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

计划摘要/摘要 经历过监禁并面临心理健康挑战的人中，黑人和 拉丁裔和低收入人群。这一群体经历了经济困难，无论因种族主义而入狱 和其他形式的歧视，以及相关的负面健康后果。这些财务问题有一个 对健康产生直接影响，对就业和住房造成障碍，给社会网络带来压力，有助于 被排斥的感觉和导致累犯，所有这些都是健康的决定因素。父母的目标是 奖励是在社区层面进行干预，以减少被监禁个人的经济困难 历史和精神健康挑战，他们主要是黑人和拉丁裔。 拟议的多样性补充将探讨以下人群中的创伤、耻辱和士气低落的经历 有物质使用障碍(SUD)和/或SUD治疗史的黑人女性，最近从 监禁。被监禁的人群经常表现出精神健康状况，包括物质 使用障碍(SUD)，估计有60%的被监禁者符合SUD标准。在过去两年中 几十年来，妇女的监禁率增加了525%，2021年黑人妇女的监禁率增加了525% 被监禁的比例是白人女性的1.6倍。此外，一致的发现突显了高比率 在被监禁妇女中受害的可能性，并假设创伤暴露是一种性别特有的 进入内脏系统的途径。研究发现，对于一些女性来说，这条途径的部分原因是 精神健康状况的存在，包括肥皂水。与成瘾和法律相关的耻辱 参与是个人重新进入社区并发起社区时面临的众多障碍之一- 以SUD为基础的治疗。体现了多种耻辱的身份，以前被监禁的黑人妇女 苏德导航的再入体验是独特的和微妙的。实施以社区为基础 参与性研究(CBPR)方法本提案将探索这些交叉身份(种族、 性别、吸毒者、监禁历史)和复合经历(监禁前 创伤、内脏创伤、内在化耻辱、士气低落)影响求医行为和 决定。我们的CBPR流程包括向社区利益相关者学习并与其合作，以 确定可改善目标人群的治疗策略和再入体验的机会； 并为减少伤害、以社区为基础和与文化相关的干预措施的发展提供信息。

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.