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Assessing the reentry needs of incarcerated individuals with co-occurring opioid use and mental health concerns

Individuals with co-occurring mental health concerns and opioid use disorder (COD) are at high risk of mortality and poor social and health outcomes upon release, and there is a need to better understand the unique reentry needs of this population. The high level of need experienced by individuals with COD will demonstrate a necessity for comprehensive reentry support which includes mental health treatment, Medications for Opioid Use Disorder (MOUD), social services such as education, employment, Medicaid, and housing. This sample included 490 adults from a targeted jail/prison reentry program for individuals experiencing COD in a Midwestern state. Program participants had histories of trauma (90%), homelessness (62%), and inpatient psychiatric care (38%). Further, most participants reported needing medical attention for a physical problem (70%) at baseline. Finally, participants had extensive criminal-legal system exposures, with an average of 10 lifetime arrests outside of their current incarceration (M = 9.91, SD = 8.74). The findings have important implications for expanding reentry services to support individuals with COD. This includes the need to begin services prior to release and ensuring the coordination and continuity of care with community-based treatment providers.

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Jail and treatment staff attitudes regarding MOUDs before and after an implementation intervention

Jails are often the first point of assessment after arrest. This structural position provides an early opportunity to document and treat opioid use disorder (OUD). This paper describes the findings of the Building Bridges Planning Initiative, a project which prepared jail staff and their community treatment partners for the implementation and/or expansion of the use of medications for opioid use disorder (MOUDs) in 16 different jurisdictions across the U.S. From August 2019 through April 2020, 123 staff participants from 16 different counties in the U.S. completed surveys at baseline and again at one-year follow-up for staff still engaged in the project documenting changes in knowledge about, and the perceived helpfulness of, six different MOUDs. Participants were predominantly female (61%), averaged 49 years of age (SD = 11), and worked in jail (60%). Bivariate and multivariate results suggest that respondents’ perceived knowledge of/helpfulness of all MOUDs increased from baseline to follow-up, though findings for naltrexone-based MOUDs were mixed, with only depot naltrexone demonstrating significant increases in perceived helpfulness. Findings presented here suggest that over the course of the intervention, familiarity with and attitudes about MOUDs improved among individuals working within treatment centers and individuals working within correctional facilities.

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Parents on probation: custody, co-residence, and care of minor children during community supervision

Family science and public health scholars have documented the consequences of incarceration for the well-being of individuals, children, families, and communities. Yet the largest form of supervision in the criminal legal system is not imprisonment, but probation, with little known about the experiences of parents on probation. We analyzed interviews with 153 adults on probation, 68 (44%) of whom reported being parents of minor children (under 18 years). Compared to participants without minor children, parents with minor children were younger and more likely to be employed. Among parents, 42% reported having custody of one or more minor children and 20% lived with their minor children at the time of the interview. Yet, most (82%) parents reported they provided some form of care or support. Qualitative analyses of four case studies show the challenges facing parents on probation and the complex intersection of custody, living arrangements, and care and support for minor children. We find that parenthood and probation are interconnected, with parent status influencing the experience of supervision and probation impacting parenting opportunities and constraints. Findings suggest service providers working with parents on probation need to attend to these complex family dynamics.

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