Mental Health and Substance Abuse Service Engagement by Men and Women During Community Reentry Following Incarceration

Abstract

Individuals reentering the community following incarceration are at high risk for experiencing mental health and substance use problems. This longitudinal study explores patterns and barriers for engaging treatment services during early reentry. Seventy-five men and 62 women in jail, prison, or community based correctional facilities (CBCFs) participated in pre- and post-release interviews. Findings indicate that services were engaged at a lower-than-needed rate and barriers were greater for individuals leaving jails compared to prison or CBCF. Exploratory factor analysis of the barriers instrument is presented. Implications for extending service access to this population are discussed, as are future directions for research.

“When you first walk out the gates…where do [you] go?”: Barriers and opportunities to achieving continuity of health care at the time of release from a provincial jail in Ontario

“…Our finding that mental health, substance use, and pain management were major concerns for people on release from custody is consistent with other research [20,21,25,28,46]. Similarly, other studies have also identified stigma and discrimination [17,[19][20][21]26,28], competing priorities such as housing and employment [17][18][19][20][21][22][23], lacking access to health care and other services [17,21,22,25,26], and lack of continuity of care on release [17,21,22,24,25,40,47] as barriers to health on release. Several studies corroborate our findings regarding facilitators of health on release, including support from family and friends, access to social services, convenient and accessible health services including for opioid agonist treatment such as methadone, and service providers [17,19,23,26,40].…”

“…The period after release from custody is particularly challenging to health, as indicated by increased risks of morbidity and mortality [13][14][15][16]. People face urgent issues on release from jail and prison, including finding housing and employment, reconnecting with family, and meeting conditions of release [17][18][19][20][21][22][23], which may compete with addressing health and health care needs [24]. In the US, lack of health insurance poses a significant barrier to accessing health care after release, especially in states where Medicare and Medicaid are revoked upon arrest [18][19][20]23,[25][26][27].…”

“…People face urgent issues on release from jail and prison, including finding housing and employment, reconnecting with family, and meeting conditions of release [17][18][19][20][21][22][23], which may compete with addressing health and health care needs [24]. In the US, lack of health insurance poses a significant barrier to accessing health care after release, especially in states where Medicare and Medicaid are revoked upon arrest [18][19][20]23,[25][26][27]. People may face discrimination relating to their criminal record, including from health care providers [17,26,28].…”

“…People may face discrimination relating to their criminal record, including from health care providers [17,26,28]. Finally, inadequate discharge planning in custody may contribute to difficulty navigating community services on release [20,22]. In this context, stakeholders have identified continuity of health care and community re-integration as priorities for prison health research in Canada [29].…”

Women in Transition to Health

“…This frequently includes several different components including full incarceration, drug and alcohol treatment, work release, community corrections, and/or long-term supervision (probation and parole). For women who are also managing a chronic illness, this transition means that they are moving from an incarceration environment where there is some limited access to healthcare services (albeit not ideal) and assistance with medications, to home situations that require them to take full responsibility for their care, often with considerably fewer resources (Begun, Early, & Hodge, 2015;Flores & Pellico, 2011).…”