Examining the Role of Familial Support During Prison and After Release on Post-Incarceration Mental Health

The experiences of men in prison who do not receive visits from family or friends: A qualitative systematic review

BACKGROUND

Visits present an opportunity for prisoners to preserve family ties and reduce isolation, but not all receive visits from family or friends whilst incarcerated.

AIMS

To locate, appraise and synthesise qualitative data on the experiences of adult male prisoners (aged 18 years+) who do not receive prison visits from family or friends.

METHODS

Nine electronic databases were searched from the date of their inception until March 2023. The quality of included studies was assessed using the Critical Appraisal Skills Programme checklist for qualitative studies, and data from the studies were synthesised using the thematic synthesis method.

RESULTS

Eighteen studies from seven countries (the USA, the UK [England, Northern Ireland & Scotland], Canada, Netherlands and the Philippines) were eligible for inclusion. Three main themes emerged: (1) reasons for not receiving visits, (2) harmful effects of not receiving visits and (3) the value of volunteer visitor programmes. Practical problems were cited as interfering with visiting opportunities, but also some prisoners or families chose not to meet in prison. Loneliness and depression were extensively described as effects of not receiving visits. Qualities associated with volunteer visitors included raised self-esteem, improved mood and personal growth.

CONCLUSION

Narratives of the experiences of adult men in prison without visits from family or friends suggest that not only the practical difficulties of imprisonment affect visiting; barriers that prisoners themselves impose would merit further exploration, as would family and relationship dynamics during incarceration and the emotional impact of prison visits, for both prisoners and their families. There are suggestions of therapeutic as well as humanitarian benefits from volunteer visiting programmes. There is a gap in the literature about any specific effect on rebuilding family relationships.

Substance Use Disorders, Mental Illness, and Health Care Utilization Among Adults With Recent Criminal Legal Involvement

OBJECTIVE

Individuals involved with the criminal legal system have higher rates of mental illness, addiction, and health care utilization. The authors examined whether substance use disorders and mental illness alone or in combination drive health care utilization among those with recent criminal legal involvement.

METHODS

This cross-sectional analysis used nationally representative data from U.S. adults with past-year criminal legal involvement (N=9,039) recorded in the National Survey on Drug Use and Health (2015-2019). Using adjusted negative binomial regression models, the authors estimated relative risks for health care utilization. Primary independent variable categories included neither substance use disorder nor mental illness, substance use disorder only, mental illness only, and both conditions. Health care utilization included emergency department (ED) visits and nights spent in inpatient care.

RESULTS

Relative to neither mental illness nor substance use disorder, mental illness alone was associated with significantly increased acute health care services use: for ED visits, incidence risk ratio (IRR)=1.43 (95% CI=1.18-1.75) and for inpatient stays, IRR=2.14 (95% CI=1.47-3.11). Having both conditions was associated with increased ED visits (IRR=1.62, 95% CI=1.38-1.91) and inpatient stays (IRR=4.16, 95% CI=2.98-5.82). Substance use disorder alone was associated only with higher risk for ED visits compared with neither condition (IRR=1.23, 95% CI=1.01-1.50).

CONCLUSIONS

Mental illness with or without co-occurring substance use disorder is a strong driver of acute health care utilization after interaction with the criminal legal system. Interventions tailored to the unique needs of individuals with mental illness or substance use disorder are needed for those with recent criminal legal involvement.

Suicide Mortality Among Formerly Incarcerated People Compared With the General Population in North Carolina, 2000-2020

We aimed to compare rates and characteristics of suicide mortality in formerly incarcerated people with those of the general population in North Carolina. We conducted a retrospective cohort study of 266,400 people released from North Carolina state prisons between January 1, 2000, and March 1, 2020. Using direct and indirect standardization by age, sex, and calendar year, we calculated standardized suicide mortality rates and standardized mortality ratios comparing formerly incarcerated people with the North Carolina general population. We evaluated effect modification by race/ethnicity, sex, age, and firearm involvement. Formerly incarcerated people had approximately twice the overall suicide mortality of the general population for 3 years after release, with the highest rate of suicide mortality being observed in the 2-week period after release. In contrast to patterns in the general population, formerly incarcerated people had higher rates of non-firearm-involved suicide mortality than firearm-involved suicide mortality. Formerly incarcerated female, White and Hispanic/Latino, and emerging adult people had a greater elevation of suicide mortality than their general-population peers compared with other groups. These findings suggest a need for long-term support for formerly incarcerated people as they return to community living and a need to identify opportunities for interventions that reduce the harms of incarceration for especially vulnerable groups. This article is part of a Special Collection on Mental Health.

Depression among incarcerated persons following the death of a loved one: Does social support mitigate grief?

The death of a loved one generates adverse and potentially damaging consequences for surviving family members and friends. The challenges of bereavement can be especially severe when experienced by incarcerated persons who must cope with and grieve the death while incarcerated. Yet, limited research evaluates bereavement among incarcerated persons and whether factors such as social support buffer against health-related consequences. Using data from the LoneStar Project-a study of 802 incarcerated men in Texas-we examine depressive symptoms among currently incarcerated persons with differential exposure to a loved one's death (i.e., immediate family, friends, extended family). Importantly, a high rate of death exists among incarcerated persons' loved ones, with 41% in the sample losing someone on the outside during their final year of incarceration. However, we find that external social support from family and friends and in-prison social cohesion from peers, significantly mitigate the harms of bereavement on depressive symptoms.

Trajectories of incarcerated coparenting: Examining differences across race and ethnicity

Emerging research suggests that those coparenting with an incarcerated person experience multiple challenges. Examining incarcerated coparenting among minority fathers is especially salient as their incarceration rates are substantially higher than White males. This study utilized data from the Multi-Site Family Study on Incarceration, Parenting and Partnering Study to examine changes in coparenting relationships when the male partner was incarcerated. Theoretically guided by structural family therapy, latent growth models were used to evaluate trajectories of fathers' coparenting reliability and coparenting cohesion across 34 months. Results indicated average declines within incarcerated men's reported coparenting responsibility and coparenting cohesion with their partner. Incarcerated men with higher relationship quality at T1 was significantly associated with higher initial levels of coparenting cohesion and coparenting responsibility-but not with the trajectories of coparenting change. Incarcerated fathers identifying as Hispanic and Other declined at a significantly steeper rate in coparenting responsibility than Black and White incarcerated fathers. Clinical implications and future research directions are provided.

Is use of opioid agonist treatment associated with broader primary healthcare use among men with recent injecting drug use histories following release from prison? A prospective cohort study

BACKGROUND

A precipitous decline in health status among people recently released from prison is common. In Victoria, Australia, opioid agonist treatment (OAT) in the community involves frequent contact with primary care, potentially facilitating broader use of primary healthcare services. Among a cohort of men who injected drugs regularly pre-imprisonment, we estimated differences in rates of primary healthcare use and medication dispensation between people who did and did not receive OAT post-release.

