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Justice-involved transition age young adults (TAY) experience a host of challenges while navigating reentry into their communities post-incarceration. These challenges include securing housing and employment, continuing or pursuing educational and vocational goals, reconnecting with families and social support systems, and contending with expected developmental milestones—all while meeting court requirements. Research on reentry also demonstrates that TAY experience a host of health challenges during this period, particularly pertaining to mental health and substance use. For TAY, barriers to accessing healthcare during reentry include a lack of coordination between different systems in which the TAY are involved and policy-level issues related to Medicaid coverage for recently incarcerated young adults.
This study builds on previous qualitative scholarship on TAYs’ healthcare access, needs, and utilization by centering their perspectives on their own health and well-being. Specifically, we explore: 1) How TAY conceptualize and define broad constructs of health and healthiness and 2) the implications of these definitions for health-related reentry services that are sensitive and responsive to TAYs’ health needs.
Methods
The study used purposive sampling to conduct a series of longitudinal interviews (N=54) with TAY during reentry. Interviews were conducted between June 2020 and May 2021. Each young adult was invited to complete up to 9 monthly interviews within the study period, and 65 total interviews with 15 unique participants were completed over the course of the study. Young adults completed 6 interviews on average. The average participant age was 21 years old. Inductive thematic analysis was used to investigate TAYs’ conceptualizations of health and well-being and their identification of their own health needs. The thematic analysis process included 1) preliminarily coding several interviews to generate an initial codebook, 2) consolidating initial codes into focused codes, 3) applying focused codes to all 65 interviews, 4) collating codes into larger themes, and 5) comparing themes across transcripts and cases.
Results
Participants discussed their conceptualizations and definitions of health in terms of the presence of “healthiness” and lack thereof. They emphasized mental health and abstaining from substances over physical health. Specifically, participants defined health as 1) abstaining from substances such as alcohol and drugs, 2) maintaining activities of daily living (e.g., cooking, cleaning, hygiene, completing chores), 3) being able to stay “motivated” and “focused” on their personal and re-entry related goals, and 4) coping with both individual and reentry-related stressors. TAY defined a lack of health as 1) the persistence of trauma and mental health challenges, 2) relapsing into substance use, and 3) experiencing stress related to reentry processes.
Conclusions and Implications
Findings demonstrate that TAYs’ conceptualizations of health and well-being are primarily centered around mental health and substance use. Specifically, TAY define “healthiness” as being able to complete activities of daily functioning and meet specific reentry goals, viewing reentry-related stressors as inextricable from their health—especially mental health—outcomes. Study findings point to the need for centering substance use prevention in reentry programming. Implications for healthcare programming within community reentry programs are further discussed.