How Public Health Can Change Reentry

I’m not a lawyer, but I work with judges and attorneys daily. I’m not a nurse, but I help develop health interventions for people with substance use challenges. Internships and law school taught me how to speak a bit of legal. My graduate program taught me how to speak health. Volunteering developed my interest and passion for working in reentry. Working in jails taught me the complexity of trauma. 

At first glance, these two systems I’ve come to interact with - healthcare and criminal justice - may not seem to have much in common. Sure, they’re large, complex, difficult systems most people would prefer to avoid and may have had poor experiences with. There’s a hierarchical structure in healthcare with doctors, nurses, social workers, practitioners, and assistants. The same exists in the legal system with judges, attorneys, officers, paralegals, and assistants. But they are also both systems that require human interaction, compassion, and empathy. Both are filled with well-educated professionals with a passion for helping others or communities. And it is incredibly hard work.

In my first year with the courts, I participated in a quality improvement program with the Federal Judicial Center (FJC) led by Christina Ruffino and Dr. Pete Luongo. Christina was an incredible educator and collaborator, extremely prepared and focused to ensure court teams from around the country found the program beneficial. Dr. Pete is a social worker specializing in addiction medicine and interventions with experience working with both sides of the isle who displayed expertise in developing collaborative interventions. I wanted to be like both of them! They were working with brilliant professionals and making them better. They knew how to speak to judges and attorneys about public health issues to build programs to actually help people. They had a way of sharing ideas, opposing viewpoints, and evidenced based strategies to politely provide suggestions. Dr. Luongo taught us the invaluable approach of PDSA (Plan, Do, Study, Act). Christina always says her role is to "help the helpers." Even though I work in the criminal justice system, I want to use public health knowledge to help the helpers. 

Professionals from the Federal Judicial Center's Quality Improvement Program from 2023, including Christina Ruffino third from the right.

Working within treatment courts, programs that offer a second chance through treatment for those facing substance use and mental health challenges, ignited a profound passion for behavioral health, ultimately leading me to pursue my graduate studies. I was particularly captivated by the population-level insights of public health, a field that focuses on improving the health and well-being of entire communities rather than just individuals. Specifically, I was drawn to the social determinants of health, which are the conditions in which people are born, grow, live, work, and age that shape their health risks and outcomes. Recognizing that these factors—such as housing, education, and economic opportunities—drive health disparities, I saw the potential for public health principles to transform criminal justice interventions. For example, learning SBIRT (Screening, Brief Intervention, and Referral to Treatment) methodology, a public health-based approach to addressing substance use, directly informed my work with clients on supervision, and public health principles highlighted the need to refine court practices through program design and evaluation to combat health inequities.

At the same time, I observed a pervasive exhaustion among professionals, a sense of being trapped in a cycle of indictment, motions, and pleas, with little time for meaningful intervention. The system's emphasis on rapid resolution often felt like a superficial fix, akin to a rushed doctor's visit – a brief encounter, a quick prescription, and a delayed follow-up. Just as my studies revealed systemic deficiencies in healthcare outcomes, I saw similar shortcomings in the criminal justice system. Both lacked a fundamental element: trust. 

How do we bridge the chasm of distrust in systems that have historically caused harm, systems that are often perceived as impenetrable, frustrating, and financially devastating? How do we cultivate safe spaces where trust can begin to flourish? For many, the criminal justice system represents generational trauma, marked by family separation, emotional wounds, and crippling debt. Similarly, the healthcare system can be a source of frustration and disillusionment, characterized by delayed care, misdiagnosis, and labyrinthine insurance processes. Both systems, though essential, are undeniably flawed, leaving individuals feeling marginalized and unheard.

Wyatt sharing about the complexities of public health and the court system to a non-profit organization.

Our approach centers on building trust incrementally, meeting participants where they are, and fostering a sense of understanding and agency. We recognize that many individuals require support in developing fundamental life skills and experiencing healthy, non-manipulative relationships. Collaborative court teams offer a unique opportunity to challenge the traditional narrative, creating a space where professionals can connect with participants on a human level. Professionals that have typically been guarded show themselves, not just their title. Judges come off the bench and sit in a round table without their robes on. Officers wear casual clothes and share their hobbies. Prosecutors speak words of empathy and support, looking past the facts of a case to recognize a person's hard work and energy as they endeavor to improve themselves. These programs are the side road to the criminal justice system rarely traveled, not the main highway most people experience. There is so much room to grow.

My experiences have illuminated the profound impact that public health interventions, particularly interdisciplinary collaboration, can have on criminal justice outcomes. Treatment courts serve as a powerful example. In these collaborative environments, judges, prosecutors, defense counsel, treatment providers, probation officers, and social workers unite to create holistic case plans addressing individual needs. This model demonstrates the transformative potential of collaboration even within the traditionally adversarial criminal justice system.

A Curiae embodies this collaborative spirit. We act as coordinators, case managers, social workers, and networkers, bridging the gap between court agencies and public health expertise. Courts are increasingly recognizing the value of social workers, substance use counselors, therapists, and public health experts, whose unique perspectives shape and improve outcomes. Just as healthcare professionals navigate the complexities of interdisciplinary care for patients, we empower court staff to address substance use and criminal thinking errors through evidence-based public health interventions. Our mission is to help the helpers by equipping them with the tools and knowledge they need to build more effective and humane systems.