Bradley Ray

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https://hdl.handle.net/1805/14116

The opioid epidemic is taking an increasingly severe toll on the well-being of Hoosiers. Drug overdose deaths between 1999 and 2014 increased by 500 percent in Indiana. In 2016, more than 80% of the record-number 345 drug overdose deaths in Marion County showed signs of an opioid. Misconceptions about drug users can hinder effective dissemination and implementation of scientific findings into opioid-related prevention and treatment. Dr. Bradley Ray, with colleague Dennis P. Watson, evaluates policy and programmatic responses to the opioid crisis in Indiana.

Dr. Ray’s interdisciplinary research examines the nuances of opioid-related policies and practices to identify and implement evidence-based responses rooted in a harm reduction approach, and his findings have shaped opioid-related policy and practice. With federal support, Dr. Ray and his team recently studied the implementation of Aaron’s Law and found that fear of arrest undercuts the law that shields anyone who administers naloxone, a lifesaving emergency antidote for opioid overdose, from criminal charges. The Indiana State Department of Health uses these results to inform future efforts around naloxone access and use. Other findings have helped guide medication-assisted treatment in Porter, Starke, and Scott counties.

Dr. Brad Ray’s work to disseminate and implement scientific findings into opioid-related policy and practice in Indiana is another example of how IUPUI faculty are TRANSLATING RESEARCH INTO PRACTICE.

