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

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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.