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，特别是来自少数族裔群体的女性的比例急剧上升。这些妇女的再犯罪率非常高，研究有力地表明，精神障碍，包括药物滥用和依赖，是出院后再次犯罪的关键因素。在新墨西哥州被监禁的妇女是被监禁妇女的困境的例证。这些妇女中精神健康问题的高患病率使监狱官员和社区再入规划者无法提供适当服务，特别是为返回农村地区的人提供服务。这项拟议的翻译研究将通过调整和完善一种以数据和理论为导向的方法-关键时间干预(CTI)来解决这一问题，该方法旨在解决精神疾病和社区重新进入的需求，并减少这一人群中的再犯罪率。CTI最初是在离开城市地区精神病院的个人中开发和测试的，是一种国家认可的循证干预措施，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，将她与住房、就业和其他经济资源联系起来，并让她参与治疗。该项目将利用形成性研究和参与性规划相结合的方法，使CTI适应以农村为主的新墨西哥州的女性囚犯。为此，该项目将评估精神疾病在从监狱移居农村的西班牙裔、美洲土著人和白人妇女中的作用，审查在重返社会过程中提供社会支持的情况，并确定加强和维持她们的社区联系和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，以研究其在加强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，我们将对预定出狱的多民族农村女囚犯进行系统的精神评估和定性访谈。这一方法的详细描述将阐明妇女如何经历精神疾病，以及这种经历可能如何影响她们重新进入社区。其次，我们将通过对构成这一背景的专业和非专业个人的定性访谈，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、心理健康专家和经历过社区重新融入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攸关方的意见，我们将使用参与性规划方法来适应CTI。这一适应进程将提供一种模式，使技术创新适应其他人群和环境，从而有助于更广泛地传播这一重要干预措施。 公共卫生相关性：项目说明：这项拟议的转化研究将调整和完善一种以数据和理论为导向的方法，即关键时间干预(CTI)，以解决精神疾病和社区重新进入的需求，并减少监狱中农村少数民族妇女这一弱势群体的累犯率。该项目将结合形成性研究和参与性规划方法，使CTI适应新墨西哥州农村地区的女性囚犯。这一适应进程将提供一种模式，使技术创新适应其他人群和环境，从而有助于更广泛地传播这一重要干预措施。

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.