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A measure of citizenship was developed and validated by Rowe and colleagues (O’Connell, Clayton, & Rowe, 2017). The items clustered around the 5 Rs of citizenship as defined by Rowe et al.: relationships, rights, resources, roles, and rights, and a sense of belonging. Although a measure has its utility in clinical settings, to address time constraints and other administrative burdens expressed by providers in their day-to-day practice, a citizens tool was developed as a practical way that providers can enhance dialogue between providers and clients on citizenship for clients served in mental health and criminal justice reentry settings. This article describes the development of the tool, testing of the tool’s utility with case managers, and implications for practice. © 2017 Taylor & Francis.
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IntroductionIncarceration in the United States disproportionately affects individuals with mental illness and substance use disorders and often exacerbates mental health conditions due to the trauma of arrest, separation, disrupted care, and stigma. Forensic Peer Support (FPS) can improve recovery outcomes by building unique trust and rapport that supports community reintegration and recovery outcomes.MethodThis paper describes findings from a qualitative study of 22 participants who are a sub-sample of the larger Recovery Finance study, a multi-level community based participatory research study designed to reduce financial hardships of individuals involved in criminal justice with mental health challenges through system level interventions as well as an individual intervention (randomized control trial testing one-on-one financial capability support (FCS) versus FCS plus forensic peer support). The focus of this paper is the mental health and peer support experiences of the qualitative sub-sample.ResultsThematic analysis of in-depth qualitative interviews revealed the following themes: 1. The Impact of Incarceration, Trauma, and Mental Health, 2. Systemic Failings in Mental Health Care in Prison and Post-Release, 3. The Cycle of Financial Strain and Mental Health, and 4. The Unique Value of Shared Lived Experience through Peer Support. Results highlight the trauma and psychological impact of incarceration, systemic failures in treatment, financial stress as a dominant source of anxiety, often perpetuating cycles of poverty and criminal activity, and the critical role of supportive relationships, in particular FPS.DiscussionThese findings point to the need for integrated models in which forensic peer support is embedded within financial wellness and reentry services.
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