Is Anyone Listening: Exploring Reentry Concerns of Incarcerated Individuals with Severe Mental Illness

Background and Purpose:

Persons with severe mental illness (SMI) who are imprisoned often struggle post-release with basic needs and other facets of reentry. Current research on the needs and priorities of individuals with SMI preparing for release from jails or prisons often falls short in incorporating the voices of the individuals who are most affected. Moreover, although great need and vulnerabilities are documented, little is known about the factors and circumstances that influence the reentry concerns of these individuals. To address these gaps, this exploratory study addresses the following questions: 1) Among imprisoned individuals with SMI, what are their levels and types of reentry concerns? 2) Is there a relationship between reentry concern and pre-incarceration factors? 3) Is there a relationship between reentry concern and prison mental health factors? 4) Is there a relationship between reentry concerns and recidivism?

Methods:

Using opportunity sampling, participant recruitment took place at multiple California state prisons in 2017. A sample of 102 participants with SMI completed a survey within 60 days of being released. Participants ranked their level of concern regarding their ability to meet reentry needs on a scale of 1-10. Due to the skewness in responses (toward the higher levels), responses were then dichotomized into two groups: low-medium concern and high concern. Participants also identified the reentry need causing them the greatest amount of concern. Additional measures included pre-incarceration factors (such as housing stability and economic needs), prison mental health factors and services, and recidivism over the 6 months after release. Logistic regression was used to test the relationships between reentry concerns and these domains.

Results:

Nearly 39% of participants rated their reentry concerns as “10” out of 10. The most frequently indicated reentry concerns were obtaining housing, followed by financial concerns, obtaining services, and engaging in social interactions. No significant relationships were found between reentry concerns and pre-incarceration factors or individuals returning to custody. However, multiple prison mental health factors had significant relationships with individual’s reentry concerns (psychological distress (OR=1.15; p<.001), perceived barriers to care (OR=1.25; p<.001), perceived stigma (OR=1.11; p<.05), perceived efficacy of treatment (OR=.94; p<.05), and overall satisfaction of services (OR=.83; p<.05)). A multivariate logistic regression of the prison mental health factors found, controlling for the previously listed factors, for every unit increase in perceived barriers to care individuals’ odds of being highly concerned increased by 23% (p<.01); all other factors were not significant in the multivariate model.

Conclusions and Implications:

Findings suggest individuals with SMI are highly concerned about meeting their reentry needs. Their greatest concerns include basic needs such as housing and finical resources. Decreasing perceived barriers to care appears important in reducing individual’s reentry concerns. These finding give insight into the concerns of this marginalized population and suggest that current practice and policies fall short in helping individuals feel prepared to reenter society. As researchers, policymakers, and community partners increase their consideration of the viewpoints of individuals preparing to reenter society valuable insights can be gained that could facilitate better meeting the needs of this population.