"When you first walk out the gates...where do [you] go?": Barriers and opportunities to achieving continuity of health care at the time of release from a provincial jail in Ontario
"When you first walk out the gates...where do [you] go?": Barriers and opportunities to achieving continuity of health care at the time of release from a provincial jail in Ontario
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DOI：
10.1371/journal.pone.0231211
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发表时间：
2020-04-10
期刊：
影响因子：
3.7
通讯作者：
Kouyoumdjian, Fiona G.
中科院分区：
文献类型：
--
作者：
Hu, Catherine;Jurgutis, Jessica;Kouyoumdjian, Fiona G.
我们的目的是探索加拿大安大略省省级惩教所释放后的医疗保健的连续性以及健康障碍、促进因素和机会。我们在加拿大安大略省的一个城市的社区组织中开展了焦点小组活动：一个男性无家可归者收容所、一个心理健康服务组织和一个为患有药物滥用障碍的人提供项目的社会服务机构。我们邀请了英语说得足够好的成年人参与讨论，并且他们是去年从省惩教所释放的。我们开展了三个焦点小组，共有 18 名参与者。参与者在释放后有复杂的健康需求，包括拘留期间持续的身体和心理影响。他们发现缺乏获得高质量医疗保健的机会；缺乏住房、就业、社会服务和社会支持；基于监禁历史的歧视是影响释放后健康的障碍。获得医疗保健、住房、社会服务和社会支持都有助于出院后的健康。为了满足出狱后的健康需求，参与者建议在监狱中提供健康信息，改进出院计划，并在社区建立无障碍诊所。这项试点研究确定了支持出狱时健康的机会，包括在监狱中提供计划、与社区建立联系和制定计划，以及支持结构性变革以防止和解决歧视的努力。这些数据将为正在进行的工作提供信息，以支持从省惩教所释放后的健康和连续性护理。
We aimed to explore continuity of health care and health barriers, facilitators, and opportunities for people at the time of release from a provincial correctional facility in Ontario, Canada. We conducted focus groups in community-based organizations in a city in Ontario, Canada: a men's homeless shelter, a mental health service organization, and a social service agency with programs for people with substance use disorders. We included adults who spoke English well enough to participate in the discussion and who had been released from the provincial correctional facility in the previous year. We conducted three focus groups with 18 total participants. Participants had complex health needs on release, including ongoing physical and psychological impacts of time in custody. They identified lack of access to high quality health care; lack of housing, employment, social services, and social supports; and discrimination on the basis of incarceration history as barriers to health on release. Access to health care, housing, social services, and social supports all facilitated health on release. To address health needs on release, participants suggested providing health information in jail, improving discharge planning, and developing accessible clinics in the community. This pilot study identified opportunities to support health at the time of release from jail, including delivery of programs in jail, linkage with and development of programs in the community, and efforts to support structural changes to prevent and address discrimination. These data will inform ongoing work to support health and continuity of care on release from a provincial correctional facility.