Because of the enormous obstacles confronting individuals with behavioral health conditions who have been incarcerated, many peer-run organizations have risen to the challenge and have created programs to help these people rejoin the community.
What follows is the Executive Summary of a report entitled Reentry and Renewal: A Review of Peer-run Organizations That Serve Individuals with Behavioral Health Conditions and Criminal Justice Involvement. This report was the result of a collaborative effort by the College for Behavioral Health Leadership’s Peer Leader Interest Group, Mental Health America, the National Mental Health Consumers’ Self-Help Clearinghouse, and the Temple University Collaborative on Community Inclusion.
There is an enormous need for peer-led programs that serve individuals with mental health conditions who have criminal justice system involvement. The United States has less than 5 percent of the world’s population, but it has almost a quarter of the world’s prisoners. And more than half of them have a mental health problem, according to the Bureau of Justice Statistics. People who live with mental health challenges are less likely to be released on bail, and have longer jail and prison terms. Even when they are released, they are more likely to incur technical probation violations. And this doesn’t even take into account how difficult it is for people coming out of jails and prisons to get jobs and housing, which are essential to finding their way back to normal lives.
Because of the great need, a survey was developed to identify peer-run programs/services that serve individuals with behavioral health conditions who are returning to the community from jails and prisons. Peer-run organizations have been, and continue to be, leaders in providing cutting-edge, recovery-oriented mental health services and supports; so there is much to learn from their experience. In addition, studies have shown that peer support services are effective in reducing hospitalizations.
There were 132 responses to the survey (of which 59 were incomplete). A compendium has been developed that includes the 41 most substantive replies, representing 15 states. The respondents offer a mix of day, residential, mobile and prison-/jail-based services and supports. They serve anywhere between six to 900 individuals, with budgets ranging from zero to $300,000.
Some programs are just getting off the ground; few have been open for more than a year or two. All of them are on the cutting edge and represent some of the best practices in facing the challenge of the skyrocketing numbers of people with behavioral health issues who come into contact with state and/or federal criminal justice systems.
Peer-run programs that serve individuals with mental health conditions and criminal justice involvement provide both direct programming—including case management services, vocational training and placement, housing resources, and other services—to help the individual returning to community life from incarceration find his or her balance; and ongoing support of their peers.
Following are snapshots of services provided by the programs covered in the report:
- Communities for Recovery, in Austin, TX, has developed a peer recovery coach program in the Travis County State Jail.
- Ellis Medicine Forensic Peer Mentor Project, in Schenectady, NY, helps clients access mental health and substance abuse treatment, housing, benefits, employment, and connection to 12-step groups and other supports, among other services.
- 1st Day Out, in San Luis Obispo, CA, works with clients on a one-to-one basis in jail, and then continues to follow them in the community, linking them with “all of the steps necessary to be successful.”
- Hands Across Long Island, in Central Islip, NY, also begins working with people while they are still incarcerated, and helps them try to identify those “people, places and things” that were not good influences, and also the opposite: people and places that provide support in the community.
- Haven House, in Juneau, AK, operates a housing program for women who have been incarcerated, as well as providing “recovery/reentry coach services” that have served hundreds of people since it opened nearly two years ago.
- Hope Lives/Vive la Esperanza, in Phoenix, AZ, includes forensic peer support and community-based suicide intervention and prevention programs. It helps clients with competitive employment and supported employment, education, community resources and referrals, social and community integration, and applying for benefits.
- The International Association of Peer Supporters, based in Victor, NY, incorporated the Alternatives to Violence Project training into its Substance Abuse and Mental Health Services Administration (SAMHSA)-funded Recovery to Practice initiative to offer workshops to “build affirmation (strength-based perspectives), communication, cooperation, conflict transformation, collaboration, and community.”
- The Northern Regional Center for Independent Living in Watertown, NY, provides peer-supports—both one-on-one and support groups in the jail—and continuation groups for those who have been released from jail.
- The services offered by PEOPLe Inc., Poughkeepsie, NY, include employment, financial management, and rep payee. Also offered are social inclusion activities, including support groups.
- REACH-Up, in Middletown, CT, is a peer-run pilot program created by REACH (Re-Entry Assisted Community Housing). REACH operates scattered-site housing in nine Connecticut cities for clients with criminal justice involvement. The clients also receive case management. In REACH-Up, a random sample of the REACH population receives additional support through peer involvement. REACH-Up clients have shown statistically significantly less early recidivism and a higher level of engagement with treatment and case management services than has been true of the other REACH clients.
- Westchester Independent Living Center (WILC), in White Plains, NY, operates a Partners for Success class based on personal awareness, personal responsibility and personal empowerment. WILC is the hub for social services assistance for employment training, anger management, domestic violence, health care/mental health care resources, self-empowerment, substance use treatment, and re-entry into the community from the criminal justice system.
- Wishing Wellness Center, in Cortland, NY, helps people find housing, connect to services, set and achieve goals, and find recreational opportunities and music and art lessons. “We also engage people in treatment services for mental health and substance abuse (both inpatient and outpatient), support services beyond the treatment process, and [assist with] connection to residential treatment services.”
It has also been demonstrated that, to help individuals with both behavioral health conditions and involvement in the criminal justice system, it is important that the peer staff members have had criminal justice involvement themselves. As the director of a community behavioral health agency within the Optum Pierce County, WA, Regional Support Network was quoted in a U.S. Department of Health and Human Services report:
We see that putting peers into situations where they have no lived experience is not helpful. For example, when we put peers without criminal justice experience into the criminal justice system it didn’t work. So then we decided to staff the peer support services with peers who had been arrested, been in jail or prison. Ta da! It was amazingly effective!
(For more information about the Optum Pierce County, WA, program, see pages 35-40 of An Assessment of Innovative Models of Peer Support Services in Behavioral Health to Reduce Preventable Acute Hospitalization and Readmissions.)
The survey was not conducted according to rigorous scientific principles, and the choice of a dozen programs to identify as exemplary was subjective. We have tried to select some of the best and most thoughtfully developed programs in the field. However, there are, undoubtedly, excellent programs that are not included, either because they did not respond to the survey or because their responses did not capture the programs’ details in a way that made them stand out.
The survey indicates that there is an ongoing expansion in the roles played by individual peer specialists and by peer-run programs in addressing the needs of individuals with both mental health conditions and criminal justice involvement. The results suggest a need for effective training programs for peer specialists interested in this important work.
The survey also indicates a need for sound research in this arena to tell us more about what strategies work best in assuring that people leaving jails and prisons receive the support they need to lead active and fulfilling lives in their communities.
This publication is based on the survey results. We hope that it will help stimulate the creation of hundreds or even thousands of peer initiatives that will assist millions of Americans with behavioral health conditions to avoid—or to get out and stay out of—our courts, jails, and prisons, and to instead pursue lives of recovery in the freedom of their home communities.
Note: A free webinar on Peer-run Organizations That Serve Individuals with Behavioral Health Conditions and Criminal Justice Involvement will be hosted by the National Mental Health Consumers’ Self-Help Clearinghouse and the Temple University Collaborative on Community Inclusion today: January 19, 2017, at 2 p.m. EST. The presenters will be Rita Cronise of the International Association of Peer Services (iNAPS), Ellen Healion of Hands Across Long Island, Steve Miccio of PEOPLe Inc., and Noelle Pollet of Peace Work. Harvey Rosenthal of the New York Association of Psychiatric Rehabilitation Services will moderate.
To register for the webinar, click here. To download the free report—Reentry and Renewal: A Review of Peer-run Organizations That Serve Individuals with Behavioral Health Conditions and Criminal Justice Involvement—click here.