Examining trauma and demoralization as factors influencing treatment engagement for Black women with SUD returning from prison

检查创伤和士气低落作为影响 SUD 出狱黑人女性治疗参与度的因素

• 批准号: 10853925
• 负责人: Chyrell Denise Bellamy
• 金额: $ 15.99万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-22 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10853925
• 关键词: Address; Affect; Attention; Award; Behavior; Black race; Collaborations; Communities; Criminal Justice; Data; Development; Discrimination; Employment; Environment; Exclusion; Face; Feeling; Financial Hardship; Gender; Goals; Harm Reduction; Health; Health Knowledge Attitudes Practice; Health Services Accessibility; Health Status; Housing; Imprisonment; Incidence; Income; Individual; Institution; Intervention; Jail; Justice; Latinx; Laws; Learning; Legal; Link; Low Income Population; Low income; Measures; Mediating; Mediator; Mental Health; Mental disorders; Methods; Occupational activity of managing finances; Outcome; Parents; Participant; Pathway interactions; Personal Satisfaction; Persons; Policies; Population; Poverty; Prisons; Process; Provider; Race; Randomized; Recording of previous events; Research; Research Methodology; Resources; Savings; Services; Social Network; Social support; Stigmatization; Substance Use Disorder; System; Target Populations; Testing; Training; Trauma; Victimization; Woman; Work; addiction; black women; community based participatory research; empowerment; experience; health determinants; improved; innovation; internalized stigma; meetings; parent grant; peer support; primary outcome; programs; racism; recidivism; secondary outcome; service providers; skills; social stigma; social stress; substance use; tool; trauma exposure; treatment strategy

Program Summary/Abstract People who experience incarceration and have mental health challenges are disproportionately Black and Latinx, and low-income. This group experiences financial hardships regardless of incarceration due to racism and other forms of discriminations, with associated negative health outcomes. These financial issues have a direct impact on health, create barriers to employment and housing, stress social networks, contribute to feelings of exclusion and contribute to recidivism, all of which are health determinants. The goal of the parent award is to intervene at the community level to reduce financial difficulties of individuals with incarceration histories and mental health challenges, who are predominantly Black and Latinx. The proposed diversity supplement will explore experiences of trauma, stigma, and demoralization among Black women with histories of a substance use disorder (SUD) and/ or SUD treatment, recently released from incarceration. Incarcerated populations are often presenting with mental health conditions, including substance use disorders (SUD), with an estimated 60% of those incarcerated meeting criteria for a SUD. In the last two decades there has been an 525% increase in the incarceration rate for women, and in 2021 Black women were incarcerated at 1.6 times the rate of White women. Furthermore, consistent findings highlight high rates of victimization among incarcerated women, and it is hypothesized that trauma exposure is a gender-specific pathway into the carceral system. Research has identified that for several women this pathway is in part due the presence of mental health conditions, including SUDs. Stigma associated with both addiction and legal involvement is one of the many barriers individuals face as they reenter the community and initiate community- based SUD treatment. Embodying multiple stigmatized identities, formerly incarcerated Black women with SUDs navigate a reentry experience that is unique and nuanced. Implementing Community-Based Participatory Research (CBPR) methods this proposal will explore how these intersecting identities (race, gender, person who uses substances, incarceration history) and compounded experiences (pre-incarceration trauma, carceral trauma, internalized stigma, demoralization) impact treatment seeking behaviors and decisions. Our CBPR process incorporates learning from and partnering with community stakeholders to identify opportunities that can improve treatment strategies and reentry experiences for the target population, and inform the development of a harm reduction, community-based, and culturally relevant intervention.

项目概要/摘要 经历过监禁并面临心理健康挑战的人中黑人和 拉丁裔低收入这个群体经历经济困难，无论因种族主义而被监禁 以及其他形式的歧视，并带来相关的负面健康后果。这些金融问题有一个 对健康的直接影响，对就业和住房造成障碍，对社交网络造成压力， 排斥感，并导致累犯，所有这些都是健康的决定因素。家长的目标 奖励是在社区一级进行干预，以减少被监禁者的经济困难 历史和心理健康挑战，主要是黑人和拉丁裔。 拟议的多样性补充将探讨创伤，耻辱和士气低落的经验， 有物质使用障碍（SUD）和/或SUD治疗史的黑人女性，最近从 监禁。被监禁的人往往会出现精神健康状况，包括吸毒 使用障碍（SUD），估计有60%的被监禁者符合SUD的标准。最近两 几十年来，女性的监禁率增加了525%，到2021年，黑人女性 是白色女性的1.6倍。此外，一致的调查结果突出表明， 受害者之间的监禁妇女，它是假设，创伤暴露是一个性别特异性 进入宫颈系统的途径。研究表明，对于一些女性来说，这条途径部分是由于 存在精神健康状况，包括SUD。与成瘾和法律的相关的污名 参与是个人重新进入社区和发起社区时面临的许多障碍之一， 基础治疗。体现了多重污名化的身份，以前被监禁的黑人妇女， SUD导航一个独特而细致入微的再入体验。落实社区 该提案将探讨这些交叉的身份（种族， 性别、使用药物者、监禁史）和复合经历（监禁前 创伤，宫颈创伤，内化的耻辱，道德败坏）影响寻求治疗的行为， 决策我们的CBPR流程包括向社区利益相关者学习并与之合作， 确定能够改善目标人群的治疗策略和重返社会经验的机会， 并为制定减少危害、基于社区和文化相关的干预措施提供信息。