The relationship between services and outcomes for a prison reentry population of those with severe mental illness

Abstract

It is approximated that 14% of prison inmates have severe mental illness (SMI; Fazel, S., & Danesh, J. (2002). Serious mental disorder in 23000 prisoners: A systematic review of 62 surveys. The Lancet, 359, 545–550) and 78% of mentally ill state prison inmates recidivate during their lifetime (James, D.J., & Glaze, L.E. (2006). Mental health problems of prison and jail inmates. Washington, DC: Bureau of Justice Statistics, US Department of Justice. Retrieved from http://www.ojp.usdoj.gov/bjs/). One factor that is thought to be particularly associated with recidivism among people with SMI is the lack of community services available upon release (Barr, H. (2003). Transinstitutionalization in the courts: Brad H. v. City of New York, and the fight for discharge planning for people with psychiatric disabilities leaving Rikers Island. Crime & Delinquency, 49, 97–123; Casper, E.S., & Clark, D. (2004). Service utilization, incidents, and hospitalizations among people with mental illnesses and incarceration histories in a supportive housing program. Psychiatric Rehabilitation Journal, 28, 181–184; Haimowitz, S. (2004). Slowing the revolving door: Community reentry of offenders with mental illness. Psychiatric Services, 55, 373–375; Pogorzelski, W., Wolff, N., Pan, K., & Blitz, C.L. (2005). Behavioral health problems, ex-offender reentry policies, and the “Second Chance Act”. American Journal of Public Health, 95, 1718–1724; Vigilante, K.C., Flynn, M.M., Affleck, P.C., Stunkle, J.C., Merriman, N.A., Falnigan, T.P., … Rich, J.D. (1999). Reduction in recidivism of incarcerated women through primary care, peer counseling, and discharge planning. Journal of Women's Health, 8, 409–415). The aim of this study was to examine factors that predict recidivism (either hospitalization or reincarceration) in a clinic sample of recently released offenders with SMI. Review of clinical records for 30 clients with SMI who had recently been released from prison receiving psychiatric treatment at a community mental health center. When controlling for receipt of financial public assistance, homelessness significantly predicted time to recidivism, so that persons who were homeless were more likely to recidivate sooner than those who were housed. This finding has potential clinical implications that treatment planning for reentering SMI offenders should have a particular focus on getting homeless offenders housed. Additional research needs to be conducted with a larger sample.

Keywords:

• recidivism
• reentry
• mentally ill offenders
• service use

Acknowledgments

The authors would like to thank Dr. Anne Black for assisting with data analysis and Dr. Madelon Baranoski for helping to facilitate this project.