METHODS

Data came from the Prison and Transition Health Cohort Study. Three-month post-release follow-up interviews were linked with primary care and medication dispensation records. Generalised linear models were fit with one exposure (OAT: none/partial/complete) for 13 outcomes relating to primary healthcare use, pathology testing, and medication dispensation, adjusted for other covariates. Coefficients were reported as adjusted incidence rate ratios (AIRR).

RESULTS

Analyses included 255 participants. Compared to no OAT use, both partial and complete OAT use were associated with increased rates of standard (AIRR: 3.02, 95%CI: 1.88-4.86; AIRR: 3.66, 95%CI: 2.57-5.23), extended (AIRR: 2.56, 95%CI: 1.41-4.67; AIRR: 2.55, 95%CI: 1.60-4.07) and mental health-related (AIRR: 2.71, 95%CI: 1.42-5.20; AIRR: 2.27, 95%CI: 1.33-3.87) general practitioner (GP) consultations, total medication (AIRR: 1.88, 95%CI: 1.19-2.98; AIRR: 2.40, 95%CI: 1.71-3.37), benzodiazepine (AIRR: 4.99, 95%CI: 2.81-8.85; AIRR: 8.30, 95%CI: 5.28-13.04) and gabapentinoid (AIRR: 6.78, 95%CI: 3.34-13.77; AIRR: 4.34, 95%CI: 2.37-7.94) dispensations, respectively. Partial OAT use was also associated with increased after-hours GP consultations (AIRR: 4.61, 95%CI: 2.24-9.48) and complete OAT use? with increased pathology utilisation (e.g. haematological, chemical, microbiological or immunological tissue/sample testing; AIRR: 2.30, 95%CI: 1.52-3.48).

CONCLUSION

We observed higher rates of primary healthcare use and medication dispensation among people who reported partial and complete OAT use post-release. Findings suggest that access to OAT post-release may have a collateral benefit in supporting broader health service utilisation, underscoring the importance of retention in OAT after release from prison.

"…he's going to be facing the same things that he faced prior to being locked up": perceptions of service needs for substance use disorders

BACKGROUND

High rates of substance use disorders (SUDs) exist among justice-involved populations (i.e., persons incarcerated or recently released). SUD treatment is crucial for justice-involved populations as unmet treatment need increases reincarceration risk and impacts other behavioral health sequalae. A limited understanding of health needs (i.e. health literacy) can be one reason for unmet treatment needs. Social support is critical to seeking SUD treatment and post-incarceration outcomes. However, little is known about how social support partners understand and influence SUD service utilization among formerly incarcerated persons.

METHODS

This mixed method, exploratory study utilized data from a larger study comprised of formerly incarcerated men (n = 57) and their selected social support partners (n = 57) to identify how social support partners understand the service needs of their loved ones recently released from prison who returned to the community with a diagnosis of a SUD. Qualitative data included 87 semi-structured interviews with the social support partners covering post-release experiences with their formerly incarcerated loved one. Univariates were conducted on the quantitative service utilization data and demographics to complement the qualitative data.

RESULTS

Majority of the formerly incarcerated men identified as African American (91%) averaging 29 years of age (SD = 9.58). Most social support partners were a parent (49%). Qualitative analyses revealed that most social support partners avoided using or did not know the language to use regarding the formerly incarcerated person's SUD. Treatment needs were often attributed to focus on peer influences and spending more time at their residence/housing. Analyses did reveal that when treatment needs were recommended in the interviews, social support partners reported employment and education services to be most needed for the formerly incarcerated person. These findings align with the univariate analysis with their loved ones reporting employment (52%) and education (26%) as their most reported service utilized post-release, compared to only 4% using substance abuse treatment.

CONCLUSION

Results provide preliminary evidence suggesting social support partners do influence the types of services accessed by formerly incarcerated persons with SUD. The findings of this study emphasize the need for psychoeducation during and after incarceration for individuals with SUDs and their social support partners.

Incarcerated Loved Ones: Building a Community to Support and Advocate on Facebook

Individuals with an incarcerated loved one are often overlooked when discussing the impacts of incarceration. It can be difficult for these individuals to navigate the criminal justice system, as well as form meaningful connections and obtain support from others that are experiencing a similar situation. Social media allows for connections to be made between individuals in similar situations that might not be geographically close to one another. Specifically, for those with an incarcerated loved one, the Facebook group "Incarcerated Loved Ones" allows for meaningful connection to others who are navigating incarceration. Posts were collected from this Facebook group, with the themes emerging including COVID, information seeking, and advocacy. Findings, as well as future directions, will be discussed.

The Disproportionate Mental Health Burden Among Incarcerated Transgender and Gender Diverse People

This article examines the distribution of self-reported mental health conditions and clinical contact among incarcerated transgender and gender diverse (TGD) individuals compared to cisgender women and men. Data are derived from the 2016 Survey of Prison Inmates. Results indicate that TGD respondents report more mental health symptoms, conditions, and clinical contact than their cisgender counterparts. The findings have important implications for the mental health disadvantages experienced by TGD people currently in prison.

Factors associated with successful reintegration for male offenders: a systematic narrative review with implicit causal model

Objectives

This systematic review explored factors associated with successful reintegration into the community for male offenders and investigated which factors may be causally related to reintegration.

Methods

Database searches were conducted in November 2021; a narrative synthesis and associated causal model with directed acyclic graph (DAG) was used to analyse the factors of reintegration.

Results

Thirty-four studies met the inclusion criteria. Risk-Need-Responsivity-based interventions had the strongest evidence for reducing post-release offending. Fourteen good-quality studies met the inclusion criteria. The DAG shows six exposure variables (prison visits, witnessing victimisation, recovery perception, risk assessment, in-prison treatment, and pre-prison health) which link to several post-release outcomes (criminal justice outcomes, drug use, mental health, housing, and reintegration barriers) and confounding variables (demographics, offending history, prior reintegration barriers, substance misuse and attitudes).

Conclusions

The review identified factors that may be causally related to reintegration for male offenders and warrant further empirical investigation.

Incarceration exposure and women's oral health experiences during pregnancy

RATIONALE

Prior research has documented an association between incarceration and poor oral health outcomes. Likewise, recent scholarship has also detailed that women exposed to incarceration either directly or vicariously through a partner during pregnancy incur worse health outcomes. However, no previous research has assessed the connection between incarceration exposure and oral health during pregnancy.

OBJECTIVE

The current study assesses the link between maternal incarceration exposure and oral health during pregnancy.

METHODS

Data are from the Pregnancy Risk Assessment Monitoring System (PRAMS) from years 2016-2019 (N = 60,342). Logistic regression was used to assess the relationship between incarceration and oral health.

