Recruiting Participants With Severe Mental Illness in a Jail Setting: A Feasibility Study
Research studies of people with serious mental illness (SMI) in correctional settings have a history of experiencing significant delays in subject recruitment that is hard to explain in light of sites’ estimates of the number of potentially eligible participants. These delays appear to be particularly lengthy in jail settings were recruitment procedures often rely on mental health staff in the jail to identify potentially eligible participants. Finding ways to recruit people with SMI as early as possible in jail settings is important because many inmates with SMI have shorter jail stays than previously thought.
The analysis presented here draws from a federally funded pilot project that used a RCT to test the effectiveness of an enhanced reentry model for individuals with severe mental illness (SMI) in jail. One of the goals of this study is to examine the feasibility of engaging a larger scale investigation of this intervention. Thus one of its aims was to develop recruitment methods that maximized the study’s access to the largest pool of potential participants as possible.
The jail’s existing booking process was used to recruit participants. Research staff worked closely with jail staff to identify criteria that jail staff could use to refer potential participants by reviewing each step in the jail booking process and all assessments completed during this process. This review identified a number of questions that are asked in the booking process that could be used as indicators of mental health problems.
A total of 225 potential participants were identified using the recruitment procedures within 261 days. 171 of these individuals were approached for participation in this study. Of these, 138 completed the screening interview. Analysis of each step in the recruitment process found that 24.0% of potential participants dropped out of the study before eligibility could be determined and 19.6% of the inmates screened were ineligible for the study. Jail mental health records for the100 participants selected for participation in the study were analyzed to determine what percent of the sample would not have been referred to the study if jail staff had relied on records of participants mental health diagnoses to refer participants. This analysis found that 33% of the sample did not have a diagnosis on file with the jail at the time they were referred to the study.
Conclusions and Implications
Using the jail’s booking procedure to identify potential participants yielded a large number of potential participants in a relatively short period of time. But the speed with which participants were identified had costs. Researchers must have personnel who are able to conduct interviews at any given time and interviewers must diagnose potential participants in order to determine study eligibility. However, this recruitment method identified a larger pool of potential participants, reduced the likelihood of gatekeeping on the part of the jail, and allowed researchers to recruit a large sample quickly. Future research should focus on minimizing the number of ineligible offenders referred to the research staff.