People reentering communities after incarceration are sicker than the general population and face barriers to accessing health care and other supports. Along with criminal justice reform, policymakers must work to improve evidence-based reentry programming that supports healthy people and communities.
What’s the Issue
Over two million adults are incarcerated in the United States, more than in any other country in the world, and representing a 500 percent increase during the last 40 years. At an estimated annual cost of $182 billion, mass incarceration is recognized by experts to be a public health crisis. More than 600,000 people are released from prison and more than nine million cycle through jails annually. These individuals are at high risk for adverse health outcomes and death due to chronic health conditions, including mental health issues and drug addiction.
Being released from incarceration affects a person’s ability to secure basic needs such as health and housing. Compounding these barriers can be issues related to returning to impoverished communities and complicated relationships with families and support systems. A criminal record impedes employment, particularly for Black people, and this population also faces a greater likelihood of homelessness. The brief reviews programs meant to guide formerly incarcerated people through the reentry process. Many existing programs focus on a person’s deficits, with the potential of reinforcing that person’s identity as an outcast. However, some approaches that provide both pre- and post-release support; focus on coordinating health and social needs; use clinical, therapeutic modalities; and emphasize people’s pro-social identity may be promising.
Some of the challenges that formerly incarcerated individuals face include serious mental health illness; substance use disorders; and HIV and hepatitis C infection. A process for reentry should begin in prisons or jails in the form of pre-release programming and then continue after release into the community—with a focus on both criminal justice-related and health-related outcomes. In wraparound programs, multiple services such as mental health, primary care, and nonmedical services (e.g., housing, education, and employment assistance) are provided with “one-stop” programs.
For youth involved in the justice and social welfare systems, multiple studies provide support for wraparound service programs. In regard to the adult reentry population, further study is needed to determine the effectiveness of this model. The overwhelming costs of mass incarceration in the United States; overrepresentation of communities of color; and inconsistent access to quality health care, programming, and release planning, along with the lack of evidence-based reentry services, requires further examination of our criminal justice policies and practices.
Some recommendations for policymakers and other stakeholders seeking to improve the health of this vulnerable population include specific reforms in the justice system; more access to federal health care and human services, especially Medicaid; and investment in evaluating existing reentry programs to include more than those focused on life skills or individual deficits.