RESULTS

Women exposed to incarceration exhibited worse oral health outcomes in the form of being more likely to report not knowing the importance of oral care, not having an oral health discussion with a provider, not getting a teeth cleaning, as well as being likely to report needing to see a dental provider, having visited a dental provider for a problem during pregnancy, and having more unmet dental care needs.

CONCLUSIONS

These findings add to a burgeoning literature that demonstrates a woman's prenatal exposure to incarceration poses risk for overall health and wellbeing. Given the influence of both incarceration exposure and oral health during pregnancy for maternal and infant health, the findings suggest that coordination between criminal justice, public health, and oral health experts can develop programmatic efforts that expand access to oral health care and improve oral health literacy among incarceration-exposed pregnant women.

Multiple Disadvantage and Social Networks: Toward an Integrated Theory of Health Care Use During Reentry From Criminal Justice Settings

Research consistently finds the disproportionate negative health impact of the criminal justice system on racial and ethnic minorities. Yet less is known about the underlying mechanisms of health care utilization during community reintegration. We contribute to the literature theoretically by integrating two perspectives: network theory of social capital and multiple disadvantage hypothesis and providing a more nuanced explanation of health service use during reentry. We identify incarceration history as a unique disadvantaged status that precludes people from accessing social networks and social capital. We further elaborate on the phenomenon of racialized reentry and illustrate how multiple disadvantaged statuses are linked to social networks and health care.

Cross-cultural adaptation and psychometric properties of the Spanish Quality in Psychiatric Care Forensic Inpatient Staff (QPC-FIPS) instrument

"Quality in Psychiatric Care-Forensic Inpatient Staff (QPC-FIPS) is an instrument of Swedish origin validated to measure the perception of the quality of mental health care provided by forensic psychiatry professionals. The aim of this study was to cross-culturally adapt the QPC-FIPS instrument and to evaluate the psychometric properties of the Spanish version of the instrument. A psychometric study was carried out. For validity, content validity, convergent validity and construct validity were included. For reliability, the analysis of internal consistency and temporal stability was included. The sample consisted of 153 mental health professionals from four Forensic Psychiatry units. The adapted Spanish version of the QPC-FIPS scale was configured with the same number of items and dimensions as the original. The psychometric properties, in terms of temporal stability and internal consistency, were adequate and the factor structure, such as the homogeneity of the dimensions of the Spanish version of the QPC-FIPS, was equivalent to the original Swedish version. We found that the QPC_FIPS-Spanish is a valid, reliable and easy-to-apply instrument for assessing the self-perception of professionals regarding the care they provide.

Psychiatric well-being among men leaving prison reporting a history of injecting drug use: A longitudinal analysis

BACKGROUND

Community reintegration from prison is typically stressful, with several health and social outcomes impacting psychiatric well-being during this time, often exacerbated among individuals with histories of drug use. Longitudinal data was used to assess change in psychiatric well-being over 2 years following release from prison among men who reported a recent history of injecting drug use.

METHODS

Data for this study come from the Prison and Transition Health cohort study of 400 men recruited in prison prior to release and followed up over three time points. Psychiatric well-being was assessed using the 12-item General Health Questionnaire. We calculated change in individual General Health Questionnaire scores between interviews and identified covariates associated with General Health Questionnaire score using linear mixed-effects regression.

RESULTS

Data from 690 follow-up interviews among 326 participants were included in analyses. There was considerable variation in individuals' General Health Questionnaire scores. Moving accommodation frequently and frequent illicit drug injections were associated with an increase in General Health Questionnaire score (i.e. decline in psychiatric well-being). Two or more prior adult imprisonment episodes, social supports and past month primary healthcare attendance were associated with a decrease in General Health Questionnaire score.

CONCLUSION

Our findings identify health, social and structural influences on psychiatric well-being after release from prison that can inform re-entry programmes to support community reintegration.

Defining the Pre-exposure Prophylaxis Care Continuum Among Recently Incarcerated Men at High Risk for HIV Infection: Protocol for a Prospective Cohort Study

Background

HIV disproportionately impacts criminal justice–involved individuals, including men who experience incarceration. Men make up the vast majority of those experiencing incarceration as well as those newly diagnosed with HIV infection. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention that significantly reduces the risk of HIV acquisition. However, implementation in criminal justice systems is limited. Little is known about effective PrEP implementation and use in this unique public health context.

Objective

The aim of this study is to characterize the experience of implementing PrEP clinical care in a criminal justice setting for men vulnerable to HIV acquisition.

Methods

This article describes a PrEP care continuum for men experiencing incarceration who are at increased risk of HIV acquisition, which can help conceptualize approaches to evaluating PrEP implementation.

Results

The outlined study will enroll 100 men experiencing incarceration at high risk for HIV acquisition prior to release into the community. The goal is to initiate PrEP prior to release and link individuals to PrEP providers in the community, capturing barriers and facilitators to PrEP use during this uniquely vulnerable time period for HIV acquisition.

Conclusions

Based on the proposed care continuum and what is known about HIV risk and prevention efforts in the criminal justice context, we outline key future research efforts to better understand effective approaches to preventing HIV infection among this vulnerable population. The described approach presents a powerful public health opportunity to help end the HIV epidemic.

International Registered Report Identifier (IRRID)

DERR1-10.2196/31928

Fetal alcohol spectrum disorder and confabulation in psycholegal settings: A beginner's guide for criminal justice, forensic mental health, and legal interviewers

Fetal alcohol spectrum disorders (FASD) are neurodevelopmental/neurobehavioral conditions caused by prenatal alcohol exposure (PAE). Impairments caused by PAE contribute to the over-representation of individuals with FASD in the United States juvenile and adult criminal justice systems. These same impairments can equally impact on individuals with FASD who are witnesses to or victims of crime who also have to navigate the complexities of the criminal justice system. Difficulties include increased susceptibility to confabulation throughout the legal process that, in turn, can contribute to increased rates of poor outcomes including false confessions and wrongful convictions. Individuals with FASD are particularity at risk of confabulation when they are subjected to tactics, such as stressful and anxiety-provoking situations, threats, and leading, suggestive, or coercive questioning. Many professionals in the forensic context are unfamiliar with FASD or related confabulation risk and may unintentionally utilize tactics that intensify impacts of pre-existing impairment. This article serves as a beginner's guide for professionals working in criminal justice settings by (a) providing research-based overviews of FASD and confabulation, (b) describing how FASD may lead to confabulation, and (c) suggesting ways that professionals can modify protocols when interacting with individuals with FASD. Suggestions in this article hold the potential to decrease the risk of confabulation in the criminal justice system and decrease problematic outcomes, such as false confessions and wrongful convictions among individuals with FASD.

