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Background
New York State is home to approximately 580,000 veterans, the fifth largest veteran population in the U.S.[1] While most military veterans transition back to civilian life without major difficulties, some encounter challenges post-service.[2] For example, veterans are at a higher risk of mental health and/or substance use issues compared to their civilian counterparts; these challenges may be exacerbated by the stigma associated with mental health in the military, difficulty navigating complex care systems, and shortages of behavioral health providers. Additional stressors such as family strain, financial insecurity, and difficulties in securing stable housing and employment also contribute to the challenges of transitioning from military to civilian life.
For these reasons, veterans face an increased risk of involvement with the criminal justice system. Approximately one-third of veterans report being arrested and booked into jail at least once, compared to one-fifth of civilians.[3],[4] Moreover, about half of incarcerated veterans report having a mental health disorder diagnosis some time in their lives, compared with one-third of incarcerated civilians.[5]
Suggested Citation: Coy, D. Cobbs, E. Ford, MM. Havusha, A. Sandman, D. 2024. “Veterans Treatment Courts in New York State: Past and Future.” New York Health Foundation. New York, NY. Available at: https://nyhealthfoundation.org/resource/veterans-treatment-courts-in-new-york-state-past-and-future.
[1] U.S. Census Bureau. “S2101: Veteran Status,” https://data.census.gov/table/ACSST1Y2022.S2101?q=veteran%20status&g=040XX00US36, accessed May 15, 2024.
[2] Sayer, N. A.; Noorbaloochi, S.; Frazier, P.; Carlson. K.; Gravely, A.; and Murdoch, M. (2010). Reintegration problems and treatment interests among Iraq and Afghanistan combat veterans receiving VA medical care. Psychiatry Services. 61, 589–597. doi: 10.1176/ps.2010.61.6.589.
[3]Timko, C.; Nash, A.; Owens, M. D.; Taylor, E.; Finlay, A. K. (2020). Systematic review of criminal and legal involvement after substance use and mental health treatment among veterans: Building toward needed research. Substance Abuse: Research & Treatment, 14, 1-13.
[4] Snowden, D. L.; Oh, S.; Salas-Wright, C. P.; Vaughn, M. G.; & King, E. (2017). Military service and crime: New evidence. Social Psychiatry & Psychiatric Epidemiology, 52(5), 605-615. http://doi.org/10.1007/s00127-017-1342-8.
[5] United States Department of Justice. “Mental Health and Reentry: How Court Services Offender Agency Meets the Challenge of Mental Health Community Supervision.” https://cops.usdoj.gov/html/dispatch/05-2022/mental_health_reentry.html#:~:text=Approximately%20half%20the%20people%20in,diagnosed%20with%20a%20mental%20illness\, accessed February 2024.
Veterans Treatment Courts in New York State
In 2008, the Honorable Judge Robert T. Russell (ret.) created the nation’s first Veterans Treatment Court (VTC) in New York State after he observed a rise in the number of veterans in the Buffalo City Court. Since then, VTCs expanded to 25 of New York State’s 62 counties.
VTCs are a type of problem-solving court for veterans with mental health or substance use issues who have committed non-violent crimes. VTCs offer treatment-oriented solutions, including peer mentorship and access to community-based resources, as an alternative to incarceration. Research indicates that VTCs are effective at a much lower cost than incarceration: only about one in seven (14.0%) veterans who participate in VTCs recidivate, compared with nearly half (46.0%) of civilians who recidivate within one year after incarceration.[1] VTCs also improve veterans’ mental health.
A 2021 law authorized case transfers from jurisdictions without VTCs to adjacent counties that have them, supporting the establishment of new VTCs and creating universal access for justice-involved veterans. This law was designed to close gaps for veterans in counties without an existing VTC and created universal access to VTCs for justice-involved veterans. While it was a critical policy win, more work is needed to fulfill the new law’s potential. The COVID-19 pandemic disrupted its initial implementation, and many legal professionals remain unaware of how to effectively connect justice-involved veterans with VTCs, resulting in low numbers of transfer cases.
This brief examines data from the New York State VTC program from January 1, 2013, to December 31, 2023, detailing court participation rates, geographic reach, and participant demographics. It provides key takeaways and offers recommendations to further strengthen, evaluate, and expand the VTC program in New York. The data were provided by the Division of Technology & Court Research at the New York State Office of Court Administration (OCA).
