work for free in exchange for access to the data for publications), they can contribute to the development of your local coalition and collaboration, provide student interns, and be more willing to develop measures/tools specific to your needs. The advantages of a professional company is that they have more resources, can draw from their experience with programs from other regions, and might be able to devote more time to your project since evaluation is their primary work. There is no reason you cannot have both involved in your work, but leadership and roles have to be carefully negotiated. An evaluator should have a background in statistics and measurement, publications that showcase this expertise, and experience with making programs work in real-world settings. There is an American Evaluators Association that sets professional and ethical standards for program evaluation, as well as maintains a membership of skilled evaluators who abide by these standards.

Transcript

  • 1. Persuading Policy Makers: Effective CIT Program Evaluation and Public Relations
    Maria Felix-Ortiz, Ph.D.
    &
    Megan Brodie
    University of the Incarnate Word
    Presentation for the CIT International Conference in San Antonio, TX
    June 2010
  • 2. Today…
    The connection between good program development and evaluation, and policymaking
    Advocacy and community involvement in
    program development/evaluation, and
    in selling CIT to policy makers
    Program evaluation “in a nutshell”
    Resources
  • 3. How can you convince policy makers and stakeholders to support your CIT program?
    Become familiar with the policy making process
    “Policy making is a cyclical process. It begins with recognition and definition of a significant public problem ... In response, government may formulate, adopt, and implement a strategy for addressing the problem. Analysis of policy effectiveness in turn often reveals shortcomings...”
    http://www.laits.utexas.edu/txp_media/html/bur/features/0303_01/policy.html
  • 4. How can you convince policy makers and stakeholders to support your CIT program?
    Build relationships with friends in your state capitol.
    Advocacy: the process of education through relationship building and sharing personal experiences that “move” people to action.
    Lobbying: telling someone how to vote.
    Defining goals and showing “results.”
    Aim for handshaking, not head butting
    “Tongue handshake” by Skorpion of the Independents
  • 5. The Old and New in Persuading Policy Makers
    Use The New
    The use of scientific data obtained through regular program evaluation
    numbers as well as interviews or observations.
    National Alliance for the Mentally Ill and other advocacy groups
    Facebook, blogs, Twitter
    Work with the PTA/O, faith-based communities, and business
    but keep The old
    Take consumers with you on visits to the policymaker and or their aides.
    Policymakers are influenced by
    consumers,
    stakeholders,
    other policymakers, and
    “campaign contributions”
    • Visit gatekeepers of powerful political institutions, social services, and neighborhood institutions
    • 6. letters to the editor of your newspaper, television, radio
    • 7. Invite the community to an open-house or panel discussion
  • The Old and New in Persuading Policy Makers
    Get to know your opponents and their positions so you can respond to/address their concerns
    In one page of bullets, show that your program
    Stretches the dollar
    Impacts real people for whom your community has sympathy
    Women
    Children
    Veterans
    Thank you notes
    build relationships
  • 8. Why involve the community in your CIT program development and evaluation?
    can offer insightful perspectives on what works and what needs changing, but getting community input can be time consuming, and sometimes it’s difficult to identify consensus or the main themes.
    • Community “buy in”
    • 9. This means people will use your program, refer others, and be your best publicity.
    • 10. Constituents who vote can be very persuasive to policymakers.
    • 11. Stakeholders can provide a variety of resources to the program.
  • Program Evaluation (in a nutshell)
    Needs Assessment
    Research design and time frame
    Collecting data
    Analysis and feedback
    Program modification and second evaluation
    Analysis and feedback
    Program modification…
  • 12. Needs Assessment
    What is it?
    A needs assessment is a lot like what you do when your TV cuts off.
    A needs assessment is about getting lots of information about what’s happening, and using it to develop a response, a program.
    Benefits of? Important so you can show results (get the TV going again…).
    Challenge of? In a needs assessment, you often discover that you were wrong about what “the community” needs.
    You might have to add to the mental health programming as well as develop a diversion program…
  • 13. Needs Assessment
    How’s it done?
    Begin with formal or informal talks with EVERYONE
    Check the information gathered
    Identify resources
    Organize a “town hall”-style meeting or legislator’s lunch
  • 14. Research Design and Time Frame
    Research Design?
    “Experimental” vs. “Control” Group
    Compare people in your program to those who get the usual
    “pre” and “post” intervention comparison
    Compare people in your program to themselves
    Compare the number of their arrests before and after being in your program
    What is your time frame?