Association Between Social Support and Mental Health of Incarcerated Individuals

Mental illness occurs more frequently in incarcerated individuals than in the general population. This study examined whether social support during incarceration is associated with improved mental health outcomes. Data were used from the 2004 Survey of Inmates in State Correctional Facilities; the analytic sample was 3,451 incarcerated individuals. Linear regression models predicted current mental health functioning from frequency of visits and phone calls while incarcerated. Controlling for demographic characteristics, incarcerated individuals with more frequent contact from family and friends had improved mental health. Mental health functioning was particularly enhanced for individuals who received more calls and visits. Future research should explore opportunities to increase visits and phone calls during incarceration along with additional social support mechanisms that may enhance mental health.

Quality of life during a randomized trial of a therapeutic-workplace intervention for opioid use disorder: Web-based mobile assessments reveal effects of drug abstinence and access to paid work

Background

Employment and improved quality of life (QOL) are, separately, valued outcomes of substance use disorder (SUD) treatment. It is also important to understand QOL changes caused by employment itself; therefore, we assessed QOL during a randomized trial of a contingency-management-based Therapeutic Workplace for people with opioid use disorder.

Methods

For 12 weeks, participants (n = 61) responded to QOL questionnaires in a mobile web app accessed with study-issued smartphones. At enrollment, participants were randomized to work in the Therapeutic Workplace immediately (immediate work group, IWG) or after a 3-week waitlist delay (delayed work group, DWG). Once both groups could work, wage-resetting contingencies were introduced for their opiate- and cocaine-urinalysis. Data were analyzed by (1) access to work with and without contingencies and (2) overall urinalysis-verified opiate- and cocaine-abstinence.

Results

DWG and/or IWG reported improvements in several QOL areas (sleep, transportation, recreation); however, they also reported increased money-related difficulties and less time spent with friends/family. These changes did not coincide with DWG's work access, but some (more sleep, money-related difficulties) coincided with the urinalysis contingencies. Greater opiate- and/or cocaine-abstinence was also associated with several improvements: sleep, paying bills, time spent with friends/family, and exercising. Surprisingly, intermediate cocaine abstinence was associated with reductions in work-capacity satisfaction and recreation.

Conclusions

Participants reported complex QOL differences during their experimental employment and associated with drug abstinence. Future work should help participants address issues that may be relevant to employment generally (e.g., time with friends/family) or contingency management specifically (e.g., money-related issues for non-abstinent participants).

Service Needs for Corrections-Involved Parents With a History of Problematic Opioid Use: A Community Needs Assessment

The incarceration of a parent is often a continuation of a challenging family situation marked by poverty, unstable housing, trauma, and abuse. These challenges make it difficult for incarcerated parents reentering their communities to raise their children effectively and, thus, increase the likelihood of poor outcomes for their children. Children whose parents are also battling opioid misuse have an even higher risk for long-term problems. This study uses survey data from 48 community service providers to better understand the service needs of parents with histories of problematic opioid use who are reentering their communities after incarceration. Community service providers recommended implementing intervention programs that cover critical information related to basic needs, supportive community resources, drug treatment programs, and parenting to help individuals thrive in their communities and meet their children's needs. The services most frequently identified by providers as important for reentering parents included housing, mentors or peer counselors, mental health support, group therapy and other support programs. Key topics to address in parenting programs included problem-solving techniques, the effect of parent's addiction on children, and strategies for connecting with and meeting children's needs. Suggestions are made for future research and intervention development.

Family member incarceration and coping strategies during the COVID-19 pandemic

BACKGROUND

The disproportionately high rate of incarceration and COVID-19 cases during the summer of 2020 in the United States contributed to a set of circumstances that has produced considerable public health concerns as correctional facilities have emerged as significant COVID-19 hot spots. During the COVID-19 pandemic, having a family member incarcerated can be an especially stressful experience. This study assesses how concern about an incarcerated family member contracting COVID-19 impacts diverse coping strategies.

RESULTS

Data are from a survey of individuals who have a family member incarcerated in Texas (N = 365). Ordinary least squares regression is used to examine the association between concern about an incarcerated family member contracting COVID-19 and coping strategies. Findings demonstrate that higher levels of concern for an incarcerated person's wellbeing during the COVID-19 pandemic is associated with dysfunctional coping mechanisms, but not adaptive or functional coping strategies.

CONCLUSIONS

Results suggest appropriate systemic responses by correctional administrations and public health practices can help mitigate dysfunctional coping mechanisms by family members during infectious disease outbreaks in correctional facilities.

Is There a Temporal Relationship between COVID-19 Infections among Prison Staff, Incarcerated Persons and the Larger Community in the United States?

Background: Our objective was to examine the temporal relationship between COVID-19 infections among prison staff, incarcerated individuals, and the general population in the county where the prison is located among federal prisons in the United States. Methods: We employed population-standardized regressions with fixed effects for prisons to predict the number of active cases of COVID-19 among incarcerated persons using data from the Federal Bureau of Prisons (BOP) for the months of March to December in 2020 for 63 prisons. Results: There is a significant relationship between the COVID-19 prevalence among staff, and through them, the larger community, and COVID-19 prevalence among incarcerated persons in the US federal prison system. When staff rates are low or at zero, COVID-19 incidence in the larger community continues to have an association with COVID-19 prevalence among incarcerated persons, suggesting possible pre-symptomatic and asymptomatic transmission by staff. Masking policies slightly reduced COVID-19 prevalence among incarcerated persons, though the association between infections among staff, the community, and incarcerated persons remained significant and strong. Conclusion: The relationship between COVID-19 infections among staff and incarcerated persons shows that staff is vital to infection control, and correctional administrators should also focus infection containment efforts on staff, in addition to incarcerated persons.

First weeks out: Social support stability and health among formerly incarcerated men

RATIONALE

Social support has a lasting and robust impact on individuals' health, wellness, and longevity. Having social support and a reliable social network is especially important for individuals returning from prison. Upon release, individuals are often left with fragmented, if any, interpersonal relationships, which influences their overall health. When a released person's support network becomes erratic or unstable, they may be unlikely to successfully reintegrate. Additionally, the impediments and stressors associated with community reentry-particularly after a long prison sentence-impact released persons' ability to preserve their physical and mental health.

OBJECTIVE

The current study examines the effects of the stability of social support on physical and mental health in a sample of recently released men in Texas.

METHODS

Data are from the LoneStar Project, a longitudinal study of men released from prison, to examine the crucial nature of social support stability on health in a unique sample of reentering persons. Regression models are employed to examine the effect of diverse domains of social support stability on self-rated physical and mental health in the first few weeks after prison release.

RESULTS

Findings indicate that emotional and instrumental social support stability from family and friends is essential to positive self-assessments of mental health, but not physical health, among a group of recently incarcerated men.

