Reduction in Recidivism of Incarcerated Women through Primary Care, Peer Counseling, and Discharge Planning

The Miriam Hospital, Brown University School of Medicine, Providence, Rhode Island 02906, USA.
Journal of women's health / the official publication of the Society for the Advancement of Women's Health Research 05/1999; 8(3):409-15. DOI: 10.1089/jwh.1999.8.409
Source: PubMed


Prior to release from the Rhode Island state prison, women at the highest risk for reincarceration and HIV infection are assigned to the Women's HIV/Prison Prevention Program (WHPPP), a discharge program designed to reduce the likelihood of reincarceration and HIV infection. Candidates for the WHPPP must meet at least one of three criteria: intravenous drug use or crack use, commercial sex work, or a history of prison recidivism with poor educational history and poor employment prospects. While incarcerated, the program participant develops a relationship with a physician and a social worker and establishes an individualized discharge plan. After release, the same physician and social worker continue to work with the client and assist an outreach worker in implementing the discharge plan. Data were collected from questionnaires administered to 78 women enrolled in the WHPPP between 1992 and 1995. The population in this program was primarily composed of ethnic minorities (55%), 25-35 years of age (55%), unmarried (90%), had children (72%), and displayed a variety of HIV risk behaviors. The WHPPP recidivism rates were compared with those of a mostly white (65%), similarly aged (51% were between 25 and 35 years of age) historical control group of all women incarcerated in Rhode Island in 1992. The intervention group demonstrated lower recidivism rates than the historical control group at 3 months (5% versus 18.5%, p = 0.0036) and at 12 months (33% versus 45%, p = 0.06). Assuming that recidivism is a marker for high-risk behavior, participation in the WHPPP was associated with a reduction in recidivism and in the risk of HIV disease in this very high risk group of women.

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    • "One article was excluded because it duplicated results reported in another article (Havens et al., 2009). An additional article was excluded because the study did not have a control or comparison group (Tsay, Childs, Cook-Heard, & Sturdevant, 2013) and a final article was excluded because the authors reported only recidivism outcomes (Vigilante et al., 1999). After these exclusions , there were 12 remaining interventions that addressed HIV prevention among women with criminal justice involvement with a cumulative sample size of 3,165 participants (see Table 1). "

    09/2014; 5(3):253-289. DOI:10.1086/677394
    • "An additional important research question that needs to be addressed is whether the timing of the implementation of services affects recidivism outcome. Discharge planning has recently received a lot of attention as a crucial step in reentry of SMI offenders (Barr, 2003; Hainmowitz, 2004; Hartwell, 2003; Lovell et al., 2002; Lurigio, 2000, 2001; Lurigio et al., 2004; Metzner, 2002; Vigilante et al., 1999; Wolff et al., 2005). Discharge planning is the coordination of services for an SMI inmate when they are preparing to leave prison, while they are still currently incarcerated (Metzner, 2002). "
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    ABSTRACT: It is approximated that 14% of prison inmates have severe mental illness (SMI; Fazel, S., & Danesh, J. (2002). Serious mental disorder in 23000 prisoners: A systematic review of 62 surveys. The Lancet, 359, 545–550) and 78% of mentally ill state prison inmates recidivate during their lifetime (James, D.J., & Glaze, L.E. (2006). Mental health problems of prison and jail inmates. Washington, DC: Bureau of Justice Statistics, US Department of Justice. Retrieved from One factor that is thought to be particularly associated with recidivism among people with SMI is the lack of community services available upon release (Barr, H. (2003). Transinstitutionalization in the courts: Brad H. v. City of New York, and the fight for discharge planning for people with psychiatric disabilities leaving Rikers Island. Crime & Delinquency, 49, 97–123; Casper, E.S., & Clark, D. (2004). Service utilization, incidents, and hospitalizations among people with mental illnesses and incarceration histories in a supportive housing program. Psychiatric Rehabilitation Journal, 28, 181–184; Haimowitz, S. (2004). Slowing the revolving door: Community reentry of offenders with mental illness. Psychiatric Services, 55, 373–375; Pogorzelski, W., Wolff, N., Pan, K., & Blitz, C.L. (2005). Behavioral health problems, ex-offender reentry policies, and the “Second Chance Act”. American Journal of Public Health, 95, 1718–1724; Vigilante, K.C., Flynn, M.M., Affleck, P.C., Stunkle, J.C., Merriman, N.A., Falnigan, T.P., … Rich, J.D. (1999). Reduction in recidivism of incarcerated women through primary care, peer counseling, and discharge planning. Journal of Women's Health, 8, 409–415). The aim of this study was to examine factors that predict recidivism (either hospitalization or reincarceration) in a clinic sample of recently released offenders with SMI. Review of clinical records for 30 clients with SMI who had recently been released from prison receiving psychiatric treatment at a community mental health center. When controlling for receipt of financial public assistance, homelessness significantly predicted time to recidivism, so that persons who were homeless were more likely to recidivate sooner than those who were housed. This finding has potential clinical implications that treatment planning for reentering SMI offenders should have a particular focus on getting homeless offenders housed. Additional research needs to be conducted with a larger sample.
    Mental Health and Substance Use dual diagnosis 01/2012; 6(1):1-11. DOI:10.1080/17523281.2012.660979
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    • "With regard to male parolees, findings expressed through the composite narrative suggest a need for new ways of conceptualizing reintegration that includes health more centrally in the processes of success or failure. The results also suggest that the health care system can sustain newly released individuals in their home communities for an extended period of time (Sheu et al., 2002; Solomon, 2006; Vigilante et al., 1999). However, effective clinical practice with men on parole should incorporate assessment of, and accommodation to, the multiple and complex needs of this population. "
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    ABSTRACT: This paper illustrates the use of composite first person narrative interpretive methods, as described by Todres, across a range of phenomena. This methodology introduces texture into the presently understood structures of phenomena and thereby creates new understandings of the phenomenon, bringing about a form of understanding that is relationally alive that contributes to improved caring practices. The method is influenced by the work of Gendlin, Heidegger, van Manen, Gadamer, and Merleau-Ponty. The method's applicability to different research topics is demonstrated through the composite narratives of nursing students learning nursing practice in an accelerated and condensed program, obese female adolescents attempting weight control, chronically ill male parolees, and midlife women experiencing distress during menopause. Within current research, these four phenomena have been predominantly described and understood through quantified articulations that give the reader a structural understanding of the phenomena, but the more embodied or "contextual" human qualities of the phenomena are often not visible. The "what is it like" or the "unsaid" aspects of such human phenomena are not clear to the reader when proxies are used to "account for" a variety of situated conditions. This novel method is employed to re-present narrative data and findings from research through first person accounts that blend the voices of the participants with those of the researcher, emphasizing the connectedness, the "we" among all participants, researchers, and listeners. These re-presentations allow readers to develop more embodied understandings of both the texture and structure of each of the phenomena and illustrate the use of the composite account as a way for researchers to better understand and convey the wholeness of the experience of any phenomenon under inquiry.
    International Journal of Qualitative Studies on Health and Well-Being 04/2011; 6(2). DOI:10.3402/qhw.v6i2.5882 · 0.93 Impact Factor
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