    Looking for short-term effects
    Looking for long-term effects: 3, 6, or 12 months after the program
  • 15. Collecting Data
    Focus of study
    Consumers/Families of consumers
    Rookie/Cadet vs. Veteran Officer’s Perspective
    First Responders
    Linear Study
    Gathering Information
    Observation
    Visiting other programs
    Case Study: Following various “typical” individuals before the program, through the program, and after
    Interviews
    Surveys
  • 16. What outcomes can you measure?
    Outcomes in your consumers
    How many referrals were diverted from jail? When were they identified (pre or post booking)? How were they identified (What kind of screening, who did it)? Where did they go?
    What are the demographics of those diverted? What kind of illness is going untreated in your community? Are there racial/ethnic or gender disparities?
    Gains in independent living skills, reduced drug use, better “quality of life,” and reduced psychological distress one year later (Cosden et al., 2003)
    Lower re-arrest, violence, homelessness, hospitalizations on year later (Lamb, Weinberger, and Reston-Parham, 1996)
    Less jail time two months later (Steadman, Cocozza, and Veyzey, 1999)
    Changes in the type of arrest
    Health problems, social support, financial circumstances, living arrangements, ongoing use of outpatient mental health services.
    Outcomes in your officers
    Attitudinal change
    Increase in skills and knowledge
    Behavior in the field
    Outcomes in the system
    Document changes
    Keep track of costs
  • 17. EXCELLENT RESULTS
    It met your goals.
    It was accepted by the community.
    Things you measured changed in a positive direction.
    There are better outcomes among your program participants compared to those who didn’t participate.
    LITTLE OR NO CHANGE?
    There was no improvement, BUT there was also no deterioration or worsening of the problem AS MIGHT BE EXPECTED
    Interpret changes in a larger context. How might the small differences be a big deal?
    Allow stakeholders and consumers themselves to see the data and help you interpret your findings.
    Analysis: How do you know that your program worked?
  • 18. Choosing an Evaluator
    helps you plan your program so that it can be evaluated for effectiveness
    Advantages of a University-based evaluator
    less costly than professional evaluators (or work for free in exchange for access to the data for publications),
    can help develop your local coalition and collaboration,
    provide student interns, and
    be more willing to develop measures/tools specific to your needs.
    Advantages of a professional program evaluation company
    more resources,
    can draw from their experience with programs from other regions,
    might be able to devote more time to your project since evaluation is their primary work.
    An evaluator should have a background in statistics and measurement, publications that showcase this expertise, and experience with making programs work in real-world settings.
    American Evaluation Association: www.eval.org
  • 19. Resources
    University relationships
    Partner with a county that already has a program
    NAMI and In Our Own Voice, their speaker program
    American Evaluation Association
    Society for Prevention Research
    The Center for Mental Health Services GAINS Center
  • 20. GAINS Resources
    With the help of its supporters, GAINS has produced several documents that focus on increasing meaningful peer involvement in jail diversion and reentry initiatives. Click on the links below to read more on best practices used to increase the inclusion of peers in systems change.
    Leveling the Playing Field: Practical Strategies for Increasing Veterans' Involvement in Diversion and Reentry Programshttp://www.gainscenter.samhsa.gov/pdfs/veterans/levelingthefield_veterans.pdf
    Overcoming Legal Impediments to Hiring Forensic Peer Specialistshttp://www.gainscenter.samhsa.gov/pdfs/integrating/Miller_Massaro_Overcoming.pdf
    Peer Support within Criminal Justice Settings: The Role of Forensic Peer Specialistshttp://www.gainscenter.samhsa.gov/pdfs/integrating/Davidson_Rowe_Peersupport.pdf
    Additional Resources
    Medicaid Coverage of Peer Support for People with Mental Illness http://cms.hhs.gov/PromisingPractices/downloads/PeerSupport.pdf
    Mental Health Consumer Providers by the Rand Corporationhttp://consensusproject.org/bja-ta-training-event-july-2009/materials-bja-ta-09/Rand_Article.pdf
    Mentoring Formerly Incarcerated Adultshttp://www.workingventures.org/ppv/publications/assets/265_publication.pdf
    Navigating the Child Support Systems http://ppv.org/ppv/publications/assets/274_publication.pdf
    Peer Specialist Compensation/Satisfaction 2007 Survey Report by NAPShttp://www.ncmhcso.org/downloads/NAPS_survey_report.doc
    Additional Resource Sites:
    Community Access: Howie the Harp http://www.communityaccess.org