CONCLUSIONS

Results regarding the intricacies of the pathway between various stable support types and mental health are discussed. Relevant practical implications include the need for quality mental health care that must begin during the prison term to minimize stressors associated with psychological health upon reentry. Policy-related ramifications comprise a push to establish support programs for families to develop positive support outcomes for the released person during the reentry process, enabling family members to attain practical skills to increase family and individual well-being long term.

Transitioning into the Community: Perceptions of Barriers and Facilitators Experienced By Formerly Incarcerated, Homeless Women During Reentry-A Qualitative Study

Formerly incarcerated, homeless women on parole or probation experience individual-and structural-level barriers and facilitators as they prepare to transition into the community during reentry. A qualitative study was undertaken using focus group methods with formerly incarcerated, currently homeless women (N = 18, M_age = 37.67, SD 10.68, 23-53 years of age) exiting jail or prison. Major themes which emerged included the following: (1) access to resources-barriers and facilitators during community transition, (2) familial reconciliation and parenting during community transition, and (3) trauma and self-care support during community transition. These findings suggest a need to develop multi-level interventions at the individual, program and institutional/societal level with a gender-sensitive lens for women who are transitioning to community reentry. It is hoped that providing such resources will reduce the likelihood of homelessness and reincarceration.

COVID-19 Inspired Relational Telemental Health Services for Incarcerated Individuals and Their Families

The novel coronavirus pandemic has caused marriage and family therapists (MFTs) to alter how they provide clinical services. MFTs must determine how to deliver relationship-oriented services to underserved populations that are often forgotten during crises, including incarcerated individuals and their families. The primary purpose of this paper is to showcase how relational telemental health (TMH) services for incarcerated individuals and their families can increase access to services and improve relational health. Information is presented about corrections in the U.S., effects of incarceration on partners, children, and other family members, the behavioral health and relationship needs of incarcerated individuals, and current approaches to relational mental health and telehealth in corrections. Finally, suggestions are offered on how relational TMH could be used in corrections during the COVID-19 pandemic, including advocacy for collaborative healthcare, recommended implementation practices, and ethical considerations.

Societal Reentry of Prison Inmates With Mental Illness: Obstacles, Programs, and Best Practices

Societal reentry from prison presents a wide array of extreme challenges to inmates attempting to reintegrate with society. This process is significantly more daunting for inmates suffering from mental illness for several reasons. This paper examines the reentry process for inmates with mental illness. Three sample reentry programs (Forensic Assertive Community Treatment, Critical Time Intervention, and Thresholds' Prison Aftercare Program) that were developed for inmates with mental illness are discussed along with research testifying to the effectiveness of these programs. Finally, components that would comprise an ideal prison reentry program for mentally ill inmates are outlined, which include a three-phase structure and a focus on preparing both inmates and communities for the reentry process.

Using multiple case studies of health and justice services to inform the development of a new complex intervention for prison-leavers with common mental health problems (Engager)

BACKGROUND

People in the criminal justice system have complex needs but often do not make use of services outside of prison, in many cases due to poorly joined up working between health and criminal justice services. The 'Engager' programme aimed to develop a complex collaborative care intervention for people leaving prison with common mental health problems that could support their transition into the community and facilitate joined up working between health, justice and social services. To augment our core intervention theory, we wanted to learn from innovative and forward-thinking services providing interagency support and/or treatment for people experiencing common mental health problems within the criminal justice system. We wanted to identify key elements of interagency practice to understand what was and was not effective in engaging people, maintaining their contact and improving mental health and other aspects of their lives.

METHOD

We used a multiple case study design with a focused ethnographic approach in four study sites. Data came from three sources (documents, field notes and semi-structured interviews) underwent a framework analysis.

RESULTS

We identified seven main themes, namely: collaboration, client engagement, client motivation, supervision, therapeutic approach, peers and preparations for ending. Engaging and motivating clients was dependent on the relationship built with the professional. This relationship was developed through building trust and rapport, which required time and respectful, open and honest communication. Professionals were often unable to build this relationship effectively if they did not work in effective interagency collaborations, particularly those which included shared practices and were supported by effective supervision.

CONCLUSIONS

The multiple case study design contributed insights as to how health and justice services work together. The main themes identified are well known factors in health and justice co-working. However, the novel insights were gleaned examining interdependence and interactions in complex, multifactorial phenomena and practice, in particular the importance of shared practice and supervision models. The approach of selecting a small number of cases representing identified knowledge gaps contributed a valuable addition to the program theory and delivery for an innovative complex intervention.

Does in-prison physical and mental health impact recidivism?

Incarceration is definitively linked to poor health, and upon release from prison, many individuals experience difficulty in maintaining good health. Given the complexity of the reentry process, one's health status, both in and out of prison, likely influences additional aspects of reentry, such as abstaining from crime or adhering to parole terms. The purpose of this study is to determine whether in-prison physical and mental health, as well as changes to an individual's health upon release from prison, are related to the likelihood of recidivating. We employ the Serious and Violent Reentry Initiative (SVORI) data, a multi-state sample of formerly incarcerated males who are followed from prison to release into the community and interviewed about a number of post-prison release issues, including health. We use hierarchical logistic and multinomial regressions, where survey waves are nested within people, to assess if in-prison physical and mental health and post-release changes to health are associated with recidivism in two ways: general re-incarceration and re-incarceration due to either a technical violation of parole or a new conviction. With right-censoring due to recidivism or “failure,” our final sample size is 2180 person-periods (i.e., waves) nested within 871 respondents. We find that better physical health, both in-prison and changes in health post-release, is related to a higher likelihood of recidivating. Better mental health, both in-prison and changes to mental health post-release, is related to a decrease in the likelihood of recidivating. Individuals with poor mental health in-prison who make significant improvements after release see the largest reduction in their odds of recidivating. Finally, the combination of better mental health in-prison and increases in mental health post-release is associated with reductions in the likelihood of re-offending for both technical violations and new convictions. In sum, in-prison health continues to influence individuals after prison and is associated with their odds of recidivating, thus contributing to the churning of individuals through the prison system.

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We examine the relationship between in-prison and change in post-release health and recidivism.

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Better physical health in-prison and post-release is related to higher recidivism likelihood.

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Better mental health in-prison and post-release is related to lower recidivism likelihood.

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This mental health benefit applies to both technical violations and new convictions.

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A person's health in prison may be related to prison system churning.

Family Matters: Moving Beyond "If" Family Support Matters to "Why" Family Support Matters during Reentry from Prison

OBJECTIVES

Informed by social control and differential coercion and social support theories, we examine how multiple theoretically and methodologically distinct factors of family support relate to reincarceration, substance use, and criminal offending during prison reentry.

METHOD

Using four waves of data from the Serious and Violent Offender Reentry Initiative, we identified three separate factors of family support-interactional (e.g., providing guidance and support), instrumental (e.g., providing housing and transportation), and emotional (e.g., providing love and belongingness). A series of mixed-effects models examined how each form of family support related to reincarceration, substance use, and criminal offending.