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Examining Mental Health Court Completion: A Focal Concerns Perspective
(Wiley, 2013-09) Ray, Bradley; Dollar, Cindy Brooks; School of Public and Environmental Affairs
Sociologists have long-raised concern about disparate treatment in the justice system. Focal concerns have become the dominant perspective in explaining these disparities in legal processing decisions. Despite the growth of problem-solving courts, little research has examined how this perspective operates in nontraditional court settings. This article used a mixed-method approach to examine focal concerns in a mental health court (MHC). Observational findings indicate that gender and length of time in court influence the court's contextualization of noncompliance. While discussions of race were absent in observational data, competing-risk survival analysis finds that gender and race interact to predict MHC termination.
Exploring Stigmatization and Stigma Management in Mental Health Court: Assessing Modified Labeling Theory in a New Context
(Wiley, 2014-09) Ray, Bradley; Dollar, Cindy Brooks; School of Public and Environmental Affairs
Drawing on Link and colleagues' modified labeling theory, this article examines whether the stigma management strategies defendants anticipate using after mental health court exit are associated with their reported experiences during court. Using survey data from 34 mental health court graduates, we find that respondents generally perceive the mental health court as procedurally just, did not experience stigmatizing shame, and anticipate using the inclusionary coping strategy of education over the exclusionary strategies of secrecy and withdrawal. Moreover, findings reveal that the anticipated use of stigma management strategies is associated with mental health court experiences in that procedural justice is associated with inclusionary coping strategies, while stigmatizing shame is associated with exclusionary coping strategies. We conclude by encouraging researchers to further explore the role of stigmatization and shame in specialty court contexts and to continue investigating these defendant perceptions of these courts' process.
Access to Recovery and Recidivism Among Former Prison Inmates
(Sage, 2015) Ray, Bradley; Grommon, Eric; Buchanan, Victoria; Brown, Brittany; Watson, Dennis P.; Department of Health Policy and Management, Richard M. Fairbanks School of Public Health
Access to Recovery (ATR) is a SAMHSA-funded initiative that offers a mix of clinical and supportive services for substance abuse. ATR clients choose which services will help to overcome barriers in their road to recovery, and a recovery consultant provides vouchers and helps link the client to these community resources. One of ATR’s goals was to provide services to those involved in the criminal justice system in the hopes that addressing substance abuse issues could reduce subsequent criminal behaviors. This study examines this goal by looking at recidivism among a sample of clients in one state’s ATR program who returned to the community after incarceration. Results suggest there were few differential effects of service selections on subsequent recidivism. However, there are significant differences in recidivism rates among the agencies that provided ATR services. Agencies with more resources and a focus on prisoner reentry had better recidivism outcomes than those that focus only on substance abuse services.
What Happens to Mental Health Court Noncompleters?
(Wiley, 2015) Ray, Bradley; Hood, Brittany J.; Canada, Kelli E.; School of Public and Environmental Affairs
Mental health court (MHC) research consistently finds that defendants who successfully complete and graduate from the court are less likely to recidivate than those who do not. However, research has not assessed what happens to these noncompleters once they are sent back to traditional court. Using follow-up data on six years of noncompleters from pre-adjudication MHC, we examine what happens to these defendants in traditional court. Findings suggest that 63.7% of defendants' charges were dismissed, 21.0% received probation, and 15.3% were sentenced to incarceration. We examine the time to disposition and differences in defendant characteristics and disposition outcome as well as the relationship between disposition and subsequent recidivism. Results suggest that more severe punishments in traditional court are associated with recidivism. Logistic regression analysis shows that defendants whose charges were dismissed in traditional court were less likely to recidivate than those who were sentenced to probation or incarceration. Our findings highlight the need for future MHC evaluations to consider traditional court outcomes and support trends towards post-adjudication courts. Copyright © 2015 John Wiley & Sons, Ltd.
Police Officer Attitudes towards Intranasal Naloxone Training
(Elsevier, 2015-01) Ray, Bradley; O'Donnell, Daniel; Kahre, Kailyn; School of Public and Environmental Affairs
Background One approach to reduce fatal opioid overdose is by distributing naloxone to law enforcement officers. While several cities have implemented these naloxone programs, little research has investigated officer attitudes about their training. The present research attempts to fill this gap by analyzing survey data from police officers following intranasal naloxone training. Methods All of the police officers within the same district in Indianapolis, Indiana, underwent training to recognize opioid overdose and to administer intranasal naloxone (N = 117). Following training, officers completed a survey that measured prior experience with opioid overdose, perceived importance of training, and items from the Opioid Overdose Attitudes Scale (OOAS) to measure attitudes following training. Results The officers had overwhelmingly positive feelings about the training, that it was not difficult, and that other officers should be trained to use naloxone. The OOAS items suggest that officers know the appropriate actions to take in the event of an overdose and feel that administering intranasal naloxone will not be difficult. Finally, we found that officers who had more experience with opioid overdose had more positive attitudes about the training. Conclusion Distributing naloxone to police officers is likely a trend that will continue so it is important to understand how police officers respond to training to assure that future trainings are as effective as possible. Further research is needed to investigate the impact that these programs have on the community.
An Outcome Evaluation of the Indianapolis Community Court
(Sage, 2015-02) Grommon, Eric; Hipple, Natalie Kroovand; Ray, Bradley; School of Public and Environmental Affairs
Seeking to alleviate traditional criminal justice system processing for low-level non-violent crimes, community courts have emerged as a viable alternative. These courts use innovative community-based efforts to address the needs of defendants charged with quality-of-life crimes and attempt to improve the surrounding community. Using a retrospective quasi-experimental design, this research examines recidivism outcomes for a sample of 574 defendants who were referred to the Indianapolis Community Court. Repeated-measures ANOVA models were used to assess 1- and 3-year follow-up intervals. Survival models were used to determine whether significant differences between groups exist on the timing of recidivism events. The analysis revealed no statistically significant differences between those individuals who were processed through community court and those processed through traditional courts. The implications of these findings for future research and community court policy and practice are discussed.
Selection into Mental Health Court: Distinguishing Among Eligible Defendants
(Sage, 2015-11) Luskin, Mary Lee; Ray, Bradley; School of Public and Environmental Affairs
How defendants are selected into mental health courts (MHC) is central to issues of fairness, efficacy, and successful program replication. Only recently has empirical research started to examine MHC selection, revealing a multi-stage process with multiple decision makers and multiple variables. In this study, we use classification and regression tree analysis (CART) to examine the variables suggested in recent research to predict selection into MHC. The analysis includes legal and diagnostic variables, treatment history, measures of treatability, motivation to change, violence risk, and symptom severity. We find that the MHC is more likely to accept defendants who did not have warrants issued for their arrest, who had diagnoses other than depression, and who did not report using illegal drugs around the time of their admission. Symptom severity and motivation to treatment also predict MHC admission, with their effects contingent on defendants’ statuses on other variables.
Anticipated Stigma and Defensive Individualism during Post-Incarceration Job Searching
(Wiley, 2016-08) Ray, Bradley; Grommon, Eric; Rydberg, Jason; School of Public and Environmental Affairs
Obtaining employment is one of the most difficult challenges for individuals released from prison. This research explores the strategies recently released male parolees employ in attempting to find work, with specific attention to the role of anticipated stigma from their ex-convict status. Through the use of in-depth longitudinal interviews, this research contributes to our understanding of returning prisoner's experiences in job searching. We find that although a majority of the sample anticipated stigma as a barrier to employment, those who did expressed an extreme self-reliance consistent with defensive individualism. This reluctance to draw on social networks may ultimately be counter-productive to the search for employment.
Traumatic Brain Injury and Recidivism among Returning Inmates
(Sage, 2017-03) Ray, Bradley; Richardson, Nicholas J.; School of Public and Environmental Affairs
In recent years, there has been a surge in research that examines the relationship between traumatic brain injury (TBI) and involvement in the criminal justice system. However, the bulk of this research has been largely retrospective and descriptive, comparing rates of TBI in the offending population with the rates of TBI in the general population. Although findings from these studies indicate a higher prevalence of TBI in the offending population, virtually no studies have examined whether those with TBI are more likely to recidivate. To address this gap, the present study examined rearrest post release from prison among a cohort sample of Indiana inmates who were screened using the Ohio State University Traumatic Brain Injury Identification (OSU-TBI-ID) instrument. Findings indicate that, net of control variables, those with TBI were more likely to recidivate sooner than those without TBI. Policy implications and directions for future research are discussed.
Erratum to: Examining Fatal Opioid Overdoses in Marion County, Indiana
(Springer-Verlag, 2017-04) Ray, Bradley; Quinet, Kenna; Dickinson, Timothy; Watson, Dennis P.; Ballew, Alfarena; School of Public and Environmental Affairs

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