Community Mental Health Status and Service Engagement upon Jail Release

Overview: For individuals reentering the community from jail with mental illness and/or substance use disorder, behavioral health service engagement is crucial to facilitate successful reentry. This exploratory study evaluates how connections to community mental health, or lack thereof, impact mental illness and substance use service engagement.Proposal text:

Background: Compared to the general population, incarcerated persons are more likely to experience mental health (MH) disorders (Bronson & Berzofsky, 2017), substance use disorders (SUD; Bronson et al., 2017), and co-occurring disorders (COD; Proctor et al., 2019; Sacks & Pearson, 2003). Individuals are at increased risk for drug-related fatalities and suicide two weeks post-release from incarceration (Binswanger et al., 2007; Lim et al., 2012) as well as homelessness, rearrest, and reincarceration in general (Prince & Wald, 2018; Backer et al., 2007; Baillargeon et al., 2009; Harris et al., 2015). Connection to community-based services may facilitate engagement in needed services, mitigating these risks (Harris et al., 2015).

This study asks: Were persons with an active community mental health (CMH) status in the year prior to jail admission more likely to connect to MH, SUD, COD, medication for opioid use disorder (MOUD) services after jail release? Did those with an active status connect to services more quickly?

Methods: In 2019, ten county jails administered screenings to collect data on demographics, serious mental illness (SMI), and substance misuse. Medicaid files identified CMH status (labeled as active if individuals received CMH care within the past year, or inactive if not); evidence of opioid use disorder (OUD); and engagement in MH, SUD, COD, and MOUD services. Chi-square and t-tests evaluated differences in service engagement and time from release to first service by CMH status (n=2,968).

Results: Overall, 42.8% (n=1,265) had an active CMH status. Active persons with SMI were significantly more likely to engage in MH services (49.1%, n=212; inactive: 16.3%, n=47; χ2[1]=80.987, p