RESULTS

Findings demonstrated that instrumental, but not interactional or emotional, support related to significantly lower odds of reincarceration and lower levels of substance use and criminal offending. Interaction terms revealed that the effect of instrumental family support is almost entirely independent, and not interactive, on each outcome.

CONCLUSIONS

Family support appears to relate to prosocial reentry outcomes not because of emotional or interactional bonds, but because families provide for the basic needs of returning individuals. Instrumental familial support mechanisms such as providing housing and financial support appear more salient in promoting prosocial reentry outcomes than mechanisms of emotional or interactional support.

Corrections and connection to the community: A diagnostic and service program for incarcerated adult men with FASD

Previous research has demonstrated that impaired social and adaptive behavior due to prenatal alcohol exposure can be associated with severe conduct disorders in adolescence, mental health concerns, school failure, employment difficulties, substance abuse, difficulty with the law, and incarceration. The Corrections and Connections to the Community research and service program was established to examine adult male offenders with frequent contact with the provincial corrections system. Individuals who participated in the program received neuropsychological testing, a functional assessment and a psychiatric interview. Results indicated that 90% of the participants identified within the spectrum of FASD. The functional profile indicated that many participants had impaired social functioning. A natural dichotomy emerged from the data which reflected those who connected early with the criminal justice system (65%) and those who did not connect within the 18 month project period. Significant differences emerged between those individuals who reconnected with the justice system and who also possessed a juvenile record and those who did not. Further analysis also indicated significant differences between scores on the Finger Tapping Test, Trail Making Test A, ILS and California Verbal Learning Test. Findings of this study highlight the importance of appropriate programming and services for incarcerated men with FASD.

Do We Have It All Wrong? The Protective Roles of Peers and Criminogenic Risks From Family During Prison Reentry

Prior work on the process of reentry from prison has highlighted the pivotal role that family and peers play during reintegration. Families are traditionally understood as important protective mechanisms against recidivism whereas peers are typically viewed as primarily criminogenic. Yet, drawing from differential coercion and social support theory, family and peer relationships can both be supportive (and protect against recidivism) and coercive (and contribute to recidivism). Using four waves of data from the Serious and Violent Offender Reentry Initiative, results of mixed-effects models demonstrate that family, but not peer, coercion relates to increased odds of reincarceration. Peer, but not family, social support relates to decreased odds of reincarceration. Findings suggest families are primarily criminogenic, whereas peers are protective during reentry.

Strain and Depression following Release from Prison: The Moderating Role of Social Support Mechanisms on Substance Use

Research on prison reentry shows that individuals with depression turn to substances to cope with the stress of reintegration. While social support drawn from families, peers, and institutions may help returning individuals avoid substance use, it is unclear how social support might condition the link between depression and substance use. Using longitudinal panel data from the Serious and Violent and Offender Reentry Initiative, results from mixed-models demonstrate that depression is significantly associated with increased substance use. Family support, but not peer support, is tied to lower use, and institutional support relates to decreased alcohol use but increased illicit drug use.

Incorporating Multicultural Couple and Family Therapy Into Incarcerated Settings

Incarceration rates have increased significantly since the 1990s, with more than two million adults in federal, state, and local facilities. More than half of the offenders report a history of mental health issues, highlighting the importance of offenders having access to effective therapeutic approaches, including individual, couples, and family counseling. Traditionally, the focus of mental health services has been individual treatment; however, family members are also significantly impacted by the offender's absence during incarceration. Incorporating family members into treatment can serve to improve relationships, leading to better outcomes at reentry and reductions in recidivism rates. Given the preponderance of persons of color in the incarcerated population, diversity issues in counseling must also be addressed. The purpose of the underlined article is to explore the implications of incorporating multicultural family therapy into incarcerated settings.

"I don't have to do this all by myself": Systems Navigation to Ensure Continuity of HIV Care for Persons Leaving Prison

Ensuring continuity of and retention in care after release from prison is critical for optimizing health outcomes among people living with HIV. As part of a large federal initiative, we conducted qualitative interviews (n = 24) with individuals living with HIV and recently released from prison in four states to understand their experiences in different navigation interventions to improve access to HIV care post-release. Interventions were delivered only in prison, only in the community, or in both settings. While the interventions varied by design, overall, participants appreciated the breadth of support received from interventionists, including health system navigation, case management and social support. Even when individuals leaving prison were returning to clinics that they were familiar with, systems navigation supported continuity of care. Our findings elucidate why navigational support was instrumental, and underscore the value of a variety of types of navigation programs in facilitating continuity of care and reintegration post-prison.

Living Conditions Influence Psychological Distress of Migrants in Long-Term Imprisonment

Background: Serving a long-term prison sentence places a heavy psychological burden on inmates. The concept of salutogenesis and the psychological stress model developed by Lazarus indicate that people can handle difficult situations if they are able to use their resources in a way that makes them feel confident that things will work out as well as can reasonably be expected. However, during long-term imprisonment inmates often have restricted access to potential coping strategies, such as close and trusting relationships. Because of migration-related difficulties, such as poor local language skills and experiences of discrimination, migrants in long-term imprisonment probably experience even more psychological distress than native citizens. Aims: The aim of the study was to compare the amount of psychological distress in migrants and native citizens in long-term imprisonment. In addition, we investigated whether any aspects of living conditions in prison reduce psychological distress. Methods: From the 1,101 participants in the European Union (EU) project "Long-term imprisonment and the issue of human rights in member states of the EU," we chose 49 migrants, defined as people born in a different country from where they were imprisoned, and 49 native citizens matched for prison, age (+/-5 years), and index offense. The participants completed a questionnaire that included the Brief Symptom Inventory (BSI) and 128 items from a revised version of the Mare-Balticum prison survey. Data were analyzed by multilevel regression models. Results: Native citizens reported higher psychological distress than migrants. However, multilevel regression analyses showed that poor relationships with fellow inmates and increased fear of crime were significant predictors of increased psychological distress in migrants only. Conclusions: Being a migrant by itself does not lead to increased psychological distress in prisoners. This finding can be explained by the so-called healthy immigrant effect. However, migrants experience psychological distress when prisons are not safe and when they do not have close and trusting relationships with fellow inmates.

The Criminogenic Influence of Family on Substance Use During Reentry: A Life-Course Perspective on Between Individual Differences and Within Individual Changes

A large body of prior research has demonstrated a clear link between family support and desistance from substance use during reentry. Emerging research also suggests that family conflict may play an independent role in this process. Accordingly, this study moves towards an understanding of how baseline between-individual differences in both family support and conflict prior to release interact with within-individual change in the respective constructs to affect substance use during the reentry time period. Results of cross-lagged dynamic panel models examining four waves of the Serious and Violent Offender Reentry Initiative data demonstrate baseline between-individual differences and within-individual changes in family conflict, but not support, significantly relate to polysubstance use. While these results suggest that families play a criminogenic role in reentry, a series of interaction terms demonstrates that within-individual increases in family support can help offset the negative influence of family conflict.

