In this section, you will learn the importance of prioritizing resources and targeting intervention strategies based on system and individual factors. Clearly, given the diversity of the jail population, unpredictable lengths of stay, limited resources, and principles of evidence-based practice, it is not possible or desirable to provide the same level of intervention to everyone who enters the jail setting.
Triage: The process by which a person is screened and assessed immediately on arrival at the jail or community service to determine the urgency of the person’s risk and needs in order to designated appropriate resources to care for the identified problems
In fact, to obtain an optimum level of efficiency and effectiveness, quick screening tools should be used to separate low-risk offenders from their medium- and high- risk counterparts. Interventions can occur both inside and outside the jail. The key is to match the right person to the right resources so that higher risk individuals receive more intensive interventions in the jail and the community. Therefore, the TJC project recommends a triage system to help a system determine “who gets what.”
The word triage comes from the French term “trier,” to sort. We often think of triage scenarios when natural and human disasters occur and decisions have to be made quickly to identify and treat the most seriously injured.
A jail setting is a busy and sometimes chaotic environment, but decisions still have to be made at reception to determine each individual’s risk and needs. This is a particularly acute problem within a jail facility because of the rapid rate of turnover and short length of stay of most inmates. A triage matrix, tailored to the needs, resources, and timelines of your jurisdiction, will help determine the appropriate allocation of services by categorizing individuals and identifying the appropriate mix of targeted interventions.
Case study 1. Mr. Smith is a 34-year-old, single man serving a nine-month sentence for possession of crack cocaine. Mr. Smith has an extensive history of criminal offenses that includes three state terms of incarceration and 10 jail sentences. Mr. Smith has spent nearly 11 years of his adult life in jail or prison. Mr. Smith’s file also indicates that he dropped out of school in the tenth grade, has a history of significant reading problems that were never addressed by the educational system, and was homeless and unemployed at the time of his arrest.2
Case study 2. Mr. Jones is a 19-year-old, single man serving a 15-day sentence for possession of marijuana and medication (i.e., Concerta, a stimulant used to treat ADHD) for which he didn’t have a prescription. Prior to his arrest, Mr. Jones had no prior criminal record, attended community college, was employed part-time as a waiter at a local eatery, and lived with his mother.
Using these two case studies, ask yourself the following questions about these individuals:
Don’t worry if you don’t have all the answers. In this module and the next three modules, you will learn how to perform the following 10 tasks (outlined in the Targeted Intervention Strategies section of the TJC Implementation Roadmap and designed to address these and related topics):
To begin, review The Triage Matrix Implementation Tool referenced in Task 1 and developed by the TJC project team to help your jurisdiction prioritize goals, identify target populations, and allocate limited resources to your jurisdiction’s intervention strategies. The underlying concept is that everyone in the jail population should get some intervention, which may be as minimal as receiving basic information on community resources, but the most intensive interventions are reserved for inmates with higher risk and needs. The triage matrix includes the following four sections:
The triage matrix includes a worksheet for each section and a sample matrix with all sections completed. All content in the sample triage matrix is approximate and should be adapted to fit your community. We recommend that you fill in the triage matrix as soon as possible to better understand the strengths and gaps in your present transition system.
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1 United States Army, Office of the Division Surgeon, 10th Mountain Division. Presentation delivered as part of a Trauma Focused Training. Fort Drum, NY.
2 Fretz, Ralph. 2006. What Makes a Correctional Treatment Program Effective: Do the Risk, Need, and Responsivity Principles (RNR) Make a Difference in Reducing Recidivism? Kearney, N.J.: Community Education Centers, Inc. http://www.cecintl.com/UploadedFiles/Freyz.pdf.