Abstract
Centering Relationships for Achieving Successful Outcomes with Formerly Incarcerated Women
APHA 2022 Annual Meeting and Expo
Formerly incarcerated people, often struggling with mental health challenges and substance use disorders that were never successfully addressed prior to their release, are particularly vulnerable to negative post-re-entry outcomes. Despite various reforms of policy over the years in California, the statistics on recidivism indicate a continued high rate of 50%, along with persistent high rates of anxiety, depression, and substance use. Programs serving this population frequently struggle to gain participant retention and to address multiple factors that erode participant resiliency, including pervasive discrimination against them in seeking housing, employment, and education. The research presented here describes a relationship-centered evidence-based model for integrated services and advocacy for formerly incarcerated women with mental health, substance use, and/or co-occurring disorders.
The program services design centers relationship-building and advocacy in a minimum of six months (with no time limit) of integrated services that address mental health, substance use, housing, employment, and social connectedness. The research was based on four years of mixed methods external evaluation of the relationship-centered programs administered by an innovative nonprofit organization in San Bernardino County, California to approximately 200 formerly incarcerated women. Methods included the use of pre/post instruments used by the Center for Substance Abuse Treatment (CSAT), surveys, and focus groups along with analysis of participants’ own narrative “success stories.
Centering relationship-building has resulted in 100% completion, 0% recidivism, near-100% abstinence from substance use, near-100% social connectedness, and statistically significant reductions in depression, anxiety, and symptoms of PTSD. The outcomes have been relatively equitable across demographic differences in participants. Key to building this relationship-centered approach has been the nonprofit founder’s own experience as a formerly incarcerated woman informing her model of care; organizational commitment to diversity, equity, and inclusion (DEI); and advancing a model of forming community rather than serving clients. When compared to the outcomes of programs providing similar services, the implication is that centering relationships and DEI in organizational and programmatic culture is key to yielding high success rates with this highly vulnerable population – in part because, as the participants have often voiced, it gives them a sense of worth and hope they have never had before.