Community-engaged research to promote mental health and successful reentry outcomes following incarceration

PROJECT SUMMARY About 600,000 people are released annually from state and federal prisons and millions more from local jails. Around half of these individuals have a history of mental illness, yet the majority fail to receive mental health treatment upon reentry. Mental health difficulties impede successful reentry outcomes such as stable housing, employment, and positive relationships, perpetuating generational cycles of incarceration and exacerbating health disparities that disproportionately affect communities of color. The long-term goal of this research is to integrate evidence-based mental health support into existing reentry programming to promote healing from trauma and facilitate successful community reintegration. The overall objective of this project is to provide preliminary feasibility, effectiveness, and implementation data on an evidence-based mental health curriculum adapted with and for formerly incarcerated people. The Healthy Minds Program (HMP), an app-based intervention with demonstrated efficacy for reducing anxiety and depression, promotes four components of well-being: Awareness, Connection, Insight, and Purpose. In collaboration with community partners and formerly incarcerated people, this Type 1 Hybrid study will create an in-person adaptation of HMP for reentry (HMP-R) and provide preliminary data in support of a future multi-site effectiveness trial through two specific aims: 1) Adapt the Healthy Minds Program with and for formerly incarcerated individuals; 2) Establish feasibility, acceptability, adherence, and preliminary effectiveness of HMP-R. Aim 1 will utilize the evidence- based ADAPT-ITT model to adapt HMP using a trauma-informed approach for in-person delivery by a mindfulness instructor and a formerly incarcerated co-facilitator. The first draft of HMP-R will be revised with input from formerly incarcerated community advisory board members, content experts in meditation practices for groups disproportionately impacted by incarceration, and professionals working in reentry services and support. The curriculum will be further refined through an iterative process of field testing and feedback from formerly incarcerated community members. Aim 2 involves a pilot randomized controlled trial of HMP-R vs. waitlist control in 60 individuals released from prison or jail in the previous year. A convergent mixed methods design will be used to integrate qualitative and quantitative data on feasibility, acceptability, and adherence for HMP-R and associated assessment procedures. Preliminary effectiveness outcomes will include increases in questionnaire measures of Awareness, Connection, Insight, and Purpose (target engagement) and associated reductions in psychological distress (clinical outcome). This project is innovative in providing a strength-based approach to supporting mental health and well-being during reentry, an approach that is grounded in the experiences and wisdom of those with lived experiences of incarceration. This project is significant because cultivating skills that facilitate well-being can boost mental health and increase the potential for successful reentry, community reintegration, and the reduction of mental health disparities.