The Role of Intimate Relationships in Quality of Life and Community Reentry of Male Prisoners with Mental Illness
Approximately half of prisoners in the US have a diagnosed severe mental illness (SMI), and only 1/3 receive any form of treatment. Incarceration also disrupts the normal development of adult intimate relationships which are crucial upon community reentry. This population is underserved in a setting that is not conducive to community reentry leading to high rates of reincarceration. The present study seeks to explore how the perception of prisoners’ intimate relationships, marital status and social network support might affect their quality of life. Quality of life has been shown to be a fundamental aspect in treatment outcomes of adults with SMI, and being in a relationship and sexual intimacy have been identified as key contributing factors to positive quality of life in the population with SMI.
Methods:
Participants in this study were 216 incarcerated men with mental illness who participated in an NIMH-funded randomized controlled trial of Critical Time Intervention between 2007 and 2012. The sample is 47 percent African-American, 18 percent Latino and predominately comprised of men with SMI. 33 percent reported being in a relationship. At baseline men reported on their overall satisfaction with quality of life as part of the Lehman’s Quality of Life questionnaire. A series of questions on the quality of their marital or equivalent situation was also included as part of the Level of Service Inventory-Revised (LSI-R) instrument. The Brief Symptom Inventory (BSI) was used to assess psychological distress. Relationship status was self-reported by the participant. Age, race, and social network support were also included in a model testing the impact of relationship status, perception of intimate relationships, and psychological distress on overall satisfaction with life. A linear regression was run using STATA 13.0.
Results:
Based on findings of a linear regression, the model was a significant predictor of quality of life among prisoners with SMI (F(6, 200)=6.63, p<.01) and explained 17 percent of the variance in quality of life. The results of the t-tests indicate that being married (β=.132, t=2.031, p<.05), BSI score (β=-.231, t=-3.514, p<.001), and social network characteristics (β=.192, t=2.909, p=.004) were associated with quality of life for this sample. Analysis indicated there were no ethnic differences.
Implications:
Intimacy and relationships represent domains amenable to intervention. As such these areas can be targeted by program designers in the implementation of community reentry approaches for this population, as well as in the modification and enforcement of visitation and contact policies between prisoners and their significant others. Sexual behavior is intricately related to satisfaction with romantic relationships in adults and it is greatly affected by incarceration, therefore it is important to further research that utilizes more comprehensive and precise measures of sexual behavior and health in the prison population with SMI. Our sample reflects the overrepresentation of minority groups in prisons which should also be considered in the design of culturally competent interventions.