This brief does not include data about transferred cases under the new policy passed in 2021.
[1] Tsai, J.; Finlay, A.; Flatley, B.; Kasprow, WJ.; Clark, S. (2018). A National Study of Veterans Treatment Court Participants: Who Benefits and Who Recidivates. Administrative Policy on Mental Health. 45, 236–244. doi: 10.1007/s10488-017-0816-z.
Source: U.S. Census Bureau, “S2101: Veteran Status,” (2022 estimates are shown). https://data.census.gov/table/ACSST1Y2022.S2101?q=veteran%20status&g=040XX00US36.
Anxiety and/or Depression in New York State
Overall
One in three adult New Yorkers are experiencing depression and/or anxiety. Reported anxiety and/or depression in New York State most recently spiked in September 2022 (37.2%) and has remained high. Throughout the first quarter of 2023, rates remained higher than they were for much of 2022.
Anxiety and/or Depression in New York State
By Income Group
Household income is closely related to mental health outcomes in New York State. Half (50.0%) of New Yorkers with very low income reported anxiety and/or depression in the first quarter 2023, more than twice the rate of New Yorkers with the highest incomes (22.1%).
Comparing calendar year 2022 to the first quarter of 2023, poor mental health increased by 21.5% for New Yorkers with household incomes between $50,000 and $99,999—the largest jump of any income band.
Anxiety and/or Depression in New York State
By Age Group
Age and mental health are also linked. Younger New Yorkers (ages 18–34) continue to report the highest rates of anxiety and/or depression. While rates for this group have improved each year between 2020 and 2023, they remain stubbornly high: two in five (40.0%) younger adults still experience poor mental health.
Anxiety and/or depression symptoms increased for older adults by more than 35% in the first quarter of 2023, compared with calendar year 2022.
Anxiety and/or Depression in New York State
By Race and Ethnicity
Reported rates of anxiety and/or depression increased among Hispanic and Asian New Yorkers in the first quarter of 2023, compared to calendar year 2022. More than two out of five (41.0%) Hispanic New Yorkers and one-third (29%) of Asian New Yorkers reported poor mental health in the first quarter of 2023.
Anxiety and/or Depression in New York State
By Household Employment Income Loss
Loss of employment income is associated with anxiety and depression.
One in two (50.7%) New Yorkers with household employment income loss during the pandemic reported anxiety and/or depression, compared with one in three (29.8%) New Yorkers in households that did not lose employment income.
Anxiety and/or Depression in New York State
By Food Sufficiency Status
Food sufficiency is closely associated with worse mental health for New Yorkers. Food insufficiency is defined by the United States Department of Agriculture (USDA) as a household sometimes or often not having enough to eat within the last seven days.[1] While anxiety and/or depression rates have declined slightly among this group each year since the onset of the pandemic, more than half (57.4%) of food–insufficient New Yorkers reported anxiety and/or depression. In comparison, fewer than one in three (29.2%) food–sufficient New Yorkers reported anxiety and/or depression for the same period.
[1] USDA. Food Insecurity in the US, https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/measurement/#insufficiency, accessed April 2023.
Key Findings
- More than three in ten (31.5%) New Yorkers reported poor mental health in March 2023, the most recent date for which data are available. That proportion shows no improvement from May 2021, when 32% of New Yorkers reported poor mental health.
- Rates of poor mental health among New Yorkers have fluctuated throughout the pandemic. They peaked in February 2021, when two in five (40.2%) New Yorkers said they experienced anxiety and/or depression. The most recent spike (37.2%) occurred in September 2022.
- Some groups of New Yorkers were more likely to experience depression and/or anxiety in the first quarter of 2023:
- One in two (50.0%) New Yorkers with very low incomes (less than $25,000 per year) reported anxiety and/or depression, more than twice the rate of those with annual household incomes of $100,000 or more (22.1%).
- Younger adults had poorer mental health rates than other age groups; two in five (40.0%) New Yorkers between the ages of 18 and 34 reported poor mental health.
- Poor mental health increased most for Asian New Yorkers and Hispanic New Yorkers; two out of five (41.0%) Hispanic New Yorkers reported anxiety and/or depression.
- One in two (50.7%) New Yorkers who lost employment income since the onset of the pandemic reported anxiety and/or depression.
- New Yorkers experiencing food insufficiency had worse mental health than their food-sufficient peers. More than half (57.4%) of food-insufficient New Yorkers had poor mental health—nearly twice the rate of food-sufficient New Yorkers (29.2%).
