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Wilderness Therapy Programs: Stakeholder Perspectives in Washington

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Julia Cramer, Colin Gibson - December 2022

This is the second report in a two-part series focused on wilderness therapy programs. Wilderness therapy combines therapeutic elements with outdoor activities in a natural setting to help support individuals with a range of behavioral, emotional, and substance use issues.

In 2021, the Washington State Legislature directed WSIPP to research wilderness therapy programs in the context of behavioral health treatment and prevention. As part of this assignment, we were asked to assess the “interest and likelihood of support” for wilderness therapy programs among interest groups like “state prevention coalitions and tribes.” We interviewed ten individuals representing a variety of stakeholder perspectives in Washington.

Generally, we found that interview respondents view wilderness therapy as potentially beneficial for the individuals they serve or those who live in their communities. However, we found that most respondents had concerns about cost, safety, access, and the lack of information about programs. Respondents also expressed wanting legislators to be aware of issues related to program flexibility, equitable access, and ongoing outreach if they consider policy decisions related to wilderness therapy in the future.

The first report on this topic was published in June 2022 and can be found here.

Report ID: 22-12-1901
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The Impacts of a Buy American Steel Policy in Washington State

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Cory Briar, Colin Gibson, Chasya Hoagland - December 2022

The 2021 Washington State Legislature directed WSIPP to study the economic and environmental impacts of a Buy American Steel policy in the state. Such a policy would require that steel used in the fulfillment of Washington State government contracts be partially or exclusively sourced from within the US. This report describes the findings from two economic analyses: a benefit-cost analysis (BCA) and an economic impacts analysis (EIA).

The BCA finds that the increase in cost to taxpayers to carry out projects under a domestic steel requirement would likely exceed new income to workers in the Washington steel industry, but net changes to the state economy would be small. The EIA finds that the requirement would support jobs in the steel industry, but the increased cost to taxpayers would lead to job losses in other sectors. Like the BCA, the net changes predicted by the EIA are small, ranging from a loss of 12 to a gain of 13 jobs per year statewide under a domestic steel requirement.

We also conduct an analysis of how the policy would impact global emissions of greenhouse gases. While the net change in emissions is ambiguous, this analysis suggests that the change in emissions could only range from a decrease of 1.2% to an increase of 1.6% of steel production-generated emissions in Washington.

Report ID: 22-12-4101
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Does Substance Use or Nutrition in Adolescence Predict Mental Health in Young Adulthood? A Systematic Review

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Marna Miller, Katelyn Kelley - December 2022

The 2021 Washington State Legislature directed WSIPP to review the research for any relationships between adolescent substance use and adolescent nutrition on subsequent mental illness in early adulthood.

For substance use, we found that adolescent alcohol use was associated with an increased risk of later depression. Adolescent cannabis use was associated with an increased risk for depression and psychosis, but we found no evidence that adolescent misuse of opioids or cocaine is associated with mental illness in young adults.

For nutrition, we found that higher quality diet in adolescence was associated with a lower risk for later depression. Obesity during adolescence was associated with an increased risk for depression in young adults, especially in females. Finally, we found no evidence of a link between adolescent intake of omega-3 fatty acids and any mental illness in young adulthood.

Report ID: 22-12-3901
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Washington State’s Drug Offender Sentencing Alternative: Introduction to the Series

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Lauren Knoth-Peterson, Katelyn Kelley - November 2022

In Washington State, individuals convicted of certain offenses may be eligible to receive a sentencing alternative called the Drug Offender Sentencing Alternative (DOSA). Established in 1995 and modified several times over the last 25 years, DOSA allows individuals to serve some or all of their standard prison sentence under community supervision instead of spending the entire sentence incarcerated. This sentencing alternative requires that individuals participate in substance use treatment programs based on their assessed needs and comply with behavioral requirements while incarcerated and/or during community supervision.

In 2020, the Washington State Legislature further expanded DOSA and directed the Washington State Institute for Public Policy (WSIPP) to analyze its effectiveness in reducing recidivism compared to standard sentencing. The directive requires WSIPP to update its evaluation in 2028 and every five years thereafter. This report introduces the forthcoming report series by describing the development of DOSA over time and reviewing prior evaluations of DOSA’s effectiveness.

Report ID: 22-11-1902
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Washington State’s Drug Offender Sentencing Alternative: 2022 Outcome Evaluation

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Lauren Knoth-Peterson, Katelyn Kelley - November 2022

In Washington State, some individuals convicted of a criminal offense may be eligible to receive a Drug Offender Sentencing Alternative (DOSA) in lieu of the standard incarceration sentence.

Using administrative data from the Department of Corrections and WSIPP’s Criminal History Database, this study examined whether individuals participating in prison or residential DOSA were less likely to recidivate compared to similar individuals who received a non-DOSA sentence.

Our findings indicate the prison DOSA reduces the likelihood of recidivism by 6.9 percentage points. These reductions in recidivism were consistent across subgroups by sex, race, and ethnicity.

Our findings for residential DOSA were less conclusive. In general, residential DOSA had no effect on the likelihood of recidivism compared to a standard sentence. While we provide several potential explanations for the differences in the effectiveness of prison and residential DOSA, future research is needed to fully understand the mechanisms by which the two DOSA programs impact individuals’ outcomes, including recidivism.

