Connecting inmates with health and social care upon reentry can help end the prison cycle

Each year, more than 600,000 people are released from state and federal prisons, and more than nine million circulate through local jail systems across the U.S. Among those individuals who are released, seven out of 10 are rearrested within five years, and half are reincarcerated, creating a vicious cycle for millions of Americans.

For a country that creates opportunity for many people, the fact that America not only has the highest incarcerated population in the world, but also one of the highest recidivism rates, demonstrates deep problems and inequities. What are we doing wrong? And what can we do better?

The criminalization of mental health issues and substance use disorders has contributed significantly to the issue, with the majority of the U.S. jail population suffering from these challenges — many left untreated. In addition, public policy has traditionally favored more investment in the criminal justice system (law enforcement, prison and the court system) and less in community health and support programs to prevent incarceration in the first place.

In addition, the conditions of confinement and limited access to care within facilities contribute to increased health care and mental health problems, and release from correctional systems often creates high-risk moments for individuals struggling with substance use; former inmates are 40 times more likely to die of a drug overdose within the first two weeks after their release than someone in the general population.

But perhaps the biggest cause of recidivism isn’t what happens inside prison, but rather what happens to individuals once they’re re-adjusting to life in their communities. A growing number of transition programs are focused on healthcare planning – helping formerly incarcerated individuals with enrollment in Medicaid, and supporting them to access covered programs to treat medical and physical health conditions. This is important because justice-involved individuals historically have received very little, if any, support for their behavioral health needs, or basic social needs upon reentry such as housing, employment, and transportation.

While some states do offer mental health care and substance abuse treatment — Rhode Island, for example, was the first state in the nation to offer access to drug treatment for everyone in the state prison system — there is still a huge number of individuals who, upon release, fall through the cracks.

Already burdened with the stigma of a criminal record, it’s difficult for former inmates to find a secure job, stable housing and other basic necessities. While our current health and human services system provides resources to help, they’re not easy to access. The onus is on the individual to figure out what programs they’re eligible for, gather the necessary documentation required to apply, and submit applications.

A system that increases access to community-based health and social services, and can efficiently connect justice-involved individuals to local resources, supports these people as they navigate reentry and reintegration into communities. In many cases, ample programs and community assets already exist — it’s a matter of connecting the dots and facilitating better collaboration. This approach requires four key components:

  • Identify the key players. Around the country, there are already community-based organizations that provide critical services such as housing assistance, job training and placement services, food assistance, and mental health and substance use treatment. Identifying these partners and building a network ensures that all the available services and resources are activated based on each individual’s needs.
  • Establish a clear point of contact. Prior to discharge, justice-involved individuals should be connected to a transition clinic or supportive organization that works with each individual to identify their holistic, whole-person needs.
  • Create a seamless care workflow. Based on these needs, social workers and care navigators can leverage community health infrastructure to process referrals, coordinate warm hand-offs to health and social service organizations, and ensure successful delivery of services so that all needs are met.
  • Measure outcomes. With this community infrastructure in place, referral outcomes and network activity data can be used to identify service gaps, common co-occurring needs, and socio-demographic trends – allowing partners to target resources where most needed and consistently improve service delivery to support justice-involved individuals.

By addressing upstream factors that contribute to successful reentry, we can help provide justice-involved individuals with the safety net and support they deserve after leaving correctional systems, and simultaneously build healthier communities through investments in safety net and underfunded community organizations. Communities across the country are already making progress in their efforts to provide a comprehensive system of support for former inmates:

  • In Rhode Island, investing just $2 million in addiction treatment services during incarceration reduced post-incarceration overdose deaths by more than 60%.
  • In Oregon, funding behavioral health, transition, skills-building and other community services helped to reduce prison length of stay and prison intake rates, saving $94 million over four years.
  • Miami-Dade County, Florida has saved $12 million a year by decriminalizing mental illness and offering treatment in lieu of incarceration for low-level offenses.

And nationwide, the White House Council of Economic Advisors found that addressing mental health or substance use issues significantly reduce crime and incarceration costs.

Justice-involved individuals face a tremendous number of unknowns and uncertainties upon release, making it difficult for them to adjust back into their communities. With timely, coordinated health and social care services, we can prevent recidivism and support individuals to achieve their full potential.

Photo: Boonyachoat, Getty Images

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