Peer navigation for individuals with serious mental illness leaving jail

严重精神疾病（SMI）是一种耻辱和致残的健康状况，减少平均寿命 预期25年。重度精神病感染也是一个普遍的公共卫生问题，影响到25%的监狱人口。再- 对重度精神障碍患者来说，入狱后进入社区是一个与司法有关的脆弱时期， 重度精神病患者需要及时和持续地获得心理健康和其他医疗保健服务。公正- 重新进入社区的重度精神障碍患者在进入社区时遇到多种障碍 精神健康、医疗保健和社会服务，因为他们的衰弱症状，实际挑战， 获得社区服务和心理健康污名。同伴导航被发现可以改善访问 精神健康和医疗保健的个人与SMI在社区。然而，没有同行 已经测试了对重度精神障碍的支持性干预措施，以帮助在重返社会期间与心理健康服务联系， 入狱后的社区这项研究将开发和试点测试同伴导航干预， 患有SMI的人在监狱服刑后重新进入社区，为更大的随机化研究提供了基础性工作。 对照试验，评价同行导航干预对涉及司法的个人的有效性， SMI。干预是基于社会支持理论。该项目将： 干预，并评估其可行性，可接受性和潜在的参与目标机制， 重度精神障碍患者重新进入精神卫生、医疗保健和物质使用服务的登记情况 社区和（B）在40名患有SMI的个体的样本中进行随机试点试验， 社区建议的目标机制包括增加工具性，信息性和情感性 支持治疗参与和康复，以及提高对社会规范的认识， 治疗参与和恢复。对照条件为标准治疗（SOC）。除了 可行性和可接受性，其他成果包括：（1）卫生服务成果（主要），包括 社区心理健康（初级）、医疗保健和物质使用的登记/参与/利用 服务;和更短的天数之间的释放和第一次接触医疗保健提供者;（2）临床结果： 减少精神症状，增加功能，坚持精神药物治疗，减少 物质使用天数，住院和自杀企图较少;（3）生活背景结局：夜间不稳定 圈养，和时间，直到再次逮捕和（4）潜在的目标机制，包括工具，信息， 和情感支持的治疗参与和社会规范的治疗参与， 复苏解决重新进入患有SMI的个人的需求是精神和心理方面的当务之急。 卫生和刑事司法系统。同行导航员可以在持续恢复中发挥关键作用， 成功重返社会，减少刑事司法介入的影响和心理健康挑战。

Serious Mental Illness (SMI) is a stigmatized and disabling health condition that reduces average life expectancy by 25 years. SMI is also a prevalent public health problem affecting 25% of jail populations. Re- entry to the community following incarceration is a vulnerable time for justice-involved individuals with SMI, and SMI requires prompt and ongoing access to mental health and other healthcare services. Justice- involved individuals with SMI re-entering the community experience multiple barriers to access to community mental health, medical care and social services due to their debilitating symptoms, practical challenges accessing community services, and mental health stigma. Peer navigation has been found to improve access to the mental health and medical care among individuals with SMI in the community. However, no peer support interventions for SMI have been tested to assist with mental health service linkage during re-entry to the community after incarceration. This study will develop and pilot test a peer navigator intervention for individuals with SMI re-entering the community after jail stay, providing formative work for a larger randomized controlled trial evaluating the effectiveness of peer navigator intervention for justice-involved individuals with SMI. The intervention is based on social support theory. The project will: (a) develop a peer navigation intervention and evaluate its feasibility, acceptability, and potential engagement of target mechanisms for enrollment in mental health, medical care and substance use services among individuals with SMI re-entering the community and (b) conduct a randomized pilot trial in a sample of 40 individuals with SMI re-entering the community. Proposed target mechanisms include increased instrumental, informational, and emotional support for treatment engagement and recovery, as well as increased perception of social norms promoting treatment engagement and recovery. The control condition will be Standard Of Care (SOC). In addition to feasibility and acceptability, other outcomes include: (1) health service outcomes (primary) including enrollment/engagement/utilization of community mental health (primary), medical care and substance use services; and shorter days between release and first contact with healthcare provider; (2) Clinical outcomes: reduced psychiatric symptoms, increased functioning, adherence to psychiatric medications, fewer substance using days, fewer hospitalizations and suicide attempts; (3) Life context outcomes: nights unstably housed, and time until rearrest and (4) Potential target mechanisms that include instrumental, informational, and emotional support for treatment engagement and social norms about treatment engagement and recovery. Addressing the needs of re-entering individuals with SMI is a pressing priority for both the mental health and criminal justice systems. Peer navigators could play a critical role in continuing recovery and successful reintegration, reducing the impact of criminal justice involvement and mental health challenges.