Meridian offered the offender programs long before it merged with Jackson-Haywood-Macon Psychological Services in 2016 to become a comprehensive provider for children and adults. Becoming a comprehensive provider was a requirement in order for providers to continue receiving Single Stream Funding and Medicaid dollars from the state.
Donald Reuss, Vaya’s senior director of provider network, said the offender therapy was “legacy programming” left over from the old days when local organizations in each county managed mental health services. Newly formed region Local Management Entities like Vaya Health now administer funds from the state to local providers. Reuss said it’s not a required program because sexual and domestic abuse isn’t necessarily caused by a mental health problem.
Since dealing with $14 million worth of cuts from the state, Vaya had to make difficult decisions about which programs to prioritize. Since the offender program only serves a limited number of people and isn’t a requirement, it was cut.
Marie Romeo, director of offender services at Meridian, said behavioral health and mental health are not mutually exclusive. Even though an abuser may not be mentally ill, assault is still a societal behavioral problem that can manifest from a number of circumstances.
“The problem is so nuanced, and we really have to look at the history of domestic violence and understand how power and control work under the system, and with gender roles and the person’s environment,” she said.
Meridian currently has 35 clients going through the sexual abuse offender program — that’s 35 people a week who have to be seen individually by a therapist and also attend a group session at least once a week. The number may not seem like a lot, but Romeo said the clinician hours it takes to serve those 35 people is significant. Six group sessions are held each week to accommodate all the clients who are spread out over seven counties and have to travel to Jackson or Haywood to attend.
“I want to stress that even if we only serve five people in these programs it’s a large number,” Romeo said. “We really believe in how this works and it has far reaching implications into the community.”
The domestic violence and sexual abuse intervention programs are aimed at rehabilitating the client, but Romeo said the programs are just as much a community service and a public safety measure to ensure these people don’t reoffend.
The domestic violence intervention program is a six-month program overseen by the North Carolina Council for Women. Meridian works with offenders to assess their risk of re-offending and provides psycho-educational treatment in a group setting to teach offenders about accountability, honesty, nonviolent, nonthreatening and non-controlling behaviors, sexual respect and partnership.
Based on her experience, Romeo said the domestic violence program is extremely successful.
“For folks who complete the program, 79 to 82 percent of them don’t come back for another domestic violence charge. If they don’t complete it, we do see people coming back again,” she said.
With the sexual abuse intervention program, offenders undergo a psychosexual risk assessment, attend treatment groups, family workshops and therapy, and also receive graduation support through continued group sessions. Clinicians check in with offenders on a monthly basis to conduct risk assessments. Group treatment aims to reduce deviant sexual thoughts and feelings, identify and change the assault cycle, develop victim empathy skills and develop a relapse prevention plan. Unlike the domestic violence program, the sex offender program doesn’t have a set length — it all depends on the progress of the offender.
Gathering recidivism statistics on the sexual abuse program is much harder to capture from Meridian’s standpoint, though Romeo said the program definitely lowers the risk of re-offense.
“It really depends on how long someone is in treatment, the age of the victim, the age when they first committed the crime and so on,” she said. “What we do know definitively is that being in treatment lowers the risk.”
Gwen said he takes his job as a peer specialist seriously — not just for the client’s safety but also for the community’s safety. He said there’s much more to consider when cutting these programs than the number of people served or the success rate.
“If we help five people from hurting someone else I think we’ve done a good job,” he said.
The funding cuts to the offender programs have resulted in a decreased staff at Meridian to handle the services. They went from having a three-person clinical team, one administrator and one half-time peer specialist to having one clinician and a half-time peer specialist, with administrative duties dispersed throughout Meridian.
Meridian also had to increase the cost of the program for offenders to keep it afloat. Offenders used to pay $10 per session and now have to pay $80 a session.
“Our clients are stepping up to be more accountable or finding ways to make money — they’ve been very accepting of the payment change because they know it’s a good service by qualified people,” Romeo said.
In the meantime, Meridian is launching its first-ever fundraising campaign to support programs not getting fully funded through the state and is working closely with many community partners to come up with innovative ways to improve behavioral health.
“So many people at Meridian have tirelessly been trying to think outside of the box to work it out but we are dedicated to making sure this program continues to happen,” Romeo said. “We have good relationships with the U.S. Probation Office and the DA’s office to where everyone knows the situation we’re in and we’re putting our heads together looking for ways to diversify funding for these programs.”
Trying to look at the possible positives, Romeo said it’s an exciting time when you begin to partner with others and look outside the box for funding sources.
“We have the possibility of making the program into something we’ve always hoped and dreamed it could be,” she said.
Domestic violence in North Carolina
• There were 108 domestic violence-related homicides in 2013 in North Carolina.
• 1,678 victims were served in a single day in North Carolina in 2014 — 860 domestic violence victims (432 children and 428 adults) found refuge in emergency shelters or transitional housing provided by local domestic violence programs.
• In a 24-hour survey period in 2014, local and state hotlines answered 637 calls, averaging more than 26 hotline calls every hour.
SOURCE: National Coalition Against Domestic Violence