8.1 Chapter Learning Objectives and Overview
Learning Objectives
The following learning objectives tell you what is most important in this chapter. Use these statements as a guide to make sure you get the most out of this chapter.
- Discuss the needs of people with mental disorders who are reentering the community, considering possible supports to meet those needs.
- Evaluate how success in reentry is defined, describing factors that contribute to success.
- Describe the relationship of risks, needs, and responsive services to successful community reentry.
- Explain key interventions that support successful community reentry for people with mental disorders, and discuss how these may be implemented in reentry programs.
Key Terms
Look for these important terms in the text in bold. Understanding these terms will help you meet the learning objectives of this chapter. You can find definitions for these terms at the end of the chapter.
- Alcohol use disorder
- Case management
- Continuity of care
- Criminogenic risk
- Evidence-based
- Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- In-reach
- Lived experience
- Medications for alcohol use disorder (MAUD)
- Medications for opioid use disorder (MOUD)
- Opioid use disorder
- Opioid drugs
- Patient navigation
- Peer support workers
- Recidivism
- Recovery
- Risk-Need-Responsivity (RNR)
- Supported employment
- Warm hand-off
Chapter Overview
In March of 2024, Arturo Ruiz, aged 49, had been living in the community for about a year after serving more than 6 years in prison for a violent crime. When he entered prison in 2017, Ruiz was one of 37,000 people with mental disorders who were incarcerated in California (figure 8.1). Ruiz had previously struggled with substance use, and while in prison, he was diagnosed with bipolar disorder. While Ruiz’s in-prison treatment for his bipolar disorder was imperfect, it was consistent, and he was prescribed medication that improved his symptoms (Naroozi, 2024).
However, when Ruiz was preparing to reenter the community, he was given little guidance for connecting to appropriate care. He secured an appointment with a community psychiatrist, but the relationship yielded little more than prescription refills and monthly calls to inquire if Ruiz was suicidal. As Ruiz describes it, the care was distant and lacked human connection. Yet Ruiz considers himself fortunate in being educated and resourceful enough to find care at all (Naroozi, 2024).
As with others leaving prison, Ruiz is trying to rebuild a life from scratch—but the process is complex and difficult. Ruiz works to support himself and to pay the restitution he owes his victim. He attends college to improve his future, but he juggles that with other priorities, including personal life changes to maintain his mental health, meeting criminal justice system obligations related to parole, and coping with challenging roommates in sober housing. Faced with these pressures, Ruiz stopped taking the medication he began in prison, worried the side effects impaired his ability to be productive (Naroozi, 2024).
Like Ruiz, many people emerge from the criminal justice system managing co-occurring disorders of substance use and mental illness. Without proper and timely access to care for mental disorders, this group faces potential recurrence of symptoms and serious threats, such as drug overdoses. They are also at greater risk of reoffense and re-incarceration than other groups (National Alliance on Mental Illness [NAMI], n.d.-b). Simply connecting people like Ruiz to care and medication may not be enough. Life post-prison is, as demonstrated by Arturo Ruiz’s story, complex. Success requires juggling and compromising, with difficult decisions that may impact risk. As Ruiz acknowledges, he is unusual in possessing the education, motivation, and advocacy skills to get his needs met.
To succeed in the longer term, people reentering the community with mental disorders may need help addressing numerous issues, including but not limited to mental health, substance use, and trauma. This chapter discusses some important considerations around supporting people with mental disorders reentering the community from prison or jail. Several established interventions can improve outcomes for this population and should be prioritized when considering how to help people returning to the community from jail or prison.
Licenses and Attributions for Chapter Learning Objectives and Overview
Open Content, Original
“Chapter Overview” by Anne Nichol is licensed under CC BY 4.0.
Open Content, Shared Previously
Figure 8.1. Photo by Karsten Winegeart is licensed under the Unsplash License.
