Homelessness and Housing Insecurity among Former Prisoners

The United States has experienced dramatic increases in both incarceration rates and the population of insecurely housed or homeless persons since the 1980s. These marginalized populations have strong overlaps, with many people being poor, minority, and from an urban area. That a relationship between homelessness, housing insecurity, and incarceration exists is clear, but the extent and nature of this relationship is not yet adequately understood. We use longitudinal, administrative data on Michigan parolees released in 2003 to examine returning prisoners’ experiences with housing insecurity and homelessness. 

Our analysis finds relatively low rates of outright homelessness among former prisoners, but very high rates of housing insecurity, much of which is linked to features of community supervision, such as intermediate sanctions, returns to prison, and absconding. 

We identify risk factors for housing insecurity, including mental illness, substance use, prior incarceration, and homelessness, as well as protective “buffers” against insecurity and homelessness, including earnings and social supports.

Below:  Cumulative Probability of Residential Moves, by Type

Full article at:   http://goo.gl/2lKBPX

By:  Claire W. Herbert, doctoral student, Jeffrey D. Morenoff, associate professor of sociology and associate research professor, and David J. Harding, associate professor of sociology

CLAIRE W. HERBERT, University of Michigan.

Contributor Information.

Direct correspondence to: Claire W. Herbert at ; Email: ude.hcimu@hwerialc, Department of Sociology, University of Michigan, 500 S. State St., Ann Arbor, MI 48109; Jeffrey D. Morenoff at ; Email: ude.hcimu@ffonerom, University of Michigan, 500 S. State St., Ann Arbor, MI 48109; and David J. Harding at ; Email: ude.yelekreb@gnidrahd, Department of Sociology, University of California, Berkeley, 462 Barrows Hall, Berkeley, CA 94720.

RSF. 2015 Nov; 1(2): 44–79.

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Low-Intensity Case Management Increases Contact with Primary Care in Recently Released Prisoners

BACKGROUND:

The world prison population is large and growing. Poor health outcomes after release from prison are common, but few programmes to improve health outcomes for ex-prisoners have been rigorously evaluated. The aim of this study was to evaluate the impact of individualised case management on contact with health services during the first 6 months post-release.

METHODS:

Single-blinded, randomised, controlled trial. Baseline assessment with N=1325 adult prisoners in Queensland, Australia, within 6 weeks of expected release; follow-up interviews 1, 3 and 6 months post-release. The intervention consisted of provision of a personalised booklet ('Passport') at the time of release, plus up to four brief telephone contacts in the first 4 weeks post-release.

RESULTS:

Of 1179 eligible participants, 1003 (85%) completed ≥1 follow-up interview. In intention-to-treat analyses, 53% of the intervention group and 41% of the control group reported contacting a general practitioner (GP) at 1 month post-release (difference=12%, 95% CI 5% to 19%). Similar effects were observed for GP contact at 3 months (difference=9%, 95% CI 2% to 16%) and 6 months (difference=8%, 95% CI 1% to 15%), and for mental health (MH) service contact at 6 months post release (difference=8%, 95% CI 3% to 14%).

CONCLUSIONS:

Individualised case management in the month after release from prison increases usage of primary care and MH services in adult ex-prisoners for at least 6 months post-release. Given the poor health profile of ex-prisoners, there remains an urgent need to develop and rigorously evaluate interventions to increase health service contact in this profoundly marginalised population.

Below:  Percentage of intervention group participants contacting a general practitioner (GP) at 1 month post release, according to number of intervention telephone calls completed

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By:  Kinner SA1, Alati R2, Longo M3, Spittal MJ4, Boyle FM2, Williams GM2, Lennox NG5.

• 1Griffith Criminology Institute & Menzies Health Institute Queensland, Griffith University, Brisbane, Australia Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, The University of Queensland, Brisbane, Australia.
• 2School of Public Health, University of Queensland, Brisbane, Australia.
• 3Drug and Alcohol Services South Australia, Adelaide, Australia.
• 4Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
• 5Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, The University of Queensland, Brisbane, Australia. 
• J Epidemiol Community Health. 2016 Jan 19. pii: jech-2015-206565. doi: 10.1136/jech-2015-206565. 

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Incarcerated Women’s Relationship-based Strategies to Avoid Drug Use After Community Re-Entry

While recent research has stressed the supportive role that family and friends play for incarcerated persons as they re-enter the community, drug-using incarcerated women re-entering the community often have to rely on family, community, and intimate relationships that have played a role in their substance abuse and criminalization. 

This study conducted qualitative analysis of clinical sessions with rural, drug-using women (N = 20) in a larger prison-based HIV risk reduction intervention in Kentucky during 2012-2014 to examine incarcerated women’s perceptions of the role of their family, community, and intimate relationships in their plans to decrease their substance abuse upon community re-entry. 

Women stressed the obstacles to receiving support in many of their family and drug-using relationships after community re-entry. Nonetheless, they asserted that changes in their relationships could support their desires to end their substance abuse by setting limits on and using their positive relationships, particularly with their children, to motivate them to change. Interventions to promote incarcerated women’s health behavior changes—including substance abuse—must acknowledge the complex social environments in which they live.

Purchase full article at:  http://goo.gl/oUaDP7

By:  Claire Snell-Rood PhD^a*, Michele Staton-Tindall PhD, MSW^b &Grant Victor MSW^b

• ^a University of Kentucky College of Medicine, Department of Behavioral Science, 108 Medical Behavioral Science Building, Lexington, KY 40536-0086
• ^b University of Kentucky College of Social Work, 619 Patterson Office Tower, Lexington, Kentucky, 40506-0027 

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Trajectories of Psychological Distress After Prison Release: Implications for Mental Health Service Need in Ex-Prisoners

Understanding individual-level changes in mental health status after prison release is crucial to providing targeted and effective mental health care to ex-prisoners. We aimed to describe trajectories of psychological distress following prison discharge and compare these trajectories with mental health service use in the community.

The Kessler Psychological Distress Scale (K10) was administered to 1216 sentenced adult prisoners in Queensland, Australia, before prison release and approximately 1, 3 and 6 months after release. We used group-based trajectory modeling to identify K10 trajectories after release. Contact with community mental health services in the year following release was assessed via data linkage.

We identified five trajectory groups, representing consistently low (51.1% of the cohort), consistently moderate (29.8%), high increasing (11.6%), high declining (5.5%) and consistently very high (1.9%) psychological distress. Mood disorder, anxiety disorder, history of self-harm and risky drug use were risk factors for the high increasing, very high and high declining trajectory groups. Women were over-represented in the high increasing and high declining groups, but men were at higher risk of very high psychological distress. Within the high increasing and very high groups, 25% of participants accessed community mental health services in the first year post-release, for a median of 4.4 contact hours.

For the majority of prisoners with high to very high psychological distress, distress persists after release. However, contact with mental health services in the community appears low. Further research is required to understand barriers to mental health service access among ex-prisoners.

Purchase full article at:  http://goo.gl/VEyvGk

By:  Thomas EG1, Spittal MJ1, Heffernan EB2, Taxman FS3, Alati R4, Kinner SA1.

• 1Melbourne School of Population and Global Health,University of Melbourne,Parkville,VIC,Australia.
• 2School of Medicine,University of Queensland,Herston,QLD,Australia.
• 3Criminology,Law & Society,College of Humanities and Social Sciences,George Mason University,Fairfax,VI,USA.
• 4School of Public Health and Centre of Youth Substance Abuse Research,University of Queensland,Herston,QLD,Australia. 

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