Development of a psycho-social transition program and transition assessment tools for Veterans with mental illness and/or substance use disorders leaving prison

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45,000-50,000 veterans are released annually from state and federal prisons. These Veterans encounter a number of severe negative outcomes following release including homelessness, inpatient psychiatric care, unemployment, divorce, inpatient substance treatment, and reincarceration. There are a number of limitations related to effectively serving these individuals, the primary ones being the limited number of programs available specifically for Veterans leaving incarceration and few assessment tools to assess needs and barriers to successful integration. To develop novel and targeted treatments and assessment tools it is important that we understand the lived experience of those leaving incarceration. This study, conducted in three phases, will develop the tools to assist and assess Veterans’ transition from incarceration with the goal of improving psychosocial outcomes. Phase 1 will be a qualitative analysis of the lived experience of Veterans leaving incarceration using identity theory and an established transition model to conceptualize the transition. Targets will be the experience of transition, barriers and impediments to VA care, perceived needs of those leaving prison, and behaviors that interfere with transition. It is estimated that approximately 30 Veterans will be needed. Phase 2 will use the findings from Phase 1 and a Clinician Counselor Advisory Council to develop a rehabilitation program and assessment tools. The rehabilitation program will be divided into modules focused around facilitating the successful transition from prison. Assessment tools will be for assessing the phases-of- transition, stigma, and interfering behaviors. Items will be developed by the CCAC and the meanings of the items will be confirmed using a sample of 30 Veterans. After items are finalized, understandablity of items will be confirmed with 20 Veterans. The psychometric properties of the assessment tools will then be determined using a sample of 200 Veterans, with subsequent refining. The tools will be piloted on an additional 51 Veterans. Phase 3 will be a pilot intervention using the developed psychosocial rehabilitation tools. Using a cross over design, 30 veterans will receive 8 weeks of no services followed by 8 weeks of the transition intervention. 30 will receive 8 weeks of the transition intervention followed by 8 weeks of no intervention. Outcomes will be, in part, the opinion of the system, willingness to recommend the system, and engagement of the system.