Community Participation Patterns of People with Serious Mental Illness after Release from Jail

Background: Community participation, defined as natural engagements with non-disabled individuals in domestic life, interpersonal life, education and employment, and community and civic life, is thought to be an important part of community integration for people with serious mental illness (SMI). Much is yet to be learned about the community participation of people with SMI leaving jail because the experience of incarceration can impact individuals’ political, economic, psychological, and social selves. This paper will contribute to our understanding in this area by examining the community participation patterns of people with SMI after release from jail.

Method: This study used a prospective, longitudinal design to examine the community participation experiences of a cohort of 97 people with SMI after release from jail. Participants’ community participation in 26 areas were assessed using the Temple University Community Participation Measure at 6 months post release. Independent t-tests were used to compare the jail based sample’s scores on the community participation measure with normative data for the measure gathered from 568 people with SMI receiving services from community based mental health programs.

Results: People with SMI leaving jail had significantly lower levels of community participation then the community based sample, in both days of community participation (53 vs 73 respectively) and number of community activities in which individuals participated (6 vs. 9 respectively). Statistically significant differences also were found in the levels of community participation in activities participants identified as important in the two samples. Here again participants in the jail sample engaged in a fewer community based activities they deemed as important (5 vs 9 respectively) and spent an average of 25 fewer days engaging in community based activities they identified as important (43 vs 68 respectively). Differences were also found in the types of activities the two groups identified as important. Both groups identified running errands, and spending time with family and friends as two of the most important areas of community participation. However participants in the jail sample identified work for pay as their most important community participant activity while the community based sample identified grocery shopping. Additionally, over 75% of participants in the community sample indicated they spent enough time participating in their most important activity (grocery shopping), while only 24% of participants in the jail sample indicated they spent enough time engaging in their most important activity (work for pay).

Discussion: The community participation patterns of people with SMI leaving jail are characterized by low rates of participation in a restricted range of activities. These lower rates of participant are likely related to the unpredictable and chaotic nature of jail releases and the high rates of recidivism associated with these first 6 months. But regardless of the causes the distinctive patterns of community participation and differences in the priorities of people with SMI leaving jail need to be considered when developing interventions to increase the community integration of this sub- population of people with SMI.