Concurrent Brainstorming Sessions

Abstract

Background: Individuals with bipolar disorders (BD) are 5x more likely to be arrested, jailed, or convicted of a criminal offense than those in the general population. BD, in turn, increases risk for adverse outcomes for prisoners post-release, including mood instability, suicide attempts, substance use relapse, and repeat incarceration. Despite these negative sequelae, up to 70% of prisoners with BD do not receive mental health treatment following re-entry. Methods: To address this critical need, we have been piloting the CARE (Community treatment Adherence at Re-Entry) Program, a hybrid in-person/ telephone-based intervention that combines cognitive-behavioral, family, and telephone outreach strategies to promote treatment engagement for prisoners with BD following community re-entry. Results: Prior to the COVID-19 pandemic, we successfully completed an open feasibility trial (N = 12). At the time of the prison lockdown, 11 (out of 40) individuals had been enrolled in the ongoing pilot RCT of CARE vs. TAU, necessitating adjustments to the study protocol so as to safely and ethically retain participants during the pandemic. Other adjustments were made to recruitment and assessment of new participants, given the unique ethical and practical considerations regarding use of telehealth services in the prison setting. Discussion: We will compare and contrast our clinical, operational, and regulatory experiences prior to and during the pandemic, with respect to implementation of this clinical trial to support prisoners with BD around community re-entry.