Substance Abuse and Mental Health Services for Individuals during Community Reentry Following Release from Incarceration: Needing One, the Other, or Both

Purpose: The purpose of Project RISE was to inventory services needed and engaged by men and women during community reentry following incarceration. Objectives of the present analyses were to compare individuals with needs for substance abuse (SA), mental health (MH), or both types of services: comparison by gender and by type of incarceration facility.

Methods: A convenience sample of individuals (N=87; men=41, women=46) were interviewed longitudinally about anticipated or experienced need for and barriers to SA and MH services, prior to and two months after release from jail (n=13), prison (n=40), or community based correctional facility (CBCF; n=34).

Results: Men and women differed significantly both in pre-release anticipation and post-release experience of need for MH and/or SA services during community reentry. Men were more likely to anticipate and actually need neither type of help, whereas women were more likely to anticipate and actually need both types [pre-release χ²(3)=20.46, p<.001, post-release χ²(3)=9.43, p<.05]. Individuals leaving CBCFs were significantly more likely to anticipate need for both MH and SA services compared with individuals leaving jail and prison [χ²(6)=40.75, p<.001]. Among individuals anticipating a need for only one type of service, those leaving jail anticipated MH service needs, and those leaving CBCFs anticipated SA service needs.  Anticipated barriers also differed significantly. Individuals anticipating need for both MH and SA services, compared to only SA services, anticipated higher levels of four out of seven types of SA service barriers: Not Knowing about Programs, Shame, Transportation, and Not Ready to Make Changes (independent sample t-test p<.05 or p<.01 for each analysis). Similarly, post-release, individuals needing both compared to only SA services encountered higher levels of three out of seven SA service barrier types: Not Knowing about Programs, Shame, and Not Ready to Make Changes, as well as a significantly greater number of SA service barriers overall. The number of anticipated barriers was significantly greater than the number experienced for either SA or MH services (paired t-tests).

Implications: Many individuals have great need for SA and/or MH services during reentry following incarceration. Among those who anticipate and experience need for SA services, significant barriers exist to receiving them. Women had both greater anticipated and experienced dual need for SA and MH services. Type of facility made a difference in both anticipated and experienced need, with individuals leaving CBCFs most likely to anticipate dual need for both SA and MH services. Individuals released from jails had the greatest anticipated need for MH services only, while those released from CBCFs had the greatest anticipated need for SA services only. By design, CBCFs may be serving individuals with more serious SA problems and be influencing individuals to continue with treatment after release. Individuals incarcerated in jails may under-report their need for SA services. Policy and programs should incorporate findings in designing reentry supports and addressing service barriers, particularly for addressing women’s service barriers and engaging individuals in SA services. Pre-release intervention to reduce shame, increase readiness for change, and provide information about available programs and barriers might prove useful.