Veterans Treatment Courts Across New York State
As of 2023, there are 35 VTCs operating in New York State. Of the 62 counties in New York, 25 counties operate at least one VTC.
Top Veterans Treatment Courts by Participation
Since 2013, when the first VTC was established, 1,318 veterans have participated. Just three courts—the Buffalo City Court, Suffolk 1st District Court, and Nassau District Court—together account for approximately half of all cases and number of participants (n = 684). These courts were some of the first established VTCs in New York. VTCs established more recently would have fewer cases.
[1] Feuer, Alan; Hong, Nicole; Weiser, Benjamin, and Ransom Jan. “N.Y.’s Legal Limbo: Pandemic Creates Backlog of 39,200 Criminal Cases,” The New York Times, June 22, 2020.
Veterans Treatment Court Completion Rates
The court system measures participants’ completion of the New York State VTC program by tracking “program closures” when a participant’s case is closed in the system. Three-quarters (74.5%) of program closures from 2013 through 2023 were successful, with VTC participants graduating from their program or having adjournment in contemplation of dismissal. Approximately 1 in 10 closures (11.1%) were defined as unsuccessful, meaning the participant failed to complete the program. Another 13.4% of all closures were reported as administrative.
Discussion
In New York State, mental health is stagnating following a period of improvement. Following a dip in the reported prevalence of anxiety and/or depression in summer 2022, rates have remained stubbornly high, with one in three New Yorkers experiencing one or both conditions. Mental health distress is more common among some groups of New Yorkers than others.
There are several possible reasons for persistently high rates of depression and anxiety among New Yorkers, even three years after the onset of the pandemic. Ongoing economic uncertainty, stagnant wages, inflation, food insecurity, social isolation, the loss of loved ones during the pandemic, and the effects of Long COVID could all be contributing factors.
In response to worsening mental health following the COVID-19 pandemic, New York State, City, and local government agencies have been mobilizing to address mental health through multiple new programs and community efforts:
- New York State’s FY 2024 budget provides $1 billion to expand mental health throughout the State, focusing on New Yorkers with serious mental health needs.[1] The plan includes new residential units, increased inpatient capacity, and expanded outpatient services. It also invests in peer-based outreach, expands school-based mental health services, and addresses gaps in insurance coverage for behavioral health services.[2],[3] The budget also provides an increase over the prior budget to support the 988 Suicide and Crisis Lifeline.
- New York City Mayor Adams and the New York City Department of Health and Mental Hygiene unveiled a $20 million plan called “Care, Community, Action: A Mental Health Plan for NYC” that takes a public health approach to address the mental health needs of children, youth, and families; people with serious mental illness; and those at risk of drug overdose.[4]
- The New York City Council released a “Mental Health Roadmap” that proposes to expand preventive and supportive services, including school-based screenings, mental health services in family shelters, and other youth mental health programs. It also addresses the mental health workforce shortage, the intersections between mental health and the criminal justice system, public awareness, and coordination among agencies.[5]
Focused government attention and funding will be critical to improving mental health in New York State, but other sectors also have important roles to play. Foundations, advocates, community-based organizations, schools, health care providers, and others are working to support New Yorkers’ mental health. No one program, no one organization, no one government entity alone can solve the substantial mental health challenges New York is facing. Making meaningful and sustainable progress will require long-term investments, collaboration, and focused attention among a range of stakeholders across the State.
[1] New York State Office of State Governor. (2023) Governor Hochul Announces Passage of $1 Billion Plan to Overhaul New York State’s Continuum of Mental Health Care, https://www.governor.ny.gov/news/governor-hochul-announces-passage-1-billion-plan-overhaul-new-york-states-continuum-mental, accessed June 2023.
[2] Mental Health Association in New York State. (2023) Governor Hochul Highlights New York’s Mental Health Budget Plan, https://mhanys.org/mh_update/governor-hochul-highlights-new-yorks-mental-health-budget-plan/#:~:text=The%20FY%202024%20Budget%20provides,those%20with%20mental%20health%20challenges, accessed June 2023.
[3] New York State Office of State Governor. (2023) Governor Hochul Announces Passage of $1 Billion Plan to Overhaul New York State’s Continuum of Mental Health Care, https://www.governor.ny.gov/news/governor-hochul-announces-passage-1-billion-plan-overhaul-new-york-states-continuum-mental, accessed June 2023.
