What Gets Measured in Reentry Research? A Scoping Review on Community Reentry From Jail and Prison for Persons With Mental Illnesses

Research on reentry for individuals with mental illnesses leaving jails and prisons lacks outcome specificity and standardization needed to advance knowledge about the efficacy and effectiveness of interventions. This scoping review aims to provide clarity about reentry outcomes by: (a) ascertaining what outcomes are a focus in reentry research, (b) explicating how outcomes are defined, and (c) identifying commonalities or gaps in outcomes reported. A search of multiple databases yielded 415 articles for potential inclusion. After independent document review by two of the authors, 61 articles were included in the review. Recidivism was the most used construct, accounting for 58% of total outcomes and 95% of criminal legal outcomes. Behavioral health indicators were reported the second most frequently and other outcomes were rarely reported. Increasing the specificity of commonly used concepts while also expanding the breadth of outcomes considered is needed to build an evidence base this area of research

Development of the citizens measure into a tool to guide clinical practice and its utility for case managers

A measure of Citizenship was developed and validated by Rowe and colleagues (O’Connell, Clayton, & Rowe, 2016). The items clustered around the 5 Rs of Citizenship as defined by Rowe: relationships, rights, resources, roles, and rights, and a sense of belonging. While a measure has its utility in clinical settings, in order to address time constraints and other administrative burdens expressed by providers in their day-to-day practice, a Citizens tool was developed as a practical way that providers can enhance dialogue between providers and clients on citizenship for clients served in mental health and criminal justice reentry settings. This paper describes the development of the tool, testing of the tool’s utility with case managers, and implications for practice

Neighbors as Distal Support for Individuals With Serious Mental Illnesses

Social networks are regarded as an asset to community integration. While family and friends provide important sources of support, familiar strangers like neighbors can facilitate support through anonymous, but meaningful interactions. Among individuals with serious mental illnesses (SMI), these interactions can help to compensate for increased social isolation and smaller networks of peers. This study explores whether neighbors can play a unique role in decreasing loneliness and bolstering a sense of community for individuals with SMI. Participants in this study were drawn from 2 samples: (a) 232 individuals with SMI receiving services at outpatient community mental health centers throughout the United States; and (b) 300 adults recruited from the Truven Health Analytics’ PULSE survey. Independent-samples t tests were performed to compare neighbor relationships between individuals with and without SMI. Multiple regression analyses were conducted to examine associations between neighbor relationships, sense of community, and loneliness. As hypothesized, individuals with SMI reported weaker relationships with their neighbors, as well as higher levels of loneliness and lower levels of community connectedness compared to individuals without SMI. For participants in both groups, the quality of neighbor relationships was significantly associated with their loneliness and sense of community regardless of how many neighbors they reported feeling close to. Participants with SMI indicated their sense of community and experiences of loneliness were associated with their relationships with their neighbors, no matter the quantity. Providers might capitalize on the utility of neighbors by expanding social and support networks of clients with SMI. (PsycINFO Database Record (c) 2020 APA, all rights reserved

Community-based family peer navigator programme to facilitate linkage to coordinated specialty care for early psychosis among Black families in the USA: A protocol for a hybrid type I feasibility study

Background Approximately 70% of Black/African American family members report no contact with mental health providers prior to initial diagnosis and the receipt of services for early psychosis. Black families often encounter barriers and experience delays on the pathway to coordinated specialty care programmes for early psychosis.Methods and analysis This mixed-methods study will (1) develop and refine a family peer navigator (FPN) for Black families designed to increase access and engagement in coordinated specialty care and (2) pilot-test FPN for Black families with 40 family members with loved ones at risk for psychosis in a randomised trial to assess the acceptability and feasibility. Families will be randomised to FPN (n=20) or a low-intensive care coordination (n=20). Other outcomes include proposed treatment targets (eg, knowledge, social connectedness), preliminary impact outcomes (time to coordinated specialty care programmes, initial family engagement), and implementation outcomes (acceptability, feasibility, appropriateness).Ethics and dissemination Ethics approval has been obtained from Washington State University Institutional Review Board and informed consent will be obtained from all participants. This study will establish an innovative culturally responsive FPN programme and implementation strategy, and generate preliminary data to support a larger hybrid effectiveness-implementation trial. Study findings will be presented at conferences and in peer-reviewed journals.Trial registration number NCT05284721

Reorienting the focus from an individual to a community-level lens to improve the pathways through care for early psychosis in the United States

The implementation of coordinated specialty care in the U.S. over the past decade has led to the improvements of clinical and functional outcomes among individuals in the early stages of psychosis. While there have been advancements in the delivery of early intervention services for psychosis, it has almost exclusively focused on short-term change at the individual level. In light of these advancements, research has identified gaps in access to care and delivery of services that are driven by different levels of determinants and have the biggest impact on historically excluded groups (e.g., ethnoracial minoritized communities). Interventions or efforts that place an emphasis on community level (structural or sociocultural) factors and how they may influence pathways to care and through care, specifically for those who have been historically excluded, have largely been missing from the design, dissemination and implementation of early psychosis services. The present paper uses a structural violence framework to review current evidence related to pathways to care for early psychosis and the physical/built environment and conditions (e.g., urbanicity, residential instability) and formal and informal community resources. Suggestions on future directions are also provided, that focus on enriching communities and creating sustainable change that spans from pathways leading to care to ‘recovery.’ In all, this lays the groundwork for a proposed paradigm shift in research and practice that encompasses the need for an emphasis on structural competency and community-driven approaches

Mixed-methods trial of a phosphatidylethanol-based contingency management intervention to initiate and maintain alcohol abstinence in formerly homeless adults with alcohol use disorders

Background: Contingency management (CM) is an intervention where incentives are provided in exchange for biochemically confirmed alcohol abstinence. CM is effective at initiating alcohol abstinence, but it is less effective at maintaining long-term abstinence. Phosphatidylethanol (PEth), collected via a finger-stick, can detect alcohol use for 14–28 days. PEth allows for the development of a CM model that includes increasingly less frequent monitoring of abstinence to assist high risk groups, such as formerly homeless individuals, maintain long-term abstinence. Aims: Investigate whether PEth-based CM intervention targeting alcohol abstinence in formerly homeless, currently housed individuals with alcohol use disorders is: (1) acceptable and feasible for housing program tenants and personnel; and is associated with increased (2) alcohol abstinence and (3) housing tenure. Methods: Acceptability and feasibility will be assessed using a QUAL+quant mixed-methods design using qualitative interviews and quantitative measures of satisfaction and attrition. Effectiveness will be evaluated through a randomized pilot trial of 50 study participants who will receive 6 months of either treatment as usual (TAU) including incentives (e.g., gift cards) for providing blood samples (Control Condition) or TAU and incentives for negative PEth results (PEth-CM Condition). Outcomes will be assessed during the intervention and at a three-month follow-up visit. The trial will be conducted via telehealth as a result of COVID-19. Discussion: This protocol seeks to utilize a novel alcohol biomarker to evaluate the acceptability, feasibility, and initial effectiveness of a CM model that encourages long-term abstinence in a high-risk group