What’s the Question?
Women experiencing incarceration often have significant histories of trauma, poor mental health, and high rates of substance use disorders, which are often all intertwined. The criminal legal system is not well-equipped to address these underlying issues, and incarceration itself frequently compounds them, both by being a traumatic experience itself and by separating women from their families and support systems.
Transitional programs start while the individual is still incarcerated and continue after their release, helping them transition back into the community by providing services like job training, therapy, and help with housing. There is an urgent need to expand access to substance use disorder (SUD) treatment for justice-involved women throughout both incarceration and following release (when risk for overdose is especially high).
How best can transitional programs support the varied and often gender-specific needs of women as they leave incarceration and return to their communities?
Researchers for this SAMHSA-supported study looked at the impact of a client-centered approach to transitional programs, the Female Offender Re-Entry Movement (FOR-Me) program, which aimed to establish a sustainable system of care for SUD treatment and reentry services for women, with a particular focus on women with high-risk histories of sex trafficking and/or sex work.
They specifically focused on these outcomes: reducing substance use, decreasing psychiatric and trauma-related symptoms, and improving recovery capital and psychosocial functioning.
How Was This Study Conducted?
Participants were within four months of scheduled release to the community and, upon immediate release, were referred to community-based treatment and recovery services. Trained recovery coaches delivered pretreatment interventions such as prescreening, motivational interviewing, and support-building to facilitate treatment entry and improve outcomes. More details about the components of the FOR-Me program can be found in the full-text of the article (see citation below).
Data for the study were obtained from SAMHSA’s Performance Accountability and Reporting System (SPARS). Additionally, all participants in the program were administered the Government Performance and Results Act (GPRA) Client Outcomes Measures for Discretionary Programs form, which includes indicators related to substance use disorder prevention and treatment, mental health services, and support for individuals in recovery.
What Did Researchers Find Out?
Of 113 participants, 40% identified as racial/ethnic minorities, and 72% fell within the 25-45 age range.
Participants in the program reported significant improvements in:
• psychiatric and trauma symptoms
• abstinence
• recovery capital (the internal and external resources a person can access in support of their recovery process), including positive changes in employment status and housing stability
• psychosocial functioning
• criminal legal involvement (that is, their involvement in the criminal legal system decreased)
What Are the Implications for the Workforce?
These highly positive results suggest that targeted, client-centered, and gender-responsive approaches to address SUD, trauma, and co-occurring mental illness can significantly improve outcomes for women leaving incarceration. The outcomes related to housing and employment in particular add another layer to the usual discussion, as these factors are closely tied to successful rehabilitation and lower recidivism rates – but, as we are increasingly learning, also play a major role in social determinants of health for both mental health and substance use disorders as well.
With a heightened focus on client-centered practices and better collaboration across sectors (criminal legal entities, academia, community organizations, etc.), we can more effectively address the complex challenges these women face, reducing health disparities and breaking the cycle of recidivism.
Need help finding a copy? Email Meg Brunner