[4] The City of New York. Care, Community, Action: A Mental Health Plan for NYC, https://www.nyc.gov/assets/doh/care-community-action-mental-health-plan/index.html, accessed June 2023.
[5] New York City Council. Mental Health Roadmap, https://council.nyc.gov/mental-health-road-map/, accessed April 2023.
Veterans Treatment Court Participants by Age
Almost two-thirds (59.1%) of VTC participants are age 45 or younger, indicating that most VTC participants are post-9/11 veterans. Overall, VTC participants are younger than the general veteran population in New York State. The overwhelming majority (91.7%) of VTC participants are under age 65, while more than half of New York State’s general veteran population (55.1%) is age 65 and older.
Veterans Treatment Court Participants by Sex
The majority of VTC participants (96.1%) are male, similar to the general veteran population in New York (92%).
Veterans Treatment Court Participants by Race/Ethnicity
VTC participants appear to be more racially and ethnically diverse than the overall veteran population in New York State. Approximately half (53.0%) of VTC participants identify as white, compared with more than three-quarters (76.9%) of the State’s overall veteran population.
Veterans Treatment Court Participants by Charge Type
Driving under the influence (DUI) charges make up almost half (44.2%) of all VTC cases, similar to data from a national evaluation of multiple VTC sites.[1] The second most frequent charge category is theft (12.4%).
[1] Baldin, J.M.; Hartley, R.D.; (2022). Executive Summary: National Institute of Justice’s Multisite Evaluation of Veterans Treatment Courts. https://www.ojp.gov/pdffiles1/nij/grants/305014.pdf.
Key Takeaways
- VTC participation increased steadily between 2013 and the onset of the COVID-19 pandemic, reaching a peak in 2019 at 226 participants. Since 2020, participation has again increased each year.
- The VTCs with the highest numbers of participants are the longest-serving VTCs in the State.
- VTCs offer a successful alternative to incarceration for veterans, with nearly 8 in 10 participating veterans completing the program.
- VTC participants are typically younger and more racially and ethnically diverse compared to the general veteran population in New York State.
Recommendations
New York State has affirmed its commitment to veterans by expanding access to VTCs. A diverse set of public and private partners should ensure every justice-involved veteran in New York State has access to the highest quality support possible during their participation in a VTC. The following recommendations lay out next steps for strengthening VTCs in New York:
Support and Streamline Data Collection, Tracking, and Reporting Systems: Maximize and increase data collection regarding VTC usage, transfers, veteran demographics, participant experiences, and program outcomes to continually improve VTCs and identify gaps in utilization, including the transfer policy. For example, improvements to the U.S. Department of Veterans Affairs Veterans Reentry Search Service (VRSS) could support data-matching with the New York State Division of Criminal Justice Universal Case Management System.
Strengthen the Peer Mentor Program Component: VTC programs include a robust peer mentorship component that is considered the “secret sauce” of the program’s success. Peer mentors, who are themselves veterans, serve on a volunteer basis and provide around-the-clock support, advice, and camaraderie for veterans currently participating in a VTC. Maintaining a well-qualified and diverse pool of peer mentors reflective of the needs and diversity of the veterans they serve to ensure the program’s viability is an important element of the program’s success. Training opportunities to increase peer mentors’ cultural competency, as well as their skills and knowledge related to suicide prevention and other relevant topics, should be easily accessible. Sharing best practices and exploring compensation and reimbursements for mentors would also strengthen the sustainability of the program.
Expand and Deepen Partnership Opportunities: Explore the possibility of establishing a partnership between OCA and an academic institution, like the one between the University of Albany and the State’s Joseph P. Dwyer Peer Support Program. Doing so would allow for better monitoring of success, barriers, trends, and opportunities, in addition to assisting with peer mentor recruitment, data collection, and training opportunities.
Maximize Use of VTCs and the Transfer Policy: Provide ongoing training and education to legal professionals on current State policies—particularly the VTC transfer policy—that affect veterans. Organizations like Justice For Vets and New York State Defenders Association offer comprehensive training for legal professionals, including defense attorneys, judges, district attorneys, and court staff, ensuring they can effectively facilitate veterans’ access to VTCs and apply the transfer policy as needed. Further development of specialized training for judges and court clerks, who are crucial in case transfers, is essential to fully implement these new policies.
