Peer navigation for individuals with serious mental illness leaving jail

严重精神疾病(SMI)是一种会降低平均寿命的耻辱和致残的健康状况 预期寿命延长25年。SMI也是一个普遍存在的公共卫生问题，影响着25%的监狱人口。重新- 入狱后进入社区对于患有SMI的正义个人来说是一个脆弱的时期， SMI需要及时和持续地获得心理健康和其他医疗服务。正义-- SMI重新进入社区的相关个人在进入社区时遇到了多个障碍 心理健康，医疗和社会服务，由于他们虚弱的症状，实际的挑战 获得社区服务，以及心理健康污名。同行导航已被发现可以改善访问 社区SMI患者的心理健康和医疗保健。然而，没有同行 对SMI的支持干预已经过测试，以帮助在重新进入 监禁后的社区。这项研究将开发和试点测试同行导航员干预 患有SMI的个人在服刑后重新进入社区，为更大规模的随机工作提供了成型性工作 评价同伴导航员干预对涉及正义的个人的有效性的对照试验 SMI。干预的依据是社会支持理论。该项目将：(A)开发同行导航 干预措施并评估其可行性、可接受性和目标机制的潜在参与性 精神卫生、医疗保健和药物使用服务重新进入的个人的登记情况 社区和(B)在40名患有SMI重新进入 社区。建议的目标机制包括增加工具性、信息性和情绪性 支持治疗参与和康复，以及提高人们对促进 治疗投入和康复。控制条件将是标准护理(SOC)。除了……之外 可行性和可接受性，其他成果包括：(1)保健服务成果(主要)包括 社区精神卫生(初级)、医疗保健和药物使用的登记/参与/利用 服务；以及从出院到第一次与医疗保健提供者接触的天数缩短；(2)临床结果： 精神症状减少，功能增强，坚持精神药物治疗，减少 使用药物的天数、住院和自杀未遂的次数减少；(3)生活背景结果：夜间不稳定 以及(4)潜在的目标机制，包括工具性、信息性、 和对治疗参与度的情感支持以及关于治疗参与度和 恢复。解决使用SMI重新进入个人的需求是两个脑力劳动者的当务之急 卫生和刑事司法系统。同行领航员可以在持续复苏和 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.