Promoting Successful Reentry from Incarceration Among Veterans: Results of a Mixed-Methods Study to Bridge the Gap between Existing Services and Unmet Needs

Background and Purpose:

Approximately 600,000 people are released from US prisons annually, including military veterans.  Formerly-incarcerated individuals face numerous needs upon release (housing, medical, mental health, social) that affect successful community reintegration. Comprehensive reentry planning and coordination across social services are essential to facilitate transition from prison to community. Yet many individuals are released with limited supports and experience lapses in care, leading to elevated risk for re-offending and re-incarceration. 

The Veterans Health Administration (VHA) created the Health Care for Reentry Veterans (HCRV) program to meet reentry veterans’ basic needs by facilitating linkage to temporary housing, benefits, healthcare, and community agencies. However the program’s services end at release, leaving veterans responsible for independently navigating their transition to community living. 

As part of a larger study to develop, test, and scale a reentry intervention, we conducted a mixed-methods formative evaluation of Massachusetts reentry veterans to (a) qualitatively examine perceptions of post-incarceration needs and existing services, and (b) quantitatively assess post-incarceration utilization patterns of VA services.

Methods:

We conducted qualitative interviews with 15 recently-released male veterans and 22 stakeholders from state prisons, community agencies, and VHA’s HCRV program. Veterans were asked about their experiences leaving incarceration and needed supports; stakeholder interviews focused on reentry planning and services provided. Transcripts were analyzed using a grounded content analysis that employed inductive line-by-line coding and constant comparison.  Quantitative data from the HCRV program, VHA homeless programs and VHA medical records were analyzed with descriptive and multivariate statistics to assess timing, type and volume of VHA services accessed following release and associated factors.

Results:

Interviews revealed unmet needs across individual, service, and system levels. INDIVIDUAL: Inconsistently met needs included access to basic resources (housing, food, clothing), income/benefits, healthcare, mental health/substance use services, social support, and skills to live independently in modern society. SERVICES: While varied services existed, reentry planning prioritized short-term needs. Existing social services did not always address transitional anxiety, development of life skills, or social support. SYSTEM: Mental health concerns, substance use, and sexual offense histories complicated re-entry planning due to system-level gaps including limited resources and conflicting perceptions of ownership for veterans with complex needs. Service provision was often fragmented with no system-level coordination.  Most participants believed that a supportive peer could mitigate gaps by offering support while linking veterans with services and coordinating across the system. 

Quantitative analysis found that approximately 90% of veterans exiting incarceration accessed services for basic needs including VA homeless or health care services within one year; most did so within 30 days following release and virtually all accessed either mental health or substance abuse services.

Conclusions and Implications:

While most veterans are connecting with VA homeless or healthcare services post-release, this necessary first step to meet short-term basic needs may be insufficient for sustained community reintegration. Indeed, qualitative results identified unmet needs across social-ecological levels that are inconsistently addressed by the existing fragmented system. Findings from this study provide actionable information with the potential to have an impact on VA programmatic and policy decisions for reentry veterans.