Prison, hospital or community: community re-entry and mentally ill offenders

DOIhttps://doi.org/10.1016/S0192-0812(03)80022-3
Publication Date10 Dec 2002
Pages199-220
AuthorStephanie Hartwell
PRISON, HOSPITAL OR COMMUNITY:
COMMUNITY RE-ENTRY AND
MENTALLY ILL OFFENDERS
Stephanie Hartwell
ABSTRACT
There remains a gap in the research on the characteristics, service needs,
and experiences of persons with mental illness post incarceration. This
analysis uses data collected by the Massachusetts Forensic Transition
Team program to describe the characteristics of the offenders with mental
illness and to examine the relationship of particular characteristics
towards community reintegration and adaptation post release from
correctional custody. Length of incarceration (misdemeanor or felony
sentence structure) and service needs at release are expected to be
associated with the ability to adapt, stigma, and, in turn, short-term
dispositions in the community or more structured settings.
I first met Andrew in a medium security prison in the fall of 2001. He had
spent the majority of his adult life in prison. During the first of three
incarcerations, he served five years and was released to live in the
community, which he did for almost a year, until he was re-arrested and
sentenced for 2 more years. This time, when he was released, he was in the
community for only 2 weeks before being arrested and re-incarcerated.
Andrew grew up in South Boston. His family has a history of mental illness
and alcoholism. Andrew is bipolar, suffering bouts of manic depression,
Community-Based Interventions for Criminal Offenders with Severe Mental Illness,
Volume 12, pages 199-220.
Copyright © 2003 by Elsevier Science Ltd.
All rights of reproduction in any form reserved.
ISBN: 0-7623-0972-5
199
200 STEPHANIE HARTWELL
and has a substance abuse problem. His drug of choice is cocaine, which
he uses intravenously. He is HIV positive. He is in his early 30s. Andrew's
current sentence is 5 years for 26 counts of malicious destruction of
property and motor vehicle theft. While he is attempting to get his sentence
revised based on his health status, he acknowledges he has difficulty living
in the community. Of prison life he says, "I excel in here.t" He works a half
an hour a day sweeping his unit, "and then I have the rest of the day to
myself" Andrew is presentable and articulate. He participates in release
planning. When he is in the community he seeks out appropriate services.
Nonetheless, he has difficulty staying out of prison.
INTRODUCTION
Whether serving sentences for misdemeanors or felony offenses, the majority
of offenders are eventually released from correctional custody (Travis, 2000;
Piehl, 2002). One consequence of release is being forced to adapt to a change
in environment. However, the stigma of incarceration can make community re-
entry and living difficult (Link et al., 1997). Living in the community with the
double stigma of mental illness and criminal history requires adapting to life in
a less structured environment and surmounting stigma. However, little is known
of the community re-entry experience of persons with mental illness involved
with the criminal justice system. For instance, what are the significant features
affecting short-term dispositions post-release from correctional custody? What
are the major differences among recently released offenders with mental illness
who are able to adapt to living in the community as opposed to those who
return to more structured environments? Specifically, how does someone like
Andrew, a recidivist, differ from other offenders with mental illness who are
able to adapt to living in the community or from those who are hospitalized
upon release from correctional custody?
This chapter analyses the short-term dispositions of 270 offenders with
mental illness released from longer-term correctional custody in Massachu-
setts. Three months post-release, 194 of the 270 remain in the community; 63
are hospitalized; and 13 are reincarcerated on a new charge. 1 While the vast
majority of recently released offenders with mental illness living in the
community are engaged in mental health services (165), 29 have disengaged
from services, but remain in the community. This group is particularly
interesting because they have avoided further contact with the criminal justice
system, hospitals, and mental health services, at least for the time being.
To date, research on mentally ill persons in the criminal justice system has
focused on prevalence studies, appropriateness of criminal justice involvement,

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