Mental Illness and Community Reentry in a Multi-Ethnic Population of Female Inmat

描述（由申请人提供）：近年来，美国各地被监禁的女性，尤其是少数族裔女性的比例急剧上升。这些妇女的再犯率非常高，研究强烈表明，精神疾病，包括药物滥用和依赖，是出院后再次犯罪的关键因素。新墨西哥州被监禁的妇女是被监禁妇女困境的一个例证。这些妇女心理健康问题的高流行率超出了监狱官员和社区重返社会规划者提供适当服务的能力，特别是对那些返回农村地区的妇女。这项转化研究将通过调整和完善一种数据和理论驱动的方法，即关键时间干预（CTI）来解决这个问题，该方法旨在解决精神疾病和社区再入需求，并减少这一人群中的再犯。CTI首先在城市地区离开精神病院的个人中开发和测试，是一种全国公认的、以证据为基础的干预措施，它推进了一种手动病例管理方法，以促进社区重新进入。CTI旨在建立个人的社会支持系统，将其与住房、就业和其他经济资源联系起来，并使其接受治疗。该项目将结合形成性研究和参与性规划方法，使CTI适用于以农村为主的新墨西哥州的女囚犯。为此，该项目将评估精神疾病在从监狱转移到农村环境的西班牙裔、美洲原住民和白人妇女中的作用，审查在重返社会过程中提供的社会支持，并确定加强和维持其社区联系以及获得正式和非正式帮助资源的战略。该项目将修改CTI，为R01申请做准备，以研究其在提高不同族裔农村女性罪犯的心理健康和刑事司法结果方面的有效性。这项研究将分三个阶段进行。首先，我们将对计划从监狱释放的多民族农村女囚犯进行结构化的精神病学评估和定性访谈。这种方法的丰富详细描述将阐明妇女如何经历精神疾病，以及这种经历如何影响她们重返社会。其次，我们将通过对专业人士和非专业人士的定性访谈，仔细考虑农村妇女重返社会的更广泛的社会支持背景。第三，我们将召集一个由刑事司法专业人员、精神卫生专家和经历过重返社区的农村妇女组成的利益攸关方小组。根据我们的研究结果和利益相关者的意见，我们将使用参与式规划方法来调整CTI。这一适应过程将为使CTI适应其他人口和环境提供一个模式，从而有助于更广泛地传播这一重要的干预措施。

DESCRIPTION (provided by applicant): The percentage of incarcerated women across the U.S., particularly women from ethnic minority groups, has increased dramatically in recent years. The recidivism rate among these women is remarkably high, and research strongly suggests that psychiatric disorders, including substance abuse and dependence, are key contributing factors in re-offending upon discharge into the community. Women incarcerated in New Mexico exemplify the plight of imprisoned women. The high prevalence rate of mental health problems among these women overwhelms the capacity of prison officials and community reentry planners to provide appropriate services, especially for those returning to rural areas. This proposed translational research will tackle this issue by adapting and refining a data- and theory-driven approach, the Critical Time Intervention (CTI), which aims to address mental illness and community reentry needs and to decrease recidivism within this population. First developed and tested among individuals leaving psychiatric hospitals in urban areas, the CTI is a nationally- recognized, evidence-based intervention that advances a manualized case management approach to facilitate community reentry. The CTI is intended to build an individual's social support system, link her to housing, employment, and other economic resources, and engage her in treatment. This project will utilize the combination of formative research and participatory planning methods to adapt the CTI for female inmates in the predominantly rural state of New Mexico. To this end, the project will assess the role of mental illness among Hispanic, Native American, and White women moving to rural environments from prison, examine the provision of social support in the reentry process, and determine strategies to strengthen and sustain their community connections and access to formal and informal helping resources. The project will modify the CTI in preparation for an R01 application to study its effectiveness in enhancing mental health and criminal justice outcomes for rural female offenders of diverse ethnicities. This research will occur in three stages. First, we will conduct structured psychiatric assessments and qualitative interviews with a multi-ethnic sample of rural female inmates scheduled for release from prison. The richly detailed descriptions from this approach will elucidate how women experience mental illness and how this experience may impact their reentry into the community. Second, we will carefully consider the broader social support context of reentry for rural women through qualitative interviews with professional and nonprofessional individuals comprising this context. Third, we will convene a stakeholder group of criminal justice professionals, mental health experts, and rural women who have experienced community reentry. Based upon our study findings and stakeholder input we will then use participatory planning methods to adapt the CTI. This adaptation process will provide a model for tailoring the CTI to other populations and settings, thus serving to disseminate this important intervention more widely. PUBLIC HEALTH RELEVANCE: Project Narrative: This proposed translational research will adapt and refine a data- and theory-driven approach, the Critical Time Intervention (CTI), in order to address mental illness and community reentry needs and to decrease recidivism within a vulnerable population of rural ethnic minority women in prison. This project will combine formative research and participatory planning methods to adapt the CTI for female inmates in the rural state of New Mexico. This adaptation process will provide a model for tailoring the CTI to other populations and settings, thus serving to disseminate this important intervention more widely.