During, After, or Both? Isolating the Effect of Religious Support on Recidivism During Reentry

OBJECTIVES

To examine the independent and interdependent roles of baseline religious support during incarceration and within-individual changes in religious support on recidivism during the prisoner reentry process.

METHODS

Using data from the Serious and Violent Offender Reentry Initiative, cross-lagged dynamic panel models are used to examine the respective roles of baseline differences and within-individual changes in religious support on two variety indices encompassing substance use and criminal offending while simultaneously controlling for pre-incarceration levels of substance use and offending.

RESULTS

Findings show that within-individual increases in religious support protect against substance use post-release, while baseline levels of religious support do not significantly influence substance use. Additionally, baseline levels of religious support fail to condition this relationship. Findings assessing criminal offending demonstrate that baseline religious support and within-individual changes in religious support fail to relate to offending independently. However, an interaction term reveals that the combination of the two relates to significantly lower levels of offending post-release.

CONCLUSIONS

Findings offer encouragement for those involved in the work of providing religious support to ex-offenders in the community, reaffirming that tailoring support programs to the religious or spiritual ways individuals make meaning in their lives can improve reentry outcomes. Methodologically, failing to distinguish between baseline levels of religious support and post-release changes in religious support fails to capture the complexity of religiosity on the reentry process.

Life After: Examining the Relationship Between Sociobehavioral Factors and Mental Health Among African American Ex-Offenders

Mental health problems are 3 times higher among prisoners than the general population. After release, reentry barriers and other factors can exacerbate mental problems. This study of 250 African American ex-offenders examines the relationship between sociobehavioral factors and mental health. Independent variables included self-reported health, alcohol use, employment, and history of mental problems before prison. Covariates included the number of immediate family with mental problems and the number of serious conflicts with family members or friends. Analyses revealed that men who had serious conflicts, used alcohol more often, reported less than excellent health, and not employed were more likely to report being troubled by mental problems. Family mental health history was not statistically significant. The current study adds to the literature by identifying selected factors associated with the mental health of African American male, ex-offenders. Findings from this study can inform interventions to address mental health issues and reduce recidivism.

The Assets and Challenges of Formerly Incarcerated Latino Men's Social Support Networks in Promoting Healthy Behaviors

After being exposed to high-risk environments in correctional facilities, formerly incarcerated Latino men (FILM) encounter new risks upon reentering their community of residence including drug use and sexual risk behaviors. Families and close social support networks are critical in potentially mitigating the stressors and risks associated with reentry and reducing the likelihood of recidivism. We conducted a study to examine the material and cognitive assets that familial networks can use to provide support to FILM to engage in health-promoting practices. This analysis is based on linear and logistic regression modeling of cross-sectional data collected through a computer-administered survey with dyads of FILM (ages 18-49, who had been in jail or prison within the past 5 years) and their nominated social network (n = 130 dyads). We found that both male and female social supports (MSS and FSS) have significantly higher levels of structural resources (education and employment) than FILM. Though FSS reported higher self-efficacy on health-promoting practices than FILM, contrary to what we predicted, FILM and FSS/MSS reported similar levels of mental health and behavioral risks. Our results suggest a number of limitations in designing family-based intervention strategies, but they also provided insight into the specificities needed to enhance the social support networks of FILM.

The Duality of the Peer Effect: The Interplay Between Peer Support and Peer Criminality on Offending and Substance Use During Reentry

Differential association theory and the closely linked differential coercion/social support theory suggest that peers exert both criminogenic and protective influences on individuals. Yet, little is known about how dimensions of peer criminality and peer support affect reentry outcomes independently and interdependently. Using data from the Serious and Violent Offender Reentry Initiative, mixed-effects models demonstrate that peer criminality relates to significantly higher odds of substance use and criminal offending, whereas peer support relates to significantly lower odds of substance use and offending. Interaction terms between peer crime and support suggest the two exert independent, and not interactive, influences on recidivism. Although peer crime exerts a more robust effect, peer support must be understood as a mechanism that drives desistance independently of peer crime.

Mental health of jail inmates within the prison of Ducos, Martinique - a cross-sectional descriptive study

BACKGROUND

Prisoners' sociocultural backgrounds and prison environments have an influence on detainees' psychopathology; complex judicial and public policies are also to be taken into account in the dynamics of that environment. Scientific literature shows a wide range prison inmates' profiles across the world. However, very little data about the mental health of Caribbean jail inmates has been published. Martinique is a French overseas administrative district in the Caribbean, with a population of about 400,000 inhabitants. Its only prison is located in the city of Ducos. Our study proposes a description of the psychiatric characteristics of jail inmates in Martinique with epidemiological tools. Its objectives are to highlight their specific features and compare them to mainland France's jail population.

METHODS

The initial study was a multicenter cross-sectional survey conducted in 18 French prisons. The selection was done using a two-stage stratified sampling strategy. For the purpose of our study, two groups were defined and compared: the detainees from the prison of Ducos (n=100) were compared to inmates from mainland France (n=698). Current psychiatric diagnoses were rigorously collected, through clinical and semi-structured interviews. We conducted a multiple logistic regression for each assessed mental disorder. Each prisoner gave us his oral and written informed consent.

RESULTS

In terms of sociodemographic characteristics, we found more children per prisoner in the Martinican group and a better educational status in the mainland France group. The inmates from Martinique had significantly more adverse experiences in their childhood and the length of incarceration at the time of the interview was longer in the Martinique sample. Major depressive disorders (aOR=0.51; 95% CI=0.26-0.95) and psychotic disorders (aOR=0.24; 95% CI=0.08-0.57) were significantly less frequent in the Martinique sample. The data concerning substance-related disorders showed significant differences in bivariate analysis but this link was no longer statistically significant in the multiple logistic regression analysis.

CONCLUSION

Even if imprisonment conditions are extremely tough, the inmates carry the heavy burden of difficult family histories, and the use of cannabis seems to be a major problem, it appears that Martinique's jail inmates have lower rates of mental illness than their counterparts from mainland France. We think this could be due to the benefit of greater proximity to their relatives and a united community, both which may contribute to lower prevalence of mental disorders.

Evaluation of a complex intervention (Engager) for prisoners with common mental health problems, near to and after release: study protocol for a randomised controlled trial

INTRODUCTION

The 'Engager' programme is a 'through-the-gate' intervention designed to support prisoners with common mental health problems as they transition from prison back into the community. The trial will evaluate the clinical and cost-effectiveness of the Engager intervention.

