Addressing the Challenge of Community Reentry Among Released Inmates with Serious Mental Illness

Abstract

The purpose of the paper is to discuss the formidable challenges to community reentry and reintegration faced by U.S. prison inmates with serious mental illness and to describe various strategies for improving transitional services for these individuals. We review epidemiologic data supporting the high prevalence of severe mental illness in U.S. prisons as well as the historical factors underlying the criminalization of the mentally ill. The importance and challenges of providing adequate psychiatric care for mentally ill prisoners during their incarceration are discussed. We also review the numerous psychosocial and economic challenges confronting these individuals upon their release from prison, such as unemployment and vulnerability to homelessness, as well as specific barriers they may encounter in attempting to access community-based mental health services. We follow with a discussion of some of the more promising strategies for improving the transition of the mentally ill from prison to the community. In the final sections, we review the evidence for a relationship between serious mental illness and recidivism and briefly discuss emerging alternatives to incarceration of the mentally ill.

Reducing the incarceration of the homeless : an examination of multi-service use and the utilization of institutional services.

“…The number of adults in the criminal justice system has increased overwhelmingly during the past 25 years (Baillargeon, Hoge, & Penn, 2010;Fagin, 2010;Ford, 2005;Golder et aI., 2005). It is estimated that roughly 47 million people in the United States have an arrest record (Fisher, Roy-Bujnowski, Wolff, Crockett, & Banks, 2011).…”

“…(2010) (Baillargeon et aI., 2010). This act provided financial incentives for states to develop community-based treatment as alternatives to institutional services (Baillargeon et al, 2010).…”

“…The passage of this act essentially ended involuntary psychiatric hospitalization unless there was convincing evidence the individual posed a danger to themselves, to others, or were incapable of caring for themselves (Baillargeon et al, 2010;Slate & Johnson, 2008). According to Baillargeon et aI.…”

“…The number of individuals in state mental health hospitals had decreased to less than 80,000 in 1999 and further decreased to 52,539 by 2005 (Baillargeon et aI., 2010;Slate & Johnson, 2008;Thompson et al, 2003;Torrey et al, 2008). The number of state mental health hospital beds had decreased tp an estimated 17 beds per 100,000 residents by 2005 (Baillargeon et al, 2010;Torrey et al, 2008). The policy of deinstitutionalization had reduced the number of psychiatric hospital beds by 50% between the 1955 and 2005 (Baillargeon et al, 2010;Hartwell, 2004;Thompson et al, 2003;Torrey et al, 2008).…”

“…The number of state mental health hospital beds had decreased tp an estimated 17 beds per 100,000 residents by 2005 (Baillargeon et al, 2010;Torrey et al, 2008). The policy of deinstitutionalization had reduced the number of psychiatric hospital beds by 50% between the 1955 and 2005 (Baillargeon et al, 2010;Hartwell, 2004;Thompson et al, 2003;Torrey et al, 2008). Torrey et al (2008) reported that approximately 96,000 additional psychiatric beds were needed to meet the minimum level of psychiatric care.…”