Risk Environments of Permanent Supportive Housing for Formerly Incarcerated People with Serious Mental Illnesses

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ABSTRACT Formerly incarcerated people with serious mental illnesses (SMI) experience the criminal legal system unequally and have elevated rates of recidivism, homelessness, general medical problems, and substance use disorders. Permanent supportive housing (PSH) is a housing intervention often used during reentry, but it has limited resources for addressing community integration, a key component of reentry. PSH are often located in high-poverty environments with increased criminogenic risk. The geography of PSH also includes public spaces, which are associated with greater self-esteem, life satisfaction, a positive orientation toward recovery, independent employment, and access to tangible and social resources. The risk environment framework provides a structure for understanding the geography of PSH through its focus on the physical, social, economic, and policy influences on both the micro and macro environments. During reentry, individual, interpersonal, and environmental factors can interact with these environments to produce or reduce risk. If addressed, these factors can contribute to reentry wellbeing, through improved community participation and treatment engagement and reduced psychiatric distress and substance use, ultimately supporting more targeted interventions. The proposed study uses a rigorous nontraditional QUAL + QUAN (spatial) concurrent mixed-methods design to examine how individual, interpersonal, and environmental factors situated in the risk environments of PSH interact with public and private spaces to inform reentry wellbeing. Eighty multi-method interviews (i.e., qualitative, quantitative, and participatory mapping methods) that look at individual, interpersonal, and environmental reentry factors will be conducted with formerly incarcerated clients with SMI. Data collected will be triangulated with go-along interviews with up to 20 of the participants. Participatory mapping will then be geocoded and sites identified as places of importance, frequent participation, and belonging will be evaluated in relation to objective features of spaces like resource and treatment availability or accessibility using GIS methods in order to develop a community resilience index model. A cluster analysis will additionally be conducted to identify and map areas of increased and decreased drug overdose and arrest and overlaid with the community resilience index model to examine the relationship between community resilience and the risk environments. I will then partner with a community advisory board of 2 providers and 6 formerly incarcerated PSH residents to integrate the findings for the purpose of co-designing a targeted multilevel intervention aimed at improving reentry wellbeing through public space engagement. My proposed research plan integrates activities, formal training, and mentorship from experts (Drs. Michael McDonell, Benjamin Henwood, Ofer Amram, Chyrell Bellamy, Susan Collins, and Mark Salzer) in supportive housing, the risk environment framework, spatial analysis, intervention development, community-based participatory research, and the mental health and criminal legal systems. The Mentored Research Scientist Development Award (K01) will build on my previous training and research to allow me to pursue my long-term career goal to become an independent investigator focused on the use and interaction of public and private spaces in supporting reentry from prisons and jails for people with SMI.