Report ID: 22-11-1903
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Technical Review of the Washington State Environmental Health Disparities Map

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Bailey Ingraham, Kara Krnacik - November 2022

The 2021 Washington State Legislature directed the Washington State Institute for Public Policy (WSIPP) to conduct a technical review of the measures and methods used in the Washington State Department of Health’s Environmental Health Disparities (EHD) Map.

We found that Washington’s EHD Map is one of many in the United States. It uses a similar range of indicators, methodology, and source data compared with the most sophisticated environmental justice (EJ) mapping tools. These EJ tools use some of the best data available at small geographical levels to measure environmental exposures and health disparities. They provide insight into a variety of the environmental harms present in communities and how well-equipped these communities are to overcome those challenges.

Over time, developers will need to regularly review their EJ map tools. The HEAL Act requires the Washington EHD Map to be regularly revised and updated, with comprehensive evaluations occurring every three years. Currently, Washington's tool is comparable in sophistication and detail to other existing tools. However, there are a few additional or enhanced features found in other state tools that Washington does not have, including the following:

  • Additional indicators reflecting sensitive populations;
  • Additional water quality measures;
  • Specific statistical adjustments for missing data; and
  • Easily accessible user guides and how-to videos on the hosting website.

Report ID: 22-11-3201
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Washington State's Reentry Community Services Program: Background and Study Outline

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Lauren Knoth-Peterson, Corey Whichard - November 2022

For the last 20 years, Washington State has provided unique reentry services for individuals who are at high-risk for recidivism and who have a mental illness. The Reentry Community Services Program (RCSP) provides eligible individuals with coordinated pre- and post-release services to assist with reentry. Individuals are eligible to receive 60 months of mental health services and housing assistance. Additional services are provided on an individual basis depending on need and the availability of resources.

Prior research shows that compared to similar individuals who do not receive these services, RCSP participants are more likely to access mental health services in the community, more likely to access social welfare services during reentry, less likely to require inpatient hospitalization after release, and less likely to recidivate. In addition, research finds that the program achieves these outcomes in a cost-beneficial way.

In 2021, the Washington State Legislature directed WSIPP to update its evaluation of the RCSP, examine the potential expansion of the program, and investigate additional therapeutic components to further support individuals’ reentry to the community.

This preliminary report reviews prior research on the RCSP and provides an outline of the approach WSIPP intends to take for its final report to be published in November 2023.

Report ID: 22-11-1901
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Findings From the 2021 Survey of Health and Recreation in Washington State: Gambling Behaviors and Prevalence

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Marna Miller, Rebecca Xie - October 2022

In 2021, the Washington State Health Care Authority (HCA) conducted a survey of adults in Washington to better understand the prevalence of gambling and problem gambling. HCA contracted with WSIPP to conduct additional analyses.

WSIPP’s analysis found that fewer than half of respondents reported they had gambled in the past 12 months. Of those who had gambled, 3.5% were classified as problem gamblers. Statistically significant differences were detected in the prevalence of gambling and problem gambling among some different demographic populations (demographics collected include gender, marital status, ethnicity, age, education, military service, employment, type of insurance, and geographic region). Compared to those who gambled only in brick-and-mortar establishments, online gamblers were significantly more likely to be problem gamblers. Gamblers who self-identified as having problems with substance use, mental health, or other behaviors, were more likely to be problem gamblers than others not reporting these problems. Most of the population said they thought the harms of gambling outweighed the benefits. A similar proportion said the availability in Washington was fine—neither too available nor not available enough.

Report ID: 22-10-3901
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Mandatory Arrest for Domestic Violence: A Systematic Review

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Marna Miller, Katelyn Kelley - June 2022

Washington State law requires that, given probable cause, police must make an arrest when called to a domestic violence (DV) incident. The 2021 Washington State Legislature directed the Washington State Institute for Public Policy (WSIPP) to conduct a systematic review of the research on mandatory arrest in DV cases. We found no evidence that mandatory arrest is more effective than discretionary arrest at reducing future DV offenses. Specifically, we found six rigorous studies of the effect of mandatory arrest on DV recidivism. On average, across the studies, mandatory arrest had no effect on whether an individual committed a subsequent DV offense. Further, another study found that mandatory arrest laws did not affect a state’s prevalence of DV. A separate study found that mandatory arrest laws had no effect on DV homicide.

Report ID: 22-06-1201
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Wilderness Therapy Programs: A Systematic Review of Research

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Julia Cramer, Paige Wanner - June 2022

Wilderness therapy programs are set in natural or remote settings and embed therapeutic elements into daily outdoor activities like camping and backpacking in order to build program participants’ personal and interpersonal skills. Some programs serve individuals with behavioral, mental health, and substance use disorders.

In 2021, the Washington State Legislature directed WSIPP to conduct a research review of wilderness therapy programs and assess stakeholder interest in Washington. We identified 88 studies evaluating programs serving youth and adult populations in need of behavioral, mental health, and substance use support. Due to limitations in the literature, we could not estimate whether or not wilderness therapy programs are effective or determine if the approach is cost beneficial. In this report, we describe our systematic literature review and summarize the main themes from the literature including program models, populations served, and general findings.

A second report, due December 2022, builds on this report and will focus on the interest of stakeholders who currently participate in wilderness therapy programs in Washington or want to in the future.

Report ID: 22-06-1901
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