8.9 Chapter Summary
- The reentry population served in the community is made up of people who, frequently, experience mental disorders and other marginalizing factors that predate or arise from their time in jail or prison.
- Successful reentry is often defined as reduced recidivism, but success may be viewed more broadly, especially for marginalized populations, to include measures such as a positive outlook on life and access to basic needs (e.g., mental health care, housing, and food).
- Effective reentry support should respond to a person’s assessed level of risk and specific needs. The RNR model emphasizes the importance of providing correctly directed interventions that are responsive to a person and reduce risk by meeting needs.
- Three types of interventions that have proven successful in reentry programs for people with mental disorders are medications for the treatment of substance use disorders (MOUD and MAUD), case management, and peer support or patient navigation. There are several guidelines for the best use of these services, including the use of training, ensuring equity, and following best practices for implementation.
- The Felton Institute’s SMI program is an example of a targeted local program that employs the reentry interventions described in this chapter, illustrating how those can be put into practice to support people impacted by significant mental disorders (serious mental illness and substance use disorders).
Key Term Definitions
- Alcohol use disorder: Substance use disorder that involves the recurrent use of alcohol, despite significant impairment or problems associated with continued use.
- Case management: Supporting clients by planning, coordinating, and connecting them to services e.g., (health care, mental health care, substance use treatment, and social services) to address their needs and goals.
- Continuity of care: The ability to access uninterrupted health and mental health services during a setting transition.
- Criminogenic risk: A person’s likelihood of criminally reoffending that is assessed based on factors that directly relate to whether the person is likely to commit another crime (criminogenic risk factors).
- Evidence-based: A descriptor of a treatment, practice, or intervention that has been proven, via research, to be effective for achieving desired outcomes.
- Health Insurance Portability and Accountability Act of 1996 (HIPAA): A law that prohibits health entities from sharing protected patient medical records without authorization.
- In-reach: A strategy in which providers from community-based organizations meet with individuals before their release from custody to begin service planning and establish continuity of care.
- Lived experience: Personal knowledge gained through direct, first-hand involvement. In the context of this text, lived experience refers to experience with mental disorders, including substance use disorders, and/or criminal justice system involvement.
- Medications for alcohol use disorder (MAUD): A medication-based approach for treating alcohol use disorders, reducing alcohol use, and sustaining recovery. The most common FDA-approved medications used to treat alcohol use disorders are acamprosate, disulfiram, and naltrexone.
- Medications for opioid use disorder (MOUD): A medication-based approach for treating opioid use disorders, preventing overdose, and sustaining recovery. The FDA has approved three medications for opioid use disorders: buprenorphine, methadone, and naltrexone.
- Opioid use disorder: A substance use disorder involving opioid drugs, such as heroin, fentanyl, or prescription opioids (e.g., OxyContin).
- Opioid drugs: A class of drugs that includes legal and illegal substances, such as heroin, fentanyl, and prescription pain relievers like oxycodone, morphine, and others.
- Patient navigation: The use of trained healthcare workers to reduce barriers to care for individuals returning from criminal justice settings. Patient navigators help people navigate complex healthcare and social services systems to improve access to care and treatment.
- Peer support workers or peers: People with lived experience, including with mental disorders and/or criminal justice system involvement, who have been successful in the recovery process and are trained to help others experiencing similar situations. Peers can have various titles: peer support workers, peer specialists, peer recovery coaches, peer advocates, or peer recovery support specialists.
- Recidivism: The return to criminal offending, as measured by re-offense, re-arrest, re-conviction, or re-incarceration.
- Recovery: Recovery is a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential.
- Risk-Need-Responsivity (RNR): A model of providing services that informs who receives services based on risk, what services are provided based on need, and how services are provided to maximize effectiveness.
- Supported employment: Evidence-based intervention that provides job development and placement, job coaching and training, and problem-solving skills development to people with disabilities and behavioral health conditions.
- Warm hand-off: A transfer of care between support people or care providers (e.g., from correctional health to community-based services) that includes direct introductions, provision of required information, and if appropriate, transportation to the receiving service provider. Warm hand-offs are a technique to ensure continuity of care for people being released from custody.
Discussion Questions
- What factors may make reentry after incarceration more difficult, and how can the specific interventions discussed in this chapter ease barriers and increase success?
- What specific risk is targeted in the RNR model? Why is it important to direct the most services to higher-risk individuals?
- Why were the approaches of MOUD and MAUD, case management, and patient navigation/peer support highlighted in this chapter? What about those three approaches makes them important for our study?
- Can you locate and describe local programs in your area that employ some of the approaches and strategies discussed in this chapter?
Knowledge Check
Use these optional questions to check your knowledge after reading this chapter.
Licenses and Attributions for Chapter Summary
“Chapter Summary” by Anne Nichol is licensed under CC BY 4.0.