METHODS AND ANALYSIS

The study is a parallel two-group randomised controlled trial with 1:1 individual allocation to either: (a) the Engager intervention plus standard care (intervention group) or (b) standard care alone (control group) across two investigation centres (South West and North West of England). Two hundred and eighty prisoners meeting eligibility criteria will take part. Engager is a person-centred complex intervention delivered by practitioners and aimed at addressing offenders' mental health and social care needs. It comprises one-to-one support for participants prior to release from prison and for up to 20 weeks postrelease. The primary outcome is change in psychological distress measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure at 6 months postrelease. Secondary outcomes include: assessment of subjective met/unmet need, drug and alcohol use, health-related quality of life and well-being-related quality of life measured at 3, 6 and 12 months postrelease; change in objective social domains, drug and alcohol dependence, service utilisation and perceived helpfulness of services and change in psychological constructs related to desistence at 6 and 12 months postrelease; and recidivism at 12 months postrelease. A process evaluation will assess fidelity of intervention delivery, test hypothesised mechanisms of action and look for unintended consequences. An economic evaluation will estimate the cost-effectiveness.

ETHICS AND DISSEMINATION

This study has been approved by the Wales Research Ethics Committee 3 (ref: 15/WA/0314) and the National Offender Management Service (ref: 2015-283). Findings will be disseminated to commissioners, clinicians and service users via papers and presentations.

TRIAL REGISTRATION NUMBER

ISRCTN11707331; Pre-results.

THE ROLE OF TURNING POINTS IN ESTABLISHING BASELINE DIFFERENCES BETWEEN PEOPLE IN DEVELOPMENTAL AND LIFE-COURSE CRIMINOLOGY

Turning points, between-person differences, and within-person changes have all been linked to desistance from crime. Nevertheless, the means through which between- person differences are frequently captured in life-course criminology makes them intertwined with, and perhaps confounded by, turning points in life. We propose that a new way of capturing the between-person effect-the baseline between-person difference-could benefit theoretically informed tests of developmental and life-course issues in criminology. Because they occur at one time point immediately preceding a turning point in life, we demonstrate that baseline between-person differences establish meaningful theoretical connections to behavior and the way people change over time. By using panel data from the Serious and Violent Offender Reentry Initiative, we estimate models capturing within-person change and baseline between-person differences in social bonds (family support) and differential association (peer criminality) at the time of release from prison. The results demonstrate that baseline levels of family support protect people from postrelease substance use but not from crime. Baseline between- person differences and within-person changes in peer criminality, however, are robustly related to crime and substance use. Collectively, baseline between-person differences seem critical for behavior and within-person change over time, and the results carry implications for reentry-based policy as well as for theory testing in developmental criminology more broadly.

A Developmental Perspective on Reentry: Understanding the Causes and Consequences of Family Conflict and Peer Delinquency during Adolescence and Emerging Adulthood

Despite the uniqueness of an incarceration experience for adolescents, there remains a shortage of research on adolescents and emerging adults who have been recently released from detention centers and are returning home during the transitional time period of "reentry". Drawing from the developmental literature, the current study uses a diverse (54% Black, 20% White, 26% Other Race) longitudinal survey of 337 male adolescents living in the United States to examine the interrelationships among crime, substance use, family conflict, and peer delinquency. A series of cross-lagged dynamic panel data models using four waves of data demonstrate that while family conflict and peer delinquency relate to increased offending and substance use, conflict in the family is a major driving force behind both future family conflict and peer delinquency. Overall, findings suggest that family conflict is an overlooked, but absolutely critical, factor in explaining deviance and deviant peer associations alike for adolescents and emerging adults who have been recently incarcerated and released.

A Developmental Perspective on Reentry: Understanding the Causes and Consequences of Family Conflict and Peer Delinquency during Adolescence and Emerging Adulthood

Despite the uniqueness of an incarceration experience for adolescents, there remains a shortage of research on adolescents and emerging adults who have been recently released from detention centers and are returning home during the transitional time period of "reentry". Drawing from the developmental literature, the current study uses a diverse (54% Black, 20% White, 26% Other Race) longitudinal survey of 337 male adolescents living in the United States to examine the interrelationships among crime, substance use, family conflict, and peer delinquency. A series of cross-lagged dynamic panel data models using four waves of data demonstrate that while family conflict and peer delinquency relate to increased offending and substance use, conflict in the family is a major driving force behind both future family conflict and peer delinquency. Overall, findings suggest that family conflict is an overlooked, but absolutely critical, factor in explaining deviance and deviant peer associations alike for adolescents and emerging adults who have been recently incarcerated and released.

Assessing the within-person impact of social/behavioral programs, increased supervision, and jail time on polysubstance use during reentry

The process of leaving prison, known as reentry, presents a host of challenges to returning individuals. Research documents that substance use is a pressing issue and widespread among the correctional population. A variety of strategies and programs have been used to promote the desistance from substance use; notably, the use of social/behavioral programs, increased supervision, and jail time. Yet, existing research investigating the respective effects of te strategies in relation to one another is relatively underdeveloped. This issue becomes more salient when considering the extent to which supervision models can impact the outcomes and future prospects associated with reentry. Therefore, this study uses four waves of data from the Serious and Violent Offender Reentry Initiative (SVORI) to examine the impact of social/behavioral programming, increased supervision, and jail sanctions on polysubstance use during reentry. Further, we use a series of interaction terms to explore any conditioning effects between approaches on substance use across time. Results from longitudinal crossed-lagged dynamic panel models reveal that social/behavioral programs contribute to within-person decreases in polysubstance use across time while enhanced monitoring and jail-time contribute to within-person increases in polysubstance use. Interactions indicate these programs exert independent, and not interactive, effects on polysubstance use post-release.

A Pilot Study of a Brief Motivational Intervention for Incarcerated Drinkers

Almost half of convicted jail inmates have an alcohol use disorder and many are released to environments that put them in contact with network members and cues that make them more likely to relapse on alcohol or drugs. Given the high-risk period immediately following release, the purpose of this study was to examine the efficacy of a brief motivational intervention administered just prior to release to increase substance use treatment entry and attendance, decrease alcohol and drug use, and change social networks for inmates with alcohol use disorders. Forty adult male inmates with AUDs were consented into the study and randomized to a motivational intervention or the control condition (an educational intervention), and then were contacted to do a 1-month follow-up interview (62.5% completed this interview). Results indicated that conducting these interventions was feasible and considered extremely helpful by participants. Although there were no significant group differences, medium to large effect sizes suggest possible benefits from the motivational intervention in decreasing days of alcohol and drug use and increasing abstinence, and reducing the proportion of heavy drug users or users of any kind in the social network. Future studies should replicate these findings in larger sample sizes and over longer follow-up time periods. Results may have implications for the use of brief intervention strategies at jails